bluuebunny/crossref_metadata_2025_split huggingface dataset:
An Electronic Alert System Is Associated With a Significant Increase in Pharmacologic Venous Thromboembolism Prophylaxis Rates Among Hospitalized Inflammatory Bowel Disease Patients
Authors: Mathers Bradley , Williams Emmanuelle , Bedi Gurneet , Messaris Evangelos , Tinsley Andrew 
Published: May 2016

Background:
Utilization of pharmacologic venous thromboembolism (VTE) prophylaxis in inflammatory bowel disease (IBD) patients seems to be suboptimal with reported rates as low as 50% in some studies. Implementation of an electronic alert system seems to be an effective tool for increasing VTE prophylaxis rates in medical inpatients. To date, no studies have assessed whether this approach is associated with improved rates of pharmacologic VTE prophylaxis specifically in IBD patients.

Aims:
To determine the efficacy of an electronic alert in improving VTE prophylaxis rates in hospitalized IBD patients.

Methods:
We conducted a retrospective cohort study of 576 hospitalized IBD patients. The medical record of each patient was then examined to determine whether pharmacologic VTE prophylaxis was both ordered and administered, the timing of pharmacologic VTE prophylaxis, and reasons for any missed doses.

Results:
The VTE pharmacologic prophylaxis rate was improved from 60% to 81.2% following the implementation of the electronic alert system (p < .001). An increase in prophylaxis rates was seen in both medical (26.3% vs. 62.8%, p < .001) and surgical services (83.7% vs. 95.5%, p < .001). In patients who received pharmacologic VTE prophylaxis, 16% of all ordered doses were not administered and 57.3% of missed doses were the result of patient refusal. Hospitalization after implementation of the electronic alert system (odds ratio [OR] 4.71, 95% confidence interval [CI] 2.94–7.57) and admission to a surgical service (OR 14.3, 95% CI 8.62–24.39) were predictive of VTE pharmacologic prophylaxis orders.

Conclusions:
The introduction of an electronic alert system was associated with a significant increase in rates of pharmacologic VTE prophylaxis. However, orders were often delayed and doses not always administered. The most common reason that ordered doses were not given was patient refusal.
Short article: Fatigue in the long term after HCV treatment in HIV–HCV-coinfected patients: functional limitations persist despite viral clearance in patients exposed to peg-interferon/ribavirin-containing regimens (ANRS CO13-HEPAVIH cohort)
Authors: Marcellin Fabienne , Protopopescu Camelia , Poizot-Martin Isabelle , Miailhes Patrick , Esterle Laure , Wittkop Linda , Spire Bruno , Bocquier Aurélie , Salmon-Ceron Dominique , Dabis François , Carrieri Maria Patrizia 
Published: May 2016

Objectives
To analyze the impact of fatigue on individuals’ global, cognitive, physical, and psychosocial functioning in the long term after hepatitis C virus (HCV) treatment and its relationship with HCV clearance among patients coinfected with HIV and HCV exposed to peg-interferon/ribavirin-containing regimens.

Patients and methods
The study sample included 107 coinfected patients treated for HCV during follow-up in the French ANRS CO13-HEPAVIH cohort. Analyses used scores from the Fatigue Impact Scale (FIS), assessed before treatment initiation and at last available measure after the end of treatment (2 years in median). Patient proportions with a clinically significant improvement in fatigue impact, defined as a decrease higher than 10 points in the 160-point global FIS score, were compared between HCV clearers and chronic HCV patients (Fisher’s exact test). Relationships between HCV clearance and FIS scores were analyzed in linear regression models adjusted for sex, time since end of HCV treatment, and pretreatment scores.

Results
Twenty-nine percent of patients showed a clinically significant improvement in fatigue (15/57 in HCV clearers vs. 16/50 in chronic HCV patients, P=0.52). HCV clearance was not significantly associated with FIS scores in multivariate models.

