bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Time Is Now: Leveraging the Affective Domain in PT Education and Clinical Practice
Authors: Berg-Carramusa Cara A. , Mucha Matthew D. , Somers Kimberly , Piemonte Nicole 
Published: January 2023

Background and Purpose.
The traditional domains of learning are cognitive, psychomotor, and affective. These parallel the habits of head, hand, and heart as the foundations for knowing, doing, and being in health professions education. Physical therapy education is deeply rooted in a cognitive (head) and psychomotor (hand) taxonomy despite the mission, vision, and values of the profession that embody the knowledge, skills, and attitudes (KSAs) requiring competence in the affective (heart) domain. Recently, the Model for Excellence and Innovation in Physical Therapy Education and the American Council of Academic Physical Therapy excellence framework in academic physical therapy identified pedagogical variables grounded in the affective domain (AD), including shared beliefs and values, partnerships and collaborations, leadership and innovation, social responsibility and inclusion, and a drive for excellence with high expectations.

Position and Rationale.
Fully integrating the AD into physical therapy education equips the future of the profession with the KSAs to achieve the mission and vision, meet stakeholder needs, and endure the demands of clinical practice.

Discussion and Conclusion.
Explicitly using the AD in physical therapy education is imperative to the success and sustainability of the profession and in meeting critical societal needs. Engaging all learners in the AD does not require monumental curricular change. Intentional activities and strategies can develop the humanistic values of the learner across a curriculum and can shift the culture of academia from primarily cognitive and psychomotor to one that is comprehensive across all domains. The AD informs the cognitive and psychomotor aspects of learning and has direct implications for clinical practice in meeting stakeholder needs.
A Targeted Discharge Planning for High-Risk Readmissions
Authors: Park-Clinton Eunice , Renda Susan , Wang Flint 
Published: January 2023

Purpose of Study:
Racial and ethnic minorities with socioeconomic disadvantages are vulnerable to 30-day hospital readmissions. A 16-week quality improvement (QI) project aimed to decrease readmissions of the vulnerable patient populations through tailored discharge planning. The project evaluated the effectiveness of using a 25-item checklist to increase patients' and caregivers' health knowledge, skills, and willingness for self-care and decrease readmissions.

Primary Practice Setting:
The project took place in an inner-city teaching hospital in the Mid-Atlantic region.

Methodology and Participants:
A casual comparative design compared readmissions of the before-intervention group (May 1–July 31, 2021) and the after-intervention group (August 1–October 31, 2021). A pre- and postintervention design evaluated the effectiveness of a 25-item checklist by analyzing the differences of Patient Activation Measure (PAM) pre- and postintervention survey scores and levels in the after-intervention group. Participants were General Medicine Unit patients 18 years or older who had Medicare Fee-for-Service, resided in 10 zip codes near the hospital, and were discharged home.

Results:
Of 30 patients who received the intervention, one patient was readmitted compared with 11 readmissions from 58 patients who did not receive the intervention. The readmission rate was decreased from 19% to 4% during the 16-week project: 11 (19%) versus 1 (4%), p = .038. After receiving the intervention, patients' PAM scores were increased by 8.55, t(22) = 2.67, p < .014. Three patients had a lower postintervention survey level, whereas 12 patients obtained a higher postintervention survey level (p = .01). The increase in scores and levels supported that the intervention effectively improved patients' self-management knowledge, skill, and willingness for self-care.

Implications for Case Management Practice:
The QI project showed that the hospital could partner with patients at high risk for readmission and their caregivers. Accurate evaluation of patients' health knowledge, skills, and willingness for self-care was essential for sufficient discharge planning. Tailored use of the checklist improved patients' self-activation and functionally facilitated patients' and caregivers' care needs and capabilities. The checklist was statistically and clinically effective in decreasing 30-day hospital readmissions of vulnerable patient populations.
Outcome Measurement in Children With a History of Disorders of Consciousness After Severe Brain Injury: Telephone Administration of the Vineland Adaptive Behavior Scales, Third Edition, and Glasgow Outcome Scale-Extended Pediatric Revision
Authors: Ludwig Natasha N. , Suskauer Stacy J. , Rodgin Sandra , Chen Julia , Borda Allison , Jones Kara , Lahey Sarah , Slomine Beth S. 
Published: January 2023

OBJECTIVES:
Examine initial feasibility and utility of a battery of measures administered via telephone interview with a caregiver for describing long-term outcomes in individuals with a history of disorders of consciousness (DoC) after pediatric acquired brain injury (ABI).

