bluuebunny/crossref_metadata_2025 huggingface dataset:
Effectiveness of the toxicant DRC‐1339 in reducing populations of common ravens in Wyoming
Authors: Peebles Luke W. , Conover Michael R.
Published: June 2016

Common raven (Corvus corax) populations have increased several‐fold in the western United States during the past century; these birds cause problems when they kill new‐borne lambs and calves and depredate nests of greater sage‐grouse (Centrocercus urophasianus). The toxicant DRC‐1339 is used by U.S. Department of Agriculture/Animal and Plant Health Inspection Service Wildlife Services to manage common raven populations and reduce the severity of these problems, but it is difficult to determine how many ravens are killed by an application because carcasses are rarely found. We examined the effectiveness of DRC‐1339 applications for preventative control of ravens at 3 landfills and 5 nearby roosts in Wyoming, USA, from 2013 through 2015. Wildlife Services removed 23%, 34%, and 7% of the radiomarked sample of ravens in southwestern Wyoming during 2013, 2014, and 2015, respectively, according to Kaplan–Meier survival estimates. During the 3 winters, 235 of 240 raven carcasses that we collected died from DRC‐1339 poisoning. The following year, raven fecundity and immigration had offset most, but not all, of the mortality produced by the DRC‐1339 program. Raven population estimates declined 9% from the 2013 winter to the 2014 winter and 12% from the 2014 winter to the 2015 winter, based on telemetry data and roost counts. Ravens did not avoid landfills after they were treated with DRC‐1339 probably because few ravens died there. Estimated mortality rates from DRC‐1339 applications based on carcass counts underestimated the actual rates by 79% and landfill counts of ravens underestimated it by 49%. Roost count estimates of mortality were within 15% of the actual mortality rate. © 2016 The Wildlife Society.
Ergonomics of laparoscopic graspers and the importance of haptic feedback: the surgeons’ perspective
Authors: Alleblas Chantal C. J. , Vleugels Michel P. H. , Nieboer Theodoor E.
Published: June 2016

Haptic feedback is drastically reduced in laparoscopic surgery compared to open surgery. Introducing enhanced haptic feedback in laparoscopic instruments might well improve surgical safety and efficiency. In the design process of a laparoscopic grasper with enhanced haptic feedback, handle design should be addressed to strive for optimal usability and comfort. Additionally, the surgeons’ perspective on the potential benefits of haptic feedback should be assessed to ascertain the clinical interest of enhanced haptic feedback. A questionnaire was designed to determine surgeons’ use and preferences for laparoscopic instruments and expectations about enhanced haptic feedback. Surgeons were also asked whether they experience physical complaints related to laparoscopic instruments. The questionnaire was distributed to a group of laparoscopic surgeons based in Europe. From the 279 contacted subjects, 98 completed the questionnaire (response rate 35 %). Of all respondents, 77 % reported physical complaints directly attributable to the use of laparoscopic instruments. No evident similarity in the main preference for graspers was found, either with or without haptic feedback. According to respondents, the added value of haptic feedback could be of particular use in feeling differences in tissue consistencies, feeling the applied pressure, locating a tumor or enlarged lymph node, feeling arterial pulse, and limiting strain in the surgeon’s hand. This study stresses that the high prevalence of physical complaints directly related to laparoscopic instruments among laparoscopic surgeons is still relevant. Furthermore, the potential benefits of enhanced haptic feedback in laparoscopic surgery are recognized by laparoscopic specialists. Therefore, haptic feedback is considered an unmet need in laparoscopy.
Apricot Kernel Oil Ameliorates Cyclophosphamide‐Associated Immunosuppression in Rats
Authors: Tian Honglei , Yan Haiyan , Tan Siwei , Zhan Ping , Mao Xiaoying , Wang Peng , Wang Zhouping
Published: June 2016

The effects of dietary apricot kernel oil (AKO), which contains high levels of oleic and linoleic acids and lower levels of α‐tocopherol, were evaluated in a rat model of cyclophosphamide‐induced immunosuppression. Rats had intraperitoneal injection with cyclophosphamide to induce immunosuppression and were then infused with AKO or normal saline (NS) for 4 weeks. Enzyme‐linked immunosorbent assays were used to detect antimicrobial factors in lymphocytes and anti‐inflammatory factors in hepatocytes. Hematoxylin & eosin staining was conducted prior to histopathological analysis of the spleen, liver, and thymus. Significant differences were observed between the immune functions of the healthy control group, the normal saline group, and the AKO group. Compared to the normal saline‐treated group, lymphocytes isolated from rats administered AKO showed significant improvement in immunoglobulin (Ig)A, IgM, IgG, interleukin (IL)‐2, IL‐12, and tumor necrosis factor‐α (TNF‐α) levels (p < 0.01). Liver tissue levels of malondialdehyde and activities of superoxide dismutase and glutathione peroxidase indicated reduced oxidative stress in rats treated with AKO (p < 0.01). Dietary AKO positively affected rat growth and inhibited cyclophosphamide‐associated organ degeneration. These results suggested that AKO may enhance the immune system in vivo. These effects may reflect the activities of intermediate oleic and linoleic acid metabolites, which play a vital role in the immune system, and the α‐tocopherol in AKO may further enhance this phenomenon. Thus, the use of AKO as a nutritional supplement can be proposed to ameliorate chemotherapy‐associated immunosuppression.
Optimization of Enzymatic Process Condition for Protein Enrichment, Sugar Recovery and Digestibility Improvement of Soy Flour
Authors: Loman Abdullah A. , Ju Lu‐Kwang
Published: June 2016

