bluuebunny/crossref_metadata_2025_split huggingface dataset:
Defining probabilities of bowel resection in deep endometriosis of the rectum: Prediction with preoperative magnetic resonance imaging
Authors: Perandini Alessio , Perandini Simone , Montemezzi Stefania , Bonin Cecilia , Bellini Gaia , Bergamini Valentino 
Published: November 2017

AbstractAimDeep endometriosis of the rectum is a highly challenging disease, and a surgical approach is often needed to restore anatomy and function. Two kinds of surgeries may be performed: radical with segmental bowel resection or conservative without resection. Most patients undergo magnetic resonance imaging (MRI) before surgery, but there is currently no method to predict if conservative surgery is feasible or whether bowel resection is required. The aim of this study was to create an algorithm that could predict bowel resection using MRI images, that was easy to apply and could be useful in a clinical setting, in order to adequately discuss informed consent with the patient and plan the an appropriate and efficient surgical session.MethodsWe collected medical records from 2010 to 2016 and reviewed the MRI results of 52 patients to detect any parameters that could predict bowel resection. Parameters that were reproducible and with a significant correlation to radical surgery were investigated by statistical regression and combined in an algorithm to give the best prediction of resection.ResultsThe calculation of two parameters in MRI, impact angle and lesion size, and their use in a mathematical algorithm permit us to predict bowel resection with a positive predictive value of 87% and a negative predictive value of 83%.Conclusions
MRI could be of value in predicting the need for bowel resection in deep endometriosis of the rectum. Further research is required to assess the possibility of a wider application of this algorithm outside our single‐center study.
Integrating Health Education in Core Curriculum Classrooms: Successes, Challenges, and Implications for Urban Middle Schools
Authors: Rajan Sonali , Roberts Katherine J. , Guerra Laura , Pirsch Moira , Morrell Ernest 
Published: November 2017

ABSTRACTBACKGROUNDSchool‐based health education efforts can positively affect health behaviors and learning outcomes; however, there is limited available time during the school day for separate health education classes. The purpose of this study was to assess the feasibility and sustainability of implementing a classroom‐based health education program that integrates skill development with health learning.METHODSA wait‐list control study design was conducted among 168 6th graders in 2 urban schools. Data on program implementation, feasibility, and health outcomes were collected from students at 3 time points and from 5 teachers across the implementation of the 10‐week program.RESULTSThere were barriers to implementation, including time limitations, unexpected school‐wide disruptions, and variations in student reading ability and teacher preparedness. However, analyses revealed there were significant increases in self‐efficacy regarding fruit and vegetable consumption and outcome expectations following program implementation, which were also sustained post‐program implementation. Despite inconsistent implementation in the wait‐list control school, small gains were also noted following the completion of the program.CONCLUSIONSIntegrating health education efforts within core curricula classes can lead to favorable outcomes. However, implementation barriers must be actively addressed by schools and program developers to improve program fidelity and maximize the sustainability of program gains.
Review of Education‐Focused Health Impact Assessments Conducted in the United States
Authors: Gase Lauren N. , DeFosset Amelia R. , Gakh Maxim , Harris Celia , Weisman Susan R. , Dannenberg Andrew L. 
Published: November 2017

ABSTRACTBACKGROUNDHealth impact assessment (HIA) provides a structured process for examining the potential health impacts of proposed policies, plans, programs, and projects. This study systematically reviewed HIAs conducted in the United States on prekindergarten, primary, and secondary education‐focused decisions.METHODSRelevant HIA reports were identified from web sources in late 2015. Key data elements were abstracted from each report. Four case studies were selected to highlight diversity of topics, methods, and impacts of the assessment process.RESULTSTwenty HIAs completed in 2003‐2015 from 8 states on issues related to prekindergarten through secondary education were identified. The types of decisions examined included school structure and funding, transportation to and from school, physical modifications to school facilities, in‐school physical activity and nutrition, and school discipline and climate. Assessments employed a range of methods to characterize the nature, magnitude, and severity of potential health impacts. Assessments fostered stakeholder engagement and provided health‐promoting recommendations, some of which were subsequently incorporated into school policies.CONCLUSIONSHealth impact assessment is a promising tool that education, health, and other stakeholders can use to maximize the health and well‐being of students, families, and communities.
Incorporating Trauma‐Informed Care Into School‐Based Programs
Authors: Martin Sandra L. , Ashley Olivia Silber , White LeBretia , Axelson Sarah , Clark Marc , Burrus Barri 
Published: November 2017

