bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Low-Cost Trainer for the Surgical Management of Postpartum Hemorrhage
Authors: Chuang Meleen , Purswani Heena , Fazzari Melissa J. , Kaplan Julie , Pardanani Setul , Banks Erika H. 
Published: March 2020

Introduction
Simulation-based training to manage surgical postpartum hemorrhage allows for improved preparation for these rarely needed life-saving procedures. Our objectives were to design a low-tech simulation model for use in training and evaluation of surgical techniques for the management of postpartum hemorrhage and to present evidence of its validity in assessment and training.

Methods
Fifty-two obstetrics and gynecology residents and 25 attending physicians from an academic hospital were video recorded while performing the O'Leary and B-Lynch techniques on the low-tech model. Performance was evaluated using a Technical Skills Checklist, for B-Lynch and O'Leary techniques, and the Reznick's Global Rating Scale. Interrater reliability was computed to assess the consistency of the ratings between 2 raters. Average scores were determined and compared between incoming residents, junior residents, senior residents, and attending physicians to show construct validity.

Results
For the B-Lynch, Technical Skills Checklist scores (maximum 17 points) of attendings (15.04) and senior residents (15.12) were higher than those of junior residents (5.63) and new residents (3.38). Global Rating Scale scores (maximum 25 points) on the B-Lynch reflected the same increase (22.38, 19.35 vs. 8.85, 6.75, respectively). For the O'Leary stitch, the scores of attendings, senior, junior, and incoming residents were as follows: 15.20, 13.65, 11.54, and 2.83, respectively (maximum 19 points). This supports the construct validity of the model. The model was considered realistic and useful for improving surgical skills in 71.4% of participants.

Conclusions
This low-cost, easily constructed model is a useful tool for training these surgical skills.
DebriefLive
Authors: Wong Nelson L. , Peng Cynthia , Park Chan W. , Pérez José , Vashi Anita , Robinson Jane , Okuda Yasuharu 
Published: March 2020

Introduction
The quality of healthcare simulation learning relies heavily on effective debriefers. Traditional methods of faculty development in debriefing lack a structured approach to achieve expertise via graduated and reflective practice.

Methods
The Simulation Learning, Education and Research Network (SimLEARN) developed DebriefLive, a virtual teaching environment, bringing together faculty and participant debriefers from across the Veterans Health Administration. Recorded simulation sessions were viewed followed by the opportunity for participant debriefers to debrief virtual learners. Participant debriefers were then provided structured and objective debriefings of the debriefings with the added opportunity for immediate practice. Program evaluation data for the pilot sessions were collected via electronic survey including a mix of Likert scale questions as well as short answer responses.

Results
On a 7-point Likert scale, participant debriefers (n = 15) rated the content as effective (mean = 6.67, SD = 0.47) and appropriate to their level (mean = 6.47, SD = 0.47). The technology of video-based scenarios (mean = 6.6, SD = 0.61), followed by avatar-based debriefing sessions (mean = 6.6, SD = 0.8), was felt to be accurate and appropriate. All participants would agree or strongly agree with recommending this training program to colleagues.

Conclusions
Simulation instructors and fellows across the spectrum of the Veterans Health Administration found the innovative computer-based faculty development program DebriefLive acceptable as well as effective in increasing self-efficacy in debriefing. DebriefLive is an innovative and potentially disruptive tool, combining best practices in simulation theory and virtual technologies, for the training and assessment of debriefers.
Perioperative Outcomes for Combined Ventral Rectopexy With Sacrocolpopexy Compared to Perineal Rectopexy With Vaginal Apical Suspension
Authors: Smith Pamela E. , Hade Erinn M. , Pandya Lopa K. , Nekkanti Silpa , Hundley Andrew F. , Hudson Catherine O. 
Published: March 2020

Objectives
To describe and compare perioperative complications in women undergoing combined ventral rectopexy with sacrocolpopexy compared with perineal rectopexy with vaginal apical suspension.

Methods
Current Procedural Terminology codes were used to identify women in the National Surgical Quality Improvement Program database who underwent ventral rectopexy with sacrocolpopexy or perineal rectopexy with vaginal apical suspension from 2006 to 2015. Perioperative complication was defined as any of the following within 30 days of surgery: death, return to the operating room, transfusion, or vascular, wound, respiratory, infectious, or renal morbidity. Secondary outcomes included length of hospital stay, operative time, blood loss, readmission, and rate of urinary tract infections. Modified Poisson regression was used to estimate the adjusted relative risks of complication associated with surgical approach, abdominal versus perineal.