Soy protein is a valuable nutritional supplement for food and animal feed. While protein constitutes ~50 % of defatted soy flour (SF), it coexists with complex carbohydrates (30–35 %) which may have anti‐nutritional effects. An enzymatic process can remove the carbohydrate and produce protein‐enriched soy products. The hydrolysate with monomerized carbohydrates is valuable fermentation feedstock. In this study, Aspergillus niger and Trichoderma reesei enzymes were compared for use in the process. Effects of pH (3.2–6.4), temperature (40–60 °C), enzyme‐to‐SF ratio (0–2 ml/g) and SF loading (150–350 g/l) were evaluated for the enzymatic conversion of SF carbohydrate to reducing sugar (YRS) and total soluble carbohydrate (YTC) in the hydrolysate. Effects of these single factors and interactions between factors were investigated. Optimal pH and temperature were similar for both enzymes: pH 4.8 and 50–51 °C for YTC, and pH 5.1–5.2 and 48–51 °C for YRS. The two enzymes also gave similar protein contents in resultant soy protein concentrates, i.e., 74–75 % with 2 ml/g enzyme broth and 150 g/l SF, which were higher than the 64–68 % protein in commercial concentrates. A. niger enzyme was significantly more effective in carbohydrate conversion, achieving YRS = 75 % and YTC = 78 % with 2 ml/g enzyme and 150 g/l SF, higher than the YRS (30 %) and YTC (64 %) obtained with T. reesei enzyme. Monomerization was essentially complete in hydrolysate produced with A. niger enzyme.
Untangling tau imaging
Authors: Villemagne Victor L. , Okamura Nobuyuki , Rowe Christopher C.
Published: June 2016

In vivo imaging of tau deposits is providing a better understanding of the temporal and spatial tau deposition in the brain, allowing a more comprehensive insight into the causes, diagnoses, and potentially treatment of tauopathies such as Alzheimer's disease, progressive supranuclear palsy, corticobasal syndrome, chronic traumatic encephalopathy, and some variants of frontotemporal lobar degeneration. The assessment of tau deposition in the brain over time will allow a deeper understanding of the relationship between tau and other variables such as cognition, genotype, and neurodegeneration, as well as assessing the role tau plays in ageing. Preliminary human studies suggest that tau imaging could also be used as a diagnostic, prognostic, and theranostic biomarker, as well as a surrogate marker for target engagement, patient recruitment, and efficacy monitoring for disease‐specific therapeutic trials.
Results of collagen sling placement following the partial removal of a synthetic midurethral sling
Authors: Hogewoning Cornelis R.C. , Elzevier Henk W. , Pelger Rob C.M. , Hogewoning Cornelis J.A.
Published: June 2016

Objective

To assess results of placement of the Pelvilace collagen sling following partial removal of a primary synthetic sling because of late complications.

Methods

A retrospective study was undertaken of patients with late complications after midurethral sling surgery who underwent placement of a Pelvilace sling at a center in the Netherlands between January 2006 and January 2011. A postoperative questionnaire was used to evaluate the continence status and continence‐related quality of life. Patients scoring 0 in the Urogenital Distress Inventory stress symptoms section were considered cured. The subjective improvement or deterioration in symptoms was scored using the Patient Global Impression of Improvement (PGI‐I).

Results

The questionnaire was completed and returned by 32 (84%) of 38 patients after a mean follow‐up of 54.3 months. Nine (28%) patients were deemed cured. Among 29 patients who had not undergone a third surgery, the PGI‐I showed a postoperative improvement in 14 (48%). The other 15 patients rated their postoperative situation as little improved, unchanged, or deteriorated. Further subanalysis showed clear differences in postoperative results between the different types of late complications (erosion and/or displacement).

Conclusion

The concomitant placement of a collagen sling following partial removal of a primary polypropylene sling shows reasonable results for specific complications.
Falls and Fear of Falling After Stroke: A Case‐Control Study
Authors: Goh Hui‐Ting , Nadarajah Mohanasuntharaam , Hamzah Norhamizan Binti , Varadan Parimalaganthi , Tan Maw Pin
Published: June 2016

Background

Falls are common after stroke, with potentially serious consequences. Few investigations have included age‐matched control participants to directly compare fall characteristics between older adults with and without stroke. Further, fear of falling, a significant psychological consequence of falls, has only been examined to a limited degree as a risk factor for future falls in a stroke population.

Objective

To compare the fall history between older adults with and without a previous stroke and to identify the determinants of falls and fear of falling in older stroke survivors.

Design

Case‐control observational study.

Setting

Primary teaching hospital.

Participants

Seventy‐five patients with stroke (mean age ± standard deviation, 66 ± 7 years) and 50 age‐matched control participants with no previous stroke were tested.

Methods

Fall history, fear of falling, and physical, cognitive, and psychological function were assessed. A χ2 test was performed to compare characteristics between groups, and logistic regression was performed to determine the risk factors for falls and fear of falling.

