bluuebunny/crossref_metadata_2025_split huggingface dataset:
Chronic Headaches After a Concussion in an Obese 16-Year-Old Girl
Authors: Kumar Maya , Gahagan Sheila , Pickering Bretten , Gold Jeffrey , Stein Martin T. 
Published: September 2016

CASE:
Jennifer is a 16-year-old Latina girl who is new to your practice. During her first well visit, she mentions that she has had daily headaches for 2 years. They began after sustaining a concussion in a car accident. Typically, her headaches are bilateral and “squeezing”; they occur in the afternoons and last for a few hours. Her concussion also resulted in depressed mood, which has improved over time.
When you ask if her headaches have changed recently, she says that they have been worse for the last few days. The quality and severity are unchanged; however, they now occur first thing in the morning, are worse when supine, and no longer remit. In the last 2 days, she has developed new-onset blurry vision, nausea, dizziness, photophobia, and sonophobia. Although she previously experienced sadness with her concussion, she now feels irritable. She has never used tobacco, alcohol, or drugs, and she takes no medications.
On examination, her body mass index is above the 99th percentile. You note mild papilledema bilaterally. She has no focal neurological deficits. The remainder of her examination is normal.
You send her to an emergency department. Her head computed tomography is normal. A lumbar puncture demonstrates an opening pressure of 32 cm H2O; she feels relief after the procedure. She is admitted with a diagnosis of benign intracranial hypertension and is started on acetazolamide. What is the differential diagnosis of chronic headaches in an obese adolescent? How should a busy community pediatrician manage Jennifer acutely? What follow-up care should Jennifer receive?
Recent developments in epigenetics of pediatric asthma
Authors: Harb Hani , Alashkar Alhamwe Bilal , Garn Holger , Renz Harald , Potaczek Daniel P. 
Published: September 2016

Purpose of review
The goal of this review was to systematically analyze recent studies updating our knowledge on the role of epigenetic mechanisms in childhood asthma.

Recent findings
A systematic literature search was conducted that identified 23 fresh articles published within the last 5 years reporting the results of human studies on the relationships between epigenetic modifications and childhood asthma or its/related phenotypes. In almost all these studies, meaningful associations between levels of epigenetic marks (DNA methylation and/or histone modifications) and pediatric asthma or its/related phenotypes have been observed. In addition, many studies identified by our screening analyzed those associations in the context of environmental factors, such as pollution, tobacco smoke, farming, or diet, showing in a huge majority a modifying effect of those exposures.

Summary
The results of our systematic literature search provide a strong support for the role of epigenetic mechanisms in (mediating the effects of environmental exposure on) pediatric asthma. This knowledge may possibly be translated into diagnostic and/or therapeutic approaches.
Implementation of a Clinical Pathway for Chest Pain in a Pediatric Emergency Department
Authors: Mohan Shaun , Nandi Deipanjan , Stephens Paul , M'Farrej Mirna , Vogel R. Lee , Bonafide Christopher P. 
Published: September 2016

Objective
To evaluate the impact of a pediatric emergency department (ED) chest pain clinical pathway on resource utilization.

Methods
Motivated by perceived overuse of cardiology consultation for non-cardiac chest pain in the ED, clinicians from the Divisions of Cardiology and Emergency Medicine collaboratively developed a chest pain clinical pathway, educated staff, and implemented the pathway on March 1, 2014. We reviewed records of children aged 3 to 18 years without prior diagnoses of heart disease who presented to the ED with chest pain between March 1, 2013, and April 22, 2015. We compared diagnostic testing rates, ED length of stay, and cardiology consults before and after implementation of the pathway.

Results
A total of 1687 patients were pathway eligible (675 patients preimplementation and 1012 postimplementation). Resource utilization was lower than expected before pathway implementation and remained low after implementation. There was a statistically significant reduction in rates of chest x-ray ordering after pathway implementation and ED length of stay but no change in other diagnostic testing or cardiology consultation. Follow-up in our health care system for pediatric chest pain increased from 15% to 29% with implementation, but none of these visits resulted in the diagnosis of a new cardiac condition. There were no instances identified where use of the pathway resulted in missed cardiac disease.

Conclusions
Implementation of a clinical pathway for pediatric chest pain did lead to a reduction in chest x-ray ordering in the ED and was associated with a higher rate of outpatient follow up for non-pathologic chest pain. Preimplementation utilization was lower than the prepathway perceptions of overuse suggested.
Brief Report: Interpersonal and Intrapersonal Factors as Parallel Independent Mediators in the Association Between Internalized HIV Stigma and ART Adherence
Authors: Seghatol-Eslami Victoria C. , Dark Heather E. , Raper James L. , Mugavero Michael J. , Turan Janet M. , Turan Bulent 
Published: September 2016

Introduction:
People living with HIV (PLWH) need to adhere to antiretroviral therapy (ART) to achieve optimal health. One reason for ART nonadherence is HIV-related stigma.

