bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outcome Measure Scores Predict Discharge Destination in Patients With Acute and Subacute Stroke: A Systematic Review and Series of Meta-analyses
Authors: Thorpe Emily R. , Garrett Katie B. , Smith Ashley M. , Reneker Jennifer C. , Phillips Robert S. 
Published: December 2017

Background and Purpose:
To identify the association between outcome measure score and discharge destination in adults following acute or subacute stroke in the United States.

Methods:
A systematic literature search was performed in 3 databases using the PRISMA guidelines. Cohort studies were selected that included patients with acute or subacute stroke, which explored the relationship between scores on outcome measures and discharge destination. Four meta-analyses were performed.

Results:
Nine articles met the inclusion criteria for systematic review and 5 for the series of meta-analyses. For every 1-point increase on the Functional Independence Measure (FIM), a patient is approximately 1.08 times more likely to be discharged home than to institutionalized care (odds ratio [OR] = 1.079; 95% confidence interval [CI], 1.056- 1.102). Patients with stroke who performed above-average (FIM ≥80; NIH Stroke Scale [NIHSS] score ≤5; etc) are 12 times (OR = 12.08; 95% CI, 3.550-41.07) more likely to discharge home. Patients who perform poorly (FIM ≤39; NIHSS score ≥14), experience discharge to institutionalized care 3.4 times (OR = 3.385; 95% CI, 2.591-4.422) more likely than home, with skilled nursing facility admission more likely than inpatient rehabilitation facility. Patients who perform average (FIM = 40-79; NIHSS score = 6-13) are 1.9 times (OR = 1.879; 95% CI, 1.227-2.877) more likely to be discharged to institutionalized care.

Discussion and Conclusion:
Outcome measure scores are strong predictors of discharge destination among patients with stroke and provide an objective means of early discharge planning. Discharge decisions should be made with consideration for patient-specific biopsychosocial factors that may supersede isolated results of the outcome measures, and further research needs to assess the success of the location that a patient is referred at discharge.

Video Abstract available for more insights from the authors (see Video, Supplemental Digital Content 1, http://links.lww.com/JNPT/A194).
Pulmonary Tumor Thrombotic Microangiopathy
Authors: Hutchinson Josh Curtis , Fulcher James W. , Hanna Jeff , Ward Michael E. 
Published: December 2017

Abstract
Pulmonary tumor thrombotic microangiopathy (PTTM) is a rare rapidly progressive fatal disease that is difficult to diagnosis antemortem. Activation of the coagulation cascade and fibrocellular intimal thickening caused by embolism of tumor cells into pulmonary vasculature leads to extensive pulmonary hypertension and eventually death. We describe a case of PTTM with association of a presumed lung adenocarcinoma primary. Although rare in nature, PTTM should be a considered diagnosis with chronic dyspnea of unknown origin, severe pulmonary hypertension coupled with right-side heart failure, in the absence of pulmonary embolism.
Randomized Clinical Trial of Lidocaine Analgesia for Transurethral Bladder Catheterization Delivered via Blunt Tipped Applicator in Young Children
Authors: Uspal Neil G. , Strelitz Bonnie , Gritton Jesse , Follmer Kristin , Bradford Miranda C. , Colton Taryn L. , Merguerian Paul A. , Klein Eileen J. 
Published: December 2017

Objective
Transurethral bladder catheterization (TUBC) is a painful, frequently performed procedure for collecting sterile urine. We sought to determine if administration of intraurethral lidocaine before TUBC using a blunt tipped syringe decreases procedural pain in young children in the pediatric emergency department.

Methods
Randomized clinical trial of children 0 to 36 months old requiring TUBC for collection of urine in a pediatric emergency department was performed. Patients received intraurethral 2% lidocaine jelly or usual care (no analgesia). Randomization was stratified by sex. Intraurethral lidocaine jelly was administered via Uro-Jet, 5 minutes before TUBC. Baseline child state, lidocaine application, TUBC, and child state 1 minute post-TUBC were videotaped. Neither providers nor parents were blinded to study arm. Videos were scored by a trained, independent, blinded reviewer using the Faces, Legs, Arms, Cry, and Consolability (FLACC) and Modified Behavioral Pain Score scales. Pain scores were compared using the Wilcoxon rank sum test. Our primary outcome was difference in FLACC scores between groups.

Results
Eighty children were enrolled in the study, and 73 had analyzable data. No differences were detected in pain by mean FLACC score between intervention (8; 95% confidence interval, 7–9) and control (9; 95% confidence interval, 8–10) groups. There were no differences between groups in mean FLACC score when stratified by age or sex or in mean Modified Behavioral Pain Score.

