bluuebunny/crossref_metadata_2025_split huggingface dataset:
Osteochondroma. An Osteological Study
Authors: Ferreira Arquez Humberto 
Published: January 2018

Background: Osteochondroma is the most common tumor of bone, accounting for approximately one third of benign lesions in the skeleton is a broad (sessile) or narrow (pedunculated) skeletal protrusion comprised of marrow and cortical bone. Although it is benign, its biological behavior still has a malignant potential. Chondrosarcoma arising in osteochondroma has been recognized for many years. Osteochondromas might occur on any bone preformed in cartilage, they were especially seen on the long bones of the extremities, predominantly around the knee. In fact, the lower limb seemed to be at a higher risk of the tumor than the upper limb on the top two locations: distal part of the femur and proximal part of the tibia, however, the proximal humerus ranked the third place for solitary osteochondroma while the proximal fibula for multiples osteochondromas.
Methods and Findings: A total of 20 skeletons and 18 cadavers of both sex, 16 males and 2 females, with different age groups were used, this study was carried out by routine dissection classes for undergraduate medical student´s in the Morphology Laboratory of the University of Pamplona during the years 2013-2016. In only one sample was found the presence of osteochondroma. The measurement of the osseous mass was of 7 x 3.5 x 1.5 cm, attached to the posterolateral aspect of the middle third of the femur.
Conclusions: Osteochondroma is generally asymptomatic or discovered accidentally, but it can cause different symptoms depending on site of occurrence local swelling, bony deformities, fracture, bursa formation, arthritis and impingement on adjacent tendons, vascular or neurologic compromise, and dislocation The importance of correct treatment and follow-up of large osteochondromas to avoid complications such as further damage to neighboring neurovascular structures, and potential malignant degeneration. The present study describe a rare location from an osteochondroma in the femur diaphysis.
Active Surveillance of Influenza A and Other Respiratory Viruses in Children with Influenza-like-illness in Two Seasons
Authors: Girit Saniye , Karaaslan Ayşe , Gençer Serap , Yılmaz Emel , Ayhan Yetkin , Vayvada Elif Ruşen , Akçay Ciblak Meral , Badur Selim , Akın Yasemin 
Published: January 2018

Introduction: The aim of this study was to asses the surveillance of influenza A/other respiratory viruses and risk factors in hospitalized children with the symptoms of influenza-like illness during two consecutive influenza seasons.
Methodology: All children hospitalized with adiagnosis of influenza-like illness had been investigated for Influenza A and other respiratory antigens in pharengeal/nasopharyngeal secretions.
Results: A total of 132 hospitalized children between December 2013-May 2014 and December 2014-May 2015 were enrolled in this study. At least one respiratory virus was found to be positive by RT-PCR in 78 (59%) patients, influenza A (H3N2) was detected in only 8 (6%) patients. In 54 (41%) patients samples no respiratory viral pathogen was detected and in 70 (53%) patients, one non- influenza A virus was detected. The respiratory viral pathogens detected in decreasing rates were:RSV (n = 46, 35%), HCoV (n = 10, 7.5%), adenovirüs (n = 7, 5%), rhinovirüs (n = 6, 4.5%), HMPV (n = 5, 4%), Influenza B (n = 4, 3%) ve human Bocavirus (n = 2, 1.5%). In 10 patients, coinfection was detected, however none was with H3N2. In the H3N2 (+) group, the following risk factors were identified: age older than three years (p < 0.05), asthma history (p < 0.05) and chronic lung diseases (p < 0.05).
Conclusion: Influenza A virus was detected in 6% of hospitalized patients with influenza-like illness. Viruses other then Influenza, especially RSV, can cause similar symptoms compatible with Influenza-like-illness.
Le concept de groupe d’appartenance et le problème de migration des concepts
Authors: Kaës René 
Published: January 2018