DESIGN:
Cross-sectional.

SETTING:
Caregiver interview administered via telephone.

PATIENTS:
Convenience sample admitted to an inpatient pediatric neurorehabilitation unit with DoC after ABI at least 1 year prior to assessment (n = 41, 5–22 yr old at assessment).

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
The Vineland Adaptive Behavior Scales, Third Edition (Vineland-3), and Glasgow Outcome Scale-Extended Pediatric Revision (GOS-E Peds) were examined. Administration time of the Vineland-3 ranged from 13 to 101 minutes (m = 50) and the GOS-E Peds ranged from 2 to 10 minutes (m = 3). Vineland-3 Adaptive Behavior Composite (ABC) ranged from standard scores (SSs) of 20 (exceptionally low) to 100 (average) and GOS-E Peds scores ranged from 3 (i.e., upper moderate disability) to 7 (vegetative state). Lower adaptive functioning on the Vineland-3 ABC was strongly associated with greater disability on the GOS-E Peds (r = –0.805). On the Vineland-3 ABC, 19.5% earned the lowest possible score, whereas 12.2% obtained the lowest possible score for survivors on the GOS-E Peds; only 7.3% earned lowest scores on both measures.

CONCLUSIONS:
The Vineland-3 and GOS-E Peds were feasibly administered by telephone and were complementary in this cohort; the GOS-E provided a quick and easy measure of gross functional outcome, whereas the Vineland-3 took longer to administer but provided a greater level of detail about functioning. When both measures were used together, the range and variability of scores were maximized.
Protocol-Driven Initiation and Weaning of High-Flow Nasal Cannula for Patients With Bronchiolitis: A Quality Improvement Initiative*
Authors: Huang Jia Xin , Colwell Blair , Vadlaputi Pranjali , Sauers-Ford Hadley , Smith Brian J. , McKnight Heather , Witkowski Jessica , Padovani Andrew , Aghamohammadi Sara , Tzimenatos Leah , Beck, RN Shelli , Reneau Kriston , Nill Barbara , Harbour Dawn , Pegadiotes Jessica , Natale JoAnne , Hamline Michelle , Siefkes Heather 
Published: January 2023

OBJECTIVES:
Bronchiolitis is the most common cause for nonelective infant hospitalization in the United States with increasing utilization of high-flow nasal cannula (HFNC). We standardized initiation and weaning of HFNC for bronchiolitis and quantified the impact on outcomes. Our specific aim was to reduce hospital and ICU length of stay (LOS) by 10% between two bronchiolitis seasons after implementation.

DESIGN:
A quality improvement (QI) project using statistical process control methodology.

SETTING:
Tertiary-care children’s hospital with 24 PICU and 48 acute care pediatric beds.

PATIENTS:
Children less than 24 months old with bronchiolitis without other respiratory diagnoses or underlying cardiac, respiratory, or neuromuscular disorders between December 2017 and November 2018 (baseline), and December 2018 and February 2020 (postintervention).

INTERVENTIONS:
Interventions included development of an HFNC protocol with initiation and weaning guidelines, modification of protocol and respiratory assessment classification, education, and QI rounds with a focus on efficient HFNC weaning, transfer, and/or discharge.

