bluuebunny/crossref_metadata_2025_split huggingface dataset:
Teaching in High-Tech Environments: Classroom Management Revisited
Authors: Sandholtz Judith Haymore , Ringstaff Cathy , Dwyer David C. 
Published: May 2005

The addition of computers to classrooms influences not only instruction but also classroom management, producing both unexpected problems and benefits. This article summarizes the experiences of thirty-two elementary and secondary teachers as they adapted to teaching in high-access-to-technology classrooms. Using a three-stage model, this article presents the teachers' classroom management concerns, their strategies for solving problems, and their abilities to utilize the technology to their advantage. Teachers moved from frustration to success in coping with changes brought about by the introduction of technology to their classrooms. This article highlights three main issues relevant to practice and research. First, classroom management is not a skill that is mastered once and for all. Second, this article provides further support to the belief that educational change takes time. Finally, it illustrates that teacher change is not unidirectional. Teachers progress through stages of concern in an idiosyncratic manner. If I had my druthers, I don't think I would ever look at a computer again. One of my students got into the Corvus network and lost lots of information because he doesn't know what he is doing. It's a typical situation, and it's caused a major problem because now the computers are down. There are so many variables like this that we deal with on a day to day basis that I didn't anticipate being part of this program. I'm anxious for the weekend so I don't have to do anything with computers (AT, November 16, 1988).1
Trauma and Dissociation in Conversion Disorder and Chronic Pelvic Pain
Authors: Spinhoven Philip , Roelofs Karin , Moene Franny , Kuyk Jarl , Nijenhuis Ellert , Hoogduin Kees , Van Dyck Richard 
Published: May 2005

Objective: The purpose of this study was to: a) assess the link between sexual and/or physical abuse and dissociation in conversion disorder and chronic pelvic pain patients; and b) assess whether this effect is independent of level of general psychopathology. Method: This report examines data from four separate samples. Fifty-two patients with chronic pelvic pain, 61 patients with non-epileptic seizures, and two samples of patients (102 and 54) with predominantly motor or sensory types of conversion disorder were studied. Results: Using point-biserial correlations no compelling evidence for a consistent and positive association of sexual and/or physical abuse with dissociation was found. After statistically controlling for level of psychopathology using multiple regression analyses, in most of the cases the association of abuse with dissociation was no longer statistically significant. Only physical abuse predicted level of somatoform dissociation over and above level of psychopathology. Conclusion: In future clinical studies of dissociation in patients with conversion disorder and chronic pelvic pain more complex models may be needed with less exclusive reliance on historical antecedents such as childhood abuse and more emphasis on recent potentially traumatizing experiences or co-morbid psychiatric disorders.
Patient-Disease Characteristics and Coping Strategies Predict Hospitalization in Emergency Psychiatry
Authors: Schnyder Ulrich , Valach Ladislav , Mörgeli Hanspeter , Heim Edgar 
Published: May 2005

Objective: The goal of this study was to analyze how far patient-disease characteristics (sociodemographic variables, previous psychiatric treatment, way of referral, the patient's current diagnosis), and the patient's coping strategies are connected with the consecutive disposition for inpatient or outpatient treatment. Methods: Data from a one-year intake of the psychiatric emergency service at a University Hospital ( N = 1439) were monitored and analyzed with regard to the decision on treatment. Four hundred eighty-one patients were hospitalized and 530 were assigned to outpatient treatment. Two subsamples of twenty-eight patients from each group filled out the Bernese Coping Modes questionnaire before the decision with regard to the treatment disposition was taken. Results: The patient's psychiatric history, the way of referral as well as the current axis I diagnosis made a significant contribution to the treatment decision. Overall, patient-disease characteristics allowed for correct classification of 69.3 percent of cases. However, coping was a comparable predictor of hospitalization. Conclusions: It is argued that the search for patient-disease characteristics in the psychiatric emergency room should be complemented by a more extensive monitoring of the patients' way of coping with their current crisis.
Diagnosis, Treatment, Comorbidity, and Resource Utilization of Depressed Patients in a General Medical Practice
Authors: Luber M. Philip , Hollenberg James P. , Williams-Russo Pamela , DiDomenico Tara N. , Meyers Barnett S. , Alexopoulos George S. , Charlson Mary E. 
Published: May 2005

