bluuebunny/crossref_metadata_2025_split huggingface dataset:
Feminist Pedagogy in the Undergraduate Music Survey Course
Authors: Wilbourne Emily 
Published: April 2017

Abstract
This article considers the pragmatic difficulties of implementing feminist pedagogy in the undergraduate music history survey course. Drawing on the author’s teaching experience at the Aaron Copland School of Music, the article tackles the question of what counts as feminist pedagogy. It considers the fundamental problem of feminist scholarship and its application to the music history survey and provides pragmatic examples of how the author teaches, bridging the theoretical/practical divide that often fractures musicology in general and pedagogical speculation in particular. It also explains the author’s syllabi and a particular set writing assignments given as part of a music history survey, considering their effectiveness as components of a distinctly feminist pedagogy and how feminist goals might result in pedagogical choices that themselves seem less obviously feminist. Finally, the article reflects on whether the idea of a feminist history survey is a useful, or even feasible, goal.
Cerebral Autoregulation-oriented Therapy at the Bedside
Authors: Rivera-Lara Lucia , Zorrilla-Vaca Andres , Geocadin Romergryko G. , Healy Ryan J. , Ziai Wendy , Mirski Marek A. 
Published: April 2017

Abstract
This comprehensive review summarizes the evidence regarding use of cerebral autoregulation-directed therapy at the bedside and provides an evaluation of its impact on optimizing cerebral perfusion and associated functional outcomes. Multiple studies in adults and several in children have shown the feasibility of individualizing mean arterial blood pressure and cerebral perfusion pressure goals by using cerebral autoregulation monitoring to calculate optimal levels. Nine of these studies examined the association between cerebral perfusion pressure or mean arterial blood pressure being above or below their optimal levels and functional outcomes. Six of these nine studies (66%) showed that patients for whom median cerebral perfusion pressure or mean arterial blood pressure differed significantly from the optimum, defined by cerebral autoregulation monitoring, were more likely to have an unfavorable outcome. The evidence indicates that monitoring of continuous cerebral autoregulation at the bedside is feasible and has the potential to be used to direct blood pressure management in acutely ill patients.
Successful Continuation of Pregnancy After Treatment of Group A Streptococci Sepsis
Authors: Alhousseini Ali , Layne Mia E. , Gonik Bernard , Bryant David , Patwardhan Sanjay , Patwardhan Manasi 
Published: April 2017

BACKGROUND:
Invasive group A streptococci infections in pregnancy have historically led to severe maternal and neonatal morbidity and mortality. We are reporting a rare and novel case of successful treatment of third-trimester group A streptococci infection with early, aggressive intervention and maintenance of the pregnancy to term.

CASE:
A 35 year old woman initially presented with fever, flu-like symptoms, and preterm contractions at 34 weeks of gestation. She demonstrated signs of early stages of septic shock, ultimately attributed to group A streptococci bacteremia. Early, aggressive intervention allowed the pregnancy to continue until 38 weeks of gestation with normal maternal and neonatal outcomes.

CONCLUSION:
Early and aggressive treatment of invasive group A streptococci infection during pregnancy can potentially avoid severe maternal and perinatal morbidity and mortality with a successful continuation of pregnancy.
Maternal Cardiovascular Mortality in Illinois, 2002–2011
Authors: Briller Joan , Koch Abigail R. , Geller Stacie E. ,   for the Illinois Department of Public Health Maternal Mortality Review Committee Working Group
Published: April 2017

OBJECTIVE:
To describe the demographic characteristics of women in Illinois who died from cardiovascular disease during pregnancy or up until 1 year postpartum, addressing specific etiologies, timing of death, proportion of potentially preventable mortality, and factors associated with preventability.

METHODS:
This is a retrospective analysis from the Illinois Department of Public Health Maternal Mortality Review process using International Classification of Diseases, 9th Revision codes that attributed cardiovascular disease as the immediate or underlying cause of maternal death in Illinois from 2002 to 2011. We categorized the etiology of cardiovascular mortality, analyzed demographic factors associated with cardiovascular mortality in comparison with noncardiovascular causes, defined the relationship to pregnancy, and identified factors associated with preventability.