Le concept de groupe d’appartenance occupe une place centrale dans la pensée et dans la théorie psychanalytique des groupes de J.C. Rouchy. L’article en décrit les principales dimensions, et comment il se rapproche et se différencie de l’« aire d’appartenance » (C. Neri) et du « sentiment d’appartenance » (A. Correale). L’analyse de ce concept offre un bon exemple du travail de la création conceptuelle et des problèmes épistémologiques qu’elle pose, lorsque cette création prend la forme d’une migration d’un concept créé dans une discipline (ici la sociologie et la psychologie sociale) et transféré dans une autre, en l’occurrence celui de la psychanalyse. L’attention de l’auteur se porte sur le fait que, dans les théories sociologiques et psychosociologiques des groupes, le concept de groupe d’appartenance fait couple avec celui de groupe de référence. Or il n’a pas fait l’objet d’un travail de « naturalisation » (S. Moscovici) analogue à celui qui a transformé le concept de groupe d’appartenance. Pourtant plusieurs caractéristiques de ce second concept, articulé au premier, pourraient présenter quelque intérêt s’ils étaient élaborés dans le champ de la psychanalyse des groupes.
Des dominants à la barre
Authors: Spire Alexis 
Published: January 2018

Resume À partir de l'observation de quatre procès pour fraude fiscale, cette contribution montre comment les justiciables du haut de l'échelle sociale gèrent la contrainte juridique, la maîtrisent et, éventuellement, la retournent à leur profit. L'analyse de la scénographie pénale révèle que le rituel judiciaire peine à transformer ces prévenus en délinquants. Ils mettent à distance la contrainte juridique en faisant valoir leurs mérites et leurs compétences, de façon à euphémiser leur délit. L'étude des stratégies de défense révèle des variations en fonction du genre : les femmes justifient leurs actes par l'argument familial tandis que les hommes mettent en avant une compétence professionnelle ou une fibre patriotique. Dans les deux cas, l'enjeu est d'utiliser l'arme du droit pour mettre en scène la violence de l'État et se présenter comme victimes de l'arbitraire de l'administration.
IFN Regulatory Factor 3 Balances Th1 and T Follicular Helper Immunity during Nonlethal Blood-Stage Plasmodium Infection
Authors: James Kylie R. , Soon Megan S. F. , Sebina Ismail , Fernandez-Ruiz Daniel , Davey Gayle , Liligeto Urijah N. , Nair Arya Sheela , Fogg Lily G. , Edwards Chelsea L. , Best Shannon E. , Lansink Lianne I. M. , Schroder Kate , Wilson Jane A. C. , Austin Rebecca , Suhrbier Andreas , Lane Steven W. , Hill Geoffrey R. , Engwerda Christian R. , Heath William R. , Haque Ashraful 
Published: January 2018

Abstract
Differentiation of CD4+ Th cells is critical for immunity to malaria. Several innate immune signaling pathways have been implicated in the detection of blood-stage Plasmodium parasites, yet their influence over Th cell immunity remains unclear. In this study, we used Plasmodium-reactive TCR transgenic CD4+ T cells, termed PbTII cells, during nonlethal P. chabaudi chabaudi AS and P. yoelii 17XNL infection in mice, to examine Th cell development in vivo. We found no role for caspase1/11, stimulator of IFN genes, or mitochondrial antiviral-signaling protein, and only modest roles for MyD88 and TRIF-dependent signaling in controlling PbTII cell expansion. In contrast, IFN regulatory factor 3 (IRF3) was important for supporting PbTII expansion, promoting Th1 over T follicular helper (Tfh) differentiation, and controlling parasites during the first week of infection. IRF3 was not required for early priming by conventional dendritic cells, but was essential for promoting CXCL9 and MHC class II expression by inflammatory monocytes that supported PbTII responses in the spleen. Thereafter, IRF3-deficiency boosted Tfh responses, germinal center B cell and memory B cell development, parasite-specific Ab production, and resolution of infection. We also noted a B cell–intrinsic role for IRF3 in regulating humoral immune responses. Thus, we revealed roles for IRF3 in balancing Th1- and Tfh-dependent immunity during nonlethal infection with blood-stage Plasmodium parasites.
Clinical Practice Informs Secure Messaging Benefits and Best Practices
Authors: Haun Jolie , Hathaway Wendy , Chavez Margeaux , Antinori Nicole , Vetter Brian , Miller Brian , Martin Tracey , Kendziora Lisa , Nazi Kim , Melillo Christine 
Published: January 2018

