bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Implications of Missed Opportunities to Diagnose Appendicitis in Children
Authors: Naiditch Jessica A. , Lautz Timothy B. , Daley Susan , Pierce Mary Clyde , Reynolds Marleta 
Published: June 2013

AbstractObjectivesThe purpose of this study was to determine the fraction of children with acute appendicitis who had recent false‐negative diagnoses and to analyze the association of a missed diagnosis of appendicitis with patient outcome.MethodsThe records of all 816 patients who underwent appendectomy for suspected appendicitis at a free‐standing children's hospital between 2007 and 2010 were reviewed. A patient admitted or evaluated in the emergency department (ED), discharged without a diagnosis of appendicitis, and then readmitted with histopathologically confirmed appendicitis within 3 days was considered to have a “missed diagnosis.” Outcomes for this missed group were compared to those of the remainder of the appendectomy cohort.ResultsThirty‐nine patients with appendicitis (4.8%) were missed at initial presentation. The most common initial discharge diagnoses were acute gastroenteritis (43.6%), constipation (10.3%), and emesis (10.3%). The median duration from the initial evaluation to the appendicitis admission was 28.3 hours (interquartile range [IQR] = 17.0 to 39.6 hours). A missed diagnosis was associated with a longer median hospitalization (5.8 days [IQR = 4.0 to 8.1 days] vs. 2.5 days [IQR = 1.8 to 4.6 days]; p < 0.001), higher rate of perforation (74.4% vs. 29.0%; p < 0.001), higher complication rate (28.2% vs. 10.4%; p = 0.002), and higher rate of reintervention (20.5% vs. 6.2%; p = 0.003).ConclusionsOf children diagnosed with appendicitis, 4.8% may have had a missed opportunity for earlier diagnosis. These false‐negative diagnoses are associated with higher rates of perforation, postoperative complications, and need for postoperative interventions, as well as longer hospitalizations.
Computer‐facilitated Review of Electronic Medical Records Reliably Identifies Emergency Department Interventions in Older Adults
Authors: Biese Kevin J. , Forbach Cory R. , Medlin Richard P. , Platts‐Mills Timothy F. , Scholer Matthew J. , McCall Brenda , Shofer Frances S. , LaMantia Michael , Hobgood Cherri , Kizer J. S. , Busby‐Whitehead Jan , Cairns Charles B. 
Published: June 2013

AbstractObjectivesAn estimated 14% to 25% of all scientific studies in peer‐reviewed emergency medicine (EM) journals are medical records reviews. The majority of the chart reviews in these studies are performed manually, a process that is both time‐consuming and error‐prone. Computer‐based text search engines have the potential to enhance chart reviews of electronic emergency department (ED) medical records. The authors compared the efficiency and accuracy of a computer‐facilitated medical record review of ED clinical records of geriatric patients with a traditional manual review of the same data and describe the process by which this computer‐facilitated review was completed.MethodsClinical data from consecutive ED patients age 65 years or older were collected retrospectively by manual and computer‐facilitated medical record review. The frequency of three significant ED interventions in older adults was determined using each method. Performance characteristics of each search method, including sensitivity and positive predictive value, were determined, and the overall sensitivities of the two search methods were compared using McNemar's test.ResultsFor 665 patient visits, there were 49 (7.4%) Foley catheters placed, 36 (5.4%) sedative medications administered, and 15 (2.3%) patients who received positive pressure ventilation. The computer‐facilitated review identified more of the targeted procedures (99 of 100, 99%), compared to manual review (74 of 100 procedures, 74%; p < 0.0001).ConclusionsA practical, non–resource‐intensive, computer‐facilitated free‐text medical record review was completed and was more efficient and accurate than manually reviewing ED records.
Emergency Ultrasound‐assisted Examination of Skin and Soft Tissue Infections in the Pediatric Emergency Department
Authors: Marin Jennifer R. , Dean Anthony J. , Bilker Warren B. , Panebianco Nova L. , Brown Naomi J. , Alpern Elizabeth R. 
Published: June 2013