Results
Of the 273 women included, 240 (88%) underwent surgery with an abdominal approach, and 33 (12%) underwent surgery with a perineal approach. Perioperative complications occurred in 24 (9%) patients; 19 (8%) in the abdominal group and 5 (15%) in the perineal group. The age-adjusted risk of perioperative complications was not significantly different between those with a perineal approach compared with those with an abdominal approach (adjusted relative risk, 1.78; 95% confidence interval, 0.73–4.33).

Conclusions
Patients in this database who underwent surgery with a vaginal/perineal approach were not more likely to have a postoperative complication after adjusting for age compared with those undergoing an abdominal approach. Larger studies are needed to determine a more precise estimate of the impact of surgical approach on rates of perioperative complications.
“Landmark” Articles in Female Pelvic Medicine and Reconstructive Surgery: Do We Read What We Cite?
Authors: Gupta Ankita , Kennedy Bridget , Meriwether Kate V. , Hobson Deslyn T. G. , Francis Sean L. , Stewart J. Ryan 
Published: March 2020

Objective
The aim of the study was to describe the provision of a “landmark” article reading list to trainees by their Female Pelvic Medicine & Reconstructive Surgery (FPMRS) fellowship programs.

Methods
In this cross-sectional study, a web-based survey was sent to program coordinators of accredited FPMRS programs. Available reading lists were collected, and a master list compiled. Nonparametric tests were used to investigate the association between the number of faculty members and presence of a reading list.

Results
We received a response from 46 (92%) of the 50 Accreditation Council for Graduate Medical Education programs contacted. Half the programs (23/46, 50%) reported that they do not offer a recommended reading list, 5 programs were unsure and over more than 60% with a list (12/18, 67%) shared their list with the investigators. Programs had between 2 and 14 core faculty members with a median (interquartile range) of 4 (3–6). Programs with a reading list had significantly fewer faculty members (3.5, 3–5 vs 5, 3–6, P = 0.03). There were 323 unique articles across the 12 lists, with a median of 25 articles per list. Thirty-four articles were on 4 or more lists; 9 of these (9/34, 26%) have previously been identified as citation classics.

Conclusions
At least 50% of the Accreditation Council for Graduate Medical Education accredited programs do not provide their fellows with a recommended reading list, and fewer core faculty members are associated with the presence of such a list. Although some commonalities are found between reading lists, a universal reading list of “landmark” articles could improve the consistency of FPMRS fellowship education.
Risk Factors for Returning to the Operating Room for a Second Surgery After Midurethral Sling for Stress Urinary Incontinence
Authors: Sharif Fatima , Mahmud Fizza , Suman Sahil , Cheng An-Lin , Shepherd Jonathan P. , Sutkin Gary 
Published: March 2020

Objectives
The objective of this study was to identify risk factors for having to return to the operating room for a second surgery after midurethral sling (MUS).

Methods
We used a case-control design. Cases return to operating room were a composite of 6 surgical complications or recurrent stress urinary incontinence because we believed that women would consider return to the operating room (OR) a similar MUS-related complication regardless of indication. Cases were obtained from Cerner Health Facts database, including 213 hospitals, using current procedural technology codes 57288 (repeat sling), 57287 (sling revision), and 53500 (urethrolysis) for procedures after index MUS. Controls no return to OR were randomly selected in 4:1 ratio from the remaining slings without these procedures. Multivariable regression analysis included all variables with P < 0.10 on univariable analysis.

Results
Between January 1, 2010, and December 31, 2016, 1247 patients returned to the OR of 17,953 patients who underwent initial MUS (6.9%). After adjusting for confounders, white race (OR, 1.47 [1.20–1.81]), lack of concomitant prolapse surgery (OR, 1.37 [1.18–1.59]), immunosuppressant drugs (OR, 1.27 [1.12–1.45]), and blood thinner use (OR, 1.38 [1.18–1.62]) significantly impacted the odds for returning to the OR. Anticholinergic use and smoking tobacco or marijuana, although significant on univariable analysis, were no longer significant after adjusting for confounders.