MEASUREMENTS AND MAIN RESULTS:
A total of 223 children were included (96 baseline and 127 postintervention). The primary outcome metric, average LOS per patient, decreased from 4.0 to 2.8 days, and the average ICU LOS per patient decreased from 2.8 to 1.9 days. The secondary outcome metric, average HFNC treatment hours per patient, decreased from 44.0 to 36.3 hours. The primary and secondary outcomes met criteria for special cause variation. Balancing measures included ICU readmission rates, 30-day readmission rates, and adverse events, which were not different between the two periods.

CONCLUSIONS:
A standardized protocol for HFNC management for patients with bronchiolitis was associated with decreased hospital and ICU LOS, less time on HFNC, and no difference in readmissions or adverse events.
Methodology of the Second Pediatric Acute Lung Injury Consensus Conference
Authors: Iyer Narayan , Khemani Robinder , Emeriaud Guillaume , López-Fernández Yolanda M. , Korang Steven Kwasi , Steffen Katherine M. , Barbaro Ryan P. , Bembea Melania M. ,   on behalf of the Second Pediatric Acute Lung Injury Consensus Conference (PALICC-2) Group on behalf and the Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network
Published: January 2023

OBJECTIVES:
This article describes the methodology used for The Second Pediatric Acute Lung Injury Consensus Conference (PALICC-2). The PALLIC-2 sought to develop evidence-based clinical recommendations and when evidence was lacking, expert-based consensus statements and research priorities for the diagnosis and management of pediatric acute respiratory distress syndrome (PARDS).

DATA SOURCES:
Electronic searches were conducted using PubMed, Embase, and Cochrane Library (CENTRAL) databases from 2012 to March 2022.

STUDY SELECTION:
Content was divided into 11 sections related to PARDS, with abstract and full text screening followed by data extraction for studies which met inclusion with no exclusion criteria.

DATA EXTRACTION:
We used a standardized data extraction form to construct evidence tables, grade the evidence, and formulate recommendations or statements using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system.

DATA SYNTHESIS:
This consensus conference was comprised of a multidisciplinary group of international experts in pediatric critical care, pulmonology, respiratory care, and implementation science which followed standards set by the Institute of Medicine, using the GRADE system and Research And Development/University of California, Los Angeles appropriateness method, modeled after PALICC 2015. The panel of 52 content and four methodology experts had several web-based meetings over the course of 2 years. We conducted seven systematic reviews and four scoping reviews to cover the 11 topic areas. Dissemination was via primary publication listing all statements and separate supplemental publications for each subtopic that include supporting arguments for each recommendation and statement.

CONCLUSIONS:
A consensus conference of experts from around the world developed recommendations and consensus statements for the definition and management of PARDS and identified evidence gaps which need further research.
How microscopic epistasis and clonal interference shape the fitness trajectory in a spin glass model of microbial long-term evolution
Authors: Boffi Nicholas M. , Guo Yipei , Rycroft Chris H. , Amir Ariel 
Published: January 2023

AbstractThe adaptive dynamics of evolving microbial populations takes place on a complex fitness landscape generated by epistatic interactions. The population generically consists of multiple competing strains, a phenomenon known as clonal interference. Microscopic epistasis and clonal interference are central aspects of evolution in microbes, but their combined effects on the functional form of the population’s mean fitness are poorly understood. Here, we develop a computational method that resolves the full microscopic complexity of a simulated evolving population subject to a standard serial dilution protocol. Through extensive numerical experimentation, we find that stronger microscopic epistasis gives rise to fitness trajectories with slower growth independent of the number of competing strains, which we quantify with power-law fits and understand mechanistically via a random walk model that neglects dynamical correlations between genes. We show that increasing the level of clonal interference leads to fitness trajectories with faster growth (in functional form) without microscopic epistasis, but leaves the rate of growth invariant when epistasis is sufficiently strong, indicating that the role of clonal interference depends intimately on the underlying fitness landscape. The simulation package for this work may be found athttps://github.com/nmboffi/spin_glass_evodyn.
FedDP: Secure Federated Learning for Disease Prediction with Imbalanced Genetic Data
Authors: Li Bin , Gao Hongchang , Shi Xinghua 
Published: January 2023