AbstractObjectivesThe objective was to evaluate the test characteristics of clinical examination (CE) with the addition of bedside emergency ultrasound (CE+EUS) compared to CE alone in determining skin and soft tissue infections (SSTIs) that require drainage in pediatric patients.MethodsThis was a prospective study of CE+EUS as a diagnostic test for the evaluation of patients 2 months to 19 years of age evaluated for SSTIs in a pediatric emergency department (ED). Two physicians clinically and independently evaluated each lesion, and the reliability of the CE for diagnosing lesions requiring drainage was calculated. Trained pediatric emergency physicians performed US following their CEs. The authors determined and compared the test characteristics for evaluating a SSTI requiring drainage for CE alone and for CE+EUS for those lesions in which the two physicians agreed and were certain regarding their CE diagnosis (clinically evident). The performance of CE+EUS was evaluated in those lesions in which the two physicians either disagreed or were uncertain of their diagnosis (not clinically evident). The reference standard for determining if a lesion required drainage was defined as pus expressed at the time of the ED visit or within 2 days by follow‐up assessment.ResultsA total of 387 lesions underwent CE+EUS and were analyzed. CE agreement between physicians was fair (κ = 0.38). For the 228 lesions for which physicians agreed and were certain of their diagnoses, sensitivity was 94.7% for CE and 93.1% for CE+EUS (difference = –1.7%; 95% confidence interval [CI] = –3.4% to 0%). The specificity of CE was 84.2% compared to 81.4% for CE+EUS (difference = –2.8%; 95% CI = –9.7% to 4.1%). For lesions not clinically evident based on CE, the sensitivity of CE was 43.7%, compared with 77.6% for CE+EUS (difference = 33.9%; 95% CI = 1.2% to 66.6%). The specificity of CE for this group was 42.0%, compared with 61.3% for CE+EUS (difference = 19.3%; 95% CI = –13.8% to 52.4%).ConclusionsFor clinically evident lesions, the addition of ultrasound (US) did not significantly improve the already highly accurate CE for diagnosing lesions requiring drainage in this study population. However, there were many lesions that were not clinically evident, and in these cases, US may improve the accuracy of the CE.
Automatic Processes and the Drinking Behavior in Early Adolescence: A Prospective Study
Authors: Peeters Margot , Monshouwer Karin , van de Schoot Rens A. G. J. , Janssen Tim , Vollebergh Wilma A. M. , Wiers Reinout W. 
Published: June 2013

BackgroundThis study examined the bi‐directional prospective link between automatic alcohol‐approach tendencies and alcohol use in a group of young adolescents (mean age = 13.6 years). The adolescents in the present study were assumed to be at‐risk of early alcohol use and later problem drinking. It was hypothesized that alcohol use and automatic approach tendencies would reinforce one another particularly in the absence of well‐developed inhibition skills.MethodsA total of 347 adolescents (N = 279 at follow‐up) from special secondary education, a risk group for the development of substance use problems, participated in the study. Automatic approach tendencies were assessed with the alcohol‐approach avoidance task, inhibition skills were assessed with the Stroop task, and alcohol used was measured using a self‐report measure.ResultsZero‐inflated Poisson analysis revealed a significant effect of automatic approach tendencies predicting alcohol use 6 months later, although only for adolescents with weaker inhibition skills.ConclusionsAutomatic approach tendencies predict future drinking behavior of young adolescents with relatively weak inhibition skills. The findings of the present study have important implications for alcohol interventions for adolescents. Results are discussed in terms of risk factors for the development of problematic alcohol use in young adolescents.
Female‐only sex‐linked amplified fragment length polymorphism markers support ZW/ZZ sex determination in the giant freshwater prawn Macrobrachium rosenbergii
Authors: Jiang Xue‐Hui , Qiu Gao‐Feng 
Published: June 2013

