bluuebunny/crossref_metadata_2025_split huggingface dataset:
Caring for Children With Medical Complexity With the Emergency Information Form
Authors: Larson Ingrid A. , Colvin Jeffrey D. , Hoffman Amber , Colliton William Scott , Shaw Ryan J. 
Published: December 2019

Background and Objective
The American Academy of Pediatrics recommends an emergency information form (EIF) for children with medical complexity (CMC) to facilitate emergency care. We sought to increase the EIF completion rate at our children's hospital's CMC clinic and to evaluate the effect on caregiver and emergency department (ED) provider opinion of preparation, comfort, and communication.

Methods
We used a pre/post–quality improvement design. The main outcomes were (1) the proportion of completed EIFs and (2) caregiver and ED provider opinion of preparation, comfort, and communication, using a Likert scale survey (1, low; 5, high).

Results
Emergency information form completion increased from 3.1% (4/133) before the intervention to 47.0% (78/166) after (P < 0.001). Twenty-three providers completed presurveys, and 8 completed postsurveys. Seventy-two caregivers completed presurveys, and 38 completed postsurveys (25 with ED visit and 13 without). There were no changes in preparation, comfort, or communication for caregivers who had an ED visit after the intervention. For those without a postintervention ED visit, caregiver median scores rose for preparation (4 [interquartile range {IQR}, 3–5] vs 5 [IQR, 4–5], P = 0.02) and comfort (4 [IQR, 2.25–5] vs 5 [IQR, 4–5], P = 0.05). After the intervention, ED providers had increased median communication scores (3 [IQR, 2.75–4.25] vs 5 [IQR, 4–5], P = 0.02), whereas scores of preparation and comfort were unchanged.

Conclusion
A quality improvement project at a CMC clinic increased EIF completion, caregiver preparation and comfort, and ED provider communication in emergencies.
The Osteoarticular Infection in a Pediatric Emergency Setting
Authors: Boccuzzi Elena , Buonsenso Danilo , Ferro Valentina , Raucci Umberto , Reale Antonino , Piga Simone , Deriu Daniele , Krzysztofiak Andrzej 
Published: December 2019

Objectives
The study aimed to evaluate the emergency department (ED) presentation of children with a diagnosis of osteomyelitis, septic arthritis, or both.

Methods
A retrospective single-center study was conducted on all children aged between 1 month and 18 years evaluated in the ED over a 7-year period and having a final diagnosis of osteoarticular infection. One hundred seventeen patients were enrolled.

Results
Only 39.3% of patients were admitted after the first evaluation, and only 45.3% had a proper diagnosis of admission. Pain was the only symptom reported by all. White cell count, C-reactive protein level, and erythrocytes sedimentation rate were normal in 49.5%, 21.4%, and 17.1% of children, respectively. X-ray findings were unremarkable in 48% of cases. Clinical and bone structural sequelae were described in 19.23% and 56.86% of all cases. No statistically significant differences were found among osteomyelitis, arthritis, and the combination of both regarding all considered variables, except for structural outcomes resulting more significant in the third group. Significant differences were evident in clinical manifestations, blood examinations, and findings of osteolysis between patients diagnosed within and after 1 week since the disease onset. Finally, questionable differences between white blood cells and C-reactive protein level were found among patients younger than 5 years and older ones, whereas a history of trauma was more often reported in the second group.