Objectives:
We aimed to examine whether HIV treatment self-efficacy (an intrapersonal mechanism) mediates the stigma–adherence association. We also examined whether self-efficacy and the concern about being seen while taking HIV medication (an interpersonal mechanism) are parallel mediators independent of each other.

Methods:
A total of 180 people living with HIV self-reported internalized HIV stigma, ART adherence, HIV treatment self-efficacy, and concerns about being seen while taking HIV medication. We calculated bias-corrected 95% confidence intervals for indirect effects using bootstrapping to conduct mediation analyses.

Results:
Adherence self-efficacy mediated the relationship between internalized stigma and ART adherence. Additionally, self-efficacy and concern about being seen while taking HIV medication uniquely mediated and explained almost all the stigma–adherence association in independent paths (parallel mediation).

Conclusion:
These results can inform intervention strategies to promote ART adherence.
Knowledge and Comfort With Pessary Use: A Survey of US Obstetrics and Gynecology Residents
Authors: Kandadai Padma , Mcvay Samantha , Larrieux Jean-Robert , O'Dell Katharine 
Published: September 2016

Objective
This study aimed to determine factors associated with perceived comfort with pessary management among obstetrics and gynecology (OB/GYN) residents in the United States.

Methods
A 31-item anonymous electronic survey regarding experience with, attitudes toward, and comfort with pessary management was distributed to US OB/GYN residents in all postgraduate years (PGYs). Demographic and program-specific data on pessary education were collected. Descriptive statistical analyses were performed. Single-predictor logistic regression analysis, followed by analysis of a multivariable model that included significant single predictors, was performed to determine factors associated with residents' perception of comfort. Results were stratified for junior (PGYs 1, 2), senior (PGYs 3, 4), and chief (PGY4) residents.

Results
Four hundred seventy-eight completed surveys were returned and analyzed. Mean age of respondents was 29.5 (±2.56) years. Training levels were distributed evenly (PGY1, 25%; PGY2, 28%; PGY3, 25%; PGY4, 22%). Twenty-eight percent had a urogynecology fellowship in the department. Factors associated with comfort were similar for all training levels and included working with advanced practitioners, a formal urogynecology rotation, experience with pessary fitting, and receiving formal pessary-specific didactics (P < 0.001). PGY4s also benefitted from a formal urogynecology rotation. Factors that did not improve comfort were having a urogynecology fellowship and receiving general didactics on prolapse and incontinence.

Conclusions
Gaining outpatient experience, especially with pessary fitting, along with formal didactics specific to pessary fitting and management may improve resident' confidence with pessary use.
Noninvasive brain stimulation after stroke: it is time for large randomized controlled trials!
Authors: Grefkes Christian , Fink Gereon R. 
Published: September 2016

Purpose of review
We here provide an update about studies published recently in the field of noninvasive neuromodulation of the motor system, aiming at facilitating recovery of function after stroke.

Recent findings
A number of longitudinal studies have confirmed that repeated stimulation of the motor cortex in combination with motor training improves performance compared with control or sham stimulation. In the early postacute stroke phase, enhancement of ipsilesional motor cortex excitability by means of repetitive transcranial magnetic stimulation (rTMS) seems to be a well tolerated and effective strategy to promote motor recovery. In contrast, recent studies suggest that transcranial direct current stimulation (tDCS) in the early poststroke phase does not facilitate motor recovery. In the chronic phase, however, both rTMS and tDCS have been shown to be beneficial when applied over several days combined with training. Interestingly, bihemispheric stimulation strategies (ipsilesional activation and contralesional suppression) seem to constitute effective protocols, especially when using rTMS.

