bluuebunny/crossref_metadata_2025_split huggingface dataset:
RADIATION SITUATION IN THE TERRITORIES AFFECTED BY MINING ACTIVITIES IN STEPNOGORSK AREAS, REPUBLIC OF KAZAKHSTAN: PILOT STUDY
Authors: Ibrayeva Danara , Bakhtin Meirat , Kashkinbayev Yerlan , Kazymbet Polat , Zhumadilov Kassym , Altaeva Nursulu , Aumalikova Moldir , Shishkina Elena 
Published: April 2020

AbstractThe Republic of Kazakhstan has a long history of mining activities, viz., gold and uranium. Mining activities represent sources of potential naturally occurring radionuclides contamination of the environment and human health of population. The aim of this study was to investigate the radiation situation of industrially modified environment in Stepnogorsk areas of Kazakhstan to understand the sources of contamination. Quite high values of ambient equivalent dose rates in air ~2.87 μSv h−1 were found in the Aqsu gold-mining site. The radon equivalent equilibrium volume activity (indoor) were in the range of 313–858 Bq m−3 in the study area buildings. The high values of activity concentration of natural radionuclides found in Aqsu soil samples were 226Ra-4060, 232Th-1170 and 40K-4080 Bq kg−1, respectively. However, our comprehensive surveys implied that the increased natural radiation background caused by the radionuclide transport from the tailing area did not have an impact, while evaluation of its potential radiation risks and remediation of the territories of the former gold mining should be needed.
The N170 event-related potential differentiates congruent and incongruent gaze responses in gaze leading
Authors: Stephenson Lisa J , Edwards S Gareth , Luri Natacha M , Renoult Louis , Bayliss Andrew P 
Published: April 2020

Abstract
To facilitate social interactions, humans need to process the responses that other people make to their actions, including eye movements that could establish joint attention. Here, we investigated the neurophysiological correlates of the processing of observed gaze responses following the participants’ own eye movement. These observed gaze responses could either establish, or fail to establish, joint attention. We implemented a gaze leading paradigm in which participants made a saccade from an on-screen face to an object, followed by the on-screen face either making a congruent or incongruent gaze shift. An N170 event-related potential was elicited by the peripherally located gaze shift stimulus. Critically, the N170 was greater for joint attention than non-joint gaze both when task-irrelevant (Experiment 1) and task-relevant (Experiment 2). These data suggest for the first time that the neurocognitive system responsible for structural encoding of face stimuli is affected by the establishment of participant-initiated joint attention.
Phylogenomics Reveals Ancient Gene Tree Discordance in the Amphibian Tree of Life
Authors: Hime Paul M , Lemmon Alan R , Lemmon Emily C Moriarty , Prendini Elizabeth , Brown Jeremy M , Thomson Robert C , Kratovil Justin D , Noonan Brice P , Pyron R Alexander , Peloso Pedro L V , Kortyna Michelle L , Keogh J Scott , Donnellan Stephen C , Mueller Rachel Lockridge , Raxworthy Christopher J , Kunte Krushnamegh , Ron Santiago R , Das Sandeep , Gaitonde Nikhil , Green David M , Labisko Jim , Che Jing , Weisrock David W 
Published: April 2020

AbstractMolecular phylogenies have yielded strong support for many parts of the amphibian Tree of Life, but poor support for the resolution of deeper nodes, including relationships among families and orders. To clarify these relationships, we provide a phylogenomic perspective on amphibian relationships by developing a taxon-specific Anchored Hybrid Enrichment protocol targeting hundreds of conserved exons which are effective across the class. After obtaining data from 220 loci for 286 species (representing 94% of the families and 44% of the genera), we estimate a phylogeny for extant amphibians and identify gene tree–species tree conflict across the deepest branches of the amphibian phylogeny. We perform locus-by-locus genealogical interrogation of alternative topological hypotheses for amphibian monophyly, focusing on interordinal relationships. We find that phylogenetic signal deep in the amphibian phylogeny varies greatly across loci in a manner that is consistent with incomplete lineage sorting in the ancestral lineage of extant amphibians. Our results overwhelmingly support amphibian monophyly and a sister relationship between frogs and salamanders, consistent with the Batrachia hypothesis. Species tree analyses converge on a small set of topological hypotheses for the relationships among extant amphibian families. These results clarify several contentious portions of the amphibian Tree of Life, which in conjunction with a set of vetted fossil calibrations, support a surprisingly younger timescale for crown and ordinal amphibian diversification than previously reported. More broadly, our study provides insight into the sources, magnitudes, and heterogeneity of support across loci in phylogenomic data sets.[AIC; Amphibia; Batrachia; Phylogeny; gene tree–species tree discordance; genomics; information theory.]
Reconstructing a Nursing Skills Lab
Authors: Brendel Heidi , Walker John P. 
Published: April 2020

