bluuebunny/crossref_metadata_2025_split huggingface dataset:
Utility of the International HIV Dementia Scale for HIV-Associated Neurocognitive Disorder
Authors: Molinaro Maria , Sacktor Ned , Nakigozi Gertrude , Anok Aggrey , Batte James , Kisakye Alice , Myanja Richard , Nakasujja Noeline , Robertson Kevin R. , Gray Ronald H. , Wawer Maria J. , Saylor Deanna 
Published: February 2020

Background:
We assessed the utility of the International HIV Dementia Scale (IHDS) in detecting HIV-associated neurocognitive disorder (HAND) in Uganda in antiretroviral (ART)-naïve and ART-experienced adults.

Setting:
A longitudinal observational cohort study in Rakai, Uganda.

Methods:
Three hundred ninety-nine HIV+ ART-naïve adults underwent neurological, functional status, and neuropsychological assessments including the IHDS. Three hundred twelve participants who initiated ART were re-evaluated after 2 years. HAND stages [asymptomatic neurocognitive impairment, mild neurocognitive disorder, and HIV-associated dementia (HAD)] were determined based on Frascati criteria using local normative data. Sensitivity, specificity, and area under the ROC curve were determined for various IHDS thresholds (≤9, ≤ 9.5, and ≤10).

Results:
At baseline, the participants' mean age was 35 years (SD ± 8), 53% were men, and 84% had less than a high school education. At baseline, sensitivity for detecting any HAND stage, symptomatic HAND [mild neurocognitive disorder, HAD], and HAD alone were maximized at IHDS ≤10 (81%, 83%, 92%, respectively). Among 312 individuals who returned for the 2-year follow-up and had initiated ART, a score of ≤10 provided a lower or equal sensitivity for detecting different stages of HAND (all HAND: 70%; symptomatic HAND: 75%; HAD: 94%). The area under the ROC curve was higher for ART-experienced versus ART-naïve individuals.

Conclusions:
The IHDS is a potentially useful screening tool for neurocognitive impairment in rural Uganda for both ART-naïve and ART-experienced adults. A cutoff ≤10 demonstrates higher sensitivity for more severe HAND stages compared with less severe HAND. Future studies should focus on potential modifications to the IHDS to improve its specificity.
Dynamic Brow Restoration Using a Soft Tissue Expander in Adult Patients With Arteriovenous Malformation
Authors: Ding Wei , Chen Hui , Lin Xiaoxi , Hu Xiaojie 
Published: February 2020

Background
Impaired brow function in adult patients with arteriovenous malformation is a serious disability that can even influence the field of vision. Brow reanimation techniques are used to recover a more natural appearance and brow function. Many static procedures have been set to augment brow elevation, but only dynamic procedures can lead to better functional results. In this study, the experience of a single surgeon addressing the challenge of brow restoration with dynamic procedures is presented.

Methods
A retrospective review was performed using the records of 4 adult patients who underwent dynamic procedures using a soft tissue expander for brow restoration after arteriovenous malformation excision in the unilateral site of the forehead with the expander on the contralateral side. Movement and electrodiagnostic examinations were performed postoperatively at 2 months.

Results
The patients included 3 males and 1 female (mean age, 20.5 ± 4.04 years). Brow improvement was noted in all patients. The results of the electrodiagnostic examination showed synchronous and spontaneous motor unit potentials and compound muscle action potentials with the contralateral forehead.

Conclusions
Dynamic procedures using a soft tissue expander can provide both static and dynamic functional brow elevation of the contralateral frontalis and skin.
Management and Outcome of Local Regrowths in a Watch-and-wait Prospective Cohort for Complete Responses in Rectal Cancer
Authors: van der Sande Marit E , Figueiredo Nuno , Beets Geerard L. 
Published: February 2020

Objective:
To evaluate the management and oncological outcomes of rectal cancer patients with local regrowth in a watch-and-wait (W&W) program.

Background:
Approximately 15%–30% of patients with a clinical complete response after (chemo) radiotherapy who undergo a W&W policy will experience a local regrowth. The risks of these local regrowths have not yet been fully established and main concerns include high postoperative morbidity, requirement of advanced surgery, and pelvic recurrence after regrowth treatment.