RESULTS:
There were 636 deaths in Illinois from 2002 to 2011 of pregnant women or within 1 year postpartum. One hundred forty women (22.2%) died of cardiovascular causes, for a cardiovascular mortality rate of 8.2 (95% confidence interval 6.9–9.6) per 100,000 live births. Women with cardiovascular mortality were likely to be older and die postpartum. The most common etiologies were related to acquired cardiovascular disease (97.1%) as compared with congenital heart disease (2.9%). Cardiomyopathy was the most common etiology (n=39 [27.9%]), followed by stroke (n=32 [22.9%]), hypertensive disorders (n=18 [12.9%]), arrhythmias (n=15 [10.7%]), and coronary disease (n=13 [9.3%]). Nearly 75% of cardiac deaths were related to pregnancy as compared with 35.3% of noncardiac deaths. More than one fourth of cardiac deaths (28.1%) were potentially preventable, attributable primarily to health care provider and patient factors.

CONCLUSION:
From 2002 to 2011, more than one fifth of maternal deaths in Illinois were attributed to cardiovascular disease such as cardiomyopathy. More than one fourth of these deaths were potentially preventable. Health care provider and patient factors were identified, which may be modifiable through education and intensive postpartum monitoring, which may diminish mortality. State maternal mortality reviews can identify opportunities for reducing maternal deaths.
Accommodating Immigrant Women's Preferences for Female Health Care Providers
Authors: Aubrey Christa , Mumtaz Zubia , Patterson Patrick B. , Chari Radha , Mitchell B. F. (Peter) 
Published: April 2017

OBJECTIVE:
To investigate obstetricians' perspectives of the importance, effect, and challenges of providing intrapartum care to immigrant women who request a female obstetrician.

METHODS:
A focused ethnography was conducted at a large teaching hospital, which serves a high proportion of immigrant clientele (predominantly North or East African, Middle Eastern, and South Asian) in Edmonton, Alberta, Canada. Data collection comprised single, semistructured interviews with a purposive sample of 20 obstetric health care providers (10 resident and 10 staff obstetricians). Interviews were audio-recorded and transcribed verbatim. Data were managed with Quirkos and analyzed using thematic analysis.

RESULTS:
A total of 13 female and seven male physicians were interviewed. Physicians recognized the validity of immigrant women's preference and requests for female health care providers and expressed sympathy for them. However, they were also resistant and expressed several concerns about accommodating these requests, including fear of perpetuating and exacerbating gender inequalities in medicine, the extent to which patient decision-making was coercion-free, the ability of the health system to meet the demands, and implications for training and quality of care.

CONCLUSION:
Although physicians were sympathetic to immigrant women's requests for female obstetricians, they placed greater value on maintaining gender equity both within the medical profession and in wider society and resisted accommodating gender-of-health-care-provider requests. Our qualitative study suggests a need for greater research to inform policy that meets the professional and personal values of both physicians and patients.
Comparison of Vaginal Hysterectomy Techniques and Interventions for Benign Indications
Authors: Jeppson Peter C. , Balgobin Sunil , Rahn David D. , Matteson Kristen A. , Dieter Alexis A. , Ellington David R. , Aschkenazi Sarit O. , Grimes Cara , Mamik Mamta M. , Balk Ethan M. , Murphy Miles ,   for the Society of Gynecologic Surgeons Systematic Review Group
Published: April 2017

OBJECTIVE:
To create evidence-based clinical practice guidelines based on a systematic review of published literature regarding the risks and benefits of available preoperative, intraoperative, and postoperative technical steps and interventions at the time of vaginal hysterectomy for benign indications.

DATA SOURCES:
We systematically searched the literature to identify studies that compared technical steps or interventions during the preoperative, intraoperative, and postoperative periods surrounding vaginal hysterectomy. We searched MEDLINE, Cochrane Central Register of Controlled Trials, Health Technology Assessments, and ClinicalTrials.gov from their inception until April 10, 2016, using the MeSH term “Hysterectomy, Vaginal” and associated text words. We included comparative studies, single-group studies, and systematic reviews published in English.