Main Outcome Measures

Fall events in the past 12 months, Fall Efficacy Scale–International, Berg Balance Scale, Functional Ambulation Category, Fatigue Severity Scale, Montreal Cognitive Assessment, and Patient Healthy Questionnaire–9 were measured for all participants. Fugl‐Meyer Motor Assessment was used to quantify severity of stroke motor impairments.

Results

Twenty‐three patients and 13 control participants reported at least one fall in the past 12 months (P = .58). Nine participants with stroke had recurrent falls (≥2 falls) compared with none of the control participants (P < .01). Participants with stroke reported greater concern for falling than did nonstroke control participants (P < .01). Female gender was associated with falls in the nonstroke group, whereas falls in the stroke group were not significantly associated with any measured outcomes. Fear of falling in the stroke group was associated with functional ambulation level and balance. Functional ambulation level alone explained 22% of variance in fear of falling in the stroke group.

Conclusions

Compared with persons without a stroke, patients with stroke were significantly more likely to experience recurrent falls and fear of falling. Falls in patients with stroke were not explained by any of the outcome measures used, whereas fear of falling was predicted by functional ambulation level. This study has identified potentially modifiable risk factors with which to devise future prevention strategies for falls in patients with stroke.

Level of Evidence

III
Evaluación de las habilidades clínicas de lactancia materna entre los estudiantes de enfermería utilizando el Examen Clínico Objetivo Estructurado (ECOE)
Authors: Villegas Natalia , Cianelli Rosina , Fernandez Madeline , Henderson Shakira , Sierra Solange , Alfonso Yarilys , Jackson Crystal
Published: June 2016

Introducción: Insuficiente educación y entrenamiento clínico de las enfermeras recién graduadas ha llevado a que estas no se sientan capacitadas para asistir a la madre lactante. Varios estudios recomiendan la implementación de entrenamiento de lactancia en todos los planes de estudio de pregrado que conlleven a enfermería y otros títulos en el área del cuidado de la salud.
Objetivo: Analizar el desarrollo de un examen clínico objetivo estructurado (ECOE) para medir las habilidades clínicas de lactancia materna y los resultados preliminares de su aplicación.
Método: Los participantes para este estudio piloto fueron 23 estudiantes de enfermería de pregrado. El ECOE de lactancia consistió en 10 estaciones donde los estudiantes implementaron diferentes habilidades clínicas bajo un ambiente simulado. Las habilidades clínicas examinadas en cada estación variaron desde extracción manual de leche materna hasta el correcto uso de la bomba extractora en el seno de un maniquí. Observadores en cada estación completaron una lista que juzgaba la habilidad clínica de cada estudiante para completar la tarea correctamente. Estudiantes condujeron una evaluación del entrenamiento inmediatamente después de completar el ECOE usando una encuesta estructurada en línea.
Resultados: Las estaciones con las puntuaciones más altas fueron: intervención en pezones adoloridos, goteo de leche materna de los pezones invertidos (estación 4, promedio=2.57, desviación estándar=.843, rango 1-3) e indicadores de agarre adecuado del niño al pecho materno (estación 6, promedio=7.09, desviación estándar=1.443, rango 4-8). Las estaciones con las puntuaciones más bajas fueron: cómo manejar la bomba de extracción de leche y cómo destetar al niño del pecho materno (estación 1, promedio=7.96, desviación estándar=1.745, rango 4-10) y las posiciones para la lactancia (estación 5, promedio=1.65, desviación estándar=. 714, rango 0---2).
Conclusión: El ECOE ha sido evaluado positivamente por su objetividad en la evaluación de estudiantes y porque funciona adecuadamente para medir las competencias clínicas. Los puntajes y las evaluaciones de los estudiantes sugieren que el ECOE puede ser una herramienta valiosa para ser utilizada en otros cursos de enfermería o planes de estudio de pregrado relacionados con el área de salud.
Mysterious "Necklace Echoes" in the Sky Explained
Authors: Zastrow Mark
Published: June 2016

Scientists studying a 50–year–old mystery in the Earth's ionosphere have come up with their best explanation of it yet.
New Law Puts the Squeeze on the Arizona Geological Survey
Authors: Showstack Randy
Published: June 2016

Arizona state services at risk include a program to map Earth fissures; the state's earthquake-monitoring network; and the Survey's mineral resources program.
Diversity and divergence of the glioma-infiltrating T-cell receptor repertoire
Authors: Sims Jennifer S. , Grinshpun Boris , Feng Yaping , Ung Timothy H. , Neira Justin A. , Samanamud Jorge L. , Canoll Peter , Shen Yufeng , Sims Peter A. , Bruce Jeffrey N.
Published: June 2016

Significance

High-throughput sequencing of T-cell receptor (TCR) repertoires provides a high-dimensional biomarker for monitoring the immune system. We applied this approach, measuring the extent to which the TCR repertoires of T-cell populations infiltrating malignant brain tumors diverge from their peripheral blood. Our analytical strategy separates the statistical properties of the repertoire derived from VJ cassette combination usage from the VJ-independent contribution that reflects the antigen-binding component of the receptor. We discovered a TCR signature strongly inversely correlated with the VJ-independent divergence between the peripheral and tissue-infiltrating repertoires of these patients. Importantly, this signature is detectable in peripheral blood and could serve as a means of noninvasively monitoring immune response in patients.
Molecular functions of the transcription factors E2A and E2-2 in controlling germinal center B cell and plasma cell development
Authors: Wöhner Miriam , Tagoh Hiromi , Bilic Ivan , Jaritz Markus , Poliakova Daniela Kostanova , Fischer Maria , Busslinger Meinrad
Published: June 2016