Methods:
All patients with a local regrowth after an initial W&W approach between January 2005 and March 2018 were retrospectively identified from 2 cohorts of rectal cancer patients with a clinical complete response after (chemo) radiotherapy. Type and outcome of regrowth treatment were assessed. Oncological outcome was assessed using Kaplan-Meier estimates.

Results:
Eighty-nine out of 385 patients developed a local regrowth after a median of 9 (interquartile range 7–14) months. Median follow-up time was 28 (interquartile range 19–41) months. Eighty-four (94%) patients underwent surgical treatment of the local regrowth: total mesorectal excision was performed in 58 out of 84 (69%) patients and local excision was performed in 26 (31%) patients. The 2-year local recurrence-free rate, distant metastasis-free rate, disease-free survival, and overall survival in the patients undergoing surgical treatment were 97.8%, 91.8%, 90.3%, and 98.4%, respectively.

Conclusion:
The vast majority (97%) of patients with regrowth after a W&W policy were able to undergo treatment with curative intent for local regrowth. Uncontrolled pelvic disease was very rare.
Transoral Endoscopic Thyroidectomy Vestibular Approach: An Initial Experience in Vietnam
Authors: Le Quang V. , Ngo Duy Q. , Tran Toan D. , Ngo Quy X. 
Published: February 2020

Background:
Transoral endoscopic thyroidectomy vestibular approach (TOETVA) can be applied to many health facilities worldwide, even in places whose medical facilities have not developed yet. To that end, our hospital is the first hospital to deploy this novel technique in Vietnam. In the study, the authors will evaluate the safety and efficacy of TOETVA, which was initially performed on patients in Vietnam.

Materials and Methods:
A TOETVA research was conducted on 28 patients in hospital K from January 1, 2018 to May 31, 2019. The surgical outcomes, cosmetic results, and complications were evaluated.

Results:
The mean operative time was 91 minutes (70 to 130 min). There were no cases with temporary and permanent hypoparathyroidism in the patients. One patient had temporary mental nerve injury recovered completely after 14-day surgery. No case used drains in patients. All patients were highly satisfied with the surgical outcome, especially, cosmetic results.

Conclusions:
TOETVA is a safe and feasible technique with acceptable complication rates and good outcomes. The authors will carry on this procedure for selected patients. TOETVA should not only be performed in some countries with well-developed health care systems but also be done in other developing countries worldwide.
Low Postoperative Levels of C-Reactive Protein Are an Early Predictor for an Uncomplicated Course After Bariatric Surgery: A Retrospective, Validated Cohort Study
Authors: Pochhammer Julius , Drozdzynski Jonas , Bernsmeier Alexander , Kersebaum Jan-Niclas , Laudes Matthias , Mehdorn Anne-Sophie , Richter Florian , Schafmayer Clemens , Becker Thomas , Beckmann Jan H. 
Published: February 2020

Background:
Bariatric surgery is popularly used to treat or prevent morbidity in severely obese patients. Severe complications are rare, but their early detection has a significant impact on clinical outcomes. We aimed to determine whether blood tests in the first few postoperative days are reliable predictors for complications.

Methods:
We retrospectively analyzed 1073 patients who underwent laparoscopic bariatric surgery between 2009 and 2018 at our center. Clinical outcome was correlated with postoperative serum C-reactive protein (CRP), white blood cell count, and vital signs, analyzed using a receiver operating characteristic (ROC) curve. A total of 570 procedures between 2009 and 2015 were used to calculate the best cutoff values (calculation group), which were validated with 330 different patients operated upon between 2016 and 2018 (validation group).

Results:
Twenty-four patients (4.2%) developed anastomotic or staple-line leakages in the calculation group. The ROC curve showed a good reliability for CRP levels on day 2 (area under the ROC curve=0.86); the highest Youden index existed for a cutoff of 119 mg/L. White blood cell count and heart rate were poor predictors. Even though several characteristics differed in the validation cohort, test quality of the cutoff was high (sensitivity, 71.4%; specificity, 94.9%; positive predictive value, 23.8%; negative predictive value, 99.3%). The prediction was excellent especially for leakages appearing on days 2 to 9 (sensitivity 100.0%, negative predictive value 100%). Leakages from day 10 were rare and prediction poor (sensitivity 0%).