Objective: The objective of the study was to determine the effect of depression on the utilization of health care resources, after adjusting for age and comorbidity from data obtained on routine clinical practice. Method: The study is an observational cohort of 15,186 patients followed over a one-year period beginning December 1993. Comprehensive demographic, clinical, and utilization data were available from the computerized medical information system generated database of a general internal medicine practice in an urban academic medical center. Results: Four point seven percent of patients carried a provider-coded diagnosis of depression. With regards to utilization of health care resources, even after controlling for age and comorbidity, depressed patients had more primary care visits (5.3 vs. 2.9 visits, p < .001), higher rates of referral to specialists (1.1 vs. 0.5, p < .002), and radiologic tests (0.9 vs. 0.4 tests, p < .001). They had higher total outpatient charges ($1,324 vs. $701, p < .001) and total charges ($2,808 vs. $1,891, p < .001). Depressed patients also had longer length of stay when hospitalized (14.1 vs. 9.5 days, p < .002). Conclusions: Patients diagnosed as depressed had significantly higher resource utilization of all types, even after controlling for the higher burden of comorbid medical illness associated with depression.
Serotonin Reuptake Inhibitors and the Adequacy of Antidepressant Treatment
Authors: Shasha Michelle , Lyons John S. , O'Mahoney Michael T. , Miller Sheldon I. , Howard Kenneth I. , Rosenberg Alan 
Published: May 2005

Objective: To determine whether the use of serotonin reuptake inhibitors (SSRIs) improves antidepressant medication prescribing patterns for both psychiatric and non-psychiatric physicians. Data Sources/Setting: Drug utilization review of 4,103 prescriptions for antidepressant medications with patients diagnosed with depressive disorders over an eighteen-month period from the formulary records of a large insurance company. Design: Using standards developed for clinical guidelines, variation in trial and treatment adequacy between drug types and physician specialty was studied. Principal Findings: Thirty-five percent of initial antidepressant trials were not prescribed for an adequate duration or at an adequate dosage level. SSRIs were more likely to be prescribed adequately than any other antidepressant reviewed. Psychiatrists were more likely to prescribe antidepressants at an adequate dosage level, whereas non-psychiatric physicians were more likely to attain adequate duration of treatment. Conclusions: A greater reliance on SSRIs may increase the likelihood of maintaining adequacy in antidepressant treatments. Although higher in cost than other treatment choices, their lower side effect profile is likely to maximize patient satisfaction and physician and patient adherence to guidelines. In order to ensure effective and efficient antidepressant usage, such patterns must be identified and appropriate performance improvement strategies (e.g., Total Quality Improvement, critical pathways) may be employed.
Recognition of the Large Ambulatory C2D Stage of Advanced Heart Failure—A Call to Action
Authors: Dunlay Shannon M. , Pinney Sean P. , Lala Anuradha , Stewart Garrick C. , McIlvennan Colleen , Wong Renee P. , Morris Alanna A. , Pagani Francis D. , Allen Larry A. , Breathett Khadijah , Cogswell Rebecca , Colvin Monica M. , Cowger Jennifer A. , Drakos Stavros G. , Gelfman Laura P. , Kanwar Manreet K. , Kiernan Michael S. , Kittleson Michelle M. , Lewis Eldrin F. , Moazami Nader , Ogunniyi Modele O. , Pandey Ambarish , Rogers Joseph G. , Schumacher Kurt R. , Slaughter Mark S. , Tedford Ryan J. , Teuteberg Jeffrey , Valantine Hannah A. , DeFilippis Ersilia M. , Dixon Debra D. , Golbus Jessica R. , Gulati Gaurav , Hanff Thomas C. , Hsiao Stephanie , Lewsey Sabra C. , McCormick Amanda D. , Nayak Aditi , Fenton Kathleen N. , Longacre Lisa Schwartz , Shanbhag Sujata M. , Taddei-Peters Wendy C. , Stevenson Lynne Warner 
Published: February 2025

