bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cost Analysis of a Multidisciplinary Aerodigestive Clinic: Are Such Clinics Financially Feasible?
Authors: Mudd Pamela A. , Silva Allison L. , Callicott Susan S. , Bauman Nancy M. 
Published: March 2017

Objective: Multidisciplinary clinics offer important value to pediatric patients with complex conditions that overlap specialties; however, such labor-intensive clinics are difficult to facilitate. We performed a cost analysis of our pediatric multidisciplinary aerodigestive clinic (MADC) to assess its financial feasibility at our tertiary care institution. Method: Revenue was based on net collections for clinic, professional, and hospital setting charges generated during 12 consecutive monthly MADCs beginning August 2013. Clinic charges included facility and speech pathologist fees. Professional charges included clinic and operative fees generated by providers and anesthesiologist. Hospital setting fees included facility and material charges for technical procedures. Direct expense calculations included all providers and staff salaries, benefits, and supply costs. Results: Charge capture for 54 consecutive patients seen during the study time included new visits 99203-99205 (n = 63), consults 99243-99245 (n = 60), and follow-up visits 99212-99215 (n = 196). Sixty percent of patients underwent a clinic nasopharyngeal or laryngeal endoscopy (92511 or 31575), and 60% underwent subsequent intraoperative procedures with 1 (n = 8) or 2 to 3 services (n = 24). Program net revenue totaled $828 136 and direct costs $518 867, accounting for a net positive margin of $309 269. Conclusions: When including direct downstream revenue, our MADC operates on a net positive margin, making it financially feasible.
Resisting Neoliberalism in Colombia: The Role of Human Rights
Authors: Chambers Paul A. 
Published: March 2017

The Colombian government’s noncompliance with the U.S.-Colombia Free Trade Agreement’s Labor Action Plan calls into question not only the government’s intentions but also the efficacy of human rights activism and discourse for social resistance to neoliberalism. Colombia has managed to adjust the narrative on human rights and improve its international image, paving the way for U.S. ratification of the free-trade agreement despite the fact that the human rights situation continues to be very serious. Its success in this is due to the way in which the debate on the agreement and human rights was framed—with a very narrow focus on trade unionists’ rights and a discourse that did not link civil and political rights to economic and social rights—and to the ideological affinity between neoliberalism and the dominant liberal discourse on human rights. El incumplimiento del Plan de Acción Laboral por parte del gobierno colombiano, en el marco del TLC con Estados Unidos, pone en tela de juicio no solo las intenciones del gobierno, sino la utilidad y eficacia del activismo y discurso de los derechos humanos para la resistencia social al neoliberalismo. El Estado colombiano ha logrado ajustar la narrativa sobre los derechos humanos y mejorar su imagen internacional, lo que le permitió ser “premiado” con la ratificación del TLC a pesar de que la situación de derechos humanos siguiera siendo grave. Esto se debe a la forma en que se enmarcó el debate sobre el TLC y los derechos humanos—con un enfoque demasiado restringido y un discurso que no integró los derechos civiles y políticos con los derechos económicos y sociales—y a la afinidad ideológica entre el neoliberalismo y el discurso dominante de los derechos humanos.
Analysis of follow-up at the diagnostic level in the Polish Universal Neonatal Hearing Screening Programme
Authors: Greczka Grażyna , Zych Monika , Wróbel Maciej , Dąbrowski Piotr , Szyfter Harris Joanna , Szyfter Witold 
Published: March 2017

Objectives Routine analysis showed that between 1 June and 30 November 2014, only 47.6% of expected follow-up visits at the diagnostic level were registered in the Polish Universal Neonatal Hearing Screening Programme central database. We attempted to detect and analyse the reasons for this low percentage. Methods A telephone survey questionnaire was developed for parents whose children had not registered for consultation at the diagnostic level, or had not received a final diagnosis according to the programme database. Questions aimed to verify the database records and compare these with information received from and given to parents. From the 7888 children not registered at the diagnostic level, 3239 records were randomly selected, i.e. 52.4% of those who had been expected to attend. Results Questions were answered by 1950 parents (60.2% of the selected group). Of these, 52.1% ( n = 734) had attended for diagnostic tests, but this was not recorded in the database. The most common reasons for not attending were the long waiting time for the visit (36.09%), lack of referral to a visit (25.9%) and conscious parent decision (16.35%). Conclusion The telephone survey disclosed omissions in database registration, and that in fact 83.6% of children had attended at the diagnostic level.
Ethics case reflection sessions: Enablers and barriers
Authors: Bartholdson Cecilia , Molewijk Bert , Lützén Kim , Blomgren Klas , Pergert Pernilla 
Published: March 2017