ABSTRACTBACKGROUNDThis article provides an overview of the rationale and process for incorporating trauma‐informed approaches into US school‐based programs, using school‐based adolescent pregnancy prevention programs as an example.METHODSResearch literature is reviewed on the prevalence and outcomes of childhood trauma, including the links between trauma and pregnancy. Information is then presented concerning the implementation of trauma‐informed approaches in school settings, describing activities undertaken, barriers encountered, and outcomes achieved. Next, we describe the implications of this literature for school‐based adolescent pregnancy prevention programs, outlining the reasons for including trauma‐informed approaches in these programs, the prerequisites for doing so, and some examples of successful implementation.RESULTSMany children in our country experience trauma, placing them at increased risk of multiple health concerns including adolescent pregnancy. In response to this situation, some schools have successfully incorporated trauma‐informed approaches into adolescent pregnancy prevention programs, as well as other programming.CONCLUSIONSIncorporating trauma‐informed approaches into school settings, including school‐based adolescent pregnancy prevention programs, is a viable and important way to address the multiple needs of traumatized children.
Type 1 immune‐mediated polyarthritis in dogs and lack of a temporal relationship to vaccination
Authors: Idowu O. A. , Heading K. L. 
Published: November 2017

ObjectivesTo investigate whether there is a temporal relationship between vaccination and the onset of type 1 immune‐mediated polyarthritis in dogs.Materials and MethodsRetrospective case–control study: 39 dogs from a referral hospital with a diagnosis of type 1 immune‐mediated polyarthritis were age‐matched with 78 control dogs with other diagnoses. A temporal association between vaccination and polyarthritis was considered positive if recent vaccination had been performed within 28 days of the onset of clinical signs of immune‐mediated polyarthritis. The odds ratio association of recent vaccination with immune‐mediated polyarthritis was calculated using matched case–control methods.ResultsOf the 39 dogs in the type 1 immune‐mediated polyarthritis group, four had been vaccinated within 28 days before onset of clinical signs compared to six dogs in the control group. The odds ratio for a dog developing type 1 immune‐mediated polyarthritis if vaccinated within the last 28 days was estimated to be 1·44 (95% confidence interval 0·25 to 8·24, P = 0·88).Clinical SignificanceThere was no evidence of a temporal relationship between vaccination and type 1 immune‐mediated polyarthritis, although the large confidence interval on the odds ratio suggests a need for larger studies to confirm this finding.
It's a long way to the top: Plant species diversity in the transition from managed to old‐growth forests
Authors: Burrascano Sabina , Ripullone Francesco , Bernardo Liliana , Borghetti Marco , Carli Emanuela , Colangelo Michele , Gangale Carmen , Gargano Domenico , Gentilesca Tiziana , Luzzi Giuseppe , Passalacqua Nicodemo , Pelle Luca , Rivelli Anna Rita , Sabatini Francesco Maria , Schettino Aldo , Siclari Antonino , Uzunov Dimitar , Blasi Carlo 
Published: November 2017