E2A is an essential regulator of early B cell development. Here, we have demonstrated that E2A together with E2-2 controlled germinal center (GC) B cell and plasma cell development. As shown by the identification of regulated E2A,E2-2 target genes in activated B cells, these E-proteins directly activated genes with important functions in GC B cells and plasma cells by inducing and maintaining DNase I hypersensitive sites. Through binding to multiple enhancers in the Igh 3′ regulatory region and Aicda locus, E-proteins regulated class switch recombination by inducing both Igh germline transcription and AID expression. By regulating 3′ Igk and Igh enhancers and a distal element at the Prdm1 (Blimp1) locus, E-proteins contributed to Igk, Igh, and Prdm1 activation in plasmablasts. Together, these data identified E2A and E2-2 as central regulators of B cell immunity.
MetaFast: fast reference-free graph-based comparison of shotgun metagenomic data
Authors: Ulyantsev Vladimir I. , Kazakov Sergey V. , Dubinkina Veronika B. , Tyakht Alexander V. , Alexeev Dmitry G.
Published: June 2016

Motivation: High-throughput metagenomic sequencing has revolutionized our view on the structure and metabolic potential of microbial communities. However, analysis of metagenomic composition is often complicated by the high complexity of the community and the lack of related reference genomic sequences. As a start point for comparative metagenomic analysis, the researchers require efficient means for assessing pairwise similarity of the metagenomes (beta-diversity). A number of approaches were used to address this task, however, most of them have inherent disadvantages that limit their scope of applicability. For instance, the reference-based methods poorly perform on metagenomes from previously unstudied niches, while composition-based methods appear to be too abstract for straightforward interpretation and do not allow to identify the differentially abundant features.

Results: We developed MetaFast, an approach that allows to represent a shotgun metagenome from an arbitrary environment as a modified de Bruijn graph consisting of simplified components. For multiple metagenomes, the resulting representation is used to obtain a pairwise similarity matrix. The dimensional structure of the metagenomic components preserved in our algorithm reflects the inherent subspecies-level diversity of microbiota. The method is computationally efficient and especially promising for an analysis of metagenomes from novel environmental niches.

Availability and Implementation: Source code and binaries are freely available for download at https://github.com/ctlab/metafast. The code is written in Java and is platform independent (tested on Linux and Windows x86_64).

Contact:  ulyantsev@rain.ifmo.ru

Supplementary information:  Supplementary data are available at Bioinformatics online.
DBSI server: DNA binding site identifier
Authors: Sukumar Shravan , Zhu Xiaolei , Ericksen Spencer S. , Mitchell Julie C.
Published: June 2016

Summary: Protein–nucleic acid interactions are among the most important intermolecular interactions in the regulation of cellular events. Identifying residues involved in these interactions from protein structure alone is an important challenge. Here we introduce the webserver interface to DNA Binding Site Identifier (DBSI), a powerful structure-based SVM model for the prediction and visualization of DNA binding sites on protein structures. DBSI has been shown to be a top-performing model to predict DNA binding sites on the surface of a protein or peptide and shows promise in predicting RNA binding sites.

Availability and Implementation: Server is available at http://dbsi.mitchell-lab.org

Contact:  jcmitchell@wisc.edu

Supplementary information:  Supplementary data are available at Bioinformatics online.
UniCon3D: de novo protein structure prediction using united-residue conformational search via stepwise, probabilistic sampling
Authors: Bhattacharya Debswapna , Cao Renzhi , Cheng Jianlin
Published: June 2016

Motivation: Recent experimental studies have suggested that proteins fold via stepwise assembly of structural units named ‘foldons’ through the process of sequential stabilization. Alongside, latest developments on computational side based on probabilistic modeling have shown promising direction to perform de novo protein conformational sampling from continuous space. However, existing computational approaches for de novo protein structure prediction often randomly sample protein conformational space as opposed to experimentally suggested stepwise sampling.

Results: Here, we develop a novel generative, probabilistic model that simultaneously captures local structural preferences of backbone and side chain conformational space of polypeptide chains in a united-residue representation and performs experimentally motivated conditional conformational sampling via stepwise synthesis and assembly of foldon units that minimizes a composite physics and knowledge-based energy function for de novo protein structure prediction. The proposed method, UniCon3D, has been found to (i) sample lower energy conformations with higher accuracy than traditional random sampling in a small benchmark of 6 proteins; (ii) perform comparably with the top five automated methods on 30 difficult target domains from the 11th Critical Assessment of Protein Structure Prediction (CASP) experiment and on 15 difficult target domains from the 10th CASP experiment; and (iii) outperform two state-of-the-art approaches and a baseline counterpart of UniCon3D that performs traditional random sampling for protein modeling aided by predicted residue-residue contacts on 45 targets from the 10th edition of CASP.

