bluuebunny/crossref_metadata_2025_split huggingface dataset:
Supplemental dose of antithrombin use in disseminated intravascular coagulation patients after abdominal sepsis
Authors: Matsui Hiroki , Fushimi Kiyohide , Yasunaga Hideo , Tagami Takashi 
Published: May 2015

SummaryThe effectiveness of supplemental dose antithrombin administration (1,500 to 3,000 IU/ day) for patients with sepsis-associated disseminated intravascular coagulation (DIC), especially sepsis due to abdominal origin, remains uncertain. This was a retrospective cohort study of patients with mechanically ventilated septic shock and DIC after emergency surgery for perforation of the lower intestinal tract using a nationwide administrative database, Japanese Diagnosis Procedure Combination inpatient database. A total of 2,164 patients treated at 612 hospitals during the 33-month study period between 2010 and 2013 were divided into an antithrombin group (n=1,021) and a control group (n=1,143), from which 518 propensity score-matched pairs were generated. Although there was no significant 28-day mortality difference between the two groups in the unmatched groups (control vs antithrombin: 25.7 vs 22.9 %; difference, 2.8 %; 95 % confidence interval [CI], –0.8–6.4), a significant difference existed between the two groups in propensity-score weighted groups (26.3 vs 21.7 %; difference, 4.6 %; 95 % CI, 2.0–7.1) and propensity-score matched groups (27.6 vs 19.9 %; difference, 7.7 %; 95 % CI, 2.5–12.9). Logistic regression analyses showed a significant association between antithrombin use and lower 28-day mortality in propensity-matched groups (odds ratio, 0.65; 95 % CI, 0.49–0.87). Analysis using the hospital antithrombin-prescribing rate as an instrumental variable showed that receipt of antithrombin was associated with a 6.5 % (95 % CI, 0.05–13.0) reduction in 28-day mortality. Supplemental dose of antithrombin administration may be associated with reduced 28-day mortality in sepsis-associated DIC patients after emergency laparotomy for intestinal perforation.
Misdiagnosis of Myocardial Infarction Related to Limitations of the Current Regulatory Approach to Define Clinical Decision Values for Cardiac Troponin
Authors: Wildi Karin , Gimenez Maria Rubini , Twerenbold Raphael , Reichlin Tobias , Jaeger Cedric , Heinzelmann Amely , Arnold Christiane , Nelles Berit , Druey Sophie , Haaf Philip , Hillinger Petra , Schaerli Nicolas , Kreutzinger Philipp , Tanglay Yunus , Herrmann Thomas , Moreno Weidmann Zoraida , Krivoshei Lian , Freese Michael , Stelzig Claudia , Puelacher Christian , Rentsch Katharina , Osswald Stefan , Mueller Christian 
Published: May 2015

Background—
Misdiagnosis of acute myocardial infarction (AMI) may significantly harm patients and may result from inappropriate clinical decision values (CDVs) for cardiac troponin (cTn) owing to limitations in the current regulatory process.

Methods and Results—

In an international, prospective, multicenter study, we quantified the incidence of inconsistencies in the diagnosis of AMI using fully characterized and clinically available high-sensitivity (hs) cTn assays (hs-cTnI, Abbott; hs-cTnT, Roche) among 2300 consecutive patients with suspected AMI. We hypothesized that the approved CDVs for the 2 assays are not biologically equivalent and might therefore contribute to inconsistencies in the diagnosis of AMI. Findings were validated by use of sex-specific CDVs and parallel measurements of other hs-cTnI assays. AMI was the adjudicated diagnosis in 473 patients (21%). Among these, 86 patients (18.2%) had inconsistent diagnoses when the approved uniform CDV was used. When sex-specific CDVs were used, 14.1% of female and 22.7% of male AMI patients had inconsistent diagnoses. Using biologically equivalent CDV reduced inconsistencies to 10% (
P
<0.001). These findings were confirmed with parallel measurements of other hs-cTn assays. The incidence of inconsistencies was only 7.0% for assays with CDVs that were nearly biologically equivalent. Patients with inconsistent AMI had long-term mortality comparable to that of patients with consistent diagnoses (
P
=NS) and a trend toward higher long-term mortality than patients diagnosed with unstable angina (
P
=0.05).