AbstractQuestionsDo vascular plant species richness and beta‐diversity differ between managed and structurally complex unmanaged stands? To what extent do species richness and beta‐diversity relate to forest structural attributes and heterogeneity?LocationFive national parks in central and southern Italy.MethodsWe sampled vascular plant species composition and forest structural attributes in eight unmanaged temperate mesic forest stands dominated or co‐dominated by beech, and in eight comparison stands managed as high forests with similar environmental features. We compared plant species richness, composition and beta‐diversity across pairs of stands (unmanaged vs managed) using GLMMs. Beta‐diversity was quantified both at the scale of each pair of stands using plot‐to‐plot dissimilarity matrices (species turnover), and across the whole data set, considering the distance in the multivariate species space of individual plots from their centroid within the same stand (compositional heterogeneity). We modelled the relationship between species diversity (richness and beta‐diversity) and forest structural heterogeneity and individual structural variables using GLMMs and multiple regression on distance matrices.ResultsSpecies composition differed significantly between managed and unmanaged stands, but not richness and beta‐diversity. We found weak evidence that plant species richness increased with increasing levels of structural heterogeneity and canopy diversification. At the scale of individual stands, species turnover was explained by different variables in distinct stands, with variables related to deadwood quantity and quality being selected most often. We did not find support for the hypothesis that compositional heterogeneity varies as a function of forest structural characteristics at the scale of the whole data set.ConclusionsStructurally complex unmanaged stands have a distinct herb layer species composition from that of mature stands in similar environmental conditions. Nevertheless, we did not find significantly higher levels of vascular plant species richness and beta‐diversity in unmanaged stands. Beta‐diversity was related to patterns of deadwood accumulation, while for species richness the evidence that it increases with increasing levels of canopy diversification was weak. These results suggest that emulating natural disturbance, and favouring deadwood accumulation and canopy diversification may benefit some, but not all, facets of plant species diversity in Apennine beech forests.
Performance of an algorithm‐based approach to the diagnosis and management of functional gastrointestinal disorders: A pilot trial
Authors: Linedale E. C. , Mikocka‐Walus A. , Vincent A. D. , Gibson P. R. , Andrews J. M. 
Published: November 2017

AbstractBackgroundRecent advances in the development of diagnostic criteria and effective management options for functional gastrointestinal disorders (FGIDs) have not yet been integrated into clinical practice. There is a clear need for the development and validation of a simple clinical pathway for the diagnosis and management of FGIDs which can be used in primary care.MethodsIn this controlled pilot study, we designed and evaluated a non‐specialist‐dependent, algorithm‐based approach for the diagnosis and management of FGIDs (ADAM‐FGID). Patients referred to 1 tertiary referral center with clinically suspected functional gastrointestinal disorders were allocated to waitlist control or algorithm group. The algorithm group was screened for organic disease, and those without clinical alarms received a written FGID diagnosis and management options. All participants were followed up for 1 year.Key ResultsThe ADAM‐FGID was found to be feasible and acceptable to both patients and primary healthcare providers. The diagnostic component identified that 39% of referrals required more urgent gastroenterological review than original triage category, with organic disease subsequently diagnosed in 31% of these. The majority of patients (82%) diagnosed with a FGID did not receive a relevant alternative diagnosis during follow‐up. Patient buy‐in to the model was good, with all reading the diagnostic/management letter, 80% entering management, and 61% reporting symptom improvement at 6 weeks. Moreover, 68% of patients and all referring doctors found the approach to be at least moderately acceptable. Patients reported being reassured by the approach and found the management options useful. Primary healthcare providers acknowledged the potential of this approach to reduce waiting times for endoscopic procedures and to provide reassurance to both patients and themselves.Conclusions & InferencesThis pilot study provides preliminary evidence to support a clinical pathway for the diagnosis and management of FGIDs which does not depend upon specialist review. Further rigorous testing within primary care is needed to conclusively establish safety and efficacy. However, this approach is safer than current management and has potential to build capacity by reducing specialist burden and expediting effective care.
A new genus and species for the globally important, multihost root pathogen Thielaviopsis basicola
Authors: Nel W. J. , Duong T. A. , Wingfield B. D. , Wingfield M. J. , de Beer Z. W. 
Published: November 2017

The plant pathogenic asexual fungus Thielaviopsis basicola (Ascomycota) causes black root rot on many important agricultural and ornamental plant species. Since its first description in 1850, this species has had a tumultuous taxonomic history, being classified in many different genera. Thus far, DNA‐based techniques have not played a significant role in identification of T. basicola and have been used only to confirm its placement in the Microascales. This investigation reconsidered the phylogenetic placement of T. basicola, using DNA sequence data for six different gene regions. It included 41 isolates identified as T. basicola from 13 geographical locations worldwide. Phylogenetic analyses showed that these isolates grouped in a well‐supported lineage distinct from other genera in the Ceratocystidaceae, here described as Berkeleyomyces gen. nov. The data also provided robust evidence that isolates of T. basicola include a cryptic sister species. As a result, this report provides a new combination as B. basicola comb. nov. and introduces a new species as B. rouxiae sp. nov.
Prospective evaluation of abdominal ultrasonographic findings in 35 dogs with leptospirosis
Authors: Sonet Juliette , Barthélemy Anthony , Goy‐Thollot Isabelle , Pouzot‐Nevoret Céline 
Published: November 2017