SummarySex determination mechanisms in many crustacean species are complex and poorly documented. In the giant freshwater prawn, Macrobrachium rosenbergii, a ZW/ZZ sex determination system was previously proposed based on sex ratio data obtained by crosses of sex‐reversed females (neomales). To provide molecular evidence for the proposed system, novel sex‐linked molecular markers were isolated in this species. Amplified fragment length polymorphism (AFLP) using 64 primer combinations was employed to screen prawn genomes for DNA markers linked with sex loci. Approximately 8400 legible fragments were produced, 13 of which were uniquely identified in female prawns with no indication of corresponding male‐specific markers. These AFLP fragments were reamplified, cloned and sequenced, producing two reliable female‐specific sequence characterized amplified region (SCAR) markers. Additional individuals from two unrelated geographic populations were used to verify these findings, confirming female‐specific amplification of single bands. Detection of internal polymorphic sites was conducted by designing new primer pairs based on these internal fragments. The internal SCAR fragments also displayed specificity in females, indicating high levels of variation between female and male specimens. The distinctive feature of female‐linked SCAR markers can be applied for rapid detection of prawn gender. These sex‐specific SCAR markers and sex‐associated AFLP candidates unique to female specimens support a sex determination system consistent with female heterogamety (ZW) and male homogamety (ZZ).
In Vitro Cardiovascular System Emulator (Bioreactor) for the Simulation of Normal and Diseased Conditions With and Without Mechanical Circulatory Support
Authors: Ruiz Paula , Rezaienia Mohammad Amin , Rahideh Akbar , Keeble Thomas R. , Rothman Martin T. , Korakianitis Theodosios 
Published: June 2013

AbstractThis article presents a new device designed to simulate in vitro flow rates, pressures, and other parameters representing normal and diseased conditions of the human cardiovascular system. Such devices are sometimes called bioreactors or “mock” simulator of cardiovascular loops (SCVLs) in literature. Most SCVLs simulate the systemic circulation only and have inherent limitations in studying the interaction of left and right sides of circulation. Those SCVLs that include both left and right sides of the circulation utilize header reservoirs simulating cycles with constant atrial pressures. The SCVL described in this article includes models for all four chambers of the heart, and the systemic and pulmonary circulation loops. Each heart chamber is accurately activated by a separate linear motor to simulate the suction and ejection stages, thus capturing important features in the perfusion waveforms. Four mechanical heart valves corresponding to mitral, pulmonary, tricuspid, and aortic are used to control the desired unidirectional flow. This SCVL can emulate different physiological and pathological conditions of the human cardiovascular system by controlling the different parameters of blood circulation through the vascular tree (mainly the resistance, compliance, and elastance of the heart chambers). In this study, four cases were simulated: healthy, congestive heart failure, left ventricular diastolic dysfunction conditions, and left ventricular dysfunction with the addition of a mechanical circulatory support (MCS) device. Hemodynamic parameters including resistance, pressure, and flow have been investigated at aortic sinus, carotid artery, and pulmonary artery, respectively. The addition of an MCS device resulted in a significant reduction in mean blood pressure and re‐establishment of cardiac output. In all cases, the experimental results are compared with human physiology and numerical simulations. The results show the capability of the SCVL to replicate various physiological and pathological conditions with and without MCS.
Low cdc27 and high securin expression predict short survival for breast cancer patients
Authors: Talvinen Kati , Karra Henna , Pitkänen Reino , Ahonen Ilmari , Nykänen Marjukka , Lintunen Minnamaija , Söderström Mirva , Kuopio Teijo , Kronqvist Pauliina 
Published: June 2013

Cell cycle regulators cdc27 and securin participate in control of the mitotic checkpoint and survey the mitotic spindle to maintain chromosomal integrity. This is achieved by their functions in metaphase–anaphase transition, DNA damage repair, enhancement of mitotic arrest and apoptosis. We report on the roles of cdc27 and securin in aneuploidy and prognosis of breast cancer. The study comprises 429 breast cancer patients with up to 22 years of follow‐up. DNA content was determined by image cytometry, and immunopositivity for cdc27 and securin was based on tissue microarrays. An inverse association between cdc27 and securin expression was observed in both image cytometric and immunohistochemical analyses. Low cdc27 and high securin expression identified patients with significant difference in disease outcome. Cdc27 and securin immunoexpression identified patients at risk of early cancer death within five years from diagnosis. In multivariate analysis, the combination of cdc27 and securin immunohistochemistry was the strongest predictor of cancer death after lymph node status. We demonstrate, for the first time in human breast cancer, the prognostic value of cdc27 and securin immunohistochemistry. Cdc27 and securin appear promising biomarkers for applications in predicting disease progression, prognostication of individual patients and potential in anti‐mitotic drug development.
Early discharge after laparoscopic or robotic partial nephrectomy: care pathway evaluation
Authors: Patel Amit , Golan Shay , Razmaria Aria , Prasad Sandip , Eggener Scott , Shalhav Arieh 
Published: June 2013