Background: In previous research on ethics case reflection (ECR) sessions about specific cases, healthcare professionals in childhood cancer care were clarifying their perspectives on the ethical issue to resolve their main concern of consolidating care. When perspectives were clarified, consequences in the team included ‘increased understanding’, ‘group strengthening’ and ‘decision grounding’. Additional analysis of the data was needed on conditions that could contribute to the quality of ECR sessions. Objective: The aim of this study was to explore conditions for clarifying perspectives during ECR sessions. Research design: Data were collected from observations and interviews and the results emerged from an inductive analysis using grounded theory. Participants and research context: Six observations during ECR sessions and 10 interviews were performed with healthcare professionals working in childhood cancer care and advanced paediatric homecare. Ethical considerations: The study was approved by a regional ethical review board. Participants were informed about their voluntary involvement and that they could withdraw their participation without explaining why. Findings: Two categories emerged: organizational enablers and barriers and team-related enablers and barriers. Organizational enablers and barriers included the following sub-categories: the timing of the ECR session, the structure during the ECR session and the climate during the ECR session. Sub-categories to team-related enablers and barriers were identified as space for inter-professional perspectives, varying levels of ethical skills and space for the patient’s and the family’s perspectives. Discussion: Space for inter-professional perspectives included the dominance of a particular perspective that can result from hierarchical positions. The medical perspective is relevant for understanding the child’s situation but should not dominate the ethical reflection. Conclusion: Conditions for ECR sessions have been explored and the new knowledge can be used when training facilitators as well as for those who organize/implement ECR sessions. Awareness of space for different perspectives, including the possible medical advantage over the nursing perspective, could reduce the somewhat unilateral attention and contribute to an inter-professionally shared reflection.
Dietary Guidelines for the Asia Pacific Region
Authors: Binns Colin W. , Lee Mi Kyung , Kagawa Masaharu , Low Wah Yun , Liqian Qiu , Guldan Georgia S. , Hokama Tomiko , Nanishi Keiko , Oy Sreymom , Tang Li , Zerfas Alfred 
Published: March 2017

Nutrition is a major determinant of health throughout all stages of life and together with smoking is the most important risk factor for morbidity and mortality in the Asia Pacific Region. The workshop participants examined Dietary Guidelines and Food Guides that are in use in our region, together with additional materials from the World Health Organization, UNICEF and the World Cancer Research Foundation. The resulting set of guidelines is meant as a reminder of the main issues to be covered in a general public health education program. It may also be of value in reminding public health practitioners, educators, administrators, and policy makers of current nutrition issues. It may additionally be useful as a checklist of the issues to be considered in public health programs and regulations. The main areas of nutrition that are included in the Guidelines are eating a variety of foods, including vegetables, fruits, whole grain cereals, and nuts. Choose fish, poultry, and meats grown in a sustainable way. Appropriate growth, including avoiding obesity, and physical activity are important. Breastfeeding is the basis of infant nutrition and nutrition of mothers is an important public health measure. Negative factors in the Asian diet include salt, refined sugar, alcohol and fats. The APACPH Dietary Guidelines will need to be kept under review and modified to meet regional differences in food supply. The Guidelines will be useful as a checklist of the issues to be considered in public health programs, addressing both acute and chronic diseases.
Randomized Trial Investigating of a Single-Session Character-Strength-Based Cognitive Intervention on Freshman’s Adaptability
Authors: Duan Wenjie , Bu He 
Published: March 2017

