bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Mutual Friend: Dual Holder Monitoring and Firm Investment Efficiency
Authors: Antón Miguel , Lin Luca X 
Published: November 2019

Abstract
We investigate the influence of simultaneous equity holdings by creditors (dual holders) on investment efficiency. Such creditors have stronger incentives and power to monitor firm investment as they have cash flow and control rights from both debt and equity sides. We provide evidence that dual holders, particularly noncommercial bank dual holders, significantly mitigate overinvestment. For high growth firms and those subject to debt overhang, dual holders also alleviate underinvestment. Equity value increases at the presence of dual holders. Our results indicate that by improving firm investment efficiency, dual holders not only make creditor investments safer but also create value for shareholders.
Received March 26, 2019; editorial decision September 17, 2019 by Editor Isil Erel.
Patterns of morphological diversification in giant Berberomeloe blister beetles (Coleoptera: Meloidae) reveal an unexpected taxonomic diversity concordant with mtDNA phylogenetic structure
Authors: Sánchez-Vialas Alberto , García-París Mario , Ruiz José L , Recuero Ernesto 
Published: November 2019

AbstractDelimiting species boundaries is a complex challenge usually hindered by overlooked morphological diversification or misinterpretation of geographically structured phenotypic variability. Independent molecular data are extremely useful to characterize and understand such morphological diversity. Morphological and molecular variability of the non-phoretic and apterous, widely distributed, giant blister beetles of the genus Berberomeloe, were investigated within and between lineages across most of the distributional range of the genus. We used two mtDNA gene fragments to characterize genetic variability and to produce a time-calibrated phylogeny of the genus. Our results reveal several mitochondrial lineages, allopatrically, parapatrically and sympatrically distributed. Most clades are not distinguishable between each other based on morphometrics. However, no morphometric overlap is observed between two closely related clades, one of them occurring in sympatry with a distantly congeneric species (B. insignis), suggesting that sympatry could trigger morphological diversification. Although most species share a morphometric space, they can be morphologically identified by a combination of easily observed characteristic qualitative features. Based on the concordance between mtDNA clades and morphological units, we describe six new species of Berberomeloe (B. castuo sp. nov., B. comunero sp. nov., B. indalo sp. nov, B. yebli sp. nov., B. payoyo sp. nov. and B. tenebrosus sp. nov.), revalidate two taxa (B. maculifrons comb. nov. and B. laevigatus comb. nov.) and redefine B. majalis.
Screening for HIV Infection in Pregnant Women: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force
Authors: Selph Shelley S. , Bougatsos Christina , Dana Tracy , Grusing Sara , Chou Roger 
Published: November 2019

(Abstracted from JAMA 2019;321(23):2349–2360)
Human immunodeficiency virus (HIV) can be transmitted from mother to child (MTCT) during pregnancy and the postpartum period. The number of perinatal HIV infections in the United States declined from 1985 to 2001 after routine prenatal screening was implemented across the country, along with the use of effective therapies for preventing MTCT.
Randomized Controlled Trial to Assess the Impact of Intraurethral Lidocaine on Urodynamic Voiding Parameters
Authors: Kisby Cassandra K. , Gonzalez Eric J. , Visco Anthony G. , Amundsen Cindy L. , Grill Warren M. 
Published: November 2019

(Abstracted from Female Pelvic Med Reconstr Surg 2019;25:265–270)
Neural circuits in the brain and spinal cord regulate the storage and elimination of urine to coordinate function between the urinary bladder and the urethra. The elimination of urine during micturition is facilitated by pelvic floor muscle relaxation and bladder wall contraction.
Surgical Site Infection After Open Upper Extremity Fracture and the Effect of Urgent Operative Intervention
Authors: Ryan Devon J. , Minhas Shobhit V. , Konda Sanjit , Catalano Louis W. 
Published: November 2019

Objectives:
To identify which factors are predictive of surgical site infection in upper extremity fractures, and to assess whether the timing of operative debridement influences infection risk.

Design:
Retrospective database review.

Setting:
Hospitals participating in the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database.

Patients:
Patients in the NSQIP database with fractures involving the upper extremity.