Objective
To determine the success of our clinical care pathway for laparoscopic (LPN) and robotic partial nephrectomy (RPN) and to examine factors predictive for success.
Patients and Methods
A retrospective review of our Institutional Review Board‐approved prospectively maintained minimally invasive PN database yielded 263 consecutive minimally invasive PNs from 2003 to 2010.
Patient, disease and surgery‐related factors were collected. The primary endpoint was successful implementation of the clinical pathway with discharge on postoperative day (POD 1).
Associated factors were modelled using univariate and multivariable logistic regression to determine factors predictive for success of the pathway.
Results
Overall, 157 (60%) of the patients had successful care pathway implementation with POD1 discharge, of which 46 (17%) were RPNs. The overall readmission rate was 5% (12/263) and similar for patients discharged on POD 1, 4.5% (7/157).
Several patient‐related, tumour‐related, and surgical factors were associated with care pathway success.
In a multiple logistic regression model, only surgery period (late cohort vs early cohort) was significant for successful pathway implementation (odds ratio 4.2; 95% confidence interval 2.1–8.4, P < 0.001).
Conclusions
Early discharge care pathways can be successfully implemented for LPN or RPN with low readmission rates. Care pathway success improves with institutional experience.
Does robot‐assisted laparoscopic ileocystoplasty (RALI) reduce peritoneal adhesions compared with open surgery?
Authors: Razmaria Aria A. , Marchetti Pablo E. , Prasad Sandip M. , Shalhav Arieh L. , Gundeti Mohan S. 
Published: June 2013

Objectives
To compare perioperative outcomes between open ileocystoplasty and robot‐assisted laparoscopic ileocystoplasty (RALI) in a porcine model, as objective data comparing outcomes between these two approaches in children with neurogenic bladder are lacking.
We specifically examined differences in postoperative peritoneal adhesion formation between the groups.
Materials and Methods
In all, 20 pigs were assigned to an open ileocystoplasty or RALI study arm. All the pigs underwent an initial urodynamic study (UDS).
In the RALI arm, reconstructive steps were performed intracorporeally using a standard da Vinci® system. Postoperatively, variables including first stool, weight gain, and complications were recorded.
After 42 days, the pigs underwent a final UDS followed by adhesion assessment.
Intraperitoneal adhesions were quantified by a third‐party ‘blinded’ surgeon according to previously described objective scoring systems.
Results
Preoperative variables including UDS were similar in both groups.
Overall operating time was significantly shorter for open ileocystoplasty than for RALI (149 vs 287 min, P < 0.001, respectively). Postoperatively, all variables including time to first stool, weight gain, and urodynamic parameters were similar amongst the groups.
Pigs in the open arm developed significantly more adhesions (P = 0.02) and adhesions with a higher complexity (P = 0.04).
Conclusions
In this porcine model, RALI achieved similar functional outcomes as the open approach, but required longer procedural times.
The number and complexity of surgical adhesions among the groups favoured the RALI cohort. This may be of clinical significance in the paediatric spina bifida population, who generally undergo multiple surgical procedures in their lifetime, with increased risk for development of adhesions and subsequent intestinal obstruction.
School participation, supports and barriers of students with and without disabilities
Authors: Coster W. , Law M. , Bedell G. , Liljenquist K. , Kao Y.‐C. , Khetani M. , Teplicky R. 
Published: June 2013