Conclusions—
Currently approved CDVs are not biologically equivalent and contribute to major inconsistencies in the diagnosis of AMI. One of 5 AMI patients will receive a diagnosis other than AMI if managed with the alternative hs-cTn assay.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT00470587.
Comprehensive Stroke Centers May Be Associated With Improved Survival in Hemorrhagic Stroke
Authors: McKinney James S. , Cheng Jerry Q. , Rybinnik Igor , Kostis John B. ,   the Myocardial Infarction Data Acquisition System (MIDAS 22) Study Group
Published: May 2015

Background

Comprehensive stroke centers (
CSC
s) provide a full spectrum of neurological and neurosurgical services to treat complex stroke patients.
CSC
s have been shown to improve clinical outcomes and mitigate disparities in ischemic stroke patients. It is believed that
CSC
s also improve outcomes in hemorrhagic stroke.

Methods and Results

We used the Myocardial Infarction Data Acquisition System (
MIDAS
) database, which includes data on patients discharged with a primary diagnosis of intracerebral hemorrhage (
ICH;
International Classification of Diseases, Ninth Revision [
ICD
‐9] 431) and subarachnoid hemorrhage (
SAH; ICD
‐9 430) from all nonfederal acute care hospitals in New Jersey (
NJ
) between 1996 and 2012. Out‐of‐hospital deaths were assessed by matching
MIDAS
records with
NJ
death registration files. The primary outcome variable was 90‐day all‐cause mortality. The primary independent variable was
CSC
versus primary stroke center (
PSC
) and nonstroke center (
NSC
) admission. Multivariate logistic models were used to measure the effects of available covariates. Overall, 36 981 patients were admitted with a primary diagnosis of
ICH
or
SAH
during the study period, of which 40% were admitted to a
CSC
. Patients admitted to
CSC
s were more likely to have neurosurgical or endovascular interventions than those admitted to a
PSC
/
NSC
(18.9% vs. 4.7%;
P
<0.0001).
CSC
admission was associated with lower adjusted 90‐day mortality (35.0% vs. 40.3%; odds ratio, 0.93; 95% confidence interval, 0.89 to 0.97) for hemorrhagic stroke. This was particularly true for those admitted with
SAH
.

Conclusions

Hemorrhagic stroke patients admitted to
CSC
s are more likely to receive neurosurgical and endovascular treatments and be alive at 90 days than patients admitted to other hospitals.
Identity Formation through Classroom Conversations and Collaboration with the Spirit
Authors: Holm Neil 
Published: May 2015

Miroslav Volf argues that God intends human beings to be co-workers with God in completing creation. Teachers in the classroom can be co-workers with God through the formation of students. Formation occurs, in part, through mutual relationships such as those between the person of the teacher and the person of the pupil. Conversations are important to formation and the Holy Spirit makes a major contribution to revelatory conversations. Martin Buber, Parker Palmer, Rowan Williams, and Simone Weil show how conversations contribute to formation and to the creation of a mutual presence and grace between conversational partners so that there is an exchange of words and feelings that resonates with the creative word of God working in the depths of the identity of each person. This process is described as a spiritual theology of teaching.
The Effect of the Sociology of Religion on Theology, a Holy Struggle for Power: A Mini-Festschrift
Authors: Mol Hans 
Published: May 2015

Jesus' kingdom involves suffering and self-denying service, unlike the power hierarchy of a worldly order. In his commentary on Matthew, Calvin saw that holy organizations are not free from corruption, and that power is a dangerous thing. In his commentary on Isaiah 42:1-9, Christ is the humble servant who came to bring the world under God's authority. Christ also represents peace, reconciling those separated from God or one another. How relevant are these bible references, and Calvin's comments for our day? (It is intriguing that Calvin reproved those who did not use ‘the works of the ungodly’ in physics, symbiotics, mathematics, etc). Mol would add (for Calvin) anthropology, psychology, sociology and political science. The areas of relevance are: Disorder and conflict minimization, where selfishness and pride endanger the social bond, whereas self-denial strengthens it. The global mission of the faith, associated with which are language- learning, health and education facilities, and the well-being of the poor. Organizational corruption, when social science organizations ‘bend’ content to suit their ends, and functional questions are not entertained.
Happiness
Authors: Andersen William 
Published: May 2015