Conclusions
The difficulty in recognizing osteoarticular infection in a pediatric ED can be due to the possible lack of the classic signs and symptoms, and the absence of specific laboratory and radiologic findings.
Molecular Magnetic Resonance Imaging of Fibrin Deposition in the Liver as an Indicator of Tissue Injury and Inflammation
Authors: Atanasova Iliyana , Sojoodi Mozhdeh , Leitão Helena S. , Shuvaev Sergei , Geraldes Carlos F.G.C. , Masia Ricard , Guimaraes Alexander S. , Tanabe Kenneth K. , Fuchs Bryan C. , Caravan Peter 
Published: December 2019

Rationale and Objectives
Liver inflammation is associated with nonalcoholic steatohepatitis and other pathologies, but noninvasive methods to assess liver inflammation are limited. Inflammation causes endothelial disruption and leakage of plasma proteins into the interstitial space and can result in extravascular coagulation with fibrin deposition. Here we assess the feasibility of using the established fibrin-specific magnetic resonance probe EP-2104R for the noninvasive imaging of fibrin as a marker of liver inflammation.

Methods
Weekly 100 mg/kg diethylnitrosamine (DEN) dosing was used to generate liver fibrosis in male rats; control animals received vehicle. Magnetic resonance imaging at 1.5 T with EP-2104R, a matched non–fibrin-binding control linear peptide, or the collagen-specific probe EP-3533 was performed at 1 day or 7 days after the last DEN administration. Imaging data were compared with quantitative histological measures of fibrosis and inflammation.

Results
After 4 or 5 DEN administrations, the liver becomes moderately fibrotic, and fibrosis is the same if the animal is killed 1 day (Ishak score, 3.62 ± 0.31) or 7 days (Ishak score, 3.82 ± 0.25) after the last DEN dose, but inflammation is significantly higher at 1 day compared with 7 days after the last DEN dose (histological activity index from 0–4, 3.54 ± 0.14 vs 1.61 ± 0.16, respectively; P < 0.0001). Peak EP-2104R signal enhancement was significantly higher in animals imaged at 1 day post-DEN compared with 7 days post-DEN or control rats (29.0% ± 3.2% vs 22.4% ± 2.0% vs 17.0% ± 0.2%, respectively; P = 0.017). Signal enhancement with EP-2104R was significantly higher than control linear peptide at 1 day post-DEN but not at 7 days post-DEN indicating specific fibrin binding during the inflammatory phase. Collagen molecular magnetic resonance with EP-3533 showed equivalent T1 change when imaging rats 1 day or 7 days post-DEN, consistent with equivalent fibrosis.

Conclusions
EP-2104R can specifically detect fibrin associated with inflammation in a rat model of liver inflammation and fibrosis.
Using patient self-checklist to improve the documentation of risk of postoperative nausea and vomiting: an implementation project
Authors: Zheng Zhen , Layton Jennifer , Stelmach Wanda , Crabbe Julie , Ma Jason , Briedis Juris , Atme Jeanette , Bourne Debra , Hau Raphael , Cleary Sonja , Xue Charlie C. 
Published: December 2019

ABSTRACT

Background and aims:
Postoperative nausea and vomiting (PONV) is a common surgical complication, affecting 30–50% of patients and 80% in high risk populations. Successful prevention and management of PONV relies on accurately assessing individual risk prior to surgery. A valid and reliable Apfel score is commonly used to assess patients’ risk. It is however challenging to translate this evidence into clinical practice. This evidence-based project aimed to identify the current practice of assessing and documenting the risk factors of PONV prior to surgery, and to develop strategies to improve the practice.

Methods:
The project had three phrases, including forming a team and conducting the baseline audit; identifying problems and developing strategies; and conducting a follow-up tool to assess the impact on compliance with best practice. A research team was formed. A baseline audit was conducted at a public hospital in Victoria in June 2016 to examine PONV risk assessment practice through checking medical files of surgical patients. A getting research into practice audit and feedback tool was used to identify barriers, implementation strategies, stakeholders and resources. After implementation, a second audit was conducted between June and October 2017. Audit criteria were based on a reliable and valid Apfel score.

