bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mechanical Ventilation Redistributes Blood to Poorly Ventilated Areas in Experimental Lung Injury*
Authors: Cronin John N. , Crockett Douglas C. , Farmery Andrew D. , Hedenstierna Göran , Larsson Anders , Camporota Luigi , Formenti Federico 
Published: December 2019

Objectives:
Determine the intra-tidal regional gas and blood volume distributions at different levels of atelectasis in experimental lung injury. Test the hypotheses that pulmonary aeration and blood volume matching is reduced during inspiration in the setting of minimal tidal recruitment/derecruitment and that this mismatching is an important determinant of hypoxemia.

Design:
Preclinical study.

Setting:
Research laboratory.

Subjects:
Seven anesthetized pigs 28.7 kg (sd, 2.1 kg).

Interventions:
All animals received a saline-lavage surfactant depletion lung injury model. Positive end-expiratory pressure was varied between 0 and 20 cm H2O to induce different levels of atelectasis.

Measurements and Main Results:
Dynamic dual-energy CT images of a juxtadiaphragmatic slice were obtained, gas and blood volume fractions within three gravitational regions calculated and normalized to lung tissue mass (normalized gas volume and normalized blood volume, respectively). Ventilatory conditions were grouped based upon the fractional atelectatic mass in expiration (< 20%, 20–40%, and ≥ 40%). Tidal recruitment/derecruitment with fractional atelectatic mass in expiration greater than or equal to 40% was less than 7% of lung mass. In this group, inspiration-related increase in normalized gas volume was greater in the nondependent (818 µL/g [95% CI, 729–908 µL/g]) than the dependent region (149 µL/g [120–178 µL/g]). Normalized blood volume decreased in inspiration in the nondependent region (29 µL/g [12–46 µL/g]) and increased in the dependent region (39 µL/g [30–48 µL/g]). Inspiration-related changes in normalized gas volume and normalized blood volume were negatively correlated in fractional atelectatic mass in expiration greater than or equal to 40% and 20–40% groups (r
2 = 0.56 and 0.40), but not in fractional atelectatic mass in expiration less than 20% group (r
2 = 0.01). Both the increase in normalized blood volume in the dependent region and fractional atelectatic mass in expiration negatively correlated with Pao
2/Fio
2 ratio (ρ = –0.77 and –0.93, respectively).

Conclusions:
In experimental atelectasis with minimal tidal recruitment/derecruitment, mechanical inspiratory breaths redistributed blood volume away from well-ventilated areas, worsening Pao
2/Fio
2.
Out of the Foxhole
Authors: Wynn Stephanie T. 
Published: December 2019

ABSTRACT:
As more veterans apply to nursing programs, nurse educators must acknowledge that many veterans are disadvantaged by moral injury and spiritual distress resulting from their military service. University faculty, in collaboration with Veterans Administration healthcare services, have found that referring students with unresolved spiritual distress to the Building Spiritual Strength intervention is a beneficial faith-based means for students to learn to manage their struggles and continue their education.
The 10 Cow Project
Authors: Johanson Linda 
Published: December 2019

ABSTRACT:
Using lessons from a modern parable about the 10-cow bride, a short-term medical missions team created a sustainable program for Ugandans, helping establish businesses for needy families by providing start-up farm animals. Christian nurses can partner with those in veterinary medicine to provide essential training related to health promotion and prevention of disease transmission in order to promote positive long-term outcomes of such projects.
A Community Respite Ministry/University Partnership Creates Meaningful Elder-Care Experiences
Authors: Yordy Morgan , Hare Julie 
Published: December 2019

ABSTRACT:
As the North American population of older adults increases, so does the need for nursing students to gain skills in geriatric care. Locating appropriate clinical sites for undergraduate students, including community and health promotion opportunities, prompted a public university's school of nursing to partner with a faith-based respite program. The collaboration between a public educational institution and a church-based program benefited the geriatric participants, the program leadership, and the nursing students and faculty.
Sequencing Ipilimumab Immunotherapy Before or After Chemotherapy (Nab-Paclitaxel and Bevacizumab) for the Treatment of BRAFwt (BRAF Wild-Type) Metastatic Malignant Melanoma
Authors: Markovic Svetomir N. , Suman Vera J. , Javed Asad , Reid Joel M. , Wall Darci J. , Erickson Lori A. , Ernstoff Marc , Anderson Daniel M. 
Published: December 2019

