bluuebunny/crossref_metadata_2025_split huggingface dataset:
Replication protein A: a multifunctional protein with roles in DNA replication, repair and beyond
Authors: Dueva Rositsa , Iliakis George 
Published: September 2020

AbstractSingle-stranded DNA (ssDNA) forms continuously during DNA replication and is an important intermediate during recombination-mediated repair of damaged DNA. Replication protein A (RPA) is the major eukaryotic ssDNA-binding protein. As such, RPA protects the transiently formed ssDNA from nucleolytic degradation and serves as a physical platform for the recruitment of DNA damage response factors. Prominent and well-studied RPA-interacting partners are the tumor suppressor protein p53, the RAD51 recombinase and the ATR-interacting proteins ATRIP and ETAA1. RPA interactions are also documented with the helicases BLM, WRN and SMARCAL1/HARP, as well as the nucleotide excision repair proteins XPA, XPG and XPF–ERCC1. Besides its well-studied roles in DNA replication (restart) and repair, accumulating evidence shows that RPA is engaged in DNA activities in a broader biological context, including nucleosome assembly on nascent chromatin, regulation of gene expression, telomere maintenance and numerous other aspects of nucleic acid metabolism. In addition, novel RPA inhibitors show promising effects in cancer treatment, as single agents or in combination with chemotherapeutics. Since the biochemical properties of RPA and its roles in DNA repair have been extensively reviewed, here we focus on recent discoveries describing several non-canonical functions.
Characteristics of mutational signatures of unknown etiology
Authors: Hu Xiaoju , Xu Zhuxuan , De Subhajyoti 
Published: September 2020

Abstract
Although not all somatic mutations are cancer drivers, their mutational signatures, i.e. the patterns of genomic alterations at a genome-wide scale, provide insights into past exposure to mutagens, DNA damage and repair processes. Computational deconvolution of somatic mutation patterns and expert curation pan-cancer studies have identified a number of mutational signatures associated with point mutations, dinucleotide substitutions, insertions and deletions, and rearrangements, and have established etiologies for a subset of these signatures. However, the mechanisms underlying nearly one-third of all mutational signatures are not yet understood. The signatures with established etiology and those with hitherto unknown origin appear to have some differences in strand bias, GC content and nucleotide context diversity. It is possible that some of the hitherto ‘unknown’ signatures predominantly occur outside gene regions. While nucleotide contexts might be adequate to establish etiologies of some mutational signatures, in other cases additional features, such as broader (epi)genomic contexts, including chromatin, replication timing, processivity and local mutational patterns, may help fully understand the underlying DNA damage and repair processes. Nonetheless, remarkable progress in characterization of mutational signatures has provided fundamental insights into the biology of cancer, informed disease etiology and opened up new opportunities for cancer prevention, risk management, and therapeutic decision making.
Six-membered-ring inorganic materials: definition and prospects
Authors: Liu Gang , Chen Xing-Qiu , Liu Bilu , Ren Wencai , Cheng Hui-Ming 
Published: September 2020

AbstractThe six-membered ring (SMR) is a common structure unit for numerous material systems. These materials include, but are not limited to, the typical two-dimensional materials such as graphene, h-BN, and transition metal dichalcogenides, as well as three-dimensional materials such as beryllium, magnesium, MgB2 and Bi2Se3. Although many of these materials have already become ‘stars’ in materials science and condensed-matter physics, little attention has been paid to the roles of the SMR unit across a wide range of compositions and structures. In this article, we systematically analyze these materials with respect to their very basic SMR structural unit, which has been found to play a deterministic role in the occurrence of many intriguing properties and phenomena, such as Dirac electronic and phononic spectra, superconductivity and topology. As a result, we have defined this group of materials as SMR inorganic materials, opening up a new perspective on materials research and development. With their unique properties, SMR materials deserve wide attention and in-depth investigation from materials design, new physical discoveries to target-wizard applications. It is expected that SMR materials will find niche applications in next-generation information technology, renewable energy, space, etc.
Calculation of a key function in the asymptotic description of moving contact lines
Authors: Scott Julian F 
Published: September 2020