Purpose: To investigate the efficiency of a single-session character-strength-based cognitive intervention on enhancing freshmen’s adaptability. Method: A randomized trial, pretest, posttest, follow-up intervention was employed using repeated-measures analyses to evaluate the effect. This 90-min intervention contained four activities with 52 undergraduate freshmen (age 17–20) randomly assigned to the intervention and control group, 38 of whom completed all the programs (19 of each group). Results: Compared with the control group, the intervention group showed a remarkable increase in well-being and a significant reduction in depression and anxiety at post and follow-up assessment. The stress level of the intervention group significantly decreased only at the follow-up test. Time effect and the interaction between time and group were significant in anxiety and stress. Conclusions: This intervention can quickly reduce negative affect and elevate well-being for freshmen. It expands the role of social worker in the prevention of mental illness among college population.
MethotrexaTE THerapy in ST-Segment Elevation MYocardial InfarctionS
Authors: Moreira Daniel Medeiros , Lueneberg Maria Emilia , da Silva Roberto Leo , Fattah Tammuz , Gottschall Carlos Antonio Mascia 
Published: March 2017

Purpose: Methotrexate is an anti-inflammatory drug that has been shown to have anti-ischemic effects. Our aim was to evaluate if methotrexate could reduce infarct size in patients with ST-segment elevation myocardial infarction (STEMI). Methods: We randomly assigned patients with STEMI to receive either methotrexate or placebo. Primary outcome was infarct size determined by calculating the area under the curve (AUC) for creatine kinase (CK) release. Secondary outcomes were AUC of CK MB (CK-MB) and AUC of troponin I; peak CK, peak CK-MB, and troponin I; B-type natriuretic peptide (BNP) level, high-sensitivity C-reactive protein (hsCRP) result, and erythrocyte sedimentation rate (ESR); left ventricular ejection fraction (LVEF); thrombolysis in myocardial infarction (TIMI) frame count; Killip score; mortality and reinfarction incidence; and incidence of adverse reactions. Results: We included 84 patients. Median AUC of CK was 78 861.0 in the methotrexate group and 68 088.0 in the placebo group ( P = .10). Patients given methotrexate and placebo exhibited, respectively, median AUC for CK-MB of 9803.4 and 8037.0 ( P = .42); median AUC for troponin of 3691.1 and 2132.6 ( P = .09); peak CK of 2806.0 and 2147.0 ( P = .05); peak CK-MB of 516.0 and 462.3 ( P = .25); and peak troponin of 121.0 and 85.1 ( P = .06). At 3 months, LVEF was lower in patients who received methotrexate (49.0% ± 14.1%) than in patients given placebo (56.4% ± 10.0%; P = .01). There were no differences in hsCRP, ESR, BNP, Killip scores, TIMI frame count, reinfarction, and mortality rates. There was a higher median serum glutamic–pyruvic transaminase levels in the methotrexate group. Conclusion: Methotrexate did not reduce infarction size and worsened LVEF at 3 months ( Clinicaltrials.gov identifier NCT01741558).
Current Developments in Machine Learning Techniques in Biological Data Mining
Authors: Dumancas Gerard G , Adrianto Indra , Bello Ghalib , Dozmorov Mikhail 
Published: March 2017

This supplement is intended to focus on the use of machine learning techniques to generate meaningful information on biological data. This supplement under Bioinformatics and Biology Insights aims to provide scientists and researchers working in this rapid and evolving field with online, open-access articles authored by leading international experts in this field. Advances in the field of biology have generated massive opportunities to allow the implementation of modern computational and statistical techniques. Machine learning methods in particular, a subfield of computer science, have evolved as an indispensable tool applied to a wide spectrum of bioinformatics applications. Thus, it is broadly used to investigate the underlying mechanisms leading to a specific disease, as well as the biomarker discovery process. With a growth in this specific area of science comes the need to access up-to-date, high-quality scholarly articles that will leverage the knowledge of scientists and researchers in the various applications of machine learning techniques in mining biological data.
Adherence of Heart Transplant Recipients to Prescribed Medication and Recommended Lifestyle Habits
Authors: Brocks Y. , Zittermann A. , Grisse D. , Schmid-Ott G. , Stock-Gießendanner S. , Schulz U. , Brakhage J. , Benkler A. , Gummert J. , Tigges-Limmer Katharina 
Published: March 2017