Conclusions:
A CRP level on day 2 <120 mg/L is a good predictor of a postoperative course without leakage, even though the predictive value goes down for late-appearing events. An earlier CRP measurement added no predictive benefit. The cutoff value was validated in an internal cohort and could be applied to different populations.
Benchmarking the value of care: Variability in hospital costs for common operations and its association with procedure volume
Authors: Zogg Cheryl K. , Bernard Andrew C. , Hirji Sameer A. , Minei Joseph P. , Staudenmayer Kristan L. , Davis Kimberly A. 
Published: February 2020

BACKGROUND
Efforts to improve health care value (quality/cost) have become a priority in the United States. Although many seek to increase quality by reducing variability in adverse outcomes, less is known about variability in costs. In conjunction with the American Association for the Surgery of Trauma Healthcare Economics Committee, the objective of this study was to examine the extent of variability in total hospital costs for two common procedures: laparoscopic appendectomy (LA) and laparoscopic cholecystectomy (LC).

METHODS
Nationally weighted data for adults 18 years and older was obtained for patients undergoing each operation in the 2014 and 2016 National Inpatient Sample. Data were aggregated at the hospital-level to attain hospital-specific median index hospital costs in 2019 US dollars and corresponding annual procedure volumes. Cost variation was assessed using caterpillar plots and risk-standardized observed/expected cost ratios. Correlation analysis, variance decomposition, and regression analysis explored costs' association with volume.

RESULTS
In 2016, 1,563 hospitals representing 86,170 LA and 2,276 hospitals representing 230,120 LC met the inclusion criteria. In 2014, the numbers were similar (1,602 and 2,259 hospitals). Compared with a mean of US $10,202, LA median costs ranged from US $2,850 to US $33,381. Laparoscopic cholecystectomy median costs ranged from US $4,406 to US $40,585 with a mean of US $12,567. Differences in cost strongly associated with procedure volume. Volume accounted for 9.9% (LA) and 12.4% (LC) of variation between hospitals, after controlling for the influence of other hospital (8.2% and 5.0%) and patient (6.3% and 3.7%) characteristics and in-hospital complications (0.8% and 0.4%). Counterfactual modeling suggests that were all hospitals to have performed at or below their expected median cost, one would see a national cost savings of greater than US $301.9 million per year (95% confidence interval, US $280.6–325.5 million).

CONCLUSION
Marked variability of median hospital costs for common operations exists. Differences remained consistent across changing coding structures and database years and were strongly associated with volume. Taken together, the findings suggest room for improvement in emergency general surgery and a need to address large discrepancies in an often-overlooked aspect of value.

LEVEL OF EVIDENCE
Epidemiological, level III.
ACE2 expression by colonic epithelial cells is associated with viral infection, immunity and energy metabolism
Authors: Wang Jun , Zhao Shanmeizi , Liu Ming , Zhao Zhiyao , Xu Yiping , Wang Ping , Lin Meng , Xu Yanhui , Huang Bing , Zuo Xiaoyu , Chen Zhanghua , Bai Fan , Cui Jun , Lew Andrew M , Zhao Jincun , Zhang Yan , Luo Hai-Bin , Zhang Yuxia 
Published: February 2020

ABSTRACTRespiratory disease caused by the 2019 novel coronavirus (2019-nCoV) pneumonia first emerged in Wuhan, Hubei Province, China, in December 2019 and spread rapidly to other provinces and other countries. Angiotensin-converting enzyme 2 (ACE2) is the receptor for SARS-CoV and has been suggested to be also the receptor for 2019-nCoV. Paradoxically, ACE2 expression in the lung protects mice from SARS-CoV spike protein induced lung injury by attenuating the renin-angiotensin system. In the intestine, ACE2 also suppresses intestinal inflammation by maintaining amino acid homeostasis, antimicrobial peptide expression and ecology of the gut microbiome. Upon analysis of single cell-RNA sequencing data from control subjects and those with colitis or inflammatory bowel disease (IBD), we found thatACE2expression in the colonocytes was positively associated with genes regulating viral infection, innate and cellular immunity, but was negatively associated with viral transcription, protein translation, humoral immunity, phagocytosis and complement activation. In summary, we suggest that ACE2 may play dual roles in mediating the susceptibility and immunity of 2019-nCoV infection.
Irish Defence Forces graduate’s opinions and experiences of UCD’s Diploma in Military Medicine
Authors: Loughman S. , Berry C. , Hickey Paul , Ruddy Mark , Bruno Brian , Bury G. 
Published: February 2020

