bluuebunny/crossref_metadata_2025_split huggingface dataset:
Surgical Trainee Feedback-Seeking Behavior in the Context of Workplace-Based Assessment in Clinical Settings
Authors: Gaunt Anne , Patel Abhilasha , Fallis Simon , Rusius Victoria , Mylvaganam Seni , Royle T. James , Almond Max , Markham Deborah H. , Pawlikowska Teresa R.B. 
Published: December 2016

Purpose
To investigate surgical trainee feedback-seeking behaviors—directly asking for feedback (inquiry) and observing and responding to situational clues (monitoring)—in the context of workplace-based assessment (WBA).

Method
A hypothetical model of trainee feedback-seeking behavior was developed using existing literature. A questionnaire, incorporating previously validated instruments from organizational psychology, was distributed to general surgical trainees at 23 U.K. hospitals in 2012–2013. Statistical modeling techniques compared the data with 12 predetermined hypothetical relationships between feedback-seeking behaviors and predictive variables (goal orientation, supervisory style) through mediating variables (perceptions of personal benefits and costs of feedback) to develop a final model.

Results
Of 235 trainees invited, 178 (76%) responded. Trainees completed 48 WBAs/year on average, and 73% reported receiving feedback via WBA. The final model was of good fit (chi-square/degree of freedom ratio = 1.620, comparative fit index = 0.953, root mean square error of approximation = 0.059). Modeled data showed trainees who perceive personal benefits to feedback use both feedback inquiry and monitoring to engage in feedback interactions. Trainees who seek feedback engage in using WBA. Trainees’ goal orientations and perceptions of trainers’ supervisory styles as supportive and instrumental are associated with perceived benefits and costs to feedback.

Conclusions
Trainees actively engage in seeking feedback and using WBA. Their perceptions of feedback benefits and costs and supervisory style play a role in their feedback-seeking behavior. Encouraging trainees to actively seek feedback by providing specific training and creating a supportive environment for feedback interactions could positively affect their ability to seek feedback.
Transitioning From Volume to Value: One Academic Medical Center’s Approach to Improving Population Health
Authors: Halvorson Stephanie A.C. , Tanski Mary E. , Yackel Thomas R. 
Published: December 2016

Problem
The U.S. health care system is undergoing a major transformation. Clinical delivery systems are now being paid according to the value of the care they provide, in accordance with the Triple Aim, which incorporates improving the quality and cost of care and the patient experience. Increasingly, financial risk is being transferred from insurers to clinical delivery systems that become responsible for both episode-based clinical care and the longitudinal care of patients. Thus, these delivery systems need to develop strategies to manage the health of populations. Academic medical centers (AMCs) serve a unique role in many markets yet may be ill prepared for this transformation.

Approach
In 2013, Oregon Health & Science University (OHSU) partnered with a large health insurer and six other hospitals across the state to form Propel Health, a collaborative partnership designed to deliver the tools, methods, and support necessary for population health management. OHSU also developed new internal structures and transformed its business model to embrace this value-based care model.

Outcomes
Each Propel Health partner included the employees and dependents enrolled in its employee medical plan, for approximately 55,000 covered individuals initially. By 2017, Propel Health is expected to cover 110,000 individuals. Other outcomes to measure in the future include the quality and cost of care provided under this partnership.

Next Steps
Anticipated challenges to overcome include insufficient primary care networks, conflicting incentives, local competition, and the magnitude of the transformation. Still, the time is right for AMCs to commit to improving the health of populations.
Development of a Limited Sampling Strategy for the Estimation of Exposure to High-Dose Etoposide After Intravenous Infusion in Pediatric Patients
Authors: Danielak Dorota , Sobiak Joanna , Wachowiak Jacek , Główka Franciszek , Chrzanowska Maria 
Published: December 2016

Background:
Etoposide (VP-16), a podophyllotoxin derivative, is used in conditioning regimens before allogeneic hematopoietic stem cell transplantation in children with acute lymphoblastic leukemia. The aim of this study was to develop a limited sampling strategy (LSS) suitable for the prediction of exposure to VP-16 defined as area under time–concentration curve (AUC).