Conclusion
The role of HCV clearance in coinfected patients’ functional recovery in the long term after peg-interferon/ribavirin treatment may be lesser than expected. Additional studies are needed in patients treated with direct-acting antiviral agents. In the meantime, the effectiveness of palliative care and targeted psychological treatments such as cognitive-behavioral therapy in reducing fatigue impact needs to be assessed in the many HCV-cured patients with HIV exposed to suboptimal interferon-based first-generation therapies.
Current updates in nasal bone reshaping
Authors: Ozucer Berke , Özturan Orhan 
Published: May 2016

Purpose of reviewTo review recent studies on nasal osseocartilaginous anatomy, osteotomy techniques and contemporary methods of nasal bone reshaping carried out under direct vision.Recent findingsCurrent cadaver studies on osseocartilaginous vault anatomy, osteotomy techniques provide valuable information that can reduce outcome variability and increase reliability of osteotomies. Nevertheless, osteotomes have limitations and contemporary approaches – namely, piezoelectric instrumentations, osteoectomy, and osteotomy carried out under direct vision–can provide valuable solutions to certain shortcomings. Contrary to widespread understanding, extended wide periosteal dissection is the common thread in newly introduced methods which claim enhanced control, reduced soft tissue trauma, and reproducible results. Comparative and cadaver studies show promising results regarding protection of underlying mucosa, reduced comminuted fractures, reduced postoperative ecchymosis, and edema.SummaryImprovements in nasal bone reshaping are promising for better esthetic and functional outcomes. Nevertheless, these approaches need to be validated by randomized controlled trials and test of time before being incorporated in routine surgical practice.
Adolescent gun violence prevention: what we know, and what we can do to keep young people safe
Authors: Dodson Nancy A. 
Published: May 2016

Purpose of reviewThis review will focus on recent research, initiatives, and legislation regarding the issue of gun violence as it pertains to adolescents.Recent findingsHomicide and suicide continue to be major killers of adolescents in the United States. Gun homicide kills teens in the most urban areas of the United States at the same rate as suicide kills teens in the most rural areas of the United States. Research on assault-injured youth sheds light on risk factors for teen gun homicide, and has found high rates of illegal gun carrying and retaliatory attitudes among at-risk teens. Suicide research continues to show a strong correlation between gun ownership and accessibility, and risk of completed suicide. Stand Your Ground laws and campus carry laws present unique threats to different populations of American teens.SummaryGiven the enormous toll that gun violence takes on adolescent lives, pediatricians should ask about guns in the home and become involved in efforts to strengthen laws that would decrease gun violence.
Clinical Use of Infliximab Trough Levels and Antibodies to Infliximab in Pediatric Patients With Inflammatory Bowel Disease
Authors: Merras‐Salmio Laura , Kolho Kaija‐Leena 
Published: May 2016

ABSTRACTObjectives:Optimizing infliximab (IFX) treatment in pediatric patients with inflammatory bowel disease (IBD) by using serum infliximab (S‐IFX) trough levels and antibodies to IFX is recommended. There is need for studies assessing this strategy in clinical practice.Methods:We retrospectively identified all pediatric patients with IBD (n = 146, median age 14.8 years) treated with IFX at our tertiary referral center from 2003 to 2014. All were analyzed for IFX trough levels (S‐IFX, n = 475), and IFX antibody (IFX‐Ab, n = 219) titers were included. Both were analyzed using enzyme‐linked immunosorbent assay. We correlated these parameters with concurrently analyzed fecal calprotectin levels and the treatment outcome.Results:If IFX had no efficacy, or a loss of response occurred, 40 of 64 (63%) had trough levels <2.0 mg/L, with negative IFX‐Ab in 37 of 59 (63%). If the S‐IFX was very low (<0.2 mg/L), 4 of 36 still had negative IFX‐Ab. Concurrent azathioprine therapy did not relate to IFX‐Ab. Fecal calprotectin was significantly lower in patients with clinical remission or ongoing therapy compared with those with subsequent loss of efficacy: medians 95 μg/g (33–308) and 670 μg/g (264–1473), P < 0.0001. The S‐IFX median was substantially higher in patients with either remission or ongoing therapy, compared with those with no or loss of efficacy: 3.7 mg/L (1.8–5.4) and 1.2 mg/L (0.03–4.4, P = 0.01), respectively.Conclusions:Measuring IFX trough levels and fecal calprotectin has a potential impact on the treatment strategies and should be included in clinical routine. Low IFX trough levels associate with increased antibodies to IFX in most, but not in all cases.
Invasive Duct Carcinoma of the Breast With Dominant Signet-Ring Cell Differentiation: A Microsatellite Stable Tumor With Aggressive Behavior
Authors: Chatterjee Debajyoti , Bal Amanjit , Das Ashim , Kohli Pavneet S. , Singh Gurpreet , Mittal Bhagwant Rai 
Published: May 2016

Aims:
Invasive duct carcinoma, no special type (IDC, NST), of the breast with signet-ring cell differentiation is uncommon. This study was undertaken to describe the clinicopathologic characteristics of IDC, NST, with dominant signet-ring cell differentiation, and look for microsatellite instability in these tumors.