Background Clinical care team members in Department of Veterans' Affairs (VA) facilities nationwide are working to integrate the use of Secure Messaging (SM) into care delivery and identify innovative uses. Identifying best practices for proactive use of SM is a key factor in its successful implementation and sustained use by VA clinical care team members and veterans.
Objectives A collaborative project solicited input from VA clinical care teams about their local practices using SM to provide access to proactive patient-centered care for veterans and enhance workflow.
Methods This project implemented a single-item cross-sectional qualitative electronic survey via internal e-mail to local coordinators in all 23 Veterans Integrated Service Networks (VISNs). Content analysis was used to manage descriptive data responses. Descriptive statistics described sample characteristics.
Results VA clinical care team members across 15 of 23 VISNs responded to the questionnaire. Content analysis of 171 responses produced two global domains: (1) benefits of SM and (2) SM best practices. Benefits of SM use emphasize enhanced and efficient communication and increased access to care. Care team members incorporate SM into their daily clinical practices, using it to provide services before, during, and after clinical encounters as a best practice. SM users suggest improvements in veteran care, clinical team workflow, and efficient use of health resources. Clinical team members invested in the successful implementation of SM integrate SM into their daily practices to provide meaningful and useful veteran-centered care and improve workflow.
Conclusion VA clinical care team members can use SM proactively to create an integrated SM culture. With adequate knowledge and motivation to proactively use this technology, all clinical team members within the VA system can replicate best practices shared by other clinical care teams to generate meaningful and useful interactions with SM to enrich veterans' health care experience.
Clinical Informatics Researcher's Desiderata for the Data Content of the Next Generation Electronic Health Record
Authors: Kennell Timothy , Willig James , Cimino James 
Published: January 2018

Objective Clinical informatics researchers depend on the availability of high-quality data from the electronic health record (EHR) to design and implement new methods and systems for clinical practice and research. However, these data are frequently unavailable or present in a format that requires substantial revision. This article reports the results of a review of informatics literature published from 2010 to 2016 that addresses these issues by identifying categories of data content that might be included or revised in the EHR.
Materials and Methods We used an iterative review process on 1,215 biomedical informatics research articles. We placed them into generic categories, reviewed and refined the categories, and then assigned additional articles, for a total of three iterations.
Results Our process identified eight categories of data content issues: Adverse Events, Clinician Cognitive Processes, Data Standards Creation and Data Communication, Genomics, Medication List Data Capture, Patient Preferences, Patient-reported Data, and Phenotyping.
Discussion These categories summarize discussions in biomedical informatics literature that concern data content issues restricting clinical informatics research. These barriers to research result from data that are either absent from the EHR or are inadequate (e.g., in narrative text form) for the downstream applications of the data. In light of these categories, we discuss changes to EHR data storage that should be considered in the redesign of EHRs, to promote continued innovation in clinical informatics.
Conclusion Based on published literature of clinical informaticians' reuse of EHR data, we characterize eight types of data content that, if included in the next generation of EHRs, would find immediate application in advanced informatics tools and techniques.
A New EHR Training Curriculum and Assessment for Pediatric Residents
Authors: Stroup Kathryn , Sanders Benjamin , Bernstein Bruce , Scherzer Leah , Pachter Lee 
Published: January 2018