Summary
An important element of the asymptotic description of flows having a moving liquid/gas interface which intersects a solid boundary is a function denoted $Q_i \left( \alpha \right)$ by Hocking and Rivers (The spreading of a drop by capillary action, J. Fluid Mech. 121 (1982) 425–442), where $0 &lt; \alpha &lt; \pi$ is the contact angle of the interface with the wall. $Q_i \left( \alpha \right)$ arises from matching of the inner and intermediate asymptotic regions introduced by those authors and is required in applications of the asymptotic theory. This article describes a new numerical method for the calculation of $Q_i \left( \alpha \right)$, which, because it explicitly allows for the logarithmic singularity in the kernel of the governing integral equation and uses quadratic interpolation of the non-singular factor in the integrand, is more accurate than that employed by Hocking and Rivers. Nonetheless, our results show good agreement with theirs, with, however, noticeable departures near $\alpha = \pi $. We also discuss the limiting cases $\alpha \to 0$ and $\alpha \to \pi $. The leading-order terms of $Q_i \left( \alpha \right)$ in both limits are in accord with the analysis of Hocking (A moving fluid interface. Part 2. The removal of the force singularity by a slip flow, J. Fluid Mech. 79 (1977) 209–229). The next-order terms are also considered. Hocking did not go beyond leading order for $\alpha \to 0$, and we believe his results for the next order as $\alpha \to \pi $ to be incorrect. Numerically, we find that the next-order terms are $O\left( {\alpha ^2} \right)$ for $\alpha \to 0$ and $O\left( 1 \right)$ as $\alpha \to \pi $. The latter result agrees with Hocking, but the value of the $O\left( 1 \right)$ constant does not. It is hoped that giving details of the numerical method and more precise information, both numerical and in terms of its limiting behaviour, concerning $Q_i \left( \alpha \right)$ will help those wanting to use the asymptotic theory of contact-line dynamics in future theoretical and numerical work.
Back to Basics: Basic Research Spillovers, Innovation Policy, and Growth
Authors: Akcigit Ufuk , Hanley Douglas , Serrano-Velarde Nicolas 
Published: September 2020

AbstractThis article introduces a general equilibrium model of endogenous technical change through basic and applied research. Basic research differs from applied research in the nature and the magnitude of the generated spillovers. We propose a novel way of empirically identifying these spillovers and embed them in a framework with private firms and a public research sector. After characterizing the equilibrium, we estimate our model using micro-level data on research expenditures by French firms. Our key finding is that uniform research subsidies can accentuate the dynamic misallocation in the economy by oversubsidizing applied research. Policies geared towards public basic research and its interaction with the private sector are significantly welfare-improving.
The Relationship Between Acuity of Organ Failure and Predictive Validity of Sepsis-3 Criteria
Authors: Gadrey Shrirang M. , Clay Russ , Zimmet Alex N. , Lawson Alexander S. , Oliver Samuel F. , Richardson Emily D. , Forrester Vernon J. , Andris Robert T. , Rhodes Garret T. , Voss John D. , Moore Christopher C. , Moorman J. Randall 
Published: September 2020

Objectives:
The Sepsis-3 taskforce defined sepsis as suspicion of infection and an acute rise in the Sequential Organ Failure Assessment score by 2 points over the preinfection baseline. Sepsis-3 studies, though, have not distinguished between acute and chronic organ failure, and may not accurately reflect the epidemiology, natural history, or impact of sepsis. Our objective was to determine the extent to which the predictive validity of Sepsis-3 is attributable to chronic rather than acute organ failure.

Design:
Retrospective cohort study.

Setting:
General medicine inpatient service at a tertiary teaching hospital.

Patients:
A total of 3,755 adult medical acute-care encounters (1,864 confirmed acute infections) over 1 year.

Interventions:
None.