AbstractAimsThis study explores the opinions and experiences of Irish Defences Forces graduates from UCD’s Diploma in Military Medicine. It aims to identify which aspects of medical education are relevant for the development of military graduates in future.MethodsA validated Clinical Learning Environment Score (CLES) tool was adapted and incorporated into an online survey. This was sent electronically to 71 graduates. Responses were anonymous.Results38 (54%) of graduates responded. Just 16 (42%) use their new skills in their daily work. Of the 9 (24%) deployed overseas, all used their new skills. Emergency and Occupational Health skills were used more, while advanced skills were used rarely. Only 22 (40%) of DMMC graduates work in the Defence Forces Medical Unit.ConclusionStudent feedback was positive regarding teaching and clinical placements at UCD. An emphasis on frequently used skills, and a change in how Defence Forces acknowledge qualifications, may support more graduates in entering the military medical workforce.Key MessagesThe Irish Defence Forces identified the need for an innovative training programme to equip its non-medical staff to address the role known as ‘Combat Medical Technician’(CMT).This led to the development of the UCD Diploma in Military Medical Care (DMMC) programme.The study shows that the skills used most frequently by graduates were those of the EMT and the Occupational Health aspects of the course.Advanced skillsets were used rarely even when deployed overseas.In developing future CMT courses it is recommended that the EMT and Occupational health skill sets are emphasised, with streamlining of the advanced skillset elements to focus the skills are most relevant in an overseas environment.It would be advantageous to the Defence Forces for systems be put in place to recognise qualifications and support graduating students in practicing and using their new skills.
A database resource for Genome-wide dynamics analysis of Coronaviruses on a historical and global scale
Authors: Zhu Zhenglin , Meng Kaiwen , Meng Geng 
Published: February 2020

AbstractThe recent outbreak of a new zoonotic origin Coronavirus has ring the bell for the potential spread of epidemic Coronavirus crossing the species. With the urgent needs to assist the control of the Coronavirus spread and to provide valuable scientific information, we developed a coronavirus database (CoVdb), an online genomics and proteomics analysis platform. Based on public available coronavirus genomic information, the database annotates the genome of every strain and identifies 780 possible ORFs of all strains available in Genebank. In addition, the comprehensive evaluation of all the published genomes of Coronavirus strains, including population genetics analysis, functional analysis and structural analysis on a historical and global scale were presented in the CoVdb. In the database, the researcher can easily obtain the basic information of a Coronavirus gene with the distribution of the gene among strains, conserved or high mutation regions, possible subcellular location and topology of the gene. Moreover, sliding windows for population genetics analysis results is provided, thereby facilitating genetics and evolutional analysis at the genomic level. CoVdb can be accessed freely athttp://covdb.popgenetics.net.
Ultrastructural Visualization of 3D Chromatin Folding Using Serial Block-Face Scanning Electron Microscopy and In Situ Hybridization (3D-EMISH)
Authors: Trzaskoma Paweł , Ruszczycki Błażej , Lee Byoungkoo , Pels Katarzyna K. , Krawczyk Katarzyna , Bokota Grzegorz , Szczepankiewicz Andrzej A. , Aaron Jesse , Walczak Agnieszka , Śliwińska Małgorzata A. , Magalska Adriana , Kadlof Michal , Wolny Artur , Parteka Zofia , Arabasz Sebastian , Kiss-Arabasz Magdalena , Plewczynski Dariusz , Ruan Yijun , Wilczyński Grzegorz M. 
Published: February 2020

AbstractThe human genome is extensively folded into 3-dimensional organization, yet the detailed 3D chromatin folding structures have not been fully visualized due to the lack of robust and ultra- resolution imaging capability. Here, we report the development of a novel electron microscopy method that combines serial block-face scanning electron microscopy with in situ hybridization (3D-EMISH) to visualize 3D chromatin folding at targeted genomic regions with ultra-resolution (5×5×30 nm in xyz dimensions, respectively). We applied 3D-EMISH to human lymphoblastoid cells at a 1.7 Mb segment of the genome and visualized a large number of distinctive 3D chromatin folding structures in high ultra-resolution. We further quantitatively characterized the reconstituted chromatin folding structures by identifying sub-domains, and uncovered a high level of heterogeneity in chromatin folding ultrastructures, suggestive of extensive dynamic fluidity in 3D chromatin states.
Large-scalein silicomutagenesis experiments reveal optimization of genetic code and codon usage for protein mutational robustness
Authors: Schwersensky Martin , Rooman Marianne , Pucci Fabrizio 
Published: February 2020