The Dalai Lama has said: “the purpose of life is to seek happiness.” First, a biblical view of happiness is presented. Second, a brief description of the philosophical stances: Hedonism, Eudaimonia, Utilitarianism and Tibetan Buddhism. Third, the Positve Psychology of Martin Seligman, where happiness is seen as an outcome of the morally good life. In contrast, the efforts of C. S. Lewis to discover general moral laws are displayed. Similarly those of Wallace, Havel and Hill to discover a limited values consensus. The Seligman project is noble, but somewhat hasty and superficial in its current statement. Happiness is a by-product emerging in pursuit of an ultimately worthwhile goal.
Your Children's Education: Duties in Christian Education, by Parents as Teachers, and Children as Learners
Authors: Brattston David W T 
Published: May 2015

This article reviews the proper content and considerations for Christians in educating their children, as put forward by the authors of the New Testament and other Christian literature before AD 250, who wrote when oral teachings and Bible interpretations of Christ and the apostles were still current in Christian memories. The paper relates or summarises: the general duty of Christian parents to provide education for their children; the content of Christian education, especially ethics; how parents are to perform their task of educating; the obligations on Christian children as learners; and the double standard, whereby Christian students may learn material incompatible with Christian belief but a Christian is forbidden to teach such material.
The Journal of Christian Education: Through Others' Lenses
Authors: Rossiter Graham , Francis Leslie J. , Shortt John , Cooling Trevor 
Published: May 2015

We sensed it would be fitting to invite several ‘critical friends’ of the Journal of Christian Education—those who are likely to have seen it as a significant forum for international thinking on Christians in education—to write a brief testimony to how they personally have perceived the value of the journal. Here we have included the comments of four such academic colleagues: one from Australia and three from the UK. While the geographical spread of these four is limited, we are sure there are past and present JCE readers in other regions who would also offer insights attesting to the value of the journal in their lives, professionally and personally.
Integrating Human Factors Engineering and Information Processing Approaches to Facilitate Evaluations in Criminal Justice Technology Research
Authors: Salvemini Anthony V. , Piza Eric L. , Carter Jeremy G. , Grommon Eric L. , Merritt Nancy 
Published: May 2015

Background: Evaluations are routinely conducted by government agencies and research organizations to assess the effectiveness of technology in criminal justice. Interdisciplinary research methods are salient to this effort. Technology evaluations are faced with a number of challenges including (1) the need to facilitate effective communication between social science researchers, technology specialists, and practitioners, (2) the need to better understand procedural and contextual aspects of a given technology, and (3) the need to generate findings that can be readily used for decision making and policy recommendations. Objectives: Process and outcome evaluations of technology can be enhanced by integrating concepts from human factors engineering and information processing. This systemic approach, which focuses on the interaction between humans, technology, and information, enables researchers to better assess how a given technology is used in practice. Subjects: Examples are drawn from complex technologies currently deployed within the criminal justice system where traditional evaluations have primarily focused on outcome metrics. Although this evidence-based approach has significant value, it is vulnerable to fully account for human and structural complexities that compose technology operations. Conclusions: Guiding principles for technology evaluations are described for identifying and defining key study metrics, facilitating communication within an interdisciplinary research team, and for understanding the interaction between users, technology, and information. The approach posited here can also enable researchers to better assess factors that may facilitate or degrade the operational impact of the technology and answer fundamental questions concerning whether the technology works as intended, at what level, and cost.
Perfusion and pH MRI in familial hemiplegic migraine with prolonged aura
Authors: Blicher Jakob Udby , Tietze Anna , Donahue Manus J , Smith Seth A , Østergaard Leif 
Published: May 2015