METHODS OF STUDY SELECTION:
We double-screened 4,250 abstracts, identifying 60 eligible studies. Discrepancies were adjudicated by a third reviewer. We followed standard systematic review methodology and the Grades for Recommendation, Assessment, Development and Evaluation approach to evaluate the evidence and generate guideline recommendations.

TABULATION, INTEGRATION, AND RESULTS:
Because of limited literature, only 16 perioperative risks, technical steps, and interventions were identified: obesity, large uteri, prior surgery, gonadotropin-releasing hormone agonists, vaginal antisepsis, bilateral salpingo-oophorectomy, morcellation, apical closure, uterine sealers, hemostatic injectants, hot cone, retractor, cystoscopy, vaginal packing, bladder management, and accustimulation. We organized and reported these as four domains: patient selection, preoperative, intraoperative, and postoperative. We did not identify any patient characteristics precluding a vaginal approach; chlorhexidine or povidone is appropriate for vaginal antisepsis; vasopressin decreases blood loss by 130 cc; tissue-sealing devices decrease blood loss by 44 cc and operative time by 15 minutes with uncertain complication implications; vertical cuff closure results in 1-cm increased vaginal length; either peritoneum or epithelium can be used for colpotomy closure; and routine vaginal packing is not advised.

CONCLUSION:
Minimal data exist to guide surgeons with respect to planning and performing a vaginal hysterectomy. This study identifies available information and future areas for investigation.
Does Sex Influence Publication Productivity Among Colorectal Surgeons Participating in Fellowship Training Programs?
Authors: Geltzeiler Cristina B. , Kelley Katherine A. , Srikanth Priya , Deveney Karen E. , Diamond Sarah , Thomas Charles R. , Enestvedt Brintha K. , Tsikitis Vassiliki L. 
Published: April 2017

BACKGROUND:
Underrepresentation of highly ranked women in academic surgery is recognized.

OBJECTIVE:
Our objective was to examine whether sex differences exist in faculty representation, academic rank, and publication productivity among colorectal faculty in fellowship programs.

DESIGN:
American Society of Colon and Rectal Surgeons fellowship program faculty were identified. Bibliometric data were obtained for each faculty member, including Hirsch index, the Hirsch index divided by research career duration, and number of publications. Linear mixed-effect regression models were constructed to determine the association between the Hirsch index and the Hirsch index divided by research career duration and sex, when controlling for institutional measures. A subset analysis of academic faculty examined the association between academic rank, sex, and Hirsch index and the Hirsch index divided by research career duration.

SETTINGS:
Colorectal fellowship programs, defined as academic, satellite-academic, and nonacademic, were evaluated.

RESULTS:
Three hundred fifty-eight faculty members were examined across 55 training programs; 22% (n = 77) were women and 78% (n = 281) were men. Sixty-one percent (n = 220) practiced in an academic setting, 23% (n = 84) in a satellite-academic setting, and 15% (n = 54) in a nonacademic setting. There was no difference in median number of publications between sexes (15 vs 10, p = 0.33); men, however, had longer careers (18 vs 11 years, p < 0.001). When controlling for confounders, there was no difference in the Hirsch index (p = 0.42) or the Hirsch index divided by research career duration (p = 0.73) between sexes. Academic rank was significantly associated with Hirsch index and the Hirsch index divided by research career duration (p < 0.001) after controlling for sex.

LIMITATIONS:
Our assessment of association between publication productivity and academic rank was only possible in the subset of academic faculty. In addition, this study is limited by its retrospective nature.

CONCLUSIONS:
We found no difference in median number of publications between men and women. When controlling for possible confounders, sex was not a significant predictor of a faculty member’s publication productivity, as measured by the Hirsch index or the Hirsch index divided by research career duration; academic rank, however, was.
Use of Anal Acoustic Reflectometry in the Evaluation of Men With Passive Fecal Leakage
Authors: Hornung Benjamin R. , Telford Karen J. , Carlson Gordon L. , Mitchell Peter J. , Klarskov Niels , Kiff Edward S. 
Published: April 2017

BACKGROUND:
Men with passive fecal leakage represent a distinct clinical entity in which the pathophysiology remains unclear. Standard anorectal investigations fail to demonstrate consistent abnormalities in this group. Anal acoustic reflectometry is a new test of anal sphincter function with greater sensitivity and discriminatory ability than conventional anal manometry.