Availability and Implementation: Source code, executable versions, manuals and example data of UniCon3D for Linux and OSX are freely available to non-commercial users at http://sysbio.rnet.missouri.edu/UniCon3D/.

Contact:  chengji@missouri.edu

Supplementary information:  Supplementary data are available at Bioinformatics online.
Designing robust watermark barcodes for multiplex long-read sequencing
Authors: Ezpeleta Joaquín , Krsticevic Flavia J , Bulacio Pilar , Tapia Elizabeth
Published: June 2016

Motivation

To attain acceptable sample misassignment rates, current approaches to multiplex single-molecule real-time sequencing require upstream quality improvement, which is obtained from multiple passes over the sequenced insert and significantly reduces the effective read length. In order to fully exploit the raw read length on multiplex applications, robust barcodes capable of dealing with the full single-pass error rates are needed.

Results

We present a method for designing sequencing barcodes that can withstand a large number of insertion, deletion and substitution errors and are suitable for use in multiplex single-molecule real-time sequencing. The manuscript focuses on the design of barcodes for full-length single-pass reads, impaired by challenging error rates in the order of 11%. The proposed barcodes can multiplex hundreds or thousands of samples while achieving sample misassignment probabilities as low as 10−7 under the above conditions, and are designed to be compatible with chemical constraints imposed by the sequencing process.

Availability and Implementation

Software tools for constructing watermark barcode sets and demultiplexing barcoded reads, together with example sets of barcodes and synthetic barcoded reads, are freely available at www.cifasis-conicet.gov.ar/ezpeleta/NS-watermark.
Designing Computerized Provider Order Entry Software in Iran
Authors: Khammarnia Mohammad , Sharifian Roxana , Zand Farid , Keshtkaran Ali
Published: June 2016

This study aimed to identify the functional requirements of computerized provider order entry software and design this software in Iran. This study was conducted using review documentation, interview, and focus group discussions in Shiraz University of Medical Sciences, as the medical pole in Iran, in 2013–2015. The study sample consisted of physicians (n = 12) and nurses (n = 2) in the largest hospital in the southern part of Iran and information technology experts (n = 5) in Shiraz University of Medical Sciences. Functional requirements of the computerized provider order entry system were examined in three phases. Finally, the functional requirements were distributed in four levels, and accordingly, the computerized provider order entry software was designed. The software had seven main dimensions: (1) data entry, (2) drug interaction management system, (3) warning system, (4) treatment services, (5) ability to write in software, (6) reporting from all sections of the software, and (7) technical capabilities of the software. The nurses and physicians emphasized quick access to the computerized provider order entry software, order prescription section, and applicability of the software. The software had some items that had not been mentioned in other studies. Ultimately, the software was designed by a company specializing in hospital information systems in Iran. This study was the first specific investigation of computerized provider order entry software design in Iran. Based on the results, it is suggested that this software be implemented in hospitals.
Use of Data Mining to Predict the Risk Factors Associated With Osteoporosis and Osteopenia in Women
Authors: Pedrassani de Lira Carolina , Toniazzo de Abreu Larissa Letieli , Veiga Silva Ana Carolina , Mazzuchello Leandro Luiz , Rosa Maria Inês , Comunello Eros , de Souza Pires Maria Marlene , Ceretta Luciane Bisognin , Martins Paulo João , Simões Priscyla Waleska
Published: June 2016

Osteoporosis has recently been acknowledged as a major public health issue in developed countries because of the decrease in the quality of life of the affected person and the increase in public costs due to complete or partial physical disability. The aim of this study was to use the J48 algorithm as a classification task for data from women exhibiting changes in bone densitometry. The study population included all patients treated at the diagnostic center for bone densitometry since 2010. Census sample data collection was conducted as all elements of the population were included in the sample. The service in question provides care to patients via the Brazilian Unified Health System and private plans. The results of the classification task were analyzed using the J48 algorithm, and among the dichotomized variables associated with a diagnosis of osteoporosis, the mean accuracy was 74.0 (95% confidence interval [CI], 61.0–68.0) and the mean area under the curve of the receiver operating characteristic (ROC) curve was 0.65 (95% CI, 0.64–0.66), with a mean sensitivity of 76.0 (95% CI, 76.0–76.0) and a mean specificity of 48.0 (95% CI, 46.0–49.0). The analyzed results showed higher values of sensitivity, accuracy, and curve of the ROC area in experiments conducted with individuals with osteoporosis. Most of the generated rules were consistent with the literature, and the few differences might serve as hypotheses for further studies.
A Formative Program Evaluation of Electronic Clinical Tracking System Documentation to Meet National Core Competencies
Authors: Smith Lynette S. , Branstetter M. Laurie
Published: June 2016

Electronic clinical tracking systems are used in many educational institutions of higher learning to document advanced practice registered nursing students’ clinical experiences. Students’ clinical experiences are constructed according to the National Organization of Nurse Practitioner Faculties core competencies. These competencies form a basis for evaluation of advanced practice registered nursing programs. However, no previous studies have evaluated the use of electronic clinical tracking systems to validate students’ clinical experiences in meeting national core competencies. Medatrax, an electronic clinical tracking system, is evaluated using a formative program evaluation approach to determine if students’ clinical documentations meet Family/Across the Lifespan Nurse Practitioner Competencies in a midsouthern family nurse practitioner program. This formative program evaluation supports the use of an electronic clinical tracking system in facilitating accreditation and program outcome goals. The significance of this study is that it provides novel evidence to support the use of an electronic clinical tracking system to assist a midsouthern school of nursing in meeting national core competencies.
Midwives and the Computerization of Perinatal Data Entry
Authors: CRASWELL ALISON , MOXHAM LORNA , BROADBENT MARC
Published: June 2016