AbstractDespite the emergence of new serovars, a detailed and current abdominal ultrasonographic description of dogs with leptospirosis is lacking. The purpose of this prospective, observational, single cohort study was to illustrate abdominal ultrasonographic findings in 35 dogs with confirmed leptospirosis. At least one ultrasonographic abnormality was seen in all of the dogs. Ultrasound renal abnormalities were found in all the dogs and included increased renal cortical echogenicity (100%), increased medullary echogenicity (86%), reduced corticomedullary definition (80%), cortical thickening (74%), renomegaly (60%), pelvic dilation (31%), and medullary band (14%). Hepatic changes were identified in 83% of the dogs, with diffuse hypoechoic parenchyma (71%) and hepatomegaly (60%). Biliary gallbladder abnormalities were found in 60% of the dogs, with biliary sludge (46%), wall thickening (29%), mucocele (26%), and hyperechoic wall (20%). The other most frequently observed abdominal abnormalities were perirenal (60%) and peritoneal (46%) effusions, small intestinal wall thickening (49%), and lymphadenopathy (38%). Two dogs (6%) presented with a small intestinal intussusception. No association was found between serogroups and the presence of ultrasonographic findings. This study is the first to prospectively and exhaustively describe abdominal ultrasonographic findings in dogs with leptospirosis. Our results should prompt clinicians to systematically perform abdominal ultrasounds on dogs with suspected leptospirosis even in the absence of abnormal physical signs. The presence of a gallbladder mucocele could be a warning sign of leptospirosis in dogs.
The impact of postdischarge surveillance on surgical site infection diagnosis
Authors: Garcia Stickney Danielle N. , Thieman Mankin Kelley M. 
Published: November 2017

AbstractObjectiveTo evaluate the impact of postdischarge surveillance on surgical site infection (SSI) diagnosis.Study designProspective enrollment with retrospective case reviewSample PopulationDogs and cats (n = 1271) undergoing surgery April 2012‐November 2013.MethodsThe medical record of each animal was reviewed and a 30‐day follow‐up questionnaire was sent to each pet owner. A standardized definition of SSI was used to identify all animals with SSI. The method of SSI detection was recorded as: re‐presentation to the hospital, scheduled recheck, questionnaire, communication with the referring veterinarian, or a combination of the above.ResultsSSI was identified in 36 (2.83%) of the 1271 animals included. All SSIs were diagnosed after discharge from the hospital. Seven of the 36 animals with SSI were diagnosed at re‐presentation to the hospital, 5/36 at scheduled recheck, 10/36 on questionnaire, 10/36 at re‐presentation to the hospital AND on questionnaire, and 4/36 on communication with referring veterinarian. Of the diagnosed SSIs, 72.2% were documented in the medical record. Therefore, without active postdischarge surveillance, 10/36 SSIs (27.8%) would have gone unknown to surgeons at our institution.ConclusionUnderstanding the incidence of SSI with feedback to surgeons is an important aspect of an infection control program and has been shown to reduce SSI risks. Without active postoperative surveillance, 27.8% of SSIs would have gone unknown to surgeons. Implementing active surveillance will allow accurate reporting of incidence of SSIs in veterinary hospitals.
Antifibrillatory effects of renal denervation on ventricular fibrillation in a canine model of pacing‐induced heart failure
Authors: Luo Qingzhi , Jin Qi , Zhang Ning , Huang Shangwei , Han Yanxin , Lin Changjian , Ling Tianyou , Chen Kang , Pan Wenqi , Wu Liqun 
Published: November 2017

New Findings
What is the central question of this study?
In the present study, we investigated the effects of renal denervation on the vulnerability to ventricular fibrillation and the ventricular electrical properties in a rapid pacing‐induced heart failure canine model.