OBJECTIVE:
The aim of this study was to determine whether men with fecal leakage have an abnormality in anal sphincter function that is detectable by anal acoustic reflectometry.

DESIGN:
This was an age-matched study of continent and incontinent men.

SETTINGS:
The study was conducted at a university teaching hospital.

PATIENTS:
Male patients with isolated symptoms of fecal leakage were recruited. Anal acoustic reflectometry, followed by conventional anal manometry, was performed. Results were then compared with those from an age-matched group of men with no symptoms of anal incontinence or anorectal pathology.

MAIN OUTCOME MEASURES:
Variables measured with anal acoustic reflectometry and anal manometry in the incontinent and continent men were compared.

RESULTS:
Thirty subjects were recruited, of whom 15 were men with fecal leakage and 15 were continent men. There was a significantly higher incidence of previous anorectal surgery in the men with leakage. The anal acoustic reflectometry variables of opening and closing pressure were significantly lower in leakers compared with continent subjects (p = 0.003 and p = 0.001). Hysteresis was significantly greater in the male leaker group (p = 0.026). No difference was seen in anal manometry.

LIMITATIONS:
With a larger sample size, the effect of previous anorectal surgery and the presence of an anal sphincter defect could be clarified.

CONCLUSIONS:
Anal acoustic reflectometry is a sensitive test of anal sphincter function and, unlike anal manometry, can discriminate male leakers from continent subjects. An identifiable abnormality has been detected using anal acoustic reflectometry, which may further our understanding of the pathogenesis in this group.
Improving Triage Accuracy
Authors: Brosinski Carmen M. , Riddell Autumn J. , Valdez Sherwin 
Published: April 2017

Purpose:
The purpose of the process improvement initiative was to improve the percentage of undertriaged patients to less than 10% (benchmark) using the Emergency Severity Index tool. Undertriaged patients have an increased potential for poor outcomes due to a lengthier waiting room stay, which results in delay of care.

Description of the Project:
An evidence-based project designed for staff development was conducted for a 7-month period. Project procedures consisted of triage chart reviews for a 3-month period during pre– and post–Emergency Severity Index training. Emergency Severity Index refresher training for nurses triaging in the emergency department was conducted for a 1-month period.

Outcome:
Chart reviews revealed that 102 of 388 patients (26.3%) were undertriaged before Emergency Severity Index training. After Emergency Severity Index training, chart reviews depicted that 41 of 440 patients (9.3%) were undertriaged. This difference was statically significant (P < .001), when tested using a 1-sided t test at the 95% confidence level and achieving at least 80% power.

Implications:
Regardless of previous training or years of emergency department nursing experience, triage refresher training has been shown to increase accuracy of triage categorization, thus leading to a decreased risk of poor patient outcomes.
Improving Culture, One Quality Improvement Project at a Time
Authors: Vander Schaaf Emily B. , Cornett Amanda C. , Randolph Greg D. 
Published: April 2017

Context:
A culture of quality improvement (QI) values collaboration, transparency, and staff empowerment. Organizations exhibiting a culture of QI are more likely to engage in QI.

Objective:
We examined whether local health departments' (LHDs') participation in a longitudinal, experiential QI training program changes QI culture.

Design:
Prior to and following participation in a QI training program, all employees of participating LHDs were asked to complete an 8-item survey assessing components of QI culture on a 5-point scale.

Intervention:
From 2010 to 2015, multidisciplinary teams from North Carolina LHDs participated in sequential cohorts of a 6-month QI training program, during which the teams completed a QI project.

Main Outcome Measure:
We dichotomized culture survey responses, with 4 or 5 being “Supportive.” We compared adjusted proportions, using linear regression, clustering at LHD, and controlling for cohort.