Objectives:With the introduction of novel immune therapeutics for the treatment of disseminated malignancies, we sought to evaluate whether deliberate sequencing of immunotherapy before/after conventional cytotoxic chemotherapy would have an impact on clinical outcomes in patients with previously treated metastatic melanoma. We sought to evaluate whether or not ipilimumab immunotherapy administered before or after cytotoxic chemotherapy (nab-paclitaxel+bevacizumab, AB) would impact clinical outcomes.Methods:We conducted a randomized phase 2 clinical trial of patients with BRAF wild-type metastatic melanoma (up to 2 prior therapies) who received either: (A) AB followed by ipilimumab therapy at progression; or (B) ipilimumab followed by AB treatment at progression. The primary goal of the study was a comparison of AB versus ipilimumab progression-free survival, with secondary clinical and laboratory endpoints.Results:This study did not reach full accrual due to concurrent Food and Drug Administration approval of anti-programmed cell death 1 agents. Nevertheless, the available data suggests a cumulative therapeutic advantage to the sequential use of ipilimumab followed by AB. Correlative laboratory data revealed a favorable effect on systemic immune homeostasis in patients receiving AB therapy, of potential interest in further investigations, especially in the context of chemotherapy/immunotherapy combinations.Conclusion:Albeit limited in scope, our data suggest that cytotoxic therapy with nab-paclitaxel and bevacizumab appear to favorably alter systemic parameters of immune function of potential benefit in combination T-cell directed immune checkpoint inhibitor therapy.
Clinical Evaluation of the “Lifeline Suture” Technique for DSAEK in Cases Without Posterior Capsule Using a Novel Donor Insertion Device
Authors: Yokogawa Hideaki , Kobayashi Akira , Mori Natsuko , Nishino Tsubasa , Sugiyama Kazuhisa 
Published: December 2019

Purpose:
This study investigated preliminary clinical outcomes of a suture pull-through technique for Descemet stripping automated endothelial keratoplasty (DSAEK) termed the “lifeline suture” technique using a newly developed donor inserter (NS Endo-Inserter: NSI; Hoya Co, Ltd, Tokyo, Japan) in cases of bullous keratopathy without posterior capsule.

Methods:
Six aphakic eyes without posterior capsule from 6 patients (mean age 73.8 ± 11.9 years) with bullous keratopathy were enrolled. DSAEK alone or as a vitreocorneal surgery was performed. Donor tissue was pulled into the anterior chamber using the NSI and a 9-0 polypropylene “lifeline suture” to prevent donor tissue from slipping into the vitreous cavity, which was removed at the end of surgery. Intraoperative and postoperative complications and 6-month postoperative central donor endothelial cell densities were measured and compared with preoperative values along with 6-month best-corrected visual acuity.

Results:
All donors were successfully loaded into the NSI and then pulled into the anterior chamber using the lifeline suture. No intraoperative complications, graft dislocation, or primary graft failures were noted. Six months postsurgery, mean endothelial cell density was 2027 ± 747 cells/mm2 (mean loss 27.2 ± 28.1%) and mean best-corrected visual acuity improved to 0.31 decimal (P = 0.018).

Conclusions:
In this preliminary case series of bullous keratopathy without posterior capsule, DSAEK outcomes using the novel NSI donor inserter with lifeline suture were comparable or better than the results expected with conventional strategies. Thus, this technique enabled apparently safe DSAEK, preventing donor migration into the vitreous cavity while maintaining a stable anterior chamber, and is suitable for complex eyes including aphakia, lacking posterior capsule, or avitreal.
Evaluation of Electronic Health Record Implementation in an Academic Oculoplastics Practice
Authors: Chen Allison J. , Baxter Sally L. , Gali Helena E. , Long Christopher P. , Ozzello Daniel J. , Liu Catherine Y. , Korn Bobby S. , Kikkawa Don O. 
Published: December 2019

Purpose:
Despite increasing electronic health record (EHR) adoption, perceptions of EHRs are negative among ophthalmologists due to concerns about productivity, costs, and documentation. The authors evaluated the effects of EHR adoption in an oculoplastics practice, which had not been previously studied.