ImportanceThe advanced ambulatory heart failure (HF) population comprises patients who have progressed beyond the pillars of recommended stage C HF therapies but can still find meaningful life-years ahead. Although these patients are commonly encountered in practice, national databases selectively capture the small groups accepted for heart transplant listing or left ventricular assist devices. The epidemiology, trajectories, and therapies for other ambulatory patients with advanced HF are poorly understood.ObservationsIn December 2022, the National Heart, Lung and Blood Institute convened a team of experts to identify knowledge gaps and research priorities for the ambulatory population with limiting daily symptoms and transition toward refractory end-stage D HF, designated as stage C2D. This article summarizes the findings from that 3-day workshop. Workshop participants surveyed the initial challenges and knowledge gaps for (1) recognition of ambulatory C2D HF, (2) estimation of the magnitude of the affected population and identifiable subpopulations, and (3) physiologic phenotypes, such as low cardiac output, right HF, cardiorenal syndromes, congestive hepatopathy and frailty, which offer distinct targets for existing and emerging therapies. Social drivers of HF and patient preferences for quality/length of survival were highlighted as essential modifiers for personalization of therapies.Conclusions and RelevanceTen key points summarized workshop findings, with target cohorts for study proposed as a crucial next step. This workshop summary is intended as a call for action to address knowledge gaps and develop new strategies to improve outcomes in the large ambulatory population with C2D HF.
Artificial Intelligence–Enabled Wearable Devices and Nocturnal Scratching in Mild Atopic Dermatitis
Authors: Yang Albert F. , Patel Soham , Chun Keum San , Richards Dylan , Walter Jessica R. , Okamoto Kazuaki , Paller Amy S. , Ikoma Akihiko , Xu Shuai 
Published: February 2025

ImportanceAlthough more than 1 in 10 people experience pruritus, there are limited medical technologies that can accurately and continuously quantify and simultaneously reduce scratching behaviors through nonpharmacological methods.ObjectiveTo evaluate the accuracy and efficacy of an artificial intelligence–enabled wearable sensor with closed-loop haptic feedback to decrease nocturnal scratch in patients with mild atopic dermatitis who report a moderate to severe degree of scratching.Design, Setting, and ParticipantsThis single-arm 2-stage cohort study with a within-participants design was conducted at a single center and carried out in an at-home environment. Adult patients with atopic dermatitis were recruited from the Northwestern University Department of Dermatology in Chicago, Illinois. Participants were fluent in English, 18 years old or older, had a diagnosis of atopic dermatitis, and self-reported moderate or severe scratching behaviors. Each participant’s disease at time of recruitment was scored via the Validated Investigator Global Assessment for Atopic Dermatitis. Data were collected from April to July 2023.ExposuresHaptic feedback delivered by a wearable sensor mounted on the hand triggered whenever nocturnal scratch was detected by an artificial intelligence algorithm. Participants initially wore the sensor for sensing only for 7 nights to assess baseline nocturnal scratching and sleep parameters. This was followed by an additional 7 nights of wearing the sensor with haptic feedback activated.Main Outcomes and MeasuresRetrospective analysis was performed for scratch events and scratch duration per night and per hour of sleep opportunity. Paired t tests were used to compare changes in patient scratching behaviors before and after use of the artificial intelligence–enabled haptic feedback devices.ResultsOf 10 included patients, 6 were female, and the mean (SD) age was 36 (12) years. All patients had a Validated Investigator Global Assessment for Atopic Dermatitis score of 0 to 2 (clear to mild) who contributed a total of 104 sleep nights and 831 monitoring hours. No patients were lost to follow-up. There was a significant decrease in mean (SD) scratch events nightly (45.6 [24.0] vs 32.8 [13.0]; P = .03), a 28% difference, and mean (SD) scratch duration per hour of sleep opportunity (15.8 [10.7] seconds vs 7.9 [3.7] seconds; P = .01), a 50% difference, when haptic feedback was activated in the second week without a decrease in total sleep opportunity.Conclusions and RelevanceThis study found that haptic feedback may be used as a nonpharmacological intervention to reduce nocturnal scratching in patients with mild atopic dermatitis. Future randomized studies are needed to confirm.
Optimizing Pemphigus Management With Rituximab and Short-Term Relapse Predictors
Authors: Hébert Vivien , Hamwi Sami , Tancrède-Bohin Emmanuelle , Quéreux Gaelle , Pham-Ledard Anne , Caux Frédéric , Tedbirt Billal , Lefebvre Alexis , Cordel Nadège , Alexandre Marina , Viguier Manuelle , Jeudy Géraldine , D’Incan Michel , Debarbieux Sébastien , Brue Alexis , Duvert-Lehembre Sophie , Fenot Marion , Seta Vannina , Ingen-Housz-Oro Saskia , Lepelletier Clémence , Joly Pascal 
Published: February 2025