Methods:
The study included 28 pediatric patients with acute lymphoblastic leukemia, who were administered a 4-hour infusion of 60 mg/kg VP-16. VP-16 concentrations were determined in samples collected 4–124 hours after the beginning of infusion. On obtaining the pharmacokinetic (PK) profiles, a population PK model was developed in NONMEM (ICON Development Solutions, Hanover, MD) with first-order conditional estimation with interaction algorithm. LSSs were chosen by means of a multivariate regression analysis and cross-validated with a leave-one-out approach. Predictive performance of LSSs was assessed by calculating relative prediction error (PE), mean PE, mean absolute PE, and root mean squared PE for model-predicted and observed AUC.

Results:
VP-16 PKs was best described by a 2-compartment first-order model, and a large variability in the PK parameters was observed. A 3-sample strategy allowed the estimation of VP-16 with highest accuracy and precision (mean relative PE = 0.18%, 95% confidence interval, 1.73%–2.09%; mean absolute relative PE = 3.47%, 95% confidence interval, 2.28%–4.66%; root mean squared PE = 4.43%). The final equation was AUC = 6.85 × C6 h + 3.88 × C12 h + 46.11 × C28 h + 282.0 (adjusted R2 = 0.9540).

Conclusions:
In conclusion, developed LSS allows accurate and precise estimation of VP-16 AUC and might be useful for therapeutic drug monitoring.
An Easy Method for Drainage of Fluid in Cases of Continuous Irrigation of the Hand
Authors: Makhijani Sumeet , Fredenberg David A. 
Published: December 2016

Summary:
Description of a novel method to perform continuous irrigation for flexor tenosynovitis in a way that is comfortable for the patient and convenient for nursing staff by placing the hand in the suction pouch of a lithotomy style drape attached to wall suction.
REPRODUCIBILITY AND RELIABILITY OF OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY FOR FOVEAL AVASCULAR ZONE EVALUATION AND MEASUREMENT IN DIFFERENT SETTINGS
Authors: La Spina Carlo , Carnevali Adriano , Marchese Alessandro , Querques Giuseppe , Bandello Francesco 
Published: December 2016

Purpose:
Optical coherence tomography angiography (OCTA) allows delineating the foveal avascular zone (FAZ) easily and noninvasively. The present study aims to test reproducibility and reliability of FAZ evaluation by means of OCTA in different settings.

Methods:
Twenty-four eyes of 24 normal subjects were investigated using AngioVue OCTA Imaging System. A series of OCTA acquisitions were taken both in basal and in different experimental settings after vasoactive stimuli. Images were evaluated separately by two operators and FAZ area was measured both manually and using the built-in automated measurement tool.

Results:
No differences for FAZ area were found in the repetition of basal acquisitions, neither in manual nor in automated measurement (0.215 ± 0.06 vs. 0.216 ± 0.07, and 0.268 ± 0.05 vs. 0.264 ± 0.09, first vs. second basal measurement in square millimetres for manual and automated evaluation, P = 0.25 and P = 0.35, respectively). Interoperators correlation was optimal (r2 = 0.978 [95% CI 0.981–0.976]). No differences were found among the other settings, which included first basal and then repeated (second) in the morning, after flickering light stimulus, after a Bruce treadmill stress test, after 30 minutes dark adaptation, and basal in the evening, neither in automated nor in manual measurements. Automated measurements for nonflow areas provided significantly larger diameters than manual ones.

Conclusion:
AngioVue OCTA Imaging System produces highly reproducible FAZ images with a high interoperators concordance level. Optical coherence tomography angiography capability to detect FAZ area seems not to be influenced by any of the vasoactive stimuli considered in the current study. Nonflow areas seem to be larger when measured automatically than manually.
CHOROIDAL THICKNESS AS A PROGNOSTIC FACTOR OF PHOTODYNAMIC THERAPY WITH AFLIBERCEPT OR RANIBIZUMAB FOR POLYPOIDAL CHOROIDAL VASCULOPATHY
Authors: Sakurada Yoichi , Sugiyama Atsushi , Tanabe Naohiko , Kikushima Wataru , Kume Atsuki , Iijima Hiroyuki 
Published: December 2016

Purpose:
To investigate factors associated with visual improvement and retreatment 12 months after a combination therapy of intravitreal injection of ranibizumab or aflibercept followed by photodynamic therapy for polypoidal choroidal vasculopathy.