Conclusions
The rate of a second surgery after MUS using a composite outcome, over a 7-year period including multiple diagnoses, is 6.9%. White race, using immunosuppressant drugs, using blood thinners, and not having concomitant prolapse surgery are all risk factors for having second surgery after MUS.
The Design of a Prospective Trial to Evaluate the Role of Preoperative Frailty Assessment in Older Women Undergoing Surgery for the Treatment of Pelvic Organ Prolapse: The FASt Supplemental Trial
Authors: Erekson Elisabeth , Menefee Shawn , Whitworth Ryan E. , Amundsen Cindy L. , Arya Lily A. , Komesu Yuko M. , Ferrando Cecile A. , Zyczynski Halina M. , Sung Vivian W. , Rahn David D. , Tan-Kim Jasmine , Mazloomdoost Donna , Gantz Marie G. , Richter Holly E. ,   on behalf of the Eunice Kennedy Shriver NICHD Pelvic Floor Disorders Network (PFDN)
Published: March 2020

Objective
We present the rationale for and the design of a prospective trial to evaluate the role of preoperative frailty and mobility assessments in older women undergoing surgery for the treatment of pelvic organ prolapse (POP) as a planned prospective supplemental trial to the ASPIRe (Apical Suspension Repair for Vault Prolapse In a Three-Arm Randomized Trial Design) trial. The Frailty ASPIRe Study (FASt) examines the impact of preoperative frailty and mobility on surgical outcomes in older women (≥65 years) participating in the ASPIRe trial. The primary objective of FASt is to determine the impact of preoperative age, multimorbidity, frailty, and decreased mobility on postoperative outcomes in older women (≥65 years old) undergoing surgery for POP.

Methods
The selection of the preoperative assessments, primary outcome measures, and participant inclusion is described. Frailty and mobility measurements will be collected at the preoperative visit and include the 6 Robinson frailty measurements and the Timed Up and Go mobility test. The main outcome measure in the FASt supplemental study will be moderate to severe postoperative adverse events according to the Clavien-Dindo Severity Classification.

Conclusions
This trial will assess impact of preoperative age, multimorbidity, frailty, and decreased mobility on postoperative outcomes in older women (≥65 years old) undergoing surgical procedures for the correction of apical POP. Information from this trial may help both primary care providers and surgeons better advise/inform women on their individual risks of surgical complications and provide more comprehensive postoperative care to women at highest risk of complications.
Identification of injury and shock driven effects on ex vivo platelet aggregometry: A cautionary tale of phenotyping
Authors: Starr Nichole E. , Matthay Zachary A. , Fields Alexander T. , Nunez-Garcia Brenda , Callcut Rachael A. , Cohen Mitchell J. , Kornblith Lucy Zumwinkle 
Published: March 2020

BACKGROUND
Platelet behavior in trauma-induced coagulopathy is poorly understood. Injured patients have impaired platelet aggregation (dysfunction) in ex vivo agonist-stimulated platelet aggregometry (PA). However, PA assumes that platelets are inactivated before ex vivo stimulated aggregation, which may be altered by injury. We hypothesized that following trauma, platelet aggregation (area under the curve) is decreased regardless of injury burden, but that (1) minor injury is associated with an increased baseline electrical impedance, characteristic of a functional platelet phenotype (platelets that activate in response to injury), and that (2) severe injury is not associated with an increased baseline electrical impedance, characteristic of a dysfunctional phenotype (platelets that do not activate well in response to injury) compared with healthy controls.

METHODS
Blood from 458 trauma patients and 30 healthy donors was collected for PA. Baseline electrical impedance (Ω); platelet aggregation stimulated by adenosine diphosphate, collagen, thrombin, and arachidonic acid; and rotational thromboelastometry were measured. Multivariate regression was performed to identify associations of PA measures with blood transfusion.

RESULTS
Compared with healthy controls, injured patients had impaired platelet aggregation in response to ex vivo stimulation, regardless of injury burden. However, minorly injured patients had increased endogenous platelet activation (baseline electrical impedance, Ω: with shock, p = 0.012; without shock, p = 0.084), but severely injured patients did not have significant increases in endogenous platelet activation (baseline electrical impedance, Ω: with shock, p = 0.86; without shock, p = 0.37). For every 10 Ω increase in baseline electrical impedance, there was an 8% decrease in units of blood transfused in the first 24 h (−0.08; confidence interval, −0.14 to −0.02; p = 0.015).