Methods:
Cases of IDC, NST, with dominant signet-ring cell differentiation, diagnosed over the past 2 years, were retrieved. Detailed clinical and pathologic analyses were performed. Immunohistochemistry was performed for estrogen receptor, progesterone receptors, Her-2 neu, Ki-67, E-cadherin, CK7, and CK20. Microsatellite instability was examined using immunohistochemistry for the 4 mismatch repair proteins: MLH1, MSH2, MSH6, and PMS2.

Results:
Of the total 1646 cases of IDC, NST, only 5 cases showed dominant signet-ring cells (ranging from 70% to 100%) and strong E-cadherin positivity and were diagnosed as IDC, NST, with dominant signet-ring cell differentiation. The age ranged from 32 to 65 years. Two cases were of histologic grade 3 and the remaining cases were grade 2 tumors. Four patients had T2 tumor and 1 had T3 tumor. All cases had axillary lymph node metastasis and distant metastasis was present in 1 case. All cases were microsatellite stable.

Conclusions:
Signet-ring cell differentiation in IDC, NST, is rare and associated with a high histologic grade. Lymph node metastasis and distant metastasis are common, indicating an aggressive clinical behavior. Thus, they should be recognized separately as they may warrant aggressive management. However, these are microsatellite-stable tumors in contrast to signet-ring cell tumors of other organs.
Pelvic Floor Health Education: Can a Workshop Enhance Patient Counseling During Pregnancy?
Authors: Hyakutake Momoe T. , Han Vanessa , Cundiff Geoffrey W. , Baerg Lauren , Koenig Nicole A. , Lee Terry , Geoffrion Roxana 
Published: May 2016

Objectives
Pelvic floor disorders commonly affect women's quality of life. Their etiology is multifactorial, yet pregnancy and vaginal delivery (VD) are major inciting risk factors. Our objectives were to assess pelvic floor health information given by maternity providers to their pregnant patients, to create a pelvic floor health information workshop, and to determine its impact on women's preferences for mode of delivery.

Methods
This descriptive study recruited primiparous women with a singleton gestation at St Paul's Hospital in Vancouver, Canada. Participants received a 2-hour workshop describing pelvic floor disorders and pregnancy, modes of delivery, as well as strategies for maintaining pelvic floor health and preventing disease. Women completed questionnaires assessing baseline knowledge and level of comfort with different modes of delivery before and after the workshop.

Results
Forty participants completed the workshop. Seventy percent had an obstetrician, 20% had a midwife, and 10% had a family physician. Five percent of the participants reported receiving information regarding pelvic organ prolapse as well as urinary and fecal incontinence. The workshop did not influence women's preferred mode of delivery, including VD (P = 1.00), forceps-assisted VD (P = 0.48), vacuum-assisted VD (P = 0.68), postlabor cesarean delivery (P = 0.32), and elective cesarean delivery (P = 0.86).

Conclusions
Current antenatal care is lacking in the area of pelvic floor health education. Patient counseling can be enhanced via a standard workshop. Concerns about negatively influencing women's preferences for mode of delivery are unwarranted, as the pelvic floor health workshop, given during pregnancy, did not significantly change participants' preferences.
Colovaginal Fistulas: Presentation, Evaluation, and Management
Authors: Berger Mitchell B. , Khandwala Nikhila , Fenner Dee E. , Burney Richard E. 
Published: May 2016

Objective
The objective of this study was to review a single institution's experience with colovaginal fistulas to provide guidance toward identification and management of this problem.

Methods
Patients with colovaginal fistulas treated by 2 senior surgeons between January 1, 1990, and June 31, 2011, were identified. A retrospective chart review was then performed to determine presenting characteristics and history, evaluation for the fistulas, and treatment outcomes.