Theory building in nursing and midwifery both to explain and inform practice is important to advance these professions via provision of a theoretical foundation. This research explored the process of perinatal data entry undertaken by midwives to explore the impact of the movement from paper to computer collection of data. Use of grounded theory methodology enabled theory building, leading to a theoretical understanding of the phenomenon and development of the Theory of Beneficial Engagement grounded in the data. Methods involved in-depth semistructured interviews with 15 users of perinatal data systems. Participants were recruited from 12 different healthcare locations and were utilizing three different electronic systems for data entry. The research question that guided the study focused on examining the influences of using the computer for perinatal data entry. Findings indicated that qualities particular to some midwives denoted engagement with perinatal data entry, suggesting a strong desire to enter complete, timely, and accurate data. The Theory of Beneficial Engagement provides a model of user engagement with systems for perinatal data entry consistent with other theories of engagement. The theory developed describes this phenomenon in a simple, elegant manner that can be applied to other areas where mandatory data entry is undertaken.
Age and clear eyes are associated with an increased risk of cutaneous squamous cell carcinomas in vemurafenib-treated melanoma patients
Authors: Herms Florian , Kramkimel Nora , Regnier-Rosencher Elodie , Carlotti Agnès , Chanal Johan , Boitier Françoise , Aractingi Selim , Dupin Nicolas , Avril Marie-Françoise
Published: June 2016

Cutaneous squamous cell carcinoma (cSCC) is a frequent side-effect of vemurafenib treatment. The main aim of this study was to identify the clinical risk factors associated with the development of cSCC in melanoma patients treated with vemurafenib. We carried out a retrospective study, including 63 consecutive melanoma patients treated with vemurafenib for BRAF-mutant metastatic melanoma in an oncodermatological department. Clinical and follow-up data were collected and analysed, and a comparison of the subgroups who did and did not develop cSCC was performed. A total of 42.9% of patients (n=27) treated with vemurafenib developed one or more cSCC. Patients with cSCC were significantly older (P=0.01). Clear eyes were also associated with a higher risk of developing cSCC (odds ratio=3.50; 95% confidence interval: 1.08–12.43). Three patients developed cSCC more than 1 year after the initiation of treatment (12, 16 and 18 months, respectively). Clinicians should be vigilant in older patients undergoing vemurafenib therapy as well as patients with clear eyes as they seem to be at increased risk of developing cSCC, even late after the initiation of treatment.
Validated Assessment Scales for Décolleté Wrinkling and Pigmentation
Authors: Landau Marina , Geister Thorin L. , Leibou Lior , Blessmann-Gurk Birgit , Görtelmeyer Roman , Frand Jacob , Grice Jenny , Pooth Rainer ,   on behalf of the Validation Assessment Scales Group
Published: June 2016

BACKGROUND

Décolleté aging includes skin dyspigmentation, laxity, and visible wrinkling. The development of globally accepted scales for the assessment of décolleté aging is essential for aesthetic research and patient evaluation.

OBJECTIVE

To develop a set of grading scales for the objective assessment of décolleté aging criteria and establish the reliability and validity of these scales.

MATERIALS AND METHODS

To describe age-related changes to the décolleté, 3 photonumeric grading scales were created and validated: décolleté wrinkles—at rest, décolleté wrinkles—dynamic, and décolleté pigmentation—at rest. Thirteen aesthetic experts rated photographs of the décolleté of 50 women at rest and at dynamic “hand-to-elbow” positions in 2 validation sessions. Responses were analyzed to assess interrater and intrarater reliability.

RESULTS

Interrater and intrarater reliability were both “almost perfect” (≥0.81, intraclass correlation coefficient and weighted kappa) for décolleté wrinkles—dynamic, summary score for décolleté, and estimated age. Reliability was “substantial” (0.61–0.80) for all other décolleté assessments. There was high correlation between all décolleté scales, estimated age, and estimated aesthetic treatment effort.

CONCLUSION

Consistent outcomes between raters and by individual raters at different time points confirm the reliability of the décolleté grading scales, indicating that they will be a valuable tool for use in clinical research and practice.
Effectiveness and Safety of Bivalirudin During Percutaneous Coronary Intervention in Acute Coronary Syndrome in the Real World: CARTAGOMAX Study
Authors: Cascón-Pérez José Domingo , Abellán-Huerta José , Giner-Caro José Antonio , Dau-Villareal Derek Farid , Mármol-Lozano Rosario , Jaulent-Huertas Leticia , Bonilla-Pacheco Yaiza Isabel , Ruiz-Abellón María del Carmen , Picó-Aracil Francisco , Castillo-Moreno Juan Antonio
Published: June 2016