AbstractThe question of how natural evolution acts on DNA and protein sequences to ensure mutational robustness and evolvability has been asked for decades without definitive answer. We tackled this issue through a structurome-scale computational investigation, in which we estimated the change in folding free energy upon all possible single-site mutations introduced in more than 20,000 protein structures. The validity of our results are supported by a very good agreement with experimental mutagenesis data. At the amino acid level, we found the protein surface to be more robust to mutations than the core, in a protein length-dependent manner. About 4% of all mutations were shown to be stabilizing, and a majority of mutations on the surface and in the core to be neutral and destabilizing, respectively. At the nucleobase level, single base substitutions were shown to yield on average less destabilizing amino acid mutations than multiple base substitutions. More precisely, the smallest average destabilization occurs for substitutions of base III in the codon, followed by base I, bases I+III, and base II. This ranking highly anticorrelates with the frequency of codon-anticodon mispairing, and suggests that the standard genetic code is optimized more to limit translation errors than the impact of random mutations. Moreover, the codon usage also appears to be optimized for minimizing the errors at the protein level, especially for surface residues that evolve faster and have therefore been under stronger selection, and for biased codons, suggesting that the codon usage bias also partly aims to optimize protein mutational robustness.
Approaches used to enhance transition and retention for newly qualified nurses (NQNs): a rapid evidence assessment
Authors: Wray Jane , Gibson Helen , Barrett David , Watson Roger 
Published: February 2020

ABSTRACTAimTo undertake a rapid evidence assessment of approaches used to enhance nurse transition and retention for NQNs.DesignA rapid evidence assessment.Data sourcesElectronic databases (CINAHL complete, Academic search premier, Open Grey, ERIC* (Education), Web of Science--Social Science Citation Index and PubMed)Review methodsA rapid evidence assessment (REA) was undertaken to gain an overview of the density and quality of evidence on nurse transition and retention from student to Registered Nurse. Electronic databases were searched, and the full texts of relevant papers were retrieved and classified according to methodology. Studies were appraised using relevant CASP and MMAT tools and a single descriptor of quality: high; medium; or low was assigned to each output. Given the disparity in methods, the lack of randomized trials, results could not be combined; therefore, a descriptive approach was used to synthesise and present the data.ResultsOrientation and creating supportive environments were frequently reported as being effective in enhancing transition across a range of studies. A range of methods: quasi-experimental, survey and qualitative were used. Generally speaking the quality of most studies was poor.ConclusionsDespite decades of research into the experiences of NQNs and development of schemes and frameworks to support them during this period, there is little substantive or robust evidence in terms of impact on retention. Further research into the longer-term retention of NQNs is recommended. Longitudinal studies would be beneficial in assessing the efficacy of approaches to enhancing retention.ImpactNurse managers need to work with education providers to facilitate experiences for final year nursing students to ease transition and also implement effective evidence based practices during the first year of registration and monitor the impact of this on retention.
Early life experiences and their impact on effective learning and development
Authors: Pandya Saurabh 
Published: February 2020

Purpose
This paper highlights the role of an individual’s early life experiences (formative years’ experiences) in the learning and development (L&D) journey of their careers. Hence, it is useful for the individual managers as well as organizations to better understand and improve the effectiveness of their L&D processes.

Design/methodology/approach
The paper draws insights from a small subset of the data collected as a part of a larger study on leadership development processes in the context of medium-sized rapid growth organizations in the Indian software services industry.

Findings
The respondents, i.e. senior managers in the software services firms, shared some of their experiences in their formative years (family/school/university/career) which they felt had a huge impact on the way their careers had shaped up. These stories spanned across diverse experiences like values instilled in childhood by parents/grandparents, influence of schoolteachers, friends and peers during growth years, academic performance during college/university days, and successful or positive experiences during early career years.

Originality/value
The paper can be useful to managers in their career development, as well as to organizations in making their L&D processes more effective. It provides a more nuanced understanding of how the experiences in formative years can help improve one’s development and performance in organizations; while the organizations allow, and create, conducive environment for the managers to harness these experiences gained early in life.