Measurements and Main Results:
We measured the total Sequential Organ Failure Assessment score at the onset of infection and separated its components (baseline and acute rise) using case-by-case chart reviews. We compared the predictive validities of acuity-focused (acute rise in Sequential Organ Failure Assessment ≥ 2) and conventional (total Sequential Organ Failure Assessment ≥ 2) implementations of Sepsis-3 criteria. Measures of predictive validity were change in the rate of outcomes and change in the area under receiver operating characteristic curves after adding sepsis criteria to multivariate logistic regression models of baseline risk (age, sex, race, and Charlson comorbidity index). Outcomes were inhospital mortality (primary) and ICU transfer or inhospital mortality (secondary). Acuity-focused implementations of Sepsis-3 were associated with neither a change in mortality (2.2% vs 1.2%; p = 0.18) nor a rise in area under receiver operating characteristic curves compared with baseline models (0.67 vs 0.66; p = 0.75). In contrast, conventional implementations were associated with a six-fold change in mortality (2.4% vs 0.4%; p = 0.01) and a rise in area under receiver operating characteristic curves compared with baseline models (0.70 vs 0.66; p = 0.04). Results were similar for the secondary outcome.

Conclusions:
The evaluation of the validity of organ dysfunction-based clinical sepsis criteria is prone to bias, because acute organ dysfunction consequent to infection is difficult to separate from preexisting organ failure in large retrospective cohorts.
Factors Affecting the Efficacy of Suction Curettage Using an Arthroscopic Shaver for Bromhidrosis
Authors: Fang Chien-Liang , Tsai Chong-Bin , Chen Ming-Shan , Yang Hsin-Yi , Fang Kai-Jan 
Published: September 2020

BACKGROUND
Suction-curettage using an arthroscopic shaver is the most effective surgical treatment for bromhidrosis; however, information regarding the procedure is limited. This study investigated the factors that affect the efficacy of suction-curettage.

PATIENTS AND METHODS
We retrospectively evaluated data for 215 patients (430 axillae) with bromhidrosis treated with suction-curettage using an arthroscopic shaver between 2011 and 2019.

RESULTS
Excellent or good efficacy with improved malodor was achieved in 418 axillae (97.21%). Secondary suction-curettage was performed for 11 (2.56%), with excellent results. Efficacy and need for secondary suction-curettage were not associated with age, sex, shaving time, and tumescent infiltration use. Complications were observed in 52 (12.09%) axillae, including hematoma or seroma, epidermis decortication, skin necrosis, and infections; 10 (2.33%) required local debridement for wounds. Complications showed a significant difference with respect to age (p < .001). Pain scores on postoperative Day 2 were significantly lower for patients treated using tumescent infiltration than those for the others (1.65 ± 0.84 vs 4.57 ± 1.16; p < .001).

CONCLUSION
The results suggest that 7 to 15 minutes of suction curettage using an arthroscopic shaver is sufficient to achieve good efficacy for bromhidrosis with few complications. Older age was a risk factor for complications, and tumescent infiltration use achieved good postoperative pain control.

Levels of Evidence
II.
The Vascular Component of Melasma: A Systematic Review of Laboratory, Diagnostic, and Therapeutic Evidence
Authors: Masub Natasha , Nguyen Julie K. , Austin Evan , Jagdeo Jared 
Published: September 2020

BACKGROUND
Melasma is a common acquired disorder of hyperpigmentation, classically manifesting as symmetric brown patches on the face. Although the exact pathogenesis is not fully understood, vascular abnormalities have been implicated in melasma.

OBJECTIVE
To evaluate the laboratory and clinical evidence regarding the safety and efficacy of antivascular agents for the treatment of melasma.

METHODS
A systematic review of PubMed, EMBASE, and Cochrane was conducted on May 13, 2020, using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Original research articles investigating the role of vascularity and/or evaluating the use of antivascular therapeutics in melasma were included. Clinical recommendations were based on the American College of Physicians guidelines.

RESULTS
A total of 34 original research articles as follows were identified: 4 laboratory studies, 15 diagnostic studies, and 15 therapeutic studies.