Methods:
Clinical volume, documentation time, time spent with patients, reimbursement, relative value units, and patient satisfaction were examined for 2 academic oculoplastics attendings between April 2018 and April 2019, with EHR implementation in September 2018.

Results:
The mean number of patients seen in a half-day clinic was 31.8 versus 27.7 (p = 0.018) pre- and post-EHR implementation, respectively. EHR implementation had no effect on total monthly reimbursement (p = 0.88) or total monthly relative value units (p = 0.54). Average reimbursement (p = 0.004) and relative value units (p = 0.001) per patient encounter were significantly greater with EHR use. Patient satisfaction scores improved (p = 0.018). Mean physician time per patient increased from 6.4 to 9.0 minutes (p < 0.001). Mean documentation time per patient increased from 1.7 to 3.6 minutes (p < 0.001). Average patient wait times decreased by 9 minutes (p = 0.03) with EHR use. No scribes were used.

Conclusions:
EHR implementation was associated with decreased patient volume without significant differences in total reimbursement. Although EHR adoption was associated with increased physician time devoted to patients and greater time expenditure on documentation, patients experienced decreased wait times. This suggests that EHR use streamlined the overall clinic flow without sacrificing physicians’ time with the patient. The author’s findings suggest that EHR implementation can be accomplished in an academic oculoplastics setting without negative impact on patient experience or reimbursement considerations.
Psychiatric and Other Medical Manifestations of Nitrous Oxide Abuse
Authors: Chien Wan-Hsi , Huang Ming-Chyi , Chen Lian-Yu 
Published: December 2019

Abstract

Background
Nitrous oxide (N2O), a commonly used anesthetic agent in dentistry, has emerged as a global public health threat in young population. Although N2O-related neurological sequelae such as spinal cord degeneration and sensorimotor peripheral neuropathy are well known, psychiatric manifestations of heavy N2O use remain unclear. Here, we presented 7 treatment-seeking patients with severe N2O use disorder to delineate the psychiatric profiles of N2O users in Asia.

Methods
Seven patients with severe N2O use disorder who sought treatment in Taipei City Psychiatric Center between 2017 and 2018 were enrolled. We used chart review method to retrospectively collect their clinical information including sociodemographics, psychiatric and substance history, urine toxicology findings, and treatment course.

Results
These N2O users all had diagnoses of severe N2O use disorder. They usually initiated N2O use in late adolescence and early adulthood. Six of them had histories of mood disorders; all of them reported other illicit substance use before using N2O. The main reasons for treatment seeking were irritability, psychotic symptoms, self-harm, or violent behaviors as four of them were given a diagnosis of substance-induced psychotic disorder. Urine drug screen showed negative for other illicit drug use except for 1 positive case for cannabis and 1 for amphetamine. Three of 7 cases were hospitalized because of the severity of their psychiatric symptoms and suicidal risk.

Conclusions
These cases with severe N2O use disorder showed high prevalence of psychotic symptoms and dangerous behaviors such as suicide or violence. This study highlights the addiction potential of N2O and its related adverse consequences in the psychiatric aspect.
Brief Report: Randomized Controlled Trial of an Intervention to Match Young Black Men and Transwomen Who Have Sex With Men or Transwomen to HIV Testing Options in New York City (All About Me)
Authors: Frye Victoria , Nandi Vijay , Hirshfield Sabina , Chiasson Mary Ann , Wilton Leo , Usher DaShawn , Hoover Donald R. , Koblin Beryl A. 
Published: December 2019

Background:
HIV testing is critical to HIV prevention and care. Infrequent HIV testing and late HIV diagnosis have been observed among young Black men who have sex with men and transwomen. Novel interventions to increase HIV testing rates among young Black men who have sex with men and transwomen are needed.