Background Conventional classroom Electronic Health Record (EHR) training is often insufficient for new EHR users. Studies suggest that enhanced training with a hands-on approach and closely supported clinical use is beneficial.
Objectives Our goals were to develop an enhanced EHR learning curriculum for Post Graduate Year 1 (PGY1) residents and measure changes in EHR skill proficiency, efficiency, and self-efficacy.
Methods A novel three-phase, multimodal enhanced EHR curriculum was designed for a cohort of PGY1 residents. After basic training, residents began phase 1 of enhanced training, including demonstrations, live practice, and order set review. Phase 2 involved skills-oriented assignments, role playing, and medication entry. Phase 3 included shadowing, scribing histories, and supervised order entry. Residents' EHR skills and attitudes were measured and compared before and after the enhanced curriculum via proficiency test and a survey of efficiency and self-efficacy.
Results Nineteen of 26 PGY1 residents participated in the study (73%). There was significant improvement in mean proficiency scores and two of the five individual proficiency scores. There were significant improvements in most efficiency survey responses from pre- to postintervention. For the self-efficacy presurvey, many PGY1s reported to be “very” or “somewhat confident” performing each of the five tasks, and perceptions did not improve or worsened on most postsurvey responses. The greatest resource was the time required to design and deliver the enhanced training.
Conclusion An enhanced training curriculum along with a proficiency assessment was developed and described here. An enhanced training curriculum significantly improved PGY1 EHR efficiency and some measures of proficiency but not self-efficacy. This intervention may support improved EHR-related clinic workflows, which ultimately could enable residents and preceptors to prioritize patient care and time for clinical education.
Core Components for a Clinically Integrated mHealth App for Asthma Symptom Monitoring
Authors: Rudin Robert , Fanta Christopher , Predmore Zachary , Kron Kevin , Edelen Maria , Landman Adam , Zimlichman Eyal , Bates David 
Published: January 2018

Background mHealth apps may be useful tools for supporting chronic disease management.
Objective Our aim was to apply user-centered design principles to efficiently identify core components for an mHealth-based asthma symptom–monitoring intervention using patient-reported outcomes (PROs).
Methods We iteratively combined principles of qualitative research, user-centered design, and “gamification” to understand patients' and providers' needs, develop and refine intervention components, develop prototypes, and create a usable mobile app to integrate with clinical workflows. We identified anticipated benefits and burdens for stakeholders.
Results We conducted 19 individual design sessions with nine adult patients and seven clinicians from an academic medical center (some were included multiple times). We identified four core intervention components: (1) Invitation—patients are invited by their physicians. (2) Symptom checks—patients receive weekly five-item questionnaires via the app with 48 hours to respond. Depending on symptoms, patients may be given the option to request a call from a nurse or receive one automatically. (3) Patient review—in the app, patients can view their self-reported data graphically. (4) In-person visit—physicians have access to patient-reported symptoms in the electronic health record (EHR) where they can review them before in-person visits. As there is currently no location in the EHR where physicians would consistently notice these data, recording a recent note was the best option. Benefits to patients may include helping decide when to call their provider and facilitating shared decision making. Benefits to providers may include saving time discussing symptoms. Provider organizations may need to pay nurses extra, but those costs may be offset by reduced visits and hospitalizations.
Conclusion Recent systematic reviews show inconsistent outcomes and little insight into functionalities required for mHealth asthma interventions, highlighting the need for systematic intervention design. We identified specific features for adoption and engagement that meet the stated needs of users for asthma symptom monitoring.
Health Information Exchange for Continuity of Maternal and Neonatal Care Supporting: A Proof-of-Concept Based on ISO Standard
Authors: Santos M.R. , de Sá T.Q.V. , da Silva F.E. , dos Santos Junior M.R. , Maia T.A. , Reis Z.S.N. 
Published: January 2018

Background Around the world, people receive care at various institutions; therefore, clinical information is recorded either on paper or distributed on different information systems with reduced capabilities for sharing data. One approach to handling the complex nature of the health information systems and making it interoperable is the two-level modeling, and the ISO 13606 standard is an option to support this model. A regionally governed EHR program in Brazil proposed to use the ISO 13606 standard and archetypes. This program includes an EHR repository for consolidating the longitudinal electronic record of patients' health.
Objective This article aims to present the results and lessons learned from a proof-of-concept (POC) for integrating the Maternal and Neonatal Healthcare Information System (SISMater) developed by the Federal University of Minas Gerais (UFMG) with the EHR system developed by the Department of Healthcare for the State of Minas Gerais (SES/MG).
Methods The design of the architecture and software development were driven by the content to be exchanged between the SISMater system and the EHR system and the usage of XML transformation to translate an ISO 13606 EHR extract and vice versa. This POC did not include tests related to revision objects according to ISO 13606 reference model.
Results The software architecture and software components required for this POC were proposed and tested. The EHR system validated the syntax and semantic and persisted the extract in the EHR repository. Complete results can be accessed at https://github.com/pocppsus/repository.
Conclusion The approach for using XML transformations could make easier the process for ISO 13606 noncompliant EMR systems to exchange EHR data with the SES/MG EHR system.
Association between Search Behaviors and Disease Prevalence Rates at 18 U.S. Children's Hospitals
Authors: Daniel Dennis , Wolbrink Traci , Logvinenko Tanya , Harper Marvin , Burns Jeffrey 
Published: January 2018