CONCLUSION
There is promising evidence supporting the use of tranexamic acid and laser/light therapies to treat the vascular component of melasma, and more rigorous clinical trials are needed to validate their efficacy. Clinicians may consider treatment with one or more antivascular therapeutics in patients with melasma. Further research is warranted to characterize the role of cutaneous vascularization in melasma and may provide insights for novel therapies.
Perceptions of disaster management knowledge and skills among advanced practice registered nurses
Authors: Fil Samantha L. , Champion Jane Dimmitt , Christiansen Brittany 
Published: September 2020

ABSTRACT

Background and purpose:
Disaster management experts around the world agree that nurses play a vital role in disaster preparation, response, and recovery. The Joint Commission on Accreditation of Health care Organizations requires biannual disaster drills for accredited facilities, and there are numerous training resources and educational materials on disaster management topics. Multiple federal and state laws govern health care provider activities during a disaster. However, there is a lack of guidance and evidence surrounding the specific roles and responsibilities of advanced practice registered nurses (APRNs) in a disaster setting. This project assesses APRNs knowledge of disaster management roles and responsibilities and the training for these roles.

Methods:
Using a cross-sectional survey research design, a 68-item survey was distributed via e-mail and social media to members of Texas APRN professional organizations. A convenience sample of those responding and meeting inclusion criteria (Texas-licensed APRN) was analyzed using SPSS to perform descriptive and nonparametric statistics.

Results:
Thirty-one percent of responding APRNs considered themselves prepared for the management of disasters. A majority of statements (29/47, 61.7%) evaluating APRN knowledge and skills were significantly different (p < .05) across three training and experience categories: post-APRN program education, workplace/community drills or exercises, and planning or disaster response.

Implications for practice:
More clearly defined roles and readily available training and resources will improve APRNs preparation for disaster situations. Recurrent training and professional experience increase knowledge and confidence related to advanced practice disaster management competencies.
The growing need to provide training in clinical procedures in family nurse practitioner educational programs
Authors: Woroch Ruth A. , Bockwoldt Denise 
Published: September 2020

ABSTRACT
Family nurse practitioners (FNPs) have a plethora of employment options upon graduation. Besides primary care, many are working in nontraditional settings such as urgent care, emergency departments, retail health, and specialty practices. In many of these settings, practitioners are required to perform procedures. However, more information is needed on the type of settings in which recent FNP graduates are working, the procedures being performed in these settings, and the perceptions of graduates of how prepared they felt to perform these procedures. Family nurse practitioners who completed an FNP program within the previous five years and who attended the 2019 AANP National Conference were invited to participate in a survey to assess their preparation in clinical procedures. Results revealed that more than half of the 198 respondents reported doing incision and drainage of abscesses and laceration repair. Respondents were divided on how they first learned to perform the procedures, with 47% stating that a preceptor demonstrated procedures to them during a clinical practicum experience, 42% stating that they learned on the job after graduation, and 43% reported that their FNP program provided training or simulation activities related to procedures. More than a quarter of respondents reported that they took a class on procedures. In all, 61% reported that they did not feel adequately prepared to perform procedures on graduation. Results indicated that colleges of nursing should ensure that FNP students have opportunities to master the procedures that are frequently performed by FNPs.
Screening for chronic kidney disease in a hypertensive primary care cohort
Authors: Llewellyn Sarah 
Published: September 2020

ABSTRACT

Background:
Screening rates for chronic kidney disease (CKD) in primary care settings remain low. Although primary care providers are well positioned to offer this testing, there are many barriers that contribute to low screening rates.

Purpose:
The purpose of this study was to examine both practice and contextual factors that relate to screening for CKD in a cohort of primary care patients with hypertension.

Methods:
A mixed-methods, single-embedded, convergent parallel design was used for this organizational case study. The Chronic Care Model served as the framework. Electronic medical record data, resource walk-through, and provider surveys were collected from selected primary care clinics within one large academic medical center in the Pacific Northwest. Analyses included regression models, descriptive statistics, narrative content analysis, and pattern matching for organizational case creation.

Results:
Screening rates were low in the cohort, but patients with more risk factors for CKD were more likely to receive orders for screening. Organizational and community support was deemed necessary for primary care providers to effectively translate guidelines into practice.