Conclusions
Intraurethral lidocaine for TUBC for urine collection using a blunt tipped applicator did not improve procedural pain scores. Pain scores were high across groups. Further study should be performed to improve analgesia for this highly painful procedure.
Improving Pediatric Preparedness in Critical Access Hospital Emergency Departments
Authors: Katznelson Jessica H. , Wang Jiangxia , Stevens Martha W. , Mills William A. 
Published: December 2017

Objectives
Critical access hospitals (CAH) see few pediatric patients. Many of these hospitals do not have access to physicians with pediatric training. We sought to evaluate the impact of an in situ pediatric simulation program in the CAH emergency department setting on care team performance during resuscitation scenarios.

Methods
Five CAHs conducted 6 high-fidelity pediatric simulations over a 12-month period. Team performance was evaluated using a validated 35-item checklist representing commonly expected resuscitation team interventions. Checklists were scored by assigning zero point for “yes” and 1 point for “no”. A lower final score meant more items on the list had been completed. The Kruskal-Wallis rank test was used to assess for differences in average scores among institutions. A linear mixed effects model with a random institution intercept was used to examine trends in average scores over time. P < 0.05 was considered significant.

Results
The Kruskal-Wallis rank test showed no difference in average scores among institutions. (P = 0.90). Checklist scores showed a significant downward trend over time, with a scenario-to-scenario decrease of 0.022 (P < 0.01). One hundred percent of providers surveyed in the last month stated they would benefit from ongoing scenarios.

Conclusions
Regularly scheduled pediatric simulations in the CAH emergency department setting improved team performance over time on expected resuscitation tasks. The program was accepted by providers. Implementation of simulation-based training programs can help address concerns regarding pediatric preparedness in the CAH setting. A future project will look at the impact of the program on patient care and safety.
Case Report of a 5-Year-Old With Epiglottitis
Authors: Kasem Amanda J. 
Published: December 2017

Abstract
Epiglottitis is a rarely encountered infection in pediatrics since the advent of the conjugate Haemophilus influenzae type b vaccine first introduced in the United States in 1985. However, the disease remains a much feared infection in pediatrics. The literature reiterates the importance of early recognition, avoidance of agitating the patient, and the need for securing the airway in the operating room as key and essential features to a good outcome. However, with only 1 case per 200,000 children reported in the United States in 2006, most practitioners have never encountered this infection. The following is a case of a previously healthy and immunized child who presented to our emergency department and whose condition was ultimately diagnosed as epiglottitis.
How Is Patient Safety Understood by Healthcare Professionals? The Case of Bhutan
Authors: Pelzang Rinchen , Hutchinson Alison M. 
Published: December 2017

Objective
The aim of the study was to explore how the term patient safety is understood by healthcare professionals (nurses, educators, doctors, ward managers, senior managers, and health assistants), all of whom are responsible for promoting the patient safety agenda in the Bhutanese healthcare system.

Methods
The study was conducted as a naturalistic inquiry using qualitative exploratory descriptive inquiry. A purposeful sample of 94 healthcare professionals and managers was recruited from three different hospitals, a training institute, and the Ministry of Health. Data were collected via in-depth individual interviews. All data were subsequently analyzed using thematic analysis strategies.

Results
Data analysis revealed variation in the understanding of patient safety among healthcare professionals. Although most participants understood patient safety as fundamentally concerning “doing no harm” or “reducing the risk of harm or injuries” to patients, some understood patient safety as simply having sturdy infrastructure/buildings with sufficient space to manage public health emergencies such as earthquakes, floods, and epidemics. Some confused patient safety with quality of care and patient rights.

Conclusions
Inadequate understanding of the term patient safety has potential to hinder improvement of patient safety processes and practices in the Bhutanese healthcare system. To improve patient safety in Bhutan’s healthcare system, patient safety training and education need to be provided to all categories of healthcare professionals.
Wave height estimates from pressure and velocity data at an intermediate depth in the presence of uniform currents
Authors: Basu Biswajit 
Published: December 2017

Bounds on estimates of wave heights (valid for large amplitudes) from pressure and flow measurements at an arbitrary intermediate depth have been provided. Two-dimensional irrotational steady water waves over a flat bed with a finite depth in the presence of underlying uniform currents have been considered in the analysis. Five different upper bounds based on a combination of pressure and velocity field measurements have been derived, though there is only one available lower bound on the wave height in the case of the speed of current greater than or less than the wave speed.This article is part of the theme issue ‘Nonlinear water waves’.
Hamiltonian models for the propagation of irrotational surface gravity waves over a variable bottom
Authors: Compelli A. , Ivanov R. , Todorov M. 
Published: December 2017