AbstractIt is challenging to share and aggregate biomedical data distributed among multiple institutions or computing resources due to various concerns including data privacy, security, and confidentiality. The federated Learning (FL) schema can effectively enable multiple institutions jointly perform machine learning by training a robust model with local data to satisfy the requirement of user privacy protection as well as data security. However, conventional FL methods are exposed to the risk of gradient leakage and cannot be directly applied to genetic data since they cannot address the unique challenges of data imbalance typically seen in genomics. To provide secure and efficient disease prediction based on genetic data distributed across multiple parties, we propose an FL framework enhanced with differential privacy (FedDP) on trained model parameters. In FedDP, local models can be trained among multiple local-hold genetic data with efficient secure and privacy-preserving techniques. The key idea of FedDP is to deploy differential privacy on compressed intermediate gradients that are computed and transmitted by optimizers from local parties. In addition, the unique weighted minmax loss in FedDP is able to address the difficulties of prediction for highly imbalanced genetic datasets. Our experiments on multiple genetic datasets demonstrate that FedDP provides a powerful tool to implement and evaluate various strategies in support of privacy preservation and model performance guarantee to overcome data imbalance.
Genetic association studies using disease liabilities from deep neural networks
Authors: Yang Lu , Sadler Marie C. , Altman Russ B. 
Published: January 2023

SummaryThe case-control study is a widely used method for investigating the genetic underpinnings of binary traits. However, long-term, prospective cohort studies often grapple with absent or evolving health-related outcomes. Here, we propose two methods,liabilityandmeta, for conducting genome-wide association study (GWAS) that leverage disease liabilities calculated from deep patient phenotyping. Analyzing 38 common traits in ∼300,000 UK Biobank participants, we identified an increased number of loci compared to the conventional case-control approach, with high replication rates in larger external GWAS. Further analyses confirmed the disease-specificity of the genetic architecture with the meta method demonstrating higher robustness when phenotypes were imputed with low accuracy. Additionally, polygenic risk scores based on disease liabilities more effectively predicted newly diagnosed cases in the 2022 dataset, which were controls in the earlier 2019 dataset. Our findings demonstrate that integrating high-dimensional phenotypic data into deep neural networks enhances genetic association studies while capturing disease-relevant genetic architecture.
Feasibility of an Evolutionary Tumor Board for Generating Novel Personalized Therapeutic Strategies
Authors: Robertson-Tessi Mark , Brown Joel S. , Poole Maria I. , Johnson Matthew , Marusyk Andriy , Gallaher Jill A. , Luddy Kimberly A. , Whelan Christopher J. , West Jeffrey , Strobl Maximillian , Turati Virginia , Enderling Heiko , Schell Michael J. , Tan AikChoon , Boyle Terry , Makanji Rikesh , Farinhas Joaquim , Soliman Hatem , Lemanne Dawn , Gatenby Robert A. , Reed Damon R. , Anderson Alexander R. A. , Chung Christine H. 
Published: January 2023

ABSTRACTThe current paradigm of clinical trials treating patients until disease progression using maximum tolerated dose does not account for the dynamic tumor-host-drug interactions that result in acquired resistance. Here, we present the concept of an Evolutionary Tumor Board (ETB) and report interim results from a prospective, non-interventional pilot study in which novel therapeutic strategies based on evolutionary principles were developed under the ETB framework. The ETB approach relies on an interdisciplinary team that integrates clinical, preclinical, and theoretical knowledge and the application of mathematical modeling to predict patient responses to different therapies, including novel approaches derived from eco-evolutionary first principles. We have previously proposed several evolutionary therapies that aim to enhance the efficacy of an overall treatment regimen, using existing agents for a given disease. Key among these evolutionary therapies is the idea of “first-strike second-strike”, where different agents are administered in sequence, and new strikes are applied as soon as the efficacy of the previous strike is nearing a minimum, as opposed to waiting until progression is identified on periodic imaging. This approach requires careful analysis of longitudinal patient data coupled with predictive dynamics generated by mathematical models. Here we describe the ETB process and the interim results from 15 patients enrolled in the feasibility trial. In addition, we describe the challenges faced as well as the solutions that can be implemented via improved modeling approaches, better patient data collection, and a reassessment of how we understand tumor dynamics in the light of evolutionary principles.
Complex interventions for aggressive challenging behaviour in adults with intellectual disability: a rapid realist review informed by multiple populations
Authors: Royston Rachel , Naughton Stephen , Hassiotis Angela , Jahoda Andrew , Ali Afia , Chauhan Umesh , Cooper Sally-Ann , Kouroupa Athanasia , Steed Liz , Strydom Andre , Taggart Laurence , Rapaport Penny 
Published: January 2023