Implications for practice:
The results of this study offer support for a wholistic approach to guideline translation into practice. Participants in the study were open to increased screening for CKD but needed support in multiple ways from the organization. Guidelines alone were not deemed the ideal vehicles for translation of research into practice.
Improving timely sepsis care using the surviving sepsis campaign one-hour bundle in a rural emergency department
Authors: Bray Carla , Kennedy Christopher 
Published: September 2020

ABSTRACT

Background:
Sepsis is deadly when not recognized and treated in a timely manner and leads to 270,000 deaths each year in America. Mortality increases eight percent for each hour treatment is delayed. Sepsis-related admission is the most expensive condition in the United States with a median cost per patient of $32,421.

Local problem:
Baseline data for patients with sepsis revealed that only 30% were recognized in triage, only 20% received correct amounts of fluids, and only 45% received antibiotics within one hour. The aim of this project was to improve timely sepsis care to 75% for patients in a rural emergency department within 90 days.

Methods:
A rapid cycle quality improvement project was completed, consisting of four plan-do-study-act cycles over 90 days. Each cycle included tests of change related to team and patient engagement, screening, and the use of timely sepsis orders. Data were collected three times weekly and analyzed using run charts.

Interventions:
Interventions included screening in triage with positively screened patients receiving participatory education, team handoff communication, a sepsis checklist for nurse-driven orders, and Power Hour for timely care.

Results:
Team communication improved to 83%. Patient education exceeded goal, with 100% of patients taking an active role in care. Sepsis screening improved to 100%. The recommended One-Hour Bundle for timely sepsis treatment improved to 83%.

Conclusion:
The project was successful in improving patient and team engagement, screening, and sepsis care within 1 hour for emergency department patients.
U.S. nurse practitioners' HIV screening behaviors and health center characteristics
Authors: Sutherland Jodi L. , Fantasia Heidi Collins , Jiang Lan , Si Bing 
Published: September 2020

ABSTRACT
One of the most effective strategies to end the human immunodeficiency virus (HIV) epidemic is HIV screening technologies. Routine HIV screening reaches the first-time tester, people with undiagnosed HIV, and those persons who are in need of frequent retesting due to their ongoing risk. This secondary analysis examined nurse practitioners' (NPs) rates of offering routine HIV screening and health center HIV screening characteristics. A convenience sample of NPs completed either a paper and pencil or an online survey in February 2016. Nurse practitioners responded to several questions about their behaviors and the health center characteristics where they work related to HIV screening. Many NPs (31%) never offer routine HIV screening to patients. Efforts are needed to implement structural changes to increase HIV screening rates among NPs and the health centers where they work. Nurse practitioners, health centers, and the health center policies must align to address the HIV epidemic and implement national HIV screening recommendations.
Providing effective inpatient care for cirrhosis by improving utilization of national guidelines
Authors: Smith Tracy Ellen , Jefferson Khara' 
Published: September 2020

ABSTRACT

Background:
Over the past 10 years, cirrhosis incidence has increased dramatically, with a 59% increase in the need for treatment of disease complications. Cirrhosis treatment complexity and cost have increased substantially, and cirrhosis deaths are increasing by 10.5% yearly.

Local problem:
A review of 29 cirrhosis admissions revealed that guideline criteria were only addressed 66% of the time on 10 key cirrhosis issues. After identifying gaps in care, the project aimed to improve right care for cirrhosis by 20% within 90 days by using a guideline-based checklist and chart audit process.

Methods:
The quality improvement (QI) initiative used four Plan-Do-Study-Act cycles. Cycles included tests of change for the checklist, patient engagement, chart audit, and team participation.

Interventions:
A guideline-based cirrhosis checklist focused on providing right care for cirrhosis patient admissions. Patient engagement was addressed with a shared decision-making tool. To monitor data, a chart audit was created. Team engagement included biweekly QI meetings with an agenda and a postmeeting survey.

Results:
The project aim was achieved, improving cirrhosis guideline-based care by 22%, while utilization of the guideline-based checklist rose to 100%. Moreover, 96% of patients approached for shared decision making agreed to participate, and the chart audit was completed on all patients. Team engagement and satisfaction remained high throughout the cycles.

Conclusions:
The project team used an evidence-based approach to effectively improve inpatient care for cirrhosis. Engaging providers and patients with this approach led to high patient and team participation and improved project outcomes.