Introduction To investigate tissue flow disturbance and hypoxia during migraine aura, we studied a case of familial hemiplegic migraine (FHM) using novel magnetic resonance imaging (MRI) techniques. Case results A 44-year-old male was admitted with suspected stroke because of confusion and aphasia. Initial gadolinium-based perfusion MRI showed a decrease in cerebral blood flow and an increase in capillary flow disturbances within the left hemisphere. Later during the prolonged aura phase, chemical exchange saturation transfer MRI indicated a drop in pH in the affected area. The patient was diagnosed with an R908Q mutation in the ATP1A2 gene causing FHM type 2. Discussion During prolonged aura in FHM, MRI shows reduced CBF, capillary flow disturbances and a possible pH drop that could indicate tissue hypoxia.
Metagenomic Analysis of Milk of Healthy and Mastitis-Suffering Women
Authors: Jiménez Esther , de Andrés Javier , Manrique Marina , Pareja-Tobes Pablo , Tobes Raquel , Martínez-Blanch Juan F. , Codoñer Francisco M. , Ramón Daniel , Fernández Leónides , Rodríguez Juan M. 
Published: May 2015

Background: Some studies have been conducted to assess the composition of the bacterial communities inhabiting human milk, but they did not evaluate the presence of other microorganisms, such as fungi, archaea, protozoa, or viruses. Objective: This study aimed to compare the metagenome of human milk samples provided by healthy and mastitis-suffering women. Methods: DNA was isolated from human milk samples collected from 10 healthy women and 10 women with symptoms of lactational mastitis. Shotgun libraries from total extracted DNA were constructed and the libraries were sequenced by 454 pyrosequencing. Results: The amount of human DNA sequences was ≥ 90% in all the samples. Among the bacterial sequences, the predominant phyla were Proteobacteria, Firmicutes, and Bacteroidetes. The healthy core microbiome included the genera Staphylococcus, Streptococcus, Bacteroides, Faecalibacterium, Ruminococcus, Lactobacillus, and Propionibacterium. At the species level, a high degree of inter-individual variability was observed among healthy women. In contrast, Staphylococcus aureus clearly dominated the microbiome in the samples from the women with acute mastitis whereas high increases in Staphylococcus epidermidis-related reads were observed in the milk of those suffering from subacute mastitis. Fungal and protozoa-related reads were identified in most of the samples, whereas Archaea reads were absent in samples from women with mastitis. Some viral-related sequence reads were also detected. Conclusion: Human milk contains a complex microbial metagenome constituted by the genomes of bacteria, archaea, viruses, fungi, and protozoa. In mastitis cases, the milk microbiome reflects a loss of bacterial diversity and a high increase of the sequences related to the presumptive etiological agents.
Parental Leave Policies and Pediatric Trainees in the United States
Authors: Dixit Avika , Feldman-Winter Lori , Szucs Kinga A. 
Published: May 2015

Background: The American Academy of Pediatrics (AAP) states that each residency program should have a clearly delineated, written policy for parental leave. Parental leave has important implications for trainees’ ability to achieve their breastfeeding goals. Objective: This study aimed to measure the knowledge and awareness among members of the AAP Section on Medical Students, Residents, and Fellowship Trainees (SOMSRFT) regarding parental leave. Methods: An online survey was emailed to SOMSRFT members in June 2013. Quantitative data are presented as percentage of respondents. Awareness of leave policies was analyzed based on having children and the sex of respondents. Results: Nine hundred twenty-seven members responded to the survey. Among those with children, 40% needed to extend the duration of their training in order to have longer maternity leave, 44% of whom did so in order to breastfeed longer. Thirty percent of respondents did not know if their program had a written, accessible policy for parental leave. Trainees without children and men were more unaware of specific aspects of parental leave such as eligibility for the Family Medical Leave Act as compared to women and those with children. Conclusion: Despite the fact that United States national policies support parental leave during pediatrics training, and a majority of programs comply, trainees’ awareness regarding these policies needs improvement.
Educating Pharmacists on a Prescription Drug Monitoring Program
Authors: Fleming Marc L. , Phan Yen , Ferries Erin A. , Hatfield Mark D. 
Published: May 2015