Methods:
A randomized controlled trial among 236 young Black men and transwomen who have sex with men or transwomen evaluated the efficacy of an intervention that included completion of a brief survey and receipt of a personalized recommendation of an optimal HIV testing approach. Participants completed a computerized baseline assessment and were randomized to electronically receive either a personalized recommendation or standard HIV testing information. Follow-up surveys were conducted online at 3 and 6 months.

Results:
Retention was 92% and 93% at 3-month and 6-month follow-up, respectively. At baseline, 41% of participants reported that they tested for HIV in the past 3 months and another 25% between 4 and 6 months ago. Intent-to-treat analyses found that participants randomized to the experimental arm (personalized recommendation) were not significantly more likely to test for HIV compared with participants in the standard HIV testing information control arm at 3 months (76% vs. 71%; P = 0.40) and 6 months (73% vs. 72%; P = 0.81), respectively.

Conclusions:
This study evaluated an innovative intervention to increase HIV testing by matching individuals to optimal HIV testing approaches. Participants in both arms increased past 3-month HIV testing, suggesting that providing information on options and/or raising risk awareness is sufficient to significantly increase HIV testing.

Trial registration:
ClinicalTrial.gov NCT02834572 https://clinicaltrials.gov/ct2/show/NCT02834572.
High- and Low-Contrast Letter Acuity Perception Matures With Age in Normally Sighted Children
Authors: Waldman Amy T. , Lavery Amy M. , Liu Geraldine W. , Avery Robert A. , Liu Grant T. , Maguire Maureen G. , Ying Gui-shuang , Banwell Brenda L. 
Published: December 2019

Background:High-contrast visual acuity (HCVA) changes with age, yet little is known about pediatric-specific age- and sex-normative values for low-contrast letter acuity (LCLA). We define maturational changes in monocular and binocular HCVA and LCLA in childhood and adolescence.Methods:Normally sighted youth (ages 5–20 years, without neurologic or ophthalmologic disease and best-corrected HCVA of 20/25 or better in each eye) were recruited. Mean monocular and binocular scores using Early Treatment Diabetic Retinopathy Study (for HCVA) and 2.5% and 1.25% Sloan (for LCLA) charts and the magnitude of binocular summation were calculated using 2-year bins. Relationships between scores and age were explored using scatterplots with Locally Weighted Scatterplot Smoothing (LOWESS) and analysis of variance that accounts for intereye correlation, followed by test of linear trend for age effect.Results:Among 101 (202 eyes) healthy participants (mean age 13 years, 42% males), monocular and binocular scores varied by age, with highest mean scores achieved in the 13 to 14–year age group for both HCVA and LCLA. Between the ages of 5 and 14.9 years, monocular scores increased linearly with age (0.76 letter/year for HCVA, 1.11 letters/year for 2.5% LCLA, and 0.97 letter/year for 1.25% LCLA; allP< 0.0001). Binocular HCVA scores also increased with age between 5 and 14.9 years (0.71 letters/year,P< 0.0001). The magnitude of binocular summation for HCVA or LCLA did not change with age.Conclusions:HCVA and LCLA abilities mature into adolescence, peak between 13 and 14.9 years of age, and then plateau into adulthood. Evaluation of patients with visual deficits should consider age-expected normal visual acuity.
Knowledge Driven Phenotyping
Authors: Wu Honghan , Wang Minhong , Zeng Qianyi , Chen Wenjun , Pan Jeff Z. , Sudlow Cathie , Robertson Dave 
Published: December 2019

AbstractExtracting patient phenotypes from routinely collected health data (such as Electronic Health Records) requires translating clinically-sound phenotype definitions into queries/computations executable on the underlying data sources by clinical researchers. This requires significant knowledge and skills to deal with heterogeneous and often imperfect data. Translations are time-consuming, error-prone and, most importantly, hard to share and reproduce across different settings. This paper proposes a knowledge driven framework that (1) decouples the specification of phenotype semantics from underlying data sources; (2) can automatically populate and conduct phenotype computations on heterogeneous data spaces. We report preliminary results of deploying this framework on five Scottish health datasets.
Local authority variation in uptake of the HPV vaccine in Greater Manchester and school-level factors: a cross-sectional ecological study
Authors: Senior Steven L. , Fletcher Rebecca , Cleary Paul , Farmer Siobhan 
Published: December 2019