The CARTAGOMAX study assessed the safety and efficacy of bivalirudin during real-world cardiac intervention. This was a single-center prospective study. Patients with acute coronary syndrome undergoing percutaneous coronary intervention were anticoagulated with bivalirudin alone or unfractionated heparin plus a glycoprotein IIb/IIIa inhibitor. Propensity score matching was performed to control for baseline imbalances and yielded 1168 patients. There was lower incidence of the composite outcome of death from any cause or major bleeding at 30 days (P = 0.005), 6 months (P = 0.005), and 12 months (P = 0.001) of follow-up in the bivalirudin group, compared with the heparin plus glycoprotein inhibitor group. The administration of bivalirudin was associated with lower rate of all-cause mortality at 1 year of follow-up (P = 0.009). The incidence of major bleeding was lower in the bivalirudin group at 1, 6, and 12 months of follow-up (P = 0.002, P = 0.013 and P = 0.017, respectively). The incidence of stroke and reinfarction were similar between groups during follow-up. The rate of stent thrombosis were slightly higher in the bivalirudin group, without reaching statistical significance at 1 and 12 months of follow-up (P = 0.06, P = 0.04, P = 0.07 at 1, 6, and 12 months, respectively). The CARTAGOMAX study found that the use of bivalirudin during percutaneous coronary intervention was associated with lower incidence of the composite outcome of death from any cause or major bleeding during follow-up. The use of bivalirudin was associated with similar rates of stroke, reinfarction, and stent thrombosis compared with heparin plus glycoprotein inhibitor. Bivalirudin proved to be a safe and effective anticoagulant during percutaneous coronary intervention.
Clinical Management of the Breast-Feeding Mother–Infant Dyad in Recovery From Opioid Dependence
Authors: Busch Deborah W.
Published: June 2016

Human milk is one of the most health-promoting and cost-effective nutritional substances known to humankind. Breastmilk provides substantial and remarkable physiological and psychological health benefits. Within the last decade, there has been a resurgence of breast-feeding in the United States and worldwide and an increased awareness of the immense health benefits for mothers, infants, and societies that support it. Each mother–baby dyad is a unique pair, with distinct relationships, biases, barriers, and obstacles. This article aims to address clinical management for the opioid-recovering breast-feeding dyad and to translate current evidenced-based practice findings, recommendations, and resources to best support this unique population. The recovering breast-feeding mother and newborn with opioid dependence deserve special consideration and expert care to foster their recovery and breast-feeding efforts. It is our moral and ethical responsibility as healthcare professionals to enable, foster, and promote breast-feeding among all families, especially those who stand to benefit the greatest. Substance recovery cannot be treated in isolation, nor can breast-feeding efforts; an interdisciplinary professional team effort promises the greatest chances for recovery success. With appropriate evidence-based practice support, training, and intervention by knowledgeable professionals, many women can overcome the biases and obstacles associated with opioid recovery to successfully breast-feed their babies.
Part 1: The Theoretical Basis for Recovery-Oriented Management of Substance Use Disorders in Primary Care
Authors: Fornili Katherine S.
Published: June 2016

There is strong evidence in the literature that screening and brief counseling interventions are effective in detecting alcohol problems and decreasing alcohol consumption among patients in primary care settings but somewhat weaker evidence regarding screening and brief intervention for drug problems. In 2014, two published studies made news and caused concern among proponents of substance Screening, Brief Intervention and Referral to Treatment (SBIRT) programs, when their authors concluded that brief interventions were not effective for decreasing drug use among primary care patients identified through screening, and advised that widespread adoption of screening and brief intervention for drug use was not warranted.

An evaluation of the theoretical foundations for evidence-based SBIRT services was conducted to produce possible explanations for why traditional SBIRT works well for individuals with unhealthy alcohol use but not as well for those with more serious substance use disorders, including drug use and alcohol/drug dependence. Smith and Liehr’s evaluation framework for middle-range theory was utilized to analyze the Chronic Care Model, which was featured prominently in early SBIRT literature, and the newer Recovery Management model, which provides a philosophical framework for organizing modern addictions services and quality-of-life enhancements (Part 1 of this two-part series).

Programs are more likely to succeed if guided by theory, and examination of relevant components of theory-based interventions can be useful in developing practical strategies for meeting program objectives. A new, theory-based, recovery-oriented framework for primary care SBIRT is introduced in Part 2 (“SBIRT+RM(C): A Proposed Model for Recovery-Oriented Primary Care”).
Part 2: Screening, Brief Intervention and Referral to Treatment Plus Recovery Management
Authors: Fornili Katherine S.
Published: June 2016

Part 1 of this two-part series (The Theoretical Basis for Recovery-Oriented Management of Substance Use Disorders in the Primary Care) explored the theoretical foundations for evidence-based substance Screening, Brief Intervention and Referral to Treatment (SBIRT) services. The aim was to produce possible explanations for why traditional SBIRT works well for individuals with unhealthy alcohol use but not as well for individuals who have more serious substance use disorders, including drug use and alcohol/drug dependence. Building on that analysis, through meaningful application of recovery management (RM) concepts within an integrated primary care/behavioral health context, a new, theory-based, recovery-oriented framework for primary care SBIRT is now introduced in Part 2. The proposed SBIRT Plus Recovery Management (SBIRT + RM) model moves traditional SBIRT from its original, limited, and narrow focus only on substance detection, brief intervention, and referral to its rightful, structured placement within a comprehensive, multidimensional, recovery-oriented system of care clinical practice environment. SBIRT+RM describes relevant strategies for improving recovery outcomes for individuals identified through primary care substance screening and defines primary care provider roles and responsibilities for sustained recovery support and long-term recovery maintenance.
Consumer-Centered, Collaborative, and Comprehensive Care
Authors: DiClemente Carlo C. , Norwood Amber E. Q. , Gregory W. Henry , Travaglini Letitia , Graydon Meagan M. , Corno Catherine M.
Published: June 2016