Intervention:
Surgical management of upper extremity fracture, including operative debridement for open injuries.

Main Outcome Measurements:
Surgical site infection, including both superficial and deep infections.

Results:
A total of 22,578 patients were identified, including 1298 patients with open injuries (5.7% of total). The overall wound infection rate was 0.79%. Patients with open injuries were found to have a higher incidence of infection compared with those with closed injuries (1.7% vs. 0.7%, P < 0.001). Independent risk factors for 30-day infection included open fracture diagnosis, obesity, smoking, and American Society of Anesthesiolgists class >2 (all P < 0.05). Of patients with open fractures, 79.7% were taken expediently to the operating room. The rate of infection did not differ based on whether surgery was performed expediently or not (1.8% vs. 1.1%, P = 0.431).

Conclusions:
Based on an analysis of the NSQIP database, the overall risk of surgical site infection following intervention for open or closed upper extremity fractures remains low. Risk factors for infection include open injury, obesity, and cigarette smoking. There was no difference in the infection rate based on the urgency of operative debridement.

Level of Evidence:
Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
A Combined Biomechanical and Tomographic Model for Identifying Cases of Subclinical Keratoconus
Authors: Atalay Eray , Özalp Onur , Erol Mehmet Akif , Bilgin Muzaffer , Yıldırım Nilgün 
Published: November 2019

Purpose:
To develop a combined biomechanical and tomographic model for identifying eyes with subclinical keratoconus (SKC) that are categorized as normal or borderline in the Pentacam Belin/Ambrósio Enhanced Ectasia Display.

Methods:
This case–control study comprised 62 eyes with SKC and randomly selected eyes of 186 age-matched healthy controls. SKC was defined as the presence of the following: 1) normal topography, topometric indices, and slit lamp; 2) normal or borderline Belin/Ambrósio Enhanced Ectasia Display D index, back and front elevation difference; and 3) keratoconus in the fellow eye. Stepwise logistic regression analysis was performed to identify the best variable combination for detecting SKC cases from Ocular Response Analyzer and Pentacam parameters. Receiver operating characteristic curve analysis was used to determine the predictive accuracy [area under the curve (AUC)] of the model. Based on the predictors in the final logistic regression model, a linear equation was derived using the discriminant function analysis.

Results:
The final model (AUC: 0.948, sensitivity: 87.1%, and specificity: 91.4%) chose corneal hysteresis (CH) and D index from a total of 63 candidate variables. The final model had a higher AUC compared with D (0.933, P = 0.053) and CH (0.80, P < 0.001) alone. According to the discriminant function analysis, a higher CH was required with increasing D index to classify an eye as normal.

Conclusions:
The proposed combined model provided varying cutoffs for CH and D as a function of the other. The probability plot as a function of CH and D index may be used for identifying eyes with SKC.
Discrepancies in Endothelial Cell Density Values of Human Donor Corneas Resulting From Comparison Between Specular Microscopes and Endothelial Analysis Methods
Authors: Shi Yue , Huang Jianyan , Conrick Patrick , Hoover Caroline , Lee Olivia L. 
Published: November 2019

Purpose:
The methods for specular microscopy evaluation across eye banks differ, which may result in variability in endothelial cell density (ECD) values that influence the surgeon's decision about donor tissue. A comparison of instruments and analysis methods is conducted in this study.

Methods:
Specular images were captured from 97 donor corneas using both HAI and Konan specular microscopes. A single best quality image of each cornea from each instrument was graded using the respective inherent software and analysis method (HAI: variable frame method; Konan: center method). All raw specular images were standardized for dimensions and regraded in the CellChek system in a blinded fashion. The grading variances and paired t test were performed between instruments in both inherent and standardized analyses. Correlation and Bland–Altman analyses between instruments were also performed.

Results:
Using the software inherent within HAI and Konan, the mean ECD readings for the 97 corneas were 2764 ± 583 and 2605 ± 517 cell/mm2 (P = 0.045), respectively, with a variance of 8.05% (range 0.26%–27.2%). HAI resulted in a higher ECD value in 79 corneas (81.4%). In CellChek software analysis, the mean ECD readings did not differ (2609 ± 514 and 2496 ± 507 cells/mm2, respectively, P = 0.127), with a variance of 5.6% (range 0.24%–19.8%).