What is the main finding and its importance?
Renal denervation significantly attenuated the process of heart failure and improved left ventricular systolic dysfunction, stabilized ventricular electrophysiological properties and decreased the vulnerability of the heart to ventricular fibrillation during heart failure. Thus, renal denervation can attenuate ventricular electrical remodelling and exert a potential antifibrillatory action in a pacing‐induced heart failure canine model.

In this study, we investigated the effects of renal denervation (RDN) on the vulnerability to ventricular fibrillation (VF) and the ventricular electrical properties in a canine model of pacing‐induced heart failure (HF). Eighteen beagles were divided into the following three groups: control (n = 6), HF (n = 6) and HF+RDN (n = 6). Heart failure was induced by rapid right ventricular pacing. Renal denervation was performed simultaneously with the pacemaker implantation in the HF+RDN group. A 64‐unipolar basket catheter was used to perform global endocardial mapping of the left ventricle. The restitution properties and dispersion of refractoriness were estimated from the activation recovery intervals (ARIs) by a pacing protocol. The VF threshold (VFT) was defined as the maximal pacing cycle length required to induce VF using a specific pacing protocol. The defibrillation threshold (DFT) was measured by an up–down algorithm. Renal denervation partly restored left ventricular systolic function and attenuated the process of HF. Compared with the control group, the VFT in the HF group was decreased by 27% (106 ± 8.0 versus 135 ± 10 ms, P < 0.01). However, RDN increased the VFT by 13% (135 ± 10 versus 118 ± 7.5 ms, P < 0.05) and decreased the DFT by 27% (30 ± 6.3 versus 21.8 ± 4.7 J, P < 0.05) in the treated hearts compared with the failing hearts. Renal denervation significantly flattened the ventricular ARI restitution curve by 15% (1.48 ± 0.2 versus 1.26 ± 0.11, P < 0.05) and decreased the dispersion of ARI by 25% (0.08 ± 0.02 versus 0.06 ± 0.01, P < 0.01) in the treated group compared with the HF group. The findings of this study suggest that RDN can attenuate ventricular electrical remodelling and exert a potential antifibrillatory action on VF in a canine model of pacing‐induced HF.
Right service, right place: optimising utilisation of a community nursing service to reduce planned re-presentations to the emergency department
Authors: Lawton Jessica Kirsten , Kinsman Leigh , Dalton Lisa , Walsh Fay , Bryan Helen , Williams Sharon 
Published: November 2017

BackgroundCongruent with international rising emergency department (ED) demand, a focus on strategies and services to reduce burden on EDs and improve patient outcomes is necessary. Planned re-presentations of non-urgent patients at a regional Australian hospital exceeded 1200 visits during the 2013–2014 financial year. Planned re-presentations perpetuate demand and signify a lack of alternative services for non-urgent patients. The Community Nursing Enhanced Connections Service (CoNECS) collaboratively evolved between acute care and community services in 2014 to reduce planned ED re-presentations.ObjectiveThis study aimed to investigate the evolution and impact of a community nursing service to reduce planned re-presentations to a regional Australian ED and identify enablers and barriers to interventionist effectiveness.MethodsA mixed-methods approach evaluated the impact of CoNECS. Data from hospital databases including measured numbers of planned ED re-presentations by month, time of day, age, gender and reason were used to calculate referral rates to CoNECS. These results informed two semistructured focus groups with ED and community nurses. The researchers used a theoretical lens, ‘diffusion of innovation’, to understand how this service could inform future interventions.ResultsAnalyses showed that annual ED planned re-presentations decreased by 43% (527 presentations) after implementation. Three themes emerged from the focus groups. These were right service at the right time, nursing uncertainty and system disconnect and medical disengagement.ConclusionsCoNECS reduced overall ED planned re-presentations and was sustained longer than many complex service-level interventions. Factors supporting the service were endorsement from senior administration and strong leadership to drive responsive quality improvement strategies. This study identified a promising alternative service outside the ED, highlighting possibilities for other hospital emergency services aiming to reduce planned re-presentations.