Introduction: Nonadherence may cause severe health problems in heart transplant (HTx) recipients. Research Questions: The present study aimed to investigate adherence to prescribed medication and recommended lifestyle habits in post-HTx patients and to assess associations between adherence, quality of life (QOL), and psychological well-being. Design: A questionnaire package was sent to all HTx patients from our clinic (n = 858) to answer questions anonymously on medication adherence, dietary recommendations (avoidance of raw animal products and ice cream), pet keeping (risk of zoonosis), anxiety and depression, QOL, and posttraumatic stress disorders. Results: Of the contacted patients, 524 (61%) responded and 505 fulfilled the inclusion criteria (age ≥18 years and ability to understand German). Of the study participants, 72.4% reported taking their medications very correctly, 72.2% stated consuming alcohol less often than once a week, 58.3% performed physical exercise at least once a week, one-third reported eating nonrecommended foods, 22.1% stated pet keeping, and 4.3% reported smoking. Adherence to prescribed medication was positively associated with age ( P < .001) and mental QOL ( P = .015) but was unrelated to eating nonrecommended foods ( P > .05). Depressiveness correlated inversely with physical QOL ( r = −0.232; P < .01) and mental QOL ( r = −0.411; P < .01). Stress disorders and minor stressful events were reported by 7.8% and 46.6%, respectively. Stress disorders correlated inversely with mental QOL ( r = −0.282; P < .01) and physical QOL ( r = −0.422; P < .01). Discussion: Many HTx patients adhere to prescribed medications and health advice. Nevertheless, nonadherence is a problem, especially in younger HTx patients, indicating the need for a nonadherence crisis intervention program for long-term HTx patients.
Rising Need for Health Education Among Renal Transplant Patients and Caregiving Competence in Care Providers
Authors: Xie Jianfei , Ming Yingzi , Ding Siqing , Wu Xiaoxia , Liu Jia , Liu Lifang , Zhou Jianda 
Published: March 2017

Background: Health education positively affects the efficacy of self-management and should be carried out according to the status of patients’ needs, knowledge, and the competence of the primary caregivers. Objectives: This study was to investigate the needs of health education knowledge in transplant patients and the competence of the primary caregivers. Methods: This is a cross-sectional study using a convenient sampling approach. Self-report questionnaires were applied to 351 renal transplantation patients and their primary caregivers. Results: Three-hundred nine valid questionnaires were included in the analysis. The intensive care unit environment, stress coping strategies, the operation procedure, anesthesia and adverse reactions, and hand hygiene were the 5 most poorly understood aspects in health education. Stress coping strategies, at-home self-monitoring of health, pulmonary infection prevention, dietary needs, and anesthesia and other adverse reactions were the top 5 health education needs. Decision and self-efficacy were the weakest caregiving competence. Significant positive correlations were observed between health education knowledge level and caregiving competence in the primary caregivers. Marriage, education level, career, expense reimbursement, and residence significantly contributed to the health education demand questionnaire model, whereas gender, age, ethnic group, education level, career, and expense reimbursement significantly contributed to health education knowledge questionnaire model ( P < .05). Conclusion: The renal transplant patients and their primary caregivers need health education on the intensive care unit environment, stress coping strategies, the operation procedure, and anesthesia and other adverse reactions. The primary caregivers need training in decision-making and self-efficacy.
Thirteen-Year Evaluation of the Management of Biliary Tract Complication After Deceased Donor Liver Transplantation
Authors: Shamsaeefar Alireza , Nikeghbalian Saman , Kazemi Kourosh , Motazedian Nasrin , Geramizadeh Bita , Malekhosseini Seyed Ali 
Published: March 2017

Introduction: Although patient and graft survival rate has increased in recent years, biliary complications after liver transplantation are associated with significant morbidity and mortality. Methods and Materials: We reviewed the database of 1930 patients who underwent deceased donor liver transplantation between 2000 and 2013. The patients had abnormal results in liver tests, as well as fever and jaundice. Abdominal sonography was performed, and if complication was identified, the patient underwent an interventional procedure by endoscopic retrograde cholangiopancreatography or percutaneous transhepatic cholangiography. If the complication was not resolved by the mentioned procedures, exploration of common bile duct and Roux-en-Y choledochojejunostomy or revision of Roux-en-Y choledochojejunostomy was done. Results: Our study group comprised 105 patients including 66 (63%) men and 39 (37.1%) women with a mean age of 36.7 ± 12.5 years (range: 15-66 years). Among 1930 patients, 105 (5.4%) cases presented with biliary complication after liver transplantation, of which 97 (5%) and 8 (0.4%) cases presented with biliary stricture and bile leak/biloma, respectively. Conclusion: In our study, most patients with biliary complications after liver transplantation responded to interventional procedures, with 37.1% requiring surgical exploration.
ERic Acute StrokE Recanalization: A study using predictive analytics to assess a new device for mechanical thrombectomy
Authors: Siemonsen Susanne , Forkert Nils D , Bernhardt Martina , Thomalla Götz , Bendszus Martin , Fiehler Jens 
Published: March 2017