Objective: To provide education to community pharmacists regarding the registration and use of the Texas prescription drug monitoring program (PDMP) and to assess the impact of the education on pharmacists’ perceptions of the PDMP. Method: The study design was a descriptive, pre and post, cross-sectional survey conducted among community pharmacists attending a PDMP education program. The program was designed to present the PDMP as a public health tool available to assist pharmacists with dispensing decisions related to controlled prescription drugs. Results: Of the 24 pharmacists who completed the survey, 23 were already registered to use the PDMP. However, all 23 felt that the program successfully educated users regarding the PDMP and agreed that other community pharmacists would benefit from the program presented. After the program, 14 participants responded they would very likely use the PDMP in the next 30 days. Recognition of the use of PDMPs as a program for both pharmacists and physicians was increased from 12.5% (pre) to 73.9% (post). Conclusion: Pharmacists found the educational program beneficial and they were very likely to use the PDMP in the future. Perceptions of the Texas PDMP were changed from pre- to post-education program, with recognition that a PDMP can be a beneficial tool for pharmacy practice.
Assessment of Pharmacy Manpower and Services in New England
Authors: Robinson Evan , Shcherbakova Natalia , Backer Louise 
Published: May 2015

Objectives: This study assessed longitudinal trends in pharmacy staffing and services in the 6 New England states by comparing survey results from 2008 and 2013. Methods: A validated 32-item survey was mailed in 2008 and 2013 to a random sample of 2000 pharmacists. Each sample represented approximately 15% (2008) and 13% (2013) of the active rosters. Results: Response rates were 24% in 2008 and 23% in 2013. In all, 45% of 2013 respondents reported a pharmacist position vacancy in the past 12 months versus 62% in 2008. In all, 12% of 2013 respondents agreed or strongly agreed with a statement regarding pharmacists’ shortage versus 77% in 2008. Disease management services were reported to be offered by 23% of 2013 respondents versus 28% in 2008. Reasons for not offering the services in 2013 included the lack of staffing (61%), expertise (28%), and reimbursement (29%). In 2008, these results were 74%, 33%, and 31%, respectively. Conclusions: The pharmacist shortage within New England was alleviated during 2008 to 2013. Participation of pharmacists in disease management services did not follow staffing trends as fewer pharmacists reported providing services. Key barriers to services provision persist and consideration of how to resolve them (medication therapy management reimbursement and additional education) should be explored.
Permanence or Change: What Makes the World Tick?
Authors: Lønning Dag Jørund 
Published: May 2015

Permanence has been the dominant cosmological and social model throughout European history. This value model is founded on centralized control of power and truth, and potential success and prosperity for the individual human being is dependent upon acceptance and subordination. New development is strictly controlled and regulated. Successions of civilizations and empires have been based on this construction of being and the world. An almost diametrically opposite understanding of being was always present, however. In Heraclitus’ model of the world as Change, humans are no longer passive and subordinate receivers but active change- and future-makers. Change is no longer seen as dangerous, but rather as the prime mover of the world and therefore, also the fountain of knowledge and insight. Change is the only eternal truth and value, Heraclitus argues. Thus, strategies for meaningful and productive action must also be eternally changing. This article discusses the views of Change propagated by Heraclitus and his most famous follower, Friedrich Nietzsche. It shows how a radical change of perspective and aim, a change from models aiming for Permanence to models with a much greater allowance for and appreciation of Change, can lead to explosions of human creativity and innovation.
Day program for young people with anorexia nervosa
Authors: Green Jessica , Melvin Glenn A , Newman Louise , Jones Meaghan , Taffe John , Gordon Michael 
Published: May 2015

Objectives: This study examined changes in body mass index (BMI), anorectic cognitions, and psychological distress following day program treatment. Methods: Participants were 42 female patients from the Monash Health Butterfly eating disorder day program, with anorexia nervosa (AN) restricting type ( n = 35) or AN binge-eating/purging type ( n = 7), ranging from 12 to 24 years. Results: Participants’ BMI increased significantly over time. Higher motivation at intake predicted a greater increase in BMI over time, compared to those with lower motivation at intake. There were also significant reductions in drive for thinness, body dissatisfaction, anxiety, and depression scores, and improved motivation following two, four and six months of treatment. Conclusions: These findings provide further evidence that day programs can assist in weight restoration and improvements in psychological aspects of AN in adolescents and young adults.