Conclusions:
There is a slight statistically significant mean difference between the ECD values obtained from the 2 specular microscopes, which is negated by standardization to a single analysis method. Eye banks and surgeons should use caution in making decisions based only on very small differences in ECD between otherwise equivalent corneal donor tissues.
Pubic Symphysis Septic Arthritis Caused by Pasteurella multocida
Authors: French Brianna , Myers Joseph P. 
Published: November 2019

Abstract
Pubic symphysis septic arthritis is rare. To our knowledge, pubic symphysis septic arthritis caused by Pasteurella multocida has not been previously reported. A 79-year-old woman presented to the emergency department with a 3-day history of progressively severe left groin pain and swelling with unintentional 20-lb weight loss. Physical examination was negative except for the presence of a tender, fluctuant mass approximately 6 × 2-cm dimensions extending from the midpubic symphysis area to the left femoral crease. Computed tomography scan of the abdomen/pelvis confirmed a multiloculated mass in the area of the pubic symphysis measuring 7.6 × 2.1 × 5.5 cm with fluid extending posteriorly behind the pubic symphysis and erosion of bone in the pubic symphysis. Ultrasound-guided aspiration of the mass yielded 6 mL of purulent fluid with many Gram-negative bacilli on Gram-stained smear and a pure growth P. multocida on culture. Intravenous piperacillin/tazobactam was begun. The patient underwent operative drainage of the mass, and operative cultures revealed pure growth of P. multocida. Subsequently obtained history revealed that the patient has 1 pet cat with only 1 remaining tooth and the patient has not been bitten, scratched, or licked by the cat. Patient was treated with parenteral piperacillin/tazobactam and then ampicillin/sulbactam followed by oral amoxicillin/clavulanate. She rapidly returned to normal activities with no recurrence at 3 months' follow-up.
Wnt signaling contributes to withdrawal symptoms from opioid receptor activation induced by morphine exposure or chronic inflammation
Authors: Wu Mingzheng , Li Zehua , Liang Lei , Ma Pingchuan , Cui Dong , Chen Peng , Wu Genhao , Song Xue-Jun 
Published: November 2019

Abstract
Preventing and treating opioid dependence and withdrawal is a major clinical challenge, and the underlying mechanisms of opioid dependence and withdrawal remain elusive. We hypothesized that prolonged morphine exposure or chronic inflammation-induced μ-opioid receptor activity serves as a severe stress that elicits neuronal alterations and recapitulates events during development. Here, we report that Wnt signaling, which is important in developmental processes of the nervous system, plays a critical role in withdrawal symptoms from opioid receptor activation in mice. Repeated exposures of morphine or peripheral inflammation produced by intraplantar injection of complete Freund's adjuvant significantly increase the expression of Wnt5b in the primary sensory neurons in dorsal root ganglion (DRG). Accumulated Wnt5b in DRG neurons quickly transmits to the spinal cord dorsal horn (DH) after naloxone treatment. In the DH, Wnt5b, acts through the atypical Wnt-Ryk receptor and alternative Wnt-YAP/TAZ signaling pathways, contributing to the naloxone-precipitated opioid withdrawal-like behavioral symptoms and hyperalgesia. Inhibition of Wnt synthesis and blockage of Wnt signaling pathways greatly suppress the behavioral and neurochemical alterations after naloxone-precipitated withdrawal. These findings reveal a critical mechanism underlying naloxone-precipitated opioid withdrawal, suggesting that targeting Wnt5b synthesis in DRG neurons and Wnt signaling in DH may be an effective approach for prevention and treatment of opioid withdrawal syndromes, as well as the transition from acute to chronic pain.
What is usual care for low back pain? A systematic review of health care provided to patients with low back pain in family practice and emergency departments
Authors: Kamper Steven J. , Logan Gabrielle , Copsey Bethan , Thompson Jacqueline , Machado Gustavo C. , Abdel-Shaheed Christina , Williams Christopher M. , Maher Christopher G. , Hall Amanda M. 
Published: November 2019