ABSTRACTBackgroundHuman papillomavirus (HPV) is the main cause of cervical cancer and contributes to a number of other cancers that affect both men and women. Vaccines exist that offer protection against the most common cancer-causing HPV types. In England, a school-based vaccination programme for girls has been in place since 2008 but vaccine coverage rates have declined since its introduction. Understanding variation between schools and between local authorities may help to inform quality improvement and guide policy development and commissioning.MethodsCross-sectional, ecological analysis of vaccine uptake among 164 schools representing 13,127 children in eight out of ten local authorities in Greater Manchester. Logistic mixed effects regression models were used to test for associations between school level factors and vaccine uptake, while allowing for variation between local authorities.ResultsIn multivariable mixed effects models, lower vaccination rates were associated with: increasing numbers of children eligible for vaccination; increasing proportions of children eligible for free school meals; increasing proportions of children with English as an additional language; Ofsted ‘inadequate’ ratings; Christian and Muslim faith schools; independent schools and special schools.ConclusionsConsistent with previous studies on vaccine uptake, this study identifies a number of factors that are associated with uptake of the school-based HPV vaccine programme. We also show that local authority variation remains after adjustment for the mix of schools in each area. This evidence may be used to guide vaccine providers, commissioners, and policymakers who want to increase uptake of the school-based HPV vaccine.
Comparison of intradermal injection and epicutaneous laser microporation for antitumor vaccine delivery in a human skin explant model
Authors: Duinkerken Sanne , Lübbers Joyce , Stolk Dorian , Vree Jana , Ambrosini Martino , Kalay Hakan , van Kooyk Yvette 
Published: December 2019

ABSTRACTHuman skin is a prime vaccination site containing multiple antigen presenting cells (APC), including Langerhans cells (LC) and dendritic cells (DC). APC deliver antigens to lymph nodes for induction of adaptive immunity through stimulating antigen specific T- and B-cells. Since intradermal (ID) injections require specific training, easy applicable delivery systems like laser microporation are emerging. In mice, combination of laser treatment and allergen injection showed enhanced T-cell responses and skewing of B-cell responses without adjuvants. However, it remains to be elucidated whether laser microporation can alter human skin DC phenotype and function without adjuvants. In an ex-vivo human skin explant model, we compared ID injection and laser microporation as anti-tumor vaccination strategy. A melanoma specific synthetic long peptide and multivalent dendrimer with gp100 antigen were used as vaccine formulation to measure APC phenotype, emigration and ability to stimulate gp100 specific CD8+ T-cells. We show that skin APC phenotype and emigration capacity was similar after laser microporation and ID injection. However, laser microporation reduced vaccine uptake by APC, resulting in decreased induction of gp100 specific CD8+ T-cell activation. To conclude, in our human skin model ID injection remains the most potent strategy to deliver antigens to skin APC for T-cell induction.Graphical Abstract
ReferenceSeeker: rapid determination of appropriate reference genomes
Authors: Schwengers O. , Hain T. , Chakraborty T. , Goesmann A. 
Published: December 2019

AbstractSummaryThe large and growing number of microbial genomes available in public databases makes the optimal selection of reference genomes necessary for many in-silico analyses, e.g. single nucleotide polymorphism detection, scaffolding and comparative genomics, increasingly difficult. Here, we present ReferenceSeeker, a novel command line tool combining a fast kmer profile-based database lookup of candidate reference genomes with subsequent calculation of highly specific average nucleotide identity (ANI) values for the rapid determination of appropriate reference genomes. Pre-built databases for bacteria, archaea, fungi, protozoa and viruses based on the RefSeq database are provided for download.Availability and ImplementationReferenceSeeker is open source software implemented in Python. Source code and binaries are freely available for download at https://github.com/oschwengers/referenceseeker under the GNU GPL3 license.Contactreferenceseeker@computational.bio