Methods:
Changes in the best-corrected visual acuity and the subfoveal thickness of the retina and choroid were studied in 56 consecutive eyes with polypoidal choroidal vasculopathy treated initially with a combination therapy of either intravitreal ranibizumab injection (n = 23) or intravitreal aflibercept injection (n = 33) followed by photodynamic therapy. Factors associated with visual improvement and retreatment were investigated.

Results:
Best-corrected visual acuity significantly improved with significant reduction in central macular thickness and subfoveal choroidal thickness at all points irrespective of treatment modalities (P < 0.001). Better best-corrected visual acuity and improvement of best-corrected visual acuity at 12 months were associated with baseline greater subfoveal choroidal thickness (P = 0.028 and P = 0.028) and baseline smaller greatest linear dimension (P = 0.0077 and P = 0.0077). Retreatment during 12-month follow-up was associated with baseline lesser subfoveal choroidal thickness (P = 0.036).

Conclusion:
Irrespective of treatment modalities, the visual outcome at 12 months is favorable in eyes with polypoidal choroidal vasculopathy treated by photodynamic therapy combined with intravitreal ranibizumab or aflibercept. Baseline greater subfoveal choroidal thickness was associated with a better visual outcome and with reduction in the need for retreatment.
Corneal Biomechanical Properties After Penetrating Keratoplasty or Deep Anterior Lamellar Keratoplasty Using the Ocular Response Analyzer: A Meta-Analysis
Authors: Jiang Min-Shan , Zhu Jing-Yuan , Li Xue , Zhang Nan-Nan , Zhang Xue-Dian 
Published: December 2016

Purpose:
To evaluate the corneal biomechanical properties of patients who have undergone penetrating keratoplasty (PK) or deep anterior lamellar keratoplasty (DALK) using the ocular response analyzer.

Methods:
Stata 13.0 SE was used for this meta-analysis. Studies in the literature that focused on corneal hysteresis (CH) or corneal resistance factor (CRF) after PK or DALK were retrieved by searching PubMed, Embase, Ovid, and Cochrane databases. We present the results as weighted mean difference (WMD) with a corresponding 95% confidence interval (CI).

Results:
Eight studies with a total of 750 eyes were included in the post-PK versus control group, and 4 studies with a total of 218 eyes were included in the post-DALK versus control group. The pooled results showed that CH and CRF were significantly reduced (P < 0.00001) for patients who have undergone PK (WMD = −1.16, 95% CI: −1.73 to −0.60 and WMD = −1.00, 95% CI: −1.61 to −0.40). No significant differences were found in both CH and CRF for patients who have undergone DALK (WMD = −0.27, 95% CI: −0.64 to −0.09 and WMD = −0.15, 95% CI: −0.53 to 0.23).

Conclusions:
This meta-analysis suggested that both CH and CRF had better recovery after corneal transplantation with DALK than PK.
Total Corneal Astigmatism Measurements: Agreement Between 2 Rotating Scheimpflug Cameras
Authors: Savini Giacomo , Næser Kristian , Schiano-Lomoriello Domenico , Ducoli Pietro 
Published: December 2016

Purpose:
To investigate agreement between rotating Scheimpflug camera (Pentacam HR, Oculus) and rotating Scheimpflug camera combined with Placido disc corneal topography (Sirius, CSO) in measuring total corneal astigmatism (TCA).

Methods:
In this observational study, all patients undergoing cataract surgery with preoperative measurement of TCA by both devices and a validated corneal topographer (Keratron, Optikon 2000) were retrospectively evaluated. Astigmatism analysis was performed with and without vector analysis separately in eyes with with-the-rule, against-the-rule, and oblique astigmatism. Vector analysis was performed using the Næser polar system.

Results:
In 130 eyes of 130 subjects, nonvectorial analysis revealed that the mean TCA values obtained with the Sirius were higher than the corresponding values given by the Pentacam HR in all subgroups, although the difference was statistically significant only in eyes with against-the-rule astigmatism (P = 0.0009). This finding was confirmed by vector analysis. A TCA magnitude difference greater than 0.5 diopters was observed in 20.8% of cases, and a TCA axis difference greater than 10 degrees was observed in 45.4% of cases. Axis differences dropped to 18.5% when only eyes with astigmatism >0.75 diopters were analyzed and 3 measurements were averaged. The mean difference in the meridional and torsional power of TCA was close to zero in all subgroups, but with relatively large standard deviations (approximately 0.5 D).