Abstract
International clinical practice guidelines for low back pain (LBP) contain consistent recommendations including universal provision of information and advice to remain active, discouraging routine referral for imaging, and limited prescription of opioids. This systematic review describes usual care provided by first-contact physicians to patients with LBP. Studies that reported the assessments and care provided to people with LBP in family practice and emergency departments (EDs) from January 2000 to May 2019 were identified by searches of PubMed, EMBASE, and CINAHL. Study quality was assessed with reference to representativeness of samples, potential misclassification of patients, potential misclassification of outcomes, inconsistent data and precision of the estimate, and the findings of high-quality studies were prioritized in the data synthesis. We included 26 studies that reported data from almost 195,000 patients: 18 from family practice, and 8 from EDs. Less than 20% of patients with LBP received evidence-based information and advice from their family practitioner. Around 1 in 4 patients with LBP received referral for imaging in family practice and 1 in 3 in EDs. Up to 30% of patients with LBP were prescribed opioids in family practice and up to 60% in EDs. Large numbers of patients who saw a physician for LBP received care that is inconsistent with evidence-based clinical practice guidelines. Usual care included overuse of imaging and opioid prescription and underuse of advice and information. Suboptimal care may contribute to the massive burden of the condition worldwide.
Patient, Caregiver, and Clinician Perceptions of Ventricular Assist Device Self-care Education Inform the Development of a Simulation-based Mastery Learning Curriculum
Authors: Barsuk Jeffrey H. , Cohen Elaine R. , Harap Rebecca S. , Grady Kathleen L. , Wilcox Jane E. , Shanklin Kerry B. , Wayne Diane B. , Cameron Kenzie A. 
Published: November 2019

Background
Patients who undergo ventricular assist device (VAD) implantation and their caregivers must rapidly learn a significant amount of self-care skills and knowledge.

Objective
The aim of this study was to explore patient, caregiver, VAD coordinator, and physician perspectives and perceptions of existing VAD self-care training to inform development of a simulation-based mastery learning (SBML) curriculum to teach patients and caregivers VAD self-care skills and knowledge.

Methods
We conducted semistructured, in-person interviews with patients with a VAD, their caregivers, VAD coordinators, and physicians (cardiac surgeons, an infectious disease physician, and advanced heart failure cardiologists). We used a 2-cycle team-based iterative inductive approach to coding and analysis.

Results
We interviewed 16 patients, 12 caregivers, 7 VAD coordinators, and 11 physicians. Seven major themes were derived from the interviews including (1) identification of critical curricular content, (2) need for standardization and assessment, (3) training modalities, (4) benefits of repetition, (5) piercing it all together, (6) need for refresher training, and (7) provision of training before implant.

Conclusions
Findings from this study suggest that SBML is a natural fit for the high-risk tasks needed to save VAD self-care. The 7 unique training-related themes derived from the qualitative data informed the design and development of a VAD SBML self-care curriculum.
The nurse practitioner workforce: One rural state's experience of comparing state data with national trends
Authors: Owens Rhoda A. , Zwilling Jana G. 
Published: November 2019

ABSTRACT

Background:
There is a great need for primary care across the country especially in rural and underserved areas. Nurse practitioners (NPs) are filling these access gaps by providing high-quality, cost-effective primary care. However, one rural midwestern state does not address NP workforce data separately from other types of nursing data. In addition, these data are not included in the state's overall primary care workforce. Therefore, the data cannot be compared to the state's needs or national workforce trends.

Purpose:
The purpose of this investigation was to describe North Dakota's (NDs) NP workforce and compare this with national data.

Methods:
A cross-sectional descriptive design was used to collect and analyze NP workforce data from several sources. State Board of Nursing licensure data were used for description of the NDs current NP workforce. Six other data sources or reports were used to complete the data picture. State information was then compared with national NP survey results.