Results:
At baseline, accurate PONV risk could only be calculated from 8% of patient files with no file formally recording the risk factors. The proportion of patients with three risk factors preoperatively, indicating high PONV risk, was 5.3%. Barriers identified were the perceived lack of necessity to record the risk, time constraint and too much paperwork. A self-checklist for risk assessment was developed to enable patients to check their own level of risk. Its face validity, construct validity and accuracy were examined. The checklist was then implemented for patients to complete prior to surgery. A number of strategies were used to improve the implementation. The second audit of 1308 files showed that at the end of audit period, 74% of patients had risk assessment conducted and documented postimplementation. 16.8% of the patients were identified as having high PONV risk, nearly triple the number identified at baseline.

Conclusion:
A simple self-checklist of PONV risk was implemented. It greatly improved PONV risk assessment and documentation in a public hospital in Australia and enabled the identification of patients at high risk.
Single Cell Profiling of Acute Kidney Injury Reveals Novel Transcriptional Signatures, Mixed Identities and Epithelial-to-Stromal Crosstalk
Authors: Rudman-Melnick Valeria , Adam Mike , Potter Andrew , Chokshi Saagar M. , Ma Qing , Drake Keri A. , Schuh Meredith P. , Kofron J. Matthew , Devarajan Prasad , Potter S. Steven 
Published: December 2019

SummaryAcute kidney injury (AKI) is a rapid decline of renal function, with an incidence of up to 67% of intensive care unit patients. Current treatments are merely supportive, emphasizing the need for deeper understanding that could lead to improved therapies. We used single cell RNA sequencing,in situhybridization and protein expression analyses to create comprehensive renal cell specific transcriptional profiles of multiple AKI stages. We revealed that AKI induces marked dedifferentiation, renal developmental gene activation and mixed identities in injured renal tubules. Moreover, we identified potential pathologic crosstalk between epithelial and stromal cells, and several novel genes involved in AKI. We also demonstrated the definitive effects of age on AKI outcome, and showed that renal developmental genes hold a potential as novel AKI markers. Moreover, our study provides the resource power which will aid in unraveling the molecular genetics of AKI.
Altered active control of step width in response to mediolateral leg perturbations while walking
Authors: Reimold Nicholas K. , Knapp Holly A. , Henderson Rachel E. , Wilson Landi , Chesnutt Alyssa N. , Dean Jesse C. 
Published: December 2019

AbstractDuring human walking, step width is predicted by mediolateral motion of the pelvis, a relationship that can be attributed to a combination of passive body dynamics and active sensorimotor control. The purpose of the present study was to investigate whether humans modulate the active control of step width in response to a novel mechanical environment. Participants were repeatedly exposed to a force-field that either assisted or perturbed the normal relationship between pelvis motion and step width, separated by washout periods to detect the presence of potential after-effects. As intended, force-field assistance directly strengthened the relationship between pelvis displacement and step width. This relationship remained strengthened with repeated exposure to assistance, and returned to baseline afterward, providing minimal evidence for assistance-driven changes in active control. In contrast, force-field perturbations directly weakened the relationship between pelvis motion and step width. Repeated exposure to perturbations diminished this negative direct effect, and produced larger positive after-effects once the perturbations ceased. Both of these results provide evidence of gradual changes in active control in response to perturbations. In the longer term, these methods may be useful for improving deficits in the active control of step width often observed among clinical populations with poor walking balance.
Neonatal granulocytic MDSCs possess phagocytic properties during bacterial infection
Authors: Seman Brittany G. , Vance Jordan K. , Witt Michelle R. , Robinson Cory M. 
Published: December 2019