Summary
Noninvasive brain stimulation seems to support motor recovery. However, to date randomised controlled trials (RCTs) that are sufficiently powered are lacking. Data suggest that the most promising protocols should now be tested in RCTs with sufficiently large samples taking into account the clinical heterogeneity of stroke.
Correlations of genotype with climate parameters suggestCaenorhabditis elegansniche preferences
Authors: Evans Kathryn S. , Zhao Yuehui , Brady Shannon C. , Long Lijiang , McGrath Patrick T. , Andersen Erik C. 
Published: September 2016

AbstractSpecies inhabit a variety of environmental niches, and the adaptation to a particular niche is often controlled by genetic factors, including gene-by-environment interactions. The genes that vary in order to regulate the ability to colonize a niche are often difficult to identify, especially in the context of complex ecological systems and in experimentally uncontrolled natural environments. Quantitative genetic approaches provide an opportunity to investigate correlations between genetic factors and environmental parameters that might define a niche. Previously, we have shown how a collection of 208 whole-genome sequenced wildCaenorhabditis eleganscan facilitate association mapping approaches. To correlate climate parameters with the variation found in this collection of wild strains, we used geographic data to exhaustively curate daily weather measurements in short-term (three month), middle-term (one year), and long-term (three year) durations surrounding the data of strain isolation. These climate parameters were then used as quantitative traits in the mapping approaches. We identified 10 QTL underlying variation in three traits: elevation, relative humidity, and average temperature. We then performed statistical analyses to further narrow the genomic interval of interest to identify gene candidates with variants potentially underlying phenotypic differences. Additionally, we performed two-strain competition assays at high and low temperatures to validate a QTL for temperature preference and found suggestive evidence that genotypes might be adapted to particular temperatures.100-word summary forG3Quantitative genetic approaches provide an opportunity to investigate correlations between genetic factors and environmental parameters that might define a niche, but these genes are difficult to identify, especially in the context of complex ecological systems. Here, we used a collection of 152 sequenced wildCaenorhabditis elegansto correlate climate parameters with the variation found in this collection of wild strains. We identified 10 QTL in five traits, including elevation, relative humidity, and temperature. Additionally, we performed competition assays to validate a QTL for temperature preference and found suggestive evidence that genotypes might be adapted to particular temperatures.
GenomeScope: Fast reference-free genome profiling from short reads
Authors: Vurture Gregory W. , Sedlazeck Fritz J. , Nattestad Maria , Underwood Charles J. , Fang Han , Gurtowski James , Schatz Michael C. 
Published: September 2016

AbstractSummaryGenomeScope is an open-source web tool to rapidly estimate the overall characteristics of a genome, including genome size, heterozygosity rate, and repeat content from unprocessed short reads. These features are essential for studying genome evolution, and help to choose parameters for downstream analysis. We demonstrate its accuracy on 324 simulated and 16 real datasets with a wide range in genome sizes, heterozygosity levels, and error rates.Availability and Implementationhttp://genomescope.org,https://github.com/schatzlab/genomescope.gitContactmschatz@jhu.edu.Supplementary informationSupplementary data are available atBioinformaticsonline.
PTRNAmark: an all-atomic distance-dependent knowledge-based potential for 3D RNA structure evaluation
Authors: Yang Yi , Gu Qi , Shi Ya-Zhou 
Published: September 2016

ABSTRACTRNA molecules play vital biological roles, and understanding their structures gives us crucial insights into their biological functions. Model evaluation is a necessary step for better prediction and design of 3D RNA structures. Knowledge-based statistical potential has been proved to be a powerful approach for evaluating models of protein tertiary structures. In present, several knowledge-based potentials have also been proposed to assess models of RNA 3D structures. However, further amelioration is required to rank near-native structures and pick out the native structure from near-native structures, which is crucial in the prediction of RNA tertiary structures. In this work, we built a novel RNA knowledge-based potential— PTRNAmark, which not only combines nucleotides’ mutual and self energies but also fully considers the specificity of every RNA. The benchmarks on different testing data sets all show that PTRNAmark are more efficient than existing evaluation methods in recognizing native state from a pool of near-native states of RNAs as well as in ranking near-native states of RNA models.
Tracking single-cell gene regulation in dynamically controlled environments using an integrated microfluidic and computational setup
Authors: Kaiser Matthias , Jug Florian , Silander Olin , Deshpande Siddharth , Pfohl Thomas , Julou Thomas , Myers Gene , Nimwegen Erik van 
Published: September 2016

AbstractBacteria adapt to changes in their environment by regulating gene expression, often at the level of transcription. However, since the molecular processes underlying gene regulation are subject to thermodynamic and other stochastic fluctuations, gene expression is inherently noisy, and identical cells in a homogeneous environment can display highly heterogeneous expression levels. To study how stochasticity affects gene regulation at the single-cell level, it is crucial to be able to directly follow gene expression dynamics in single cells under changing environmental conditions. Recently developed microfluidic devices, used in combination with quantitative fluorescence time-lapse microscopy, represent a highly promising experimental approach, allowing tracking of lineages of single cells over long time-scales while simultaneously measuring their growth and gene expression. However, current devices do not allow controlled dynamical changes to the environmental conditions which are needed to study gene regulation. In addition, automated analysis of the imaging data from such devices is still highly challenging and no standard software is currently available. To address these challenges, we here present an integrated experimental and computational setup featuring, on the one hand, a new dual-input microfluidic chip which allows mixing and switching between two growth media and, on the other hand, a novel image analysis software which jointly optimizes segmentation and tracking of the cells and allows interactive user-guided fine-tuning of its results. To demonstrate the power of our approach, we study the lac operon regulation inE. colicells grown in an environment that switches between glucose and lactose, and quantify stochastic lag times and memory at the single cell level.
An exploratory insight into the workplace demographic challenges in the public sector
Authors: Madichie Nnamdi O. , Nyakang’o Margaret 
Published: September 2016