Results:
Data from 42 LHDs were included. At baseline, 7.8% responded that their LHD had a supportive culture for all 8 components, compared with 12% at follow-up (P < .001), adjusted for cohort and clustering by LHD. At follow-up, the percentage of employees responding that their LHDs had supportive cultures increased for all components of culture including communication by 4.1% (95% CI: 2.0%-6.2%), problem solving by 2.9% (95% CI: 1.6%-5.5%), team work by 5.2% (95% CI: 2.5%-7.8%), vision by 4.3% (95% CI: 1.1%-7.5%), performance measures by 5.6% (95% CI: 1.6%-9.6%), recognition by 4.7% (95% CI: 1.4%-8.0%), for conflict by 5.5% (95% CI: 1.7%-9.4%), and alignment by 5.8% (95% CI: 2.3%-9.2%).

Conclusions:
Engagement with structured QI training programs—and perhaps simply completing QI projects—can cause small, but important changes in organizations' cultures, thus increasing engagement in future QI and improving overall care and services. The article demonstrates that when LHDs participate in a longitudinal, experiential QI training program, their cultures of QI improve. Local health departments participating in similar training programs might experience similar improvements in culture, increasing subsequent participation in QI projects and improving related health outcomes.
Effects of California Assembly Bill 2109 in Low Vaccination Rate Counties: Are We Looking at the Right Variables?
Authors: Rosentrater Cody , Finlayson Tracy L. , Peddecord K. Michael 
Published: April 2017

Objectives:
California Assembly Bill 2109 (AB2109) was passed in 2012 and restricted the obtainment of personal belief exemptions (PBEs) for vaccination requirements for school-aged children. This study examined changes in up-to-date (UTD) vaccination rates, PBEs, and conditionally accepted students (CASs) at 3 time points. The study also examined the association of PBEs and CASs on county and school immunization rates.

Design:
This study utilized 6 academic years of immunization data from all kindergartens in California from 2010-2011 to 2015-2016. The years were selected to include data 2 years prior to the introduction of the bill, 2 years prior to implementation, and 2 years after the new legislation went into effect in 2014. Data were analyzed for changes in variables over time at the state, county, and school levels. A Pearson correlation was performed to assess the association between CAS, PBE, and not-UTD rates in low- and high-UTD counties.

Results:
Counties with the highest percentage of unimmunized students have significantly higher mean CAS rates than PBE rates (P < .01 for all years). CASs were found to be more highly correlated with students not-UTD with immunizations than PBEs in all years studied (P < .01 for all years) and with far greater effect size in low-UTD counties (<90% UTD rate). There was a small rise in PBEs and a small reduction in UTD rates after AB2109 was signed but a fall in PBE and CAS rates and a rise in UTD rates postimplementation.

Conclusion:
Many California counties have high levels of CASs at the time of kindergarten entry. The extent to which schools require CASs to complete required vaccinations is not known, which could contribute to the pool of undervaccinated students in California. Public health officials should be vigilant to ensure that schools follow up and enforce the completion of vaccines for conditionally admitted students. This study has policy implications due to the fact that it has been revealed that there is a large undervaccinated population remaining relatively unaccounted for in California despite recent efforts.
MMTF - an efficient file format for the transmission, visualization, and analysis of macromolecular structures
Authors: Bradley Anthony R. , Rose Alexander S. , Pavelka Antonín , Valasatava Yana , Duarte Jose M. , Prlić Andreas , Rose Peter W. 
Published: April 2017

AbstractRecent advances in experimental techniques have led to a rapid growth in complexity, size, and number of macromolecular structures that are made available through the Protein Data Bank. This creates a challenge for macromolecular visualization and analysis. Macromolecular structure files, such as PDB or PDBx/mmCIF files can be slow to transfer, parse, and hard to incorporate into third-party software tools. Here, we present a new binary and compressed data representation, the MacroMolecular Transmission Format, MMTF, as well as software implementations in several languages that have been developed around it, which address these issues. We describe the new format and its APIs and demonstrate that it is several times faster to parse, and about a quarter of the file size of the current standard format, PDBx/mmCIF. As a consequence of the new data representation, it is now possible to visualize structures with millions of atoms in a web browser, keep the whole PDB archive in memory or parse it within few minutes on average computers, which opens up a new way of thinking how to implement efficient algorithms in structural bioinformatics. The PDB archive is available in MMTF file format through web services and data are updated on a weekly basis.