Aim and hypothesis Using a new study design, we investigate whether next-generation mechanical thrombectomy devices improve clinical outcomes in ischemic stroke patients. We hypothesize that this new methodology is superior to intravenous tissue plasminogen activator therapy alone. Methods and design ERic Acute StrokE Recanalization is an investigator-initiated prospective single-arm, multicenter, controlled, open label study to compare the safety and effectiveness of a new recanalization device and distal access catheter in acute ischemic stroke patients with symptoms attributable to acute ischemic stroke and vessel occlusion of the internal cerebral artery or middle cerebral artery. Study outcome The primary effectiveness endpoint is the volume of saved tissue. Volume of saved tissue is defined as difference of the actual infarct volume and the brain volume that is predicted to develop infarction by using an optimized high-level machine learning model that is trained on data from a historical cohort treated with IV tissue plasminogen activator. Sample size estimates Based on own preliminary data, 45 patients fulfilling all inclusion criteria need to complete the study to show an efficacy >38% with a power of 80% and a one-sided alpha error risk of 0.05 (based on a one sample t-test). Discussion ERic Acute StrokE Recanalization is the first prospective study in interventional stroke therapy to use predictive analytics as primary and secondary endpoint. Such trial design cannot replace randomized controlled trials with clinical endpoints. However, ERic Acute StrokE Recanalization could serve as an exemplary trial design for evaluating nonpivotal neurovascular interventions.
Antagonizing dabigatran by idarucizumab in cases of ischemic stroke or intracranial hemorrhage in Germany – A national case collection
Authors: Kermer Pawel , Eschenfelder Christoph C , Diener Hans-Christoph , Grond Martin , Abdalla Yasser , Althaus Katharina , Berrouschot Jörg , Cangür Hakan , Daffertshofer Michael , Edelbusch Sebastian , Gröschel Klaus , Haase Claus G , Harloff Andreas , Held Valentin , Kauert Andreas , Kraft Peter , Lenz Arne , Müllges Wolfgang , Obermann Mark , Partowi Someieh , Purrucker Jan , Ringleb Peter A , Röther Joachim , Rossi Raluca , Schäfer Niklas , Schneider Andreas , Schuppner Ramona , Seitz Rüdiger J , Szabo Kristina , Wruck Robert 
Published: March 2017

Background Idarucizumab is a monoclonal antibody fragment with high affinity for dabigatran that reverses its anticoagulant effects within minutes. It may exhibit the potential for patients under dabigatran therapy suffering ischemic stroke to regain eligibility for thrombolysis with rt-PA and may inhibit lesion growth in patients with intracerebral hemorrhage on dabigatran. Aims To provide insights into the clinical use of idarucizumab in patients under effective dabigatran anticoagulation presenting with signs of ischemic stroke or intracranial hemorrhage. Methods Retrospective data collected from German neurological/neurosurgical departments administering idarucizumab following product launch from January to August 2016 were used. Results Thirty-one patients presenting with signs of stroke received idarucizumab in 22 stroke centers. Nineteen patients treated with dabigatran presented with ischemic stroke and 12 patients suffered from intracranial bleeding. In patients receiving rt-PA thrombolysis following idarucizumab, 79% benefitted from i.v. thrombolysis with a median improvement of five points in NIHSS. No bleeding complications occurred. Hematoma growth was observed in 2 out of 12 patients with intracranial hemorrhage. The outcome was favorable with a median NIHSS improvement of 5.5 points and mRS 0–3 in 67%. Overall, mortality was low with 6.5% (one patient in each group). Conclusion Administration of rt-PA after reversing dabigatran activity with idarucizumab in case of ischemic stroke is feasible, easy to manage, effective, and appears to be safe. In dabigatran-associated intracranial hemorrhage, idarucizumab has the potential to prevent hematoma growth and improve outcome. Idarucizumab represents a new therapeutic option for patients under dabigatran treatment presenting with ischemic stroke or intracranial hemorrhage.