CONCLUSION
Injury and shock confer differential patterns of platelet aggregation in PA. Minor injury overestimates the presence of platelet dysfunction, while severe injury induces a truly dysfunctional phenotype—platelets that do not activate nor aggregate appropriately after injury. This is consequential in improving accurate phenotyping of postinjury platelet behavior for platelet-based therapeutics.

LEVEL OF EVIDENCE
Prognostic, level IV.
Guidelines for preventing respiratory illness in older adults aged 60 years and above living in long-term care
Authors: Rios Patricia , Radhakrishnan Amruta , Thomas Sonia M. , Darvesh Nazia , Straus Sharon E. , Tricco Andrea C. 
Published: March 2020

ABSTRACTBackgroundThe overall objective of this rapid review was to identify infection protection and control recommendations from published clinical practice guidelines (CPGs) for adults aged 60 years and older in long-term care settingsMethodsComprehensive searches in MEDLINE, EMBASE, the Cochrane Library, and relevant CPG publishers/repositories were carried out in early March 2020. Title/abstract and full-text screening, data abstraction, and quality appraisal (AGREE-II) were carried out by single reviewers.ResultsA total of 17 relevant CPGs were identified, published in the USA (n=8), Canada (n=6), Australia (n=2), and the United Kingdom (n=1). All of the CPGs dealt with infection control in long-term care facilities (LTCF) and addressed various types of viral respiratory infections (e.g., influenza, COVID-19, severe acute respiratory syndrome). Ten or more CPGs recommended the following infection control measures in LTCF: hand hygiene (n=13), wearing personal protective equipment (n=13), social distancing or isolation (n=13), disinfecting surfaces (n=12), droplet precautions (n=12), surveillance and evaluation (n=11), and using diagnostic testing to confirm illness (n=10). While only two or more CPGs recommended these infection control measures: policies and procedures for visitors, staff and/or residents (n=9), respiratory hygiene/cough etiquette (n=9), providing supplies (n=9), staff and/or residents education (n=8), increasing communication (n=6), consulting or notifying health professionals (n=6), appropriate ventilation practices (n=2), and cohorting equipment (n=2). Ten CPGs also addressed management of viral respiratory infections in LTCF and recommended antiviral chemoprophylaxis (n=10) and one CPG recommended early mobilization of residents.ConclusionThe recommendations from current guidelines overall seem to support environmental measures for infection prevention and antiviral chemoprophylaxis for infection management as the most appropriate first-line response to viral respiratory illness in long-term care.
Bedrock radioactivity influences the rate and spectrum of mutation
Authors: Saclier Nathanaëlle , Chardon Patrick , Malard Florian , Konecny-Dupré Lara , Eme David , Bellec Arnaud , Breton Vincent , Duret Laurent , Lefébure Tristan , Douady Christophe J. 
Published: March 2020

AbstractAll organisms on Earth are exposed to low doses of natural radioactivity but some habitats are more radioactive than others. Yet, documenting the influence of natural radioactivity on the evolution of biodiversity is challenging. Here, we addressed whether organisms living in naturally more radioactive habitats accumulate more mutations across generations using 14 species of waterlice living in subterranean habitats with contrasted levels of radioactivity. We found that the mitochondrial and nuclear mutation rates across a waterlouse species’ genome increased on average by 60 and 30%, respectively, when radioactivity increased by a factor of three. We also found a positive correlation between the level of radioactivity and the probability of G to T (and complementary C to A) mutations, a hallmark of oxidative stress. We conclude that even low doses of natural bedrock radioactivity influence the mutation rate through the likely accumulation of oxidative damage, in particular in the mitochondrial genome.
AntiCP 2.0: An updated model for predicting anticancer peptides
Authors: Agrawal Piyush , Bhagat Dhruv , Mahalwal Manish , Sharma Neelam , Raghava Gajendra P. S. 
Published: March 2020