PurposeThe purpose of this paper is to investigate the need for a Strategic Workforce Plan (SWP) in a public sector organization (PSO) confronting an ageing workforce situation.Design/methodology/approachThe study is based upon an action research protocol with a view to initiating change through SWP developed in-house at a PSO that is arguably the custodian of workplace diversity.FindingsThe findings reveal a general consensus on the ageing workforce challenges at the PSO requiring the need to revisit the status quo on the recruitment and retention strategies as well as succession planning and talent management practices within the organization.Research limitations/implicationsThe study highlights the case of a PSO that has set about addressing the workplace demographic challenge by involving employees to become more reflexive in their engagement within the organization, which serves the dual purpose of “custodian” and “role model” for the country.Originality/valueThe challenge of an ageing workforce is not common occurrence in developing countries such as Kenya. However the manifestations of this unusual occurrence, and attempts to “nip things in the bud”, using an internally generated SWP with a view to changing the status quo is a demonstration of organizational learning and employee buy-in.
A new method to improve the objectivity of early Six Sigma analysis
Authors: Cox Steven , Elton Virginia , Garside John A. , Kotsialos Apostolos , Marmo João Victor , Cunha Lorena , Lennon Grant , Gill Chris 
Published: September 2016

Purpose
A process improvement sampling methodology, known as process variation diagnostic tool (PROVADT), was proposed by Cox et al. (2013). The method was designed to support the objectivity of Six Sigma projects performing the measure-analyse phases of the define-measure-analyse-improve-control cycle. An issue in PROVADT is that it is unable to distinguish between measurement and product variation in the presence of a poor Gage repeatability and reproducibility (R&R) result. The purpose of this paper is to improve and address PROVADT’s sampling structure by enabling a true Gage R&R as part of its design.

Design/methodology/approach
This paper derives an enhanced PROVADT method by examining the theoretical sampling constraints required to perform a Gage R&R study. The original PROVADT method is then extended to fulfil these requirements. To test this enhanced approach, it was applied first to a simulated manufacturing process and then in two industry case studies.

Findings
The results in this paper demonstrates that enhanced PROVADT was able to achieve a full Gage R&R result. This required 20 additional measurements when compared to the original method, but saved up to ten additional products and 20 additional measurements being taken in future experiments if the original method failed to obtain a valid Gage R&R. These benefits were highlighted in simulation and industry case studies.

Originality/value
The work into the PROVADT method aims to improve the objectivity of early Six Sigma analyses of quality issues, which has documented issues.
Greenhouse gas management model – a triple cause-effect logic
Authors: Chen Chi-Kuang , Kamba Madi , Shie An-Jin , Dahlgaard Jens 
Published: September 2016

Purpose
The purpose of this paper is to develop a greenhouse gas (GHG) management model for mitigating GHG emission. GHG emission by way of human activities is causing catastrophic effects on the natural environment in the form of climate change and global warming. GHG management of different products, bodies and processes is going on worldwide, expressed through carbon footprints by using product life cycle assessment (LCA). LCA is a useful approach, but it only looks at the micro level of cause-effect scenarios rather than the macro level cause-effect scenarios of GHG emission. Therefore, a system to scrutinize underlined assumptions and values of such policies/strategies is an urgent necessity.

Design/methodology/approach
This paper uses the double-loop learning concept, which was proposed by Argyris in 1976, to develop a triple cause-effect model for the management of GHG emission. The proposed model has a knowledge system that introduces the learning loop of GHG emission and environmental impact management.

Findings
A case study is conducted to demonstrate how the proposed triple cause-effect model is operationalized. The ideas and benefits of the proposed model are further discussed.

Originality/value
A triple cause-effect model for the measurement and analysis of GHG emission is proposed in this paper to complement GHG management by using only product LCA. This paper seeks to show that GHG management should look at not only a single tree (product LCA approach) but also the whole forest (the proposed model).