Conclusions:
Agreement between both devices in measuring TCA is only moderate with respect to both magnitude and axis orientation.
Neonatal Bacterial Conjunctivitis in Korea in the 21st Century
Authors: Pak Kang Yeun , Kim Sung Il , Lee Jong Soo 
Published: December 2016

Purpose:
To investigate the microbial cause and antibiotic susceptibility of neonatal bacterial conjunctivitis in Korean patients in the 21st century.

Methods:
We retrospectively reviewed the medical records of patients diagnosed with neonatal bacterial conjunctivitis between January 2000 and December 2015. We recorded the organism, antibiotic susceptibility, and antibiotics used.

Results:
A total of 82 neonates were included in the study (53 males and 29 females), with a mean age of 17.5 ± 7.1 days. The most commonly isolated organisms were Staphylococcus aureus (43 cases, 52.4%), coagulase-negative staphylococci (11 cases, 13.4%), Staphylococcus epidermidis (11 cases, 13.4%), Serratia marcescens (4 cases, 4.9%), Pseudomonas aeruginosa (4 cases, 4.9%), and Enterobacter cloacae (3 cases, 3.7%). We found no cases of Neisseria gonorrhoeae or Chlamydia trachomatis infection. Resistance to methicillin (83.7%), macrolide (81.4%), and aminoglycoside (23.3%) was observed in patients with S. aureus infection. Conjunctivitis that did not improve with erythromycin or tobramycin generally improved with the additional use of tosufloxacin.

Conclusions:
The prevalence of neonatal gonococcal or chlamydial conjunctivitis has decreased in the 21st century. However, methicillin-resistant S. aureus has been increasing, but these cases are responsive to tosufloxacin.
Presenting Features and Prognosis of Ischemic and Nonischemic Neonatal Liver Failure
Authors: Zozaya Nieto Carlos , Fernández Caamaño Beatriz , Muñoz Bartolo Gema , Menéndez Suso Juan J. , Frauca Remacha Esteban , Valverde Núñez Eva 
Published: December 2016

ABSTRACTObjectives:To describe the epidemiological features, clinical characteristics and outcomes of neonates diagnosed with liver failure, as well as determine prognostic factors.Methods:Cohort study conducted at a single tertiary referral and university‐affiliated pediatric center. Hospital records of all neonates diagnosed with liver failure between January 2003 and December 2015 were retrospectively reviewed, and data on clinical and laboratory findings, treatment, and outcomes were collected. Survival analysis (Kaplan‐Meier) and Cox regression were performed to identify prognostic factors at diagnosis. Liver failure diagnosis was established using the pediatric acute liver failure study group's diagnostic criteria for every patient with coagulopathy and biochemical pattern of liver disease.Results:Forty‐five patients were included. In our series, most cases were secondary to ischemia (28.9%). Other causes were neonatal hemochromatosis (17.8%), viral infections (13.3%), and inborn errors of metabolism (13.3%). A total 55.6% (25/45) of the patients died (median age: 16 days; range 1–235 days). Alanine aminotransferase (ALT) at diagnosis was associated with higher mortality or the need for liver transplantation on day 21 after diagnosis (P = .006). For every 500 IU/L increase in ALT serum levels, the mortality/liver transplantation rate increased 1.3 times (hazard ratio 95% confidence interval: 1.1–1.6). Although ischemic neonatal acute liver failure presents with higher ALT levels, these cases appear to have better outcomes. Higher international normalized ratio tended to increase mortality/transplantation (hazard ratio 1.02; 95% confidence interval 0.91–1.2).Conclusions:Neonatal liver failure should perhaps be considered in the differential diagnoses of any coagulopathy. ALT and international normalized ratio levels at diagnosis could predict prognosis in the short term. Ischemic liver failure appears to have a better prognosis.
Relationship Between Time to Initiation of Antiretroviral Therapy and Treatment Outcomes: A Cohort Analysis of ART Eligible Adolescents in Zimbabwe
Authors: Vogt Florian , Rehman Andrea M. , Kranzer Katharina , Nyathi Mary , Van Griensven Johan , Dixon Mark , Ndebele Wedu , Gunguwo Hilary , Colebunders Robert , Ndlovu Mbongeni , Apollo Tsitsi , Ferrand Rashida A. 
Published: December 2016

Background:
Age-specific retention challenges make antiretroviral therapy (ART) initiation in adolescents difficult, often requiring a lengthy preparation process. This needs to be balanced against the benefits of starting treatment quickly. The optimal time to initiation duration in adolescents is currently unknown.