AbstractIncreasing use of therapeutic peptides for treating cancer has received considerable attention of the scientific community in the recent years. The present study describes thein silicomodel developed for predicting and designing anticancer peptides (ACPs). ACPs residue composition analysis revealed the preference of A, F, K, L and W. Positional preference analysis revealed that residue A, F and K are preferred at N-terminus and residue L and K are preferred at C-terminus. Motif analysis revealed the presence of motifs like LAKLA, AKLAK, FAKL, LAKL in ACPs. Prediction models were developed using various input features and implementing different machine learning classifiers on two datasets main and alternate dataset. In the case of main dataset, ETree Classifier based model developed using dipeptide composition achieved maximum MCC of 0.51 and 0.83 AUROC on the training dataset. In the case of alternate dataset, ETree Classifier based model developed using amino acid composition performed best and achieved the highest MCC of 0.80 and AUROC of 0.97 on the training dataset. Models were trained and tested using five-fold cross validation technique and their performance was also evaluated on the validation dataset. Best models were implemented in the webserver AntiCP 2.0, freely available athttps://webs.iiitd.edu.in/raghava/anticp2. The webserver is compatible with multiple screens such as iPhone, iPad, laptop, and android phones. The standalone version of the software is provided in the form of GitHub package as well as in docker technology.
Functional Localization of an Attenuating Filter within Cortex for a Selective Detection Task in Mice
Authors: Aruljothi Krithiga , Marrero Krista , Zhang Zhaoran , Zareian Behzad , Zagha Edward 
Published: March 2020

AbstractAn essential feature of goal-directed behavior is the ability to selectively respond to the diverse stimuli in one’s environment. However, the neural mechanisms that enable us to respond to target stimuli while ignoring distractor stimuli are poorly understood. To study this sensory selection process, we trained male and female mice in a selective detection task in which mice learn to respond to rapid stimuli in the target whisker field and ignore identical stimuli in the opposite, distractor whisker field. In expert mice, we used widefield Ca2+imaging to analyze target-related and distractor-related neural responses throughout dorsal cortex. For target stimuli, we observed strong signal activation in primary somatosensory cortex (S1) and frontal cortices, including both the whisker representation of primary motor cortex (wMC) and anterior lateral motor cortex (ALM). For distractor stimuli, we observe strong signal activation in S1, with minimal propagation to frontal cortex. Our data support only modest subcortical filtering, with robust, step-like attenuation in distractor processing between mono-synaptically coupled regions of S1 and wMC. This study establishes a highly robust model system for studying the neural mechanisms of sensory selection and places important constraints on its implementation.SummaryResponding to task-relevant stimuli while ignoring task-irrelevant stimuli is critical for goal-directed behavior. Yet, the neural mechanisms involved in this selection process are poorly understood. We trained mice in a detection task with both target and distractor stimuli. During expert performance, we measured neural activity throughout cortex using widefield imaging. We observed responses to target stimuli in multiple sensory and motor cortical regions. In contrast, responses to distractor stimuli were abruptly suppressed beyond sensory cortex. Our findings localize the sites of attenuation when successfully ignoring a distractor stimulus, and provide essential foundations for further revealing the neural mechanism of sensory selection and distractor suppression.
Estimating bobcat (Lynx rufus) abundance in Wisconsin during 1981-2015
Authors: Allen Maximilian L. , Roberts Nathan , Bauder Javan 
Published: March 2020

AbstractQuantifying and estimating trends in wildlife abundance is critical for their management and conservation. Harvest-based indices are often used as a surrogate index for wildlife population. Sex-Age-Kill (SAK) models generally use the age-at-harvest of males and females, combined with annual mortality and reproduction rates to calculate a preharvest population estimate. We used and SAK model to estimate abundance for bobcats from 1981-2015. Pre-hunt population size ranged from approximately 1630-2148 during 1981-1995 after which the population increased to a maximum of 4439 in 2005 before declining to 2598 in 2013. Pre-hunt population size was highly correlated an index of abundance from winter track counts (r= 0.93). We found that the model, as currently implemented by WNDR, appears to provide an accurate trend of statewide bobcat abundance. SAK models more logistically feasible for long-term evaluations of population trends overbroad spatial extents than more intensive methods. While SAK models may be the only technique available to wildlife managers for estimating the abundance of harvested species, we encourage additional research to evaluate the effects of potential biases on estimates of abundance.