A single incompressible, inviscid, irrotational fluid medium bounded by a free surface and varying bottom is considered. The Hamiltonian of the system is expressed in terms of the so-called Dirichlet–Neumann operators. The equations for the surface waves are presented in Hamiltonian form. Specific scaling of the variables is selected which leads to approximations of Boussinesq and Korteweg–de Vries (KdV) types, taking into account the effect of the slowly varying bottom. The arising KdV equation with variable coefficients is studied numerically when the initial condition is in the form of the one-soliton solution for the initial depth.This article is part of the theme issue ‘Nonlinear water waves’.
Analytical approximation and numerical simulations for periodic travelling water waves
Authors: Kalimeris Konstantinos 
Published: December 2017

We present recent analytical and numerical results for two-dimensional periodic travelling water waves with constant vorticity. The analytical approach is based on novel asymptotic expansions. We obtain numerical results in two different ways: the first is based on the solution of a constrained optimization problem, and the second is realized as a numerical continuation algorithm. Both methods are applied on some examples of non-constant vorticity.This article is part of the theme issue ‘Nonlinear water waves’.
Evolution of statistically inhomogeneous degenerate water wave quartets
Authors: Stuhlmeier R. , Stiassnie M. 
Published: December 2017

A discretized equation for the evolution of random surface wave fields on deep water is derived from Zakharov's equation, allowing for a general treatment of the stability and long-time behaviour of broad-banded sea states. It is investigated for the simple case of degenerate four-wave interaction, and the instability of statistically homogeneous states to small inhomogeneous disturbances is demonstrated. Furthermore, the long-time evolution is studied for several cases and shown to lead to a complex spatio-temporal energy distribution. The possible impact of this evolution on the statistics of freak wave occurrence is explored.
This article is part of the theme issue ‘Nonlinear water waves’.
Prediction of the free-surface elevation for rotational water waves using the recovery of pressure at the bed
Authors: Henry D. , Thomas G. P. 
Published: December 2017

This paper considers the pressure–streamfunction relationship for a train of regular water waves propagating on a steady current, which may possess an arbitrary distribution of vorticity, in two dimensions. The application of such work is to both near shore and offshore environments, and in particular, for linear waves we provide a description of the role which the pressure function on the seabed plays in determining the free-surface profile elevation. Our approach is shown to provide a good approximation for a range of current conditions.This article is part of the theme issue ‘Nonlinear water waves’.
afpCOOL: An Accurate Tool for Antifreeze Protein Detection
Authors: Eslami Morteza , Shirali-hossein-zade Ramin , Takalloo Zeinab , Mahdevar Ghasem , Emamjomeh Abbasali , Hasan Sajedi Reza , Zahiri Javad 
Published: December 2017

ABSTRACTVarious cold-adapted organisms produce antifreeze proteins (AFPs), which prevent to freeze of cell fluids by resisting the growth of the ice crystal. AFPs are currently being recognized in various organisms that are living in extremely low temperatures. AFPs have several important applications in increasing freeze tolerance of plants; maintain the tissue in frozen conditions and producing cold-hardy plants using transgenic technology. Substantial differences in the sequence and structure of the AFPs, pose a challenge for researcher to identify these proteins. In this paper, we proposed a novel method for identifying AFPs using support vector machine (SVM) by incorporating 4 types of features. Results on two benchmark datasets revealed the strength of the proposed method in AFP prediction. Also, according to the results on an independent test set, our method outperformed the current state-of-the-art methods. The further analysis showed the non-satisfactory performance of the BLAST in AFP detection: more than 62% of the BLAST searches have specificity less than 10% and there is no any BLAST search with sensitivity higher than 10%. These results reveal the urgent need for an accurate tool for AFP detection. In addition, the comparison results of the discrimination power of different feature types disclosed that evolutionary features and amino acid composition are the most contributing features in AFP detection. This method has been implemented as a stand-alone tool, namely afpCOOL, for various operating systems to predict AFPs with a user friendly graphical interface.AvailabilityafpCOOL is freely available at http://bioinf.modares.ac.ir:8080/AFPCOOL/page/afpcool.ispContactDr Zahiri zahiri@modares.ac.ir
Male success against con- and heterospecific competitors indicates a positive but modest role for sexual selection as driver of speciation
Authors: Davis Jeremy S. , Moyle Leonie C. 
Published: December 2017