Recovery from substance abuse and mental health disorders represents a journey through which individuals move beyond treatment of provider-identified problems toward a path of achieving wellness and productive lives. Overcoming obstacles and barriers encountered along the recovery process, individuals reveal their own strengths and resilience necessary to cope, survive, and thrive in the face of adversity. Recovery-oriented system of care (ROSC) is a framework designed to address the multidimensional nature of recovery by creating a system for coordinating multiple systems, services, and supports that are person centered and build on the strengths and resiliencies of individuals, families, and communities. As is common knowledge among substance abuse and mental health providers, consumers often present with high rates of comorbidity, which complicates care. In addition, behavioral health consumers engage in risky health behaviors (e.g., smoking) at a disproportionate rate, which places them at increased risk for developing noncommunicable diseases. ROSCs are ideal for addressing the complicated and varied needs of consumers as they progress toward wellness. The challenges of creating an ROSC framework that is effective, efficient, and acceptable to consumers is formidable. It requires change on the part of agencies, organizations, providers, and consumers. The importance of comprehensive, integrated screening is highlighted as a critical component of ROSC. Key suggestions for initiating ROSC are offered.
Implementation of Recovery Programming on an Inpatient Acute Psychiatric Unit and Its Impact on Readmission
Authors: Koval Renee D. , Mcdonagh James , Grubaugh Anouk , Young Wendy , Corcoran Beth , Lee Angela , Dumas Bonnie , Edlund Barbara
Published: June 2016

Background

Recovery-oriented models of care are evidence based and have been shown to improve patient satisfaction and outcomes as well as decrease the percentage of readmissions to inpatient psychiatric units.

Methods

This quality improvement project was implemented on a 16-bed inpatient adult mental health unit in a Veterans Affairs Medical Center. Percentages of readmissions were compared throughout the course of implementation of the recovery model. Readmissions during the months of July–September were tabulated over 3 subsequent years and compared readmission percentages before recovery implementation, during the early stage of recovery implementation, and finally, during ongoing recovery implementation.

Results

A decrease in readmission percentages was seen with implementation of recovery-oriented care when comparing the same 3-month period over 3 years.

Conclusion

After implementation of recovery-oriented care measures, there was a decrease in percentage of readmissions to the unit. In addition, this decrease was sustained and was shown to improve over time as recovery-oriented programming was further developed on the unit. These data suggest that Veterans Affairs Medical Centers should consider adding tools and procedures to successfully implement recovery programming on inpatient units and efforts should include direct involvement of patients in their own recovery journey, revision of policies and procedures to reflect the importance of recovery, thorough training of frontline staff regarding recovery principles, and transfer of recovery information directly from inpatient units to outpatient providers.
Houston Recovery Initiative
Authors: Bitting Sara , Nash Angela , Ochoa Ashley
Published: June 2016

Recovery from alcohol and drug problems is a process of change through which an individual achieves control and improved quality of life. Recovery is a primary goal for individuals with substance use disorder as it provides hope that treatment and overall health are possible for every individual. More than 23 million Americans are in recovery from addiction to alcohol and other drugs.

Recovery-oriented systems of care (ROSC) are networks of community services and peer support that help individuals and families achieve recovery from substances and improve overall health. ROSC is a strengths-based and person-centered model that leverages existing community resources to address the needs of individuals and families as they progress through the journey of recovery. The ROSC model serves as the foundation of the Houston Recovery Initiative (HRI).

The purpose of this article is to describe the history, development, and infrastructure of the HRI, which is a volunteer collaboration whose main goal is to educate the community on recovery and broaden the recovery safety net for people with substance use disorder in Houston, Texas. Since 2010, the HRI has grown to include more than 200 agencies across the spectrum of treatment and recovery support services in Houston so as to provide a resource for the community. Herein, we detail efforts to grow the HRI, lessons learned, future plans, and resources needed to move the HRI forward.
A Spot on the Abdomen
Authors: Jacob Sharon E.
Published: June 2016

Teledermatology is a term to describe the provision of dermatologic medical services through telecommunication technology. In this modality, there is transfer of patient medical information electronically (including history and visual data) obtained in one location to a provider who is in another location (Roman & Jacob, 2015). The construct of the TeleDermViewPoint column is such that cases are presented in a standardized teledermatology reader format reflective of an actual teledermatology report. This is a case of a spot on the abdomen.
Dermatology Emergencies
Authors: Kellen Roselyn , Berlin Joshua M.
Published: June 2016

Dermatology is primarily an outpatient specialty. However, it is important to recognize certain conditions that require referral for inpatient management as well as for healthcare professionals to appreciate the types of patients who need to be triaged appropriately in the emergency room or urgent care setting. This article will serve to summarize some of the diagnostic features and management of these patients.