Background Usage of online resources by clinicians in training and practice can provide insight into knowledge gaps and inform development of decision support tools. Although online information seeking is often driven by encountered patient problems, the relationship between disease prevalence and search rate has not been previously characterized.
Objective This article aimed to (1) identify topics frequently searched by pediatric clinicians using UpToDate (http://www.uptodate.com) and (2) explore the association between disease prevalence rate and search rate using data from the Pediatric Health Information System.
Methods We identified the most common search queries and resources most frequently accessed on UpToDate for a cohort of 18 children's hospitals during calendar year 2012. We selected 64 of the most frequently searched diseases and matched ICD-9 data from the PHIS database during the same time period. Using linear regression, we explored the relationship between clinician query rate and disease prevalence rate.
Results The hospital cohort submitted 1,228,138 search queries across 592,454 sessions. The majority of search sessions focused on a single search topic. We identified no consistent overall association between disease prevalence and search rates. Diseases where search rate was substantially higher than prevalence rate were often infectious or immune/rheumatologic conditions, involved potentially complex diagnosis or management, and carried risk of significant morbidity or mortality. None of the examined diseases showed a decrease in search rate associated with increased disease prevalence rates.
Conclusion This is one of the first medical learning needs assessments to use large-scale, multisite data to identify topics of interest to pediatric clinicians, and to examine the relationship between disease prevalence and search rate for a set of pediatric diseases. Overall, disease search rate did not appear to be associated with hospital disease prevalence rates based on ICD-9 codes. However, some diseases were consistently searched at a higher rate than their prevalence rate; many of these diseases shared common features.
Comparison of global observations and trends of total precipitable water derived from microwave radiometers and COSMIC radio occultation from 2006 to 2013
Authors: Ho Shu-Peng , Peng Liang , Mears Carl , Anthes Richard A. 
Published: January 2018

Abstract. We compare atmospheric total precipitable water (TPW) derived from
the
SSM/I (Special Sensor Microwave Imager) and SSMIS (Special Sensor Microwave
Imager/Sounder) radiometers and WindSat to collocated TPW estimates derived
from COSMIC (Constellation System for Meteorology, Ionosphere, and Climate)
radio occultation (RO) under clear and cloudy conditions over the oceans from
June 2006 to December 2013. Results show that the mean microwave (MW)
radiometer – COSMIC TPW differences range from 0.06 to 0.18 mm for clear
skies, from
0.79 to 0.96 mm for cloudy skies, from 0.46 to 0.49 mm for cloudy but non-precipitating
conditions, and from 1.64 to 1.88 mm for precipitating conditions. Because RO
measurements are not significantly affected by clouds and precipitation, the
biases mainly result from MW retrieval uncertainties under cloudy and
precipitating conditions. All COSMIC and MW radiometers detect a positive TPW
trend over these 8 years. The trend using all COSMIC observations
collocated with MW pixels for this data set is 1.79 mm decade−1, with a 95 %
confidence interval of (0.96, 2.63), which is in close agreement with the
trend estimated by the collocated MW observations (1.78 mm decade−1 with a
95 % confidence interval of 0.94, 2.62). The sample of MW and RO pairs used
in this study is highly biased toward middle latitudes (40–60∘ N and 40–65∘ S), and thus these trends are
not representative of global average trends. However, they are representative
of the latitudes of extratropical storm tracks and the trend values are
approximately 4 to 6 times the global average trends, which are
approximately 0.3 mm decade−1. In addition, the close agreement of these two
trends from independent observations, which represent an increase in TPW in
our data set of about 6.9 %, are a strong indication of the positive water
vapor–temperature feedback on a warming planet in regions where precipitation
from extratropical storms is already large.