AbstractObjectivesApproximately 10% of people with intellectual disability display aggressive challenging behaviour, usually due to unmet needs. There are a variety of interventions available, yet a scarcity of understanding about what mechanisms contribute to successful interventions. We explored how complex interventions for aggressive challenging behaviour work in practice and what works for whom by developing programme theories through contexts-mechanism-outcome (CMO) configurations.MethodsThis review followed modified rapid realist review methodology and RAMESES-II standards. Eligible papers reported on a range of population groups (intellectual disability, mental health, dementia, young people and adults) and settings (community and inpatient) to broaden the scope and available data for review.ResultsFive databases and grey literature were searched and a total of 59 studies were included. We developed three overarching domains comprising of 11 CMOs; 1. Working with the person displaying aggressive challenging behaviour, 2. Relationships and team focused approaches and 3. Sustaining and embedding facilitating factors at team and systems levels. Mechanisms underlying the successful application of interventions included improving understanding, addressing unmet need, developing positive skills, enhancing carer compassion and boosting staff self-efficacy and motivation.ConclusionThe review emphasises how interventions for aggressive challenging behaviour should be personalised and tailored to suit individual needs. Effective communication and trusting relationships between service users, carers, professionals, and within staff teams is essential to facilitate effective intervention delivery. Carer inclusion and service level buy-in supports the attainment of desired outcomes. Implications for policy, clinical practice and future directions are discussed.Prospero Registration NumberCRD42020203055.
Magnitude of wasting and its predictors among under-five children in Bakadawula Ari district, Southern Ethiopia
Authors: Tesfaye Getamesay Aynalem , Wana Ermias Wabeto , Gebru Moges Getie 
Published: January 2023

ABSTRACTBackgroundGlobally, wasting threatens the lives of 50 million children under-five. In Ethiopia, wasting is not decreasing at the intended rate, but the reason remains unclear. Moreover, Bakadawula Ari district lacks scientific information regarding wasting among children.ObjectiveThis study was conducted to determine the magnitude of wasting and its predictors among under-five children in the district.MethodsA community-based cross-sectional study was conducted from January to March 2022. A multistage sampling technique was used to select 421 children. The data were entered and analyzed by SPSS 26 (Statistical Package for the Social Sciences version 26). Logistic regression analyses were used and presented with crude odds ratio (COR) and adjusted odds ratio (AOR) with their 95% confidence intervals (CI).ResultsThe prevalence of wasting among children in the study area was 22.6% (95% CI: 18.5-26.8). Fathers with primary education (AOR= 4.48; 95% CI: 1.93-10.39), households with improper solid waste-disposal (AOR= 2.54; 95% CI: 1.11-5.82), not usually sleeping under insecticide-treated bed net (ITN) (AOR=1.79; 95% CI: 1.01-3.19), unacceptable children dietary diversity score (DDS) (AOR= 2.56; 95% CI: 1.28-5.14) and unacceptable household DDS (AOR= 2.26; 95% CI: 1.02-5.00) were predictors of wasting.ConclusionsThe prevalence of wasting among children was critically high. Upgrading educational status of fathers, encouraging safe solid waste disposal, ensuring consistent use of ITN, and improving both children and household DDS should be given a due emphasis to reduce wasting in the study area.