AbstractBackgroundWe compared school participation patterns of students ages 5–17 with and without disabilities and examined whether features of the school environment were perceived to help or hinder their participation.MethodsParents (n = 576) residing in the USA and Canada completed the Participation and Environment Measure for Children and Youth (PEM‐CY) via the internet.ResultsParents of students with disabilities reported that their children participated less frequently in school clubs and organizations and getting together with peers outside the classroom and that they were less involved in all school activities. Parents of students with disabilities also were significantly more likely to report that features of the environment hindered school participation and that resources needed to support their child's participation were not adequate.ConclusionsParents of students with disabilities report that their children are participating less in important school‐related activities. Barriers limiting school participation include features of the physical and social environment as well as limited resources.
The Questionnaire of Young People's Participation (QYPP): a new measure of participation frequency for disabled young people
Authors: Tuffrey C. , Bateman B. J. , Colver A. C. 
Published: June 2013

AbstractIntroductionThe concept of participation was introduced by the World Health Organisation in the International Classification of Functioning, Disability and Health, 2001. Instruments to measure participation have been developed for children and adults, but none specifically for adolescents. Adolescence is a life stage with distinct patterns of participation, and previous research has shown that young people with disabilities have poorer participation than the general population. The aim of this study was to develop a measure of participation frequency, covering all major domains, for young people with cerebral palsy (CP). CP was chosen as an exemplar because it is a significant cause of disability in young people, with affected individuals experiencing a range of different impairments of varying severity.MethodsA pool of 88 items was developed using the published literature, existing measures and qualitative data from young people. The item pool was revised following expert review by 17 experts. Cognitive interviews on the items were carried out with 12 young people and 12 carers; field‐testing was then undertaken with 107 young people with CP aged 13–21 years, and 540 young people from the general population to enable item reduction and to examine reliability and construct validity.ResultsThe content review resulted in a 92‐item draft questionnaire, content validity index of 93%. Cognitive interviews led to further wording changes. Following field‐testing, the questionnaire was shortened to 45 items. Known‐groups validity was demonstrated by correlation with impairment severity. Test–retest reliability was satisfactory for all domains. Internal consistency varied between domains.ConclusionThis is the first instrument developed specifically to measure frequency of participation across multiple domains for young people with disability. Use of the questionnaire in research and clinical work will enable its properties to be better understood and its generalizability to wider groups to be clearer.
A clinical study of the spectrum of photodermatoses in dark-skinned populations
Authors: Wadhwani A. R. , Sharma V. K. , Ramam M. , Khaitan B. K. 
Published: June 2013

SummaryBackgroundPhotodermatoses are characterized by an abnormal cutaneous response to ‘ordinary’ light exposure.AimTo study the spectrum of photodermatoses in populations with dark skin (skin types IV–VI) at a tertiary referral centre.MethodsConsecutive patients with skin lesions confined to or predominantly located on photoexposed parts of the body and/or with photosensitivity were enrolled in the study, and their clinical details were recorded. Diagnosis was made on clinical grounds, and relevant investigations were carried out if required. Patch and photopatch testing were carried out in patients with chronic actinic dermatitis (CAD). Selected patients with CAD also underwent phototesting with UV (ultraviolet) A and broadband UVB light.ResultsWe enrolled 362 patients (146 men, 216 women; mean age 35.6 ± 13.6 years), with mean disease duration of 3.4 years. The Fitzpatrick skin types were IV and V (52.8% and 47.2% of patients, respectively). Polymorphic light eruption (PMLE) was the commonest photodermatosis seen, affecting 59.7% of patients, followed by CAD (13.8%), collagen vascular disorders (7.7%), photoaggravated atopic dermatitis (6.1%), actinic lichen planus (ALP; 2.2%) and lichen planus pigmentosus (LPP; 1.6%). The majority (84.5%) of patients were involved in indoor work. Papular PMLE (37%) was the most common variant of PMLE, followed by pinpoint (31%), eczematous (22.2%), lichenoid (5.5%) and plaque-type (4.1%) PMLE.ConclusionsThe spectrum of photodermatoses in Indian patients with dark skin phototypes (IV and V), is similar to that reported from other parts of the world. PMLE was the commonest photodermatosis seen, with the pinpoint and lichenoid variants accounting for over one-third of the PMLE cases. ALP and LPP were also not uncommon in our dark-skinned population.