AbstractMyeloid-derived suppressor cells (MDSCs) are an immunosuppressive cell type found in high abundance in early life. Currently, there has been limited mechanistic understanding of MDSC phagocytosis of bacteria and the corresponding consequences in the context of acute infection. We set out to determine whether human granulocytic MDSCs have phagocytic capacity that is comparable to other professional phagocytes. To investigate these properties, we utilized fluorescent confocal microscopy, flow cytometry, and bacterial burden assays. We demonstrate that human granulocytic MDSCs phagocytoseE. coliO1:K1:H7, and subsequently traffic the bacteria into acidic compartments similar to other phagocytes. However, MDSCs were significantly less efficient at bacterial uptake and killing compared to monocytes. This activity is associated with an inflammatory response, but the amount of TNFα gene and protein expression was reduced in infected MDSCs compared to monocytes. Interestingly, we also found that MDSCs release DNA (MeDNA) into the extracellular space that resembles neutrophil extracellular traps. We found that MeDNA had some impact on bacterial viability in single cultures, with an increase in bacterial recovery in MDSCs treated with DNAse. However, MeDNA did not impact the ability of monocytes to eliminate bacteria in co-cultures, suggesting that MDSC extracellular DNA does not compromise monocyte function. Overall, our data reveals mechanistic insight into MDSC activity during infection that includes the kinetics and efficiency of bacterial uptake, elimination through trafficking to acidified compartments, and inflammatory contributions relative to primary human monocytes. These results enhance our understanding of MDSC contributions during acute bacterial infection and identify host-directed targets for immune intervention to improve outcomes and reduce susceptibility to infection early in life.
Induction of Recurrent Break Cluster Genes in Neural Progenitor Cells Differentiated from Embryonic Stem Cells In Culture
Authors: Tena Aseda , Zhang Yuxiang , Kyritsis Nia , Devorak Anne , Zurita Jeffrey , Wei Pei-Chi , Alt Frederick W. 
Published: December 2019

ABSTRACTMild replication stress enhances appearance of dozens of robust recurrent genomic break clusters, termed RDCs, in cultured primary mouse neural stem and progenitor cells (NSPCs). Robust RDCs occur within genes (“RDC-genes”) that are long and have roles in neural cell communications and/or have been implicated in neuropsychiatric diseases or cancer. We sought to develop anin vitroapproach to determine whether specific RDC formation is associated with neural development. For this purpose, we adapted a system to induce neural progenitor cell (NPC) development from mouse embryonic stem cell (ESC) lines deficient for XRCC4 plus p53, a genotype that enhances DNA double-strand break (DSB) persistence to enhance detection. We tested for RDCs by our genome wide DSB identification approach that captures DSBs genome-wide via their ability to join to specific genomic Cas9/sgRNA-generated bait DSBs. In XRCC4/p53-deficient ES cells, we detected 7 RDCs, which were in genes, with two RDCs being robust. In contrast, in NPCs derived from these ES cell lines, we detected 29 RDCs, a large fraction of which were robust and associated with long, transcribed neural genes that were also robust RDC-genes in primary NSPCs. These studies suggest that many RDCs present in NSPCs are developmentally influenced to occur in this cell type and indicate that induced development of NPCs from ES cells provides an approach to rapidly elucidate mechanistic aspects of NPC RDC formation.SIGNIFICANCE STATEMENTWe previously discovered a set of long neural genes susceptible to frequent DNA breaks in primary mouse brain progenitor cells. We termed these genes RDC-genes. RDC-gene breakage during brain development might alter neural gene function and contribute to neurological diseases and brain cancer. To provide an approach to characterize the unknown mechanism of neural RDC-gene breakage, we asked whether RDC-genes appear in neural progenitors differentiated from embryonic stem cells in culture. Indeed, robust RDC-genes appeared in neural progenitors differentiated in culture and many overlapped with robust RDC-genes in primary brain progenitors. These studies indicate thatin vitrodevelopment of neural progenitors provides a model system for elucidating how RDC-genes are formed.
Prediction-based highly sensitive CRISPR off-target validation using target-specific DNA enrichment
Authors: Kang Seung-Hun , Lee Wi-jae , An Ju-Hyun , Lee Jong-Hee , Kim Young-Hyun , Kim Hanseop , Oh Yeounsun , Park Young-Ho , Jin Yeung Bae , Jun Bong-Hyun , Hur Junho K , Kim Sun-Uk , Lee Seung Hwan 
Published: December 2019