Results
Nineteen patients were identified. The mean age was 63.5 years and median parity of 2. 37% complained of flatus per vagina, 89% reported stool per vagina, and 68% noted vaginal discharge. Ninety-five percent had previously undergone hysterectomy. The fistulas were identified at the left vaginal apex in 90% of the subjects. Self-reported history and/or operative findings suggested diverticulitis as the most common etiology (79% of the subjects). All subjects underwent sigmoid resection with primary anastomosis, with complete symptom resolution in 84%.

Conclusions
Patients with colovaginal fistulas commonly present for primary evaluation by gynecologists. A triad of symptoms and history should trigger a high index of suspicion for colovaginal fistulas: (1) complaints of stool or flatus per vagina or foul-smelling vaginitis resistant to treatment, (2) previous hysterectomy, and (3) history of diverticulitis. The fistulas can often be visualized on speculum examination at the left vaginal apex. Rolling the patient from left to right lateral decubitus positions during a contrast enema study can improve its sensitivity. Repair of colovaginal fistulas via rectosigmoid resection and primary reanastomosis is safe and effective. We recommend multidisciplinary management involving colorectal surgery and gynecology.
Kidney Transplant Outcomes After Primary, Repeat and Kidney After Nonrenal Solid Organ Transplantation
Authors: Sood Puneet , Gao Xiaotian , Mehta Rajil , Landsittel Douglas , Wu Christine , Nusrat Rabeeya , Puttarajappa Chethan , Tevar Amit D. , Hariharan Sundaram 
Published: May 2016

Background
Improvements in renal allograft outcomes have permitted kidney transplantation after prior kidney allograft failure as well as after nonrenal solid organ transplantation. This study compares renal allograft outcomes in the 3 groups, that is, primary, repeat, and kidney after nonrenal solid organ transplantation, where transplant group was coded as a time-dependent variable.

Methods
We retrospectively reviewed registry data for kidney transplant recipients at University of Pittsburgh Medical Center from January 2000 to December 2011. We compared overall graft survival between the 3 groups using Cox regression modeling. We calculated 1-, 3-, and 5-year graft survival and half-lives for each group where feasible.

Results
The study cohort (N = 2014) consisted of group A (primary kidney transplant, n = 1578, with 7923.2 years of follow-up time), group B (repeat kidney transplant, n = 314, with 1566.7 years of follow-up time) and group C (kidney post-nonrenal solid organ transplant, n = 176, with 844.8 years of follow-up time). Of the 1578 patients in the primary kidney transplant group, 74 later received a repeat transplant and thus also have follow-up counted in the repeat kidney transplant group. The median follow-up was 56, 53, and 55 months, respectively. The 5-year actuarial and death-censored graft survival was 68.69%, 68.79%, and 66.48% and 65.53%, 67.68%, and 62.92%, respectively (P = 0.70). There was no difference in overall graft survival in the Cox-adjusted analysis (group B: odds ratio, 1.02; 95% confidence interval, 0.84-1.26; P = 0.79; group C: odds ratio, 0.96; 95% confidence interval, 0.75-1.23; P = 0.76).

Conclusions
The adjusted kidney graft survivals in the 3 groups were similar.
Phages rarely encode antibiotic resistance genes: a cautionary tale for virome analyses
Authors: Enault François , Briet Arnaud , Bouteille Léa , Roux Simon , Sullivan Matthew B. , Petit Marie-Agnès 
Published: May 2016

AbstractAntibiotic resistance genes (ARG) are pervasive in gut microbiota, but it remains unclear how often ARG are transferred, particularly to pathogens. Traditionally, ARG spread is attributed to horizontal transfer mediated either by DNA transformation, bacterial conjugation or generalized transduction. However, recent viral metagenome (virome) analyses suggest that ARG are frequently carried by phages, which is inconsistent with the traditional view that phage genomes rarely encode ARG. Here we used exploratory and conservative bioinformatic strategies found in the literature to detect ARG in phage genomes, and experimentally assessed a subset of ARG predicted using exploratory thresholds. ARG abundances in 1,181 phage genomes were vastly over-estimated using exploratory thresholds (421 predicted vs 2 known), due to low similarities and matches to protein unrelated to antibiotic resistance. Consistent with this, 4 ARG predicted using exploratory thresholds were experimentally evaluated and failed to confer antibiotic resistance inEscherichia coli. Re-analysis of available human-or mouse-associated viromes for ARG and their genomic context suggested thatbona fideARG attributed to phages in viromes were previously over-estimated. These findings provide guidance for documentation of ARG in viromes, and re-assert that ARG are rarely encoded in phages.
Seed size and its rate of evolution correlate with species diversification across angiosperms
Authors: Igea J. , Miller E. F. , Papadopulos A. S. T. , Tanentzap A. J. 
Published: May 2016