ImportanceRituximab is approved for the treatment of moderate to severe pemphigus. However, 20% of patients in the RITUX 3 trial relapsed within the first year of treatment.ObjectiveTo assess the outcome of an additional rituximab infusion at month 6 in patients with pemphigus who were in complete remission (CR) after rituximab regimen but had 1 or more predictors of relapse at month 3.Design, Settings, and ParticipantsThis multicenter cohort study was conducted in France from September 2018 to June 2023 to assess patients with newly diagnosed pemphigus who were in CR after treatment with the RITUX 3 regimen but had predictors of relapse at month 3. Relapse factors were a Pemphigus Disease Area Index (PDAI) score of 45 or higher, desmoglein 1 (DSG1) antibodies greater than 20 IU/mL, and/or DSG3 antibodies greater than 130 IU/mL.ExposurePatients in CR at month 6 with at least 1 predictor of relapse were treated with an additional rituximab infusion at month 6.Main Outcomes and MeasuresPrimary end point was the rate of CR without corticosteroid therapy for 2 months at month 12. Secondary end points were the rate of relapse, number of patients needing to be re-treated (NNT) with rituximab to avoid a relapse, and safety.ResultsThe study population comprised 87 patients (44 females [50.6%] and 43 [49.4%] males), with a mean (SD [range]) age of 55.3 (15.2 [24-92]) years at pemphigus diagnosis. Of these, 64 patients (73.6%) had pemphigus vulgaris and 23 (26.4%) had pemphigus foliaceus. At month 6, CR had been achieved by 77 patients (88.5%), and 10 (11.5%) had persistent disease activity. Of the 77 patients in CR, 30 (39.0%) had at least 1 predictor of relapse and received an additional infusion of rituximab; 47 patients (61.0%) without a predictor did not. Two patients without a predictor and no patients with a predictor experienced relapse—an overall relapse rate of 2.6% and an NNT of 3.6 (95% CI, 1.6-46.5). The 10 patients (11.5%) with persistent disease activity at month 6 were re-treated with rituximab, 1000 mg. At month 12, the rate of CR without corticosteroid therapy for a minimum of 2 months was 72 of 77 (93.5%) among patients who had achieved CR at month 6, and 72 of 87 (82.7%) for the whole study population. Eight serious adverse effects were reported among 5 patients; there were no deaths.Conclusion and RelevanceThis multicenter cohort study indicates that using predictors such as baseline PDAI score, anti-DSG1 antibodies, and/or anti-DSG3 antibodies to initiate preemptive treatment with additional rituximab may reduce the rate of short-term relapse.
Validated Integration of Tumor Deposits in N Staging for Prognostication in Colon Cancer
Authors: Sassun Richard , Sileo Annaclara , Ng Jyi Cheng , Violante Tommaso , Gomaa Ibrahim , Mandrekar Jay , Rumer Kristen K. , McKenna Nicholas P. , Larson David W. 
Published: February 2025

ImportanceTumor deposits have prognostic value in colon cancer, but the current American Joint Committee on Cancer (AJCC) staging only considers them if there are no concurrent positive lymph nodes.ObjectiveTo devise a staging system for colon cancer by integrating counts of tumor deposits with positive lymph nodes while retaining the current AJCC staging framework.Design, Setting, and ParticipantsThis retrospective cohort study examines data from a large-volume, tertiary care center database (January 2010 through March 2023 with follow-up until December 2023) and the population-based National Cancer Database (January 2010 through December 2020 with follow-up until December 2021). Participants were adults (age 18-75 years) with stage III colon adenocarcinoma who underwent chemotherapy, and had a specified positive lymph node count and tumor deposit count were selected.ExposureA real positive lymph nodes count was developed and used to derive Sassun-Mayo N/tumor, lymph node, and metastasis (TNM) stages that were compared with the AJCC N/TNM stages.Main Outcomes and MeasuresReceiver operating characteristic (ROC) curves and Kaplan-Meier analyses for 3-year overall survival were performed to assess the efficiency of the 2 staging systems. The concordance index was used for validation using the National Cancer Database.ResultsFrom a total patient number of 11 162 (institutional) and 848 704 (national), the final patient numbers were 788 and 77 790, respectively. The institutional database patients had a mean (SD) age of 58.5 (11.5) years; there were 433 male patients (54.9%) and 355 female (45.1%). The national database patients had a mean (SD) age of 59.3 (10.6) years; there were 40 315 male patients (51.8%) and 37 475 female (48.2%). ROC curve areas were improved using the Sassun-Mayo stages (3-year death for AJCC TMN, 0.63 [95% CI, 0.57-0.69] vs 0.66 [95% CI, for 0.60-0.72] for Sassun-Mayo TNM). Kaplan-Meier curves revealed visible overlaps among AJCC N stages, which were absent in the Sassun-Mayo N stages. The concordance index in the Sassun-Mayo N/TNM stages was 0.611 and 0.616, respectively, while in the AJCC N/TNM stages, it was 0.598 and 0.606, respectively. Patients upstaged from N1 to N2 (n = 10 307; 13.2%) had a 3-year overall survival rate nearly identical to that of AJCC N2a patients. Additionally, 3001 patients (3.9%) were upstaged from N2a to N2b, indicating that 13 308 patients (17.1%) with stage III colon cancer across cohorts were understaged.Conclusions and RelevanceThis study found that Sassun-Mayo N/TNM staging provided superior overall survival stratification compared with the current AJCC staging, suggesting that their implementation could improve prognostication in colon cancer.
Double‐Sided Bifunctional Blue‐Green Light Photodetector Based on Liquid Crystalline Polymer for Light Positioning and Health Monitoring
Authors: Liu Zhefeng , Wang Rui , Han Jianing , Chen Tianhao , Deng Zichao , Sun Yalan , Zhao Yongbin , Chen Aihua 
Published: February 2025