AbstractFor sexual selection within species to drive the evolution of reproductive isolation between lineages, sexually selected and reproductive isolating traits must both share underlying mechanisms and operate in the same direction. While some work has been done to evaluate mechanistic overlap, fewer studies have evaluated whether intraspecific sexually-selected variation is associated with elevated reproductive isolation between species. Here we evaluate this association by assessing the relationship between male reproductive success against conspecifics versus heterospecific males at each of two different mating stages. We find that male precopulatory performance (remating success following a conspecific versus a heterospecific first mating) was not associated between conspecific and heterospecific contexts, but postcopulatory success (sperm competition against conspecific versus heterospecific males) was modestly positively correlated. We discuss two lines of evidence that suggest this modest association is due to incomplete mechanistic overlap between postcopulatory competition in conspecific and heterospecific mating contexts. This study provides an explicit test of a necessary condition for sexual selection to drive speciation, and finds that while sexual selection is not individually sufficient to explain the magnitude of reproductive isolation in this system, it could nonetheless facilitate the evolution of isolation via postcopulatory sperm competition.
Enrichment of de novo mutations in non SNP sites in autism spectrum disorders and an empirical test of the neutral DNA model
Authors: Zhang Ye , Huang Shi 
Published: December 2017

AbstractThe genetic basis of autism spectrum disorders (ASD) remains better understood and might concern only a small fraction of the genome if the neutral theory were true. We here analyzed published de novo mutations (DNMs) in ASD and controls. We found that DNMs in normal subjects occurred at positions bearing SNPs at least 3.45 fold more frequent than expected from the neutral theory, whereas DNMs in ASD were less frequent relative to those in controls, especially so for common SNPs with minor allele frequency >0.01. Among sites bearing both SNPs and DNMs, DNMs in controls occurred significantly more frequent than DNMs in ASD at reference allele sites bearing C or G nucleotides, indicating depletion of ASD associated DNMs in known regions of hypermutability or less functional constraints such as CpG sites. We also analyzed the nucleotide compositions of DNMs and the parity (1:1 ratio) of pyrimidines and purines. We found that DNMs in ASD showed overall lower AT content than that in controls. Parity violations and AT bias in DNMs occurred at expected frequency based on chance in both ASD and controls. These results show enrichment of DNMs at positions bearing SNP sites and C or G sites in normal subjects and less so in ASD, which is not expected from the neutral model, and indicate that DNMs are on average more deleterious in ASD than in controls.
Acto-myosin driven functional nanoclusters of GPI-anchored proteins are generated by integrin receptor signaling
Authors: Kalappurakkal Joseph Mathew , Anilkumar Anupama Ambika , Patra Chandrima , van Zanten Thomas S. , Sheetz Michael P. , Mayor Satyajit 
Published: December 2017

SUMMARYGPI-anchored protein (GPI-AP) nanoclusters are generated by cortical acto-myosin activity. While our understanding of the physical principles behind this process is emerging, the molecular machinery required for the generation of these nanoclusters is unknown. Here, we show that ligand-mediated membrane receptor signaling triggers nanocluster formation. Both soluble and surface-tethered RGD ligands bind the β1-integrin receptor and activate focal adhesion and src-kinases, resulting in RhoA signaling. This cascade ultimately triggers actin-nucleation via specific formins, driving nanoclustering of both GPI-APs and a model transmembrane protein with an actin-binding domain. Integrin signaling concurrently results in talin mediated activation of vinculin. This is necessary for the coupling of the dynamic actin machinery to the inner leaflet driving GPI-AP nanoclustering. Disruption of GPI-AP nanoclustering in either GPI-anchor remodeling mutants or in cells that express vinculin mutants, provide evidence that these nanoclusters are necessary for activating cell spreading, a hallmark of integrin function.
Measuring the net outcome of conditional mutualism: a case study with oaks and scatterhoarding rodents
Authors: Bogdziewicz Michał , Crone Elizabeth E. , Zwolak Rafał 
Published: December 2017

AbstractNumerous interactions between plants and animals vary in their outcome between antagonism and mutualism, but it has proven to be difficult to quantify their final outcome. Interactions between plants and scatterhoarding animals provide a prime example of this phenomenon. Scatterhoarders consume large quantities of seeds (potentially reducing plant establishment), yet also disperse seeds and bury them in shallow caches (potentially improving recruitment). However, it has been rarely determined which role prevails for particular plant species. We demonstrate how plant-scatterhoarder interactions can be placed at the antagonism-mutualism continuum, with interactions between rodents and two oaks species (sessile oak Quercus petraea, and red oak Q. rubra) as an empirical example. Our approach consists of quantifying the net outcome of the interaction through assembling different vital rates (e.g. probability of seedling recruitment with and without rodents; near and far from conspecific trees; with and without seed pilferage) piecewise with a simple mathematical model. Our results indicate that during the period of the study, interactions between scatterhoarding rodents and both focal oaks were antagonistic. Even though acorn burial increased the likelihood of seedling establishment, this effect was not strong enough to compensate for the costs of seed predation. Furthermore, we found no evidence that the short-distance transportation that is usually provided by small mammals benefited early oak recruitment. Our study demonstrates how readily accessible field data can be used to gauge the outcomes in conditional mutualisms.