Results:
Both ND and national data sources reported the largest percentage of NPs certified in either primary care or adult care and practice primary care at either an outpatient or inpatient setting. North Dakota has a higher percentage of NPs working in primary care as compared with the national numbers. However, inconsistent categories are used in ND's NP workforce data and national surveys making comparisons difficult.

Implications for practice:
Accurate inclusion of NP workforce data in the overall health care workforce data will better guide state and national policy makers on necessary changes to decrease provider shortages and promote increased access to rural primary care services.
Persistent Soiling Affects Quality of Life in Children With Hirschsprung's Disease
Authors: Espeso Lucile , Coutable Audrey , Flaum Valérie , Rebeuh Julie , Lavrand Frédéric , Podevin Guillaume , Lamireau Thierry , Enaud Raphaël , Talon Isabelle 
Published: November 2019

ABSTRACTObjective:This multicentric study aimed to evaluate the quality of life (QOL) in children with Hirschsprung's disease (HD).Methods:HD patients aged from 6 to 18 years and followed‐up in 2 French pediatric surgery centers were included in this study. QOL was assessed using the HAQL questionnaires according to age (6–11 and 12–18), filled by patients and their parents (proxy reports) and correlated with initial disease characteristics, nutritional status, and functional score of Krickenbeck.Results:Sixty‐three patients were included. The acquisition of satisfactory voluntary bowel movements was found in only 50% of the 6 to 11 years old and 68% of the teenagers. Seventy percentage of the children and 55% of teenagers had soiling issues. The overall HAQLproxy6‐‐11 score was 528/700; best scores were found for “fecal continence” (94/100), “social functioning” (94/100), and “urinary continence” (92/100) whereas the worst scores were for “general well‐being” (64/100) and “diurnal fecal continence” (58/100). The overall HAQLproxy12‐‐16 score was 607/700; best scores were for “urinary continence” (96/100) and “social functioning” (93/100). In a multivariate analysis, soiling was the only factor significantly associated with low QOL (P = 0.03).Conclusions:Soiling remains frequent in children operated on for HD and negatively affects their QOL. Assessment and treatment of soiling should be the priority for medical teams in the follow‐up of these children.
Cardiometabolic Risk Factors and Benign Gynecologic Disorders
Authors: AlAshqar Abdelrahman , Patzkowsky Kristin , Afrin Sadia , Wild Robert , Taylor Hugh S. , Borahay Mostafa A. 
Published: November 2019

Importance
While it has long been known that polycystic ovarian syndrome is associated with cardiometabolic risk factors (CMRFs), there is emerging evidence that other benign gynecologic conditions, such as uterine leiomyomas, endometriosis, and even hysterectomy without oophorectomy, can be associated with CMRFs. Understanding the evidence and mechanisms of these associations can lead to novel preventive and therapeutic interventions.

Objective
This article discusses the evidence and the potential mechanisms mediating the association between CMRFs and benign gynecologic disorders.

Evidence Acquisition
We reviewed PubMed, EMBASE, Scopus, and Google Scholar databases to obtain plausible clinical and biological evidence, including hormonal, immunologic, inflammatory, growth factor–related, genetic, epigenetic, atherogenic, vitamin D–related, and dietary factors.

Results
Cardiometabolic risk factors appear to contribute to uterine leiomyoma pathogenesis. For example, obesity can modulate leiomyomatous cellular proliferation and extracellular matrix deposition through hyperestrogenic states, chronic inflammation, insulin resistance, and adipokines. On the other hand, endometriosis has been shown to induce systemic inflammation, thereby increasing cardiometabolic risks, for example, through inducing atherosclerotic changes.

Conclusion and Relevance
Clinical implications of these associations are 2-fold. First, screening and early modification of CMRFs can be part of a preventive strategy for uterine leiomyomas and hysterectomy. Second, patients diagnosed with uterine leiomyomas or endometriosis can be screened and closely followed for CMRFs and cardiovascular disease.

Target Audience
Obstetricians and gynecologists, family physicians.

Learning Objectives
After participating in this activity, the learner should be better able to identify the association between cardiometabolic risk factors and benign gynecologic disorders; explain the potential underlying mechanisms of such association; and discuss their clinical implications on health and health care.