AbstractWearable blue‐green photodetectors have attracted considerable attention in underwater and medical applications. However, semiconductor‐based photodetectors generally suffer from inevitable performance deterioration because of elastic modulus mismatch between rigid inorganic materials and polymer matrixes. Besides, most of the photodetectors reported so far can't be used on both sides and the multiple functionalizations can only be realized by stacking different types of devices. Herein, an intrinsically flexible and size‐customizable blue‐green photodetector has been fabricated based on well‐designed composite fabrics with oriented electrospun fibers, consisting of pseudo‐stilbene azobenzene‐containing cross–linked liquid crystalline polymers (NAzo‐CLCP) and piezoelectric poly(vinylidene fluoride‐trifluoroethylene) [P(VDF‐TrFE)] nanogenerator. Taking advantage of the synergistic effect between liquid crystalline alignment and polymer networks, the NAzo‐CLCP devices construct a consecutive and efficient conversion of illuminance – internal stress – electric signal. A responsivity of 233 mV W−1 is achieved in voltage signals and a comparable response time of 0.1 s in current signals compared to the reported wearable semiconductor‐based photodetectors. Benefiting from the inherent flexibility and compatibility of the hydrophobic fabrics, the NAzo‐CLCP devices exhibit robust stabilities under cyclic irradiations, humidity and temperature variations, and especially slightly dynamic conditions, fulfilling basic requirements for wearable electronics. For practical applications, a photodetector array for light positioning based on blue light and a bracelet for real‐time health monitoring based on green light are developed. Profiting from the uniformity of the fabrics and the consistency of detection performance, the integrated bifunction of code transmission and health monitoring over a double‐sided one‐piece photodetector has been realized for the first time, providing extensive potential for wearable electronics based on the NAzo‐CLCP fabrics.
Kidney Fibrosis In Vitro and In Vivo Models: Path Toward Physiologically Relevant Humanized Models
Authors: Addario Gabriele , Moroni Lorenzo , Mota Carlos 
Published: February 2025

AbstractChronic kidney disease (CKD) affects over 10% of the global population and is a leading cause of mortality. Kidney fibrosis, a key endpoint of CKD, disrupts nephron tubule anatomy and filtration function, and disease pathomechanisms are not fully understood. Kidney fibrosis is currently investigated with in vivo models, that gradually support the identification of possible mechanisms of fibrosis, but with limited translational research, as they do not fully recapitulate human kidney physiology, metabolism, and molecular pathways. In vitro 2D cell culture models are currently used, as a starting point in disease modeling and pharmacology, however, they lack the 3D kidney architecture complexity and functions. The failure of several therapies and drugs in clinical trials highlights the urgent need for advanced 3D in vitro models. This review discusses the urinary system's anatomy, associated diseases, and diagnostic methods, including biomarker analysis and tissue biopsy. It evaluates 2D and in vivo models, highlighting their limitations. The review explores the state‐of‐the‐art 3D‐humanized in vitro models, such as 3D cell aggregates, on‐chip models, biofabrication techniques, and hybrid models, which aim to mimic kidney morphogenesis and functions. These advanced models hold promise for translating new therapies and drugs for kidney fibrosis into clinics.