AbstractCRISPR effectors, which comprise a CRISPR-Cas protein and a guide (g)RNA derived from the bacterial immune system, are widely used to induce double-strand breaks in target DNA and activate the in-vivo DNA repair system for target-specific genome editing. When the gRNA recognizes genomic loci with sequences that are similar to the target, deleterious and often carcinogenic mutations can occur. Off-target mutations with a frequency below 0.5% remain mostly undetected by current genome-wide off-target detection techniques. In this study, we developed a method to effectively detect extremely small amounts of mutated DNA based on predicted off-target-specific amplification. We used various genome editors, including CRISPR-Cpf1, Cas9, and an adenine base editor, to induce intracellular genome mutations. The CRISPR amplification method detected off-target mutations at a significantly higher rate (1.6∼984 fold increase) than did an existing targeted amplicon sequencing method. In the near future, CRISPR amplification in combination with genome-wide off-target detection methods will allow to detect genome editor-induced off-target mutations with high sensitivity and in a non-biased manner.
Collective turnover: organization design and processes or contagion effects?
Authors: Kraichy David , Schmidt Joseph 
Published: December 2019

PurposeUsing organization-level data, the purpose of this paper is to investigate whether and how turnover spreads at different job levels (i.e. managers, non-managers) and how vacancy rate and manager span of control precipitate continued turnover.Design/methodology/approachOrganization-level longitudinal data were collected quarterly from 40 Canadian organizations on various HR metrics from 2009 to 2012, totaling 232 observations. The authors used covariate balance propensity score (CBPS) weighting to make stronger causal inferences.FindingsThe organization-level data provided limited support for turnover spreading at different job levels. Instead, vacancy rate predicted subsequent non-manager turnover rates, whereas span of control predicted subsequent manager turnover rates.Practical implicationsThe implications of this research are twofold. First, to offset continued turnover among non-managers, it may be wise for organizations to fill vacancies promptly, particularly when unfilled positions affect job demands and resources of those who remain. Second, to minimize ongoing manager turnover, organizations may benefit from redesigning work units to have smaller manager-to-employee ratios.Originality/valueThis study adds to the collective turnover literature by demonstrating that organizational factors play a substantive role in predicting continued manager and non-manager turnover. Moreover, by using longitudinal data and CBPS weighting, this research allowed for establishing temporal precedence and greater confidence that these factors play a causal role. Lastly, this research highlights how the factors precipitating collective turnover differ between managers and non-managers.
Three-dimensional fatigue crack growth simulation of embedded cracks using s-version FEM
Authors: Tomaru Shuji , Takahashi Akiyuki 
Published: December 2019

Purpose
Since the most of structures and structural components suffers from cyclic loadings, the study on the fatigue failure due to the crack growth has a great importance. The purpose of this paper is to present a three-dimensional fatigue crack growth simulation of embedded cracks using s-version finite element method (SFEM). Using the numerical results, the validity of the fitness-for-service (FFS) code evaluation method is verified.

Design/methodology/approach
In this paper, three-dimensional fatigue crack propagation analysis of embedded cracks is performed using the SFEM. SFEM is a numerical analysis method in which the shape of the structure is represented by a global mesh, and cracks are modeled by local meshes independently. The independent global and local meshes are superimposed to obtain the displacement solution of the problem simultaneously.

Findings
The fatigue crack growth of arbitrary shape of cracks is slow compared to that of the simplified circular crack and the crack approximated based on the FFS code of the Japan Society of Mechanical Engineers (JSME). The results tell us that the FFS code of JSME can provide a conservative evaluation of the fatigue crack growth and the residual life time.

Originality/value
This paper presents a three-dimensional fatigue crack growth simulation of embedded cracks using SFEM. Using this method, it is possible to apply mixed mode loads to complex shaped cracks that are closer to realistic conditions.