AbstractSpecies diversity varies greatly across the different taxonomic groups that comprise the Tree of Life (ToL). This imbalance is particularly conspicuous within angiosperms, but is largely unexplained. Seed mass is one trait that may help clarify why some lineages diversify more than others because it confers adaptation to different environments, which can subsequently influence speciation and extinction. The rate at which seed mass changes across the angiosperm phylogeny may also be linked to diversification by increasing reproductive isolation and allowing access to novel ecological niches. However, the magnitude and direction of the association between seed mass and diversification has not been assessed across the angiosperm phylogeny. Here, we show that absolute seed size and the rate of change in seed size are both associated with variation in diversification rates. Based on the largest available angiosperm phylogenetic tree, we found that smaller-seeded plants had higher rates of diversification, possibly due to improved colonisation potential. The rate of phenotypic change in seed size was also strongly positively correlated with speciation rates, providing rare, large-scale evidence that rapid morphological change is associated with species divergence. Our study now reveals that variation in morphological traits and, importantly, the rate at which they evolve can contribute to explaining the extremely uneven distribution of diversity across the ToL.
Inclusive education in New Zealand: rhetoric and reality
Authors: Selvaraj Judith Anne 
Published: May 2016

Purpose
– New Zealand continues to struggle with interpreting and implementing its current policy of inclusion, especially as it relates to children traditionally known as having “special educational needs”. The purpose of this paper is to trace the discursive development of institutionalised Special Education in New Zealand and examines how the funding and policy mechanisms of neoliberalism within which rights-based inclusion was introduced have complicated the planning and delivery of services in schools.

Design/methodology/approach
– The paper draws on Gillian Fulcher’s (1989) discourses of disability as they are expressed through policy documents and educational reports to examine the language and values that have underpinned the development of Special Education policy and provision in New Zealand.

Findings
– The paper has identified and attempted to explain the extent to which traditional forms of exclusion have continued to structure current policy and practice despite a paradigm shift to inclusion. It argues that this has militated against clear understanding, acceptance and success of this major paradigm shift.

Research limitations/implications
– In examining the social nature of disability, and its implications in the structures of education today, it is possible to consider opportunities for acting to address these.

Originality/value
– The value of this work is in taking an historical approach to help understand why there continues be a distance between policy rhetoric and the reality of its implementation in practice.
Heterogeneous urban traffic data and their integration through kernel-based interpolation
Authors: Chow Andy 
Published: May 2016

Purpose
This paper aims to present collection and analysis of heterogeneous urban traffic data, and integration of them through a kernel-based approach for assessing performance of urban transport network facilities. The recent development in sensing and information technology opens up opportunities for researching the use of this vast amount of new urban traffic data. This paper contributes to analysis and management of urban transport facilities.

Design/methodology/approach
In this paper, the data fusion algorithm are developed by using a kernel-based interpolation approach. Our objective is to reconstruct the underlying urban traffic pattern with fine spatial and temporal granularity through processing and integrating data from different sources. The fusion algorithm can work with data collected in different space-time resolution, with different level of accuracy and from different kinds of sensors. The properties and performance of the fusion algorithm is evaluated by using a virtual test bed produced by VISSIM microscopic simulation. The methodology is demonstrated through a real-world application in Central London.

Findings
The results show that the proposed algorithm is able to reconstruct accurately the underlying traffic flow pattern on transport network facilities with ordinary data sources on both virtual and real-world test beds. The data sources considered herein include loop detectors, cameras and GPS devices. The proposed data fusion algorithm does not require assumption and calibration of any underlying model. It is easy to implement and compute through advanced technique such as parallel computing.

Originality/value
The presented study is among the first utilizing and integrating heterogeneous urban traffic data from a major city like London. Unlike many other existing studies, the proposed method is data driven and does not require any assumption of underlying model. The formulation of the data fusion algorithm also allows it to be parallelized for large-scale applications. The study contributes to the application of Big Data analytics to infrastructure management.