Objective:
To assess the effect of time to ART initiation on mortality and loss to follow-up (LTFU) among treatment eligible adolescents.

Methods:
We conducted a retrospective cohort analysis among 1499 ART eligible adolescents aged ≥10 to <19 years registered in a public sector HIV program in Bulawayo, Zimbabwe, between 2004 and 2011. Hazard ratios (HR) for mortality and LTFU were calculated for different time to ART durations using multivariate Cox regression models.

Results:
Median follow-up duration was 1.6 years. Mortality HRs of patients who initiated at 0 to ≤7 days, >14 days to ≤1 month, >1 to ≤2 months, >2 months, and before initiation were 1.59, 1.19, 1.56, 1.08, and 0.94, respectively, compared with the reference group of >7 to ≤14 days. LTFU HRs were 1.02, 1.07, 0.85, 0.97, and 3.96, respectively. Among patients not on ART, 88% of deaths and 85% of LTFU occurred during the first 3 months after becoming ART eligible, but only 37% and 29% among adolescents on ART, respectively.

Conclusions:
Neither mortality or LTFU was associated with varying time to ART. The initiation process can be tailored to the adolescents' needs and individual life situations without risking to increase poor treatment outcomes. Early mortality was high despite rapid ART initiation, calling for earlier rather than faster initiation through HIV testing scale-up.
Integrated deep learned transcriptomic and structure-based predictor of clinical trials outcomes
Authors: Artemov Artem V. , Putin Evgeny , Vanhaelen Quentin , Aliper Alexander , Ozerov Ivan V. , Zhavoronkov Alex 
Published: December 2016

AbstractDespite many recent advances in systems biology and a marked increase in the availability of high-throughput biological data, the productivity of research and development in the pharmaceutical industry is on the decline. This is primarily due to clinical trial failure rates reaching up to 95% in oncology and other disease areas. We have developed a comprehensive analytical and computational pipeline utilizing deep learning techniques and novel systems biology analytical tools to predict the outcomes of phase I/II clinical trials. The pipeline predicts the side effects of a drug using deep neural networks and estimates drug-induced pathway activation. It then uses the predicted side effect probabilities and pathway activation scores as an input to train a classifier which predicts clinical trial outcomes. This classifier was trained on 577 transcriptomic datasets and has achieved a cross-validated accuracy of 0.83. When compared to a direct gene-based classifier, our multi-stage approach dramatically improves the accuracy of the predictions. The classifier was applied to a set of compounds currently present in the pipelines of several major pharmaceutical companies to highlight potential risks in their portfolios and estimate the fraction of clinical trials that were likely to fail in phase I and II.
Genomes of all known members of aPlasmodiumsubgenus reveal paths to virulent human malaria
Authors: Otto Thomas D. , Gilabert Aude , Crellen Thomas , Böhme Ulrike , Arnathau Céline , Sanders Mandy , Oyola Samuel , Okouga Alain Prince , Boundenga Larson , Willaume Eric , Ngoubangoye Barthélémy , Moukodoum Nancy Diamella , Paupy Christophe , Durand Patrick , Rougeron Virginie , Ollomo Benjamin , Renaud François , Newbold Chris , Berriman Matthew , Prugnolle Franck 
Published: December 2016

AbstractPlasmodium falciparum,the most virulent agent of human malaria, shares a recent common ancestor with the gorilla parasiteP. praefalciparum.Little is known about the other gorilla and chimpanzee-infecting species in the same (Laverania) subgenus asP. falciparumbut none of them are capable of establishing repeated infection and transmission in humans. To elucidate underlying mechanisms and the evolutionary history of this subgenus, we have generated multiple genomes from all knownLaveraniaspecies. The completeness of our dataset allows us to conclude that interspecific gene transfers as well as convergent evolution were important in the evolution of these species. Striking copy number and structural variations were observed within gene families and one,stevorshows a host specific sequence pattern. The complete genome sequence of the closest ancestor ofP. falciparumenables us to estimate confidently for the first time the timing of the beginning of speciation to be 40,000-60,000 years ago followed by a population bottleneck around 4,000-6,000 years ago. Our data allow us also to search in detail for the features ofP. falciparumthat made it the only member of theLaveraniaable to infect and spread in humans.