Abstract
Safety is a paramount consideration when preparing nursing students for clinical practice. Skills lab traditions steeped in the rote memorization of procedures fail to bridge the gap between theory and practice, leaving patients at risk. The foundations of nursing skills lab curriculum in an associate degree nursing program was revised utilizing the Quality and Safety Education for Nurses and evidence-based teaching pedagogy to better prepare students for their first clinical experience. This article discusses how the skills lab curriculum was revised and examines how faculty felt the revisions impacted students’ clinical performance outcomes related to safety and patient-centered care.
Addressing Nursing Student Understanding of Health Care Transitions Through a Cross-Course Writing Assignment
Authors: Keeler Donna Turissini , Gotwals Beth 
Published: April 2020

Abstract
Caring for patients with chronic health conditions and providing them appropriate transitional care that provides positive outcomes and decreased rehospitalizations is essential in today’s heath care environment. Nursing students must learn to think critically and communicate effectively in order to provide appropriate transitional care. This pedagogical challenge may be met in part by implementing a cross-course writing assignment that combines the concepts of chronic illness and community health as an effective tool to teach students about transitional care, stimulate critical thinking, and improve writing competencies.
Correlating Ophthalmology Exposure in Medical School to Applying and Matching Into an Ophthalmology Residency
Authors: Yamane Maya L.M. , Kassotis Alexis S. , De Moraes C. Gustavo , Dagi Glass Lora R. 
Published: April 2020

Purpose
To correlate ophthalmology curricular exposure in medical school to the number of students who applied and matched into ophthalmology residency programs. Given the high curricular burden placed on medical schools, the authors sought to better characterize existing ophthalmology curricula and to delineate which offerings are closely related to high numbers of students applying and matching into ophthalmology residencies.

Method
The authors reviewed the extent of ophthalmology curricula between 2007 and 2017 via a survey administered in 2018 to all U.S. Association of American Medical Colleges (AAMC)-affiliated medical schools. They obtained residency application and match data with permission from the Association of University Professors of Ophthalmology. The authors compared metrics of ophthalmology exposure with the number of students who applied and matched into ophthalmology during the corresponding year using mixed-effects Poisson regression analysis.

Results
This study includes 49 U.S. AAMC-affiliated medical schools. When adjusted for the number of applicants per year, the following were significantly (P < .05) associated with matching into an ophthalmology residency: the presence of an ophthalmology department, an ophthalmology residency program, an ophthalmology interest group, ophthalmologists on faculty, ophthalmology content in the preclinical curriculum, preclinical lectures taught by ophthalmologists, and the availability of an optional fourth-year ophthalmology elective. Multivariable analysis indicated both that the presence of an ophthalmology residency program was the only independent predictor of matching into an ophthalmology residency and that the presence of an ophthalmology residency program, ophthalmology content in the preclinical curriculum, and preclinical lectures taught by ophthalmologists are independent predictors for applying.

Conclusions
A foundation in ophthalmology is crucial for all physicians, especially those who may encounter patients with eye problems in emergency or primary care settings. However, for those students considering a career in ophthalmology, choosing a medical school with an ophthalmology department and residency program is particularly important.
What we can learn from nonoperating room anesthesia registries: analysis of clinical outcomes and closed claims data
Authors: Yeh Tiffany , Beutler Sascha S. , Urman Richard D. 
Published: April 2020

Purpose of review
The prevalence of procedures performed outside of the operating room is steadily growing around the world, especially in the United States. This review aims to discuss the risks and safety of anesthesia performed in remote locations based on an up-to-date literature review, with a focus on the results from closed claims and other database analyses.

Recent findings
The published literature in the last decade shows that there is an increase in nonoperating room anesthesia cases and that the highest number of these cases are in gastroenterology endoscopy suites. There are safety concerns in nonoperating room cases that involve both anesthesia and nonanesthesia providers. Specific complications found in closed claims analyses include airway compromise, aspiration pneumonia, and dental injuries.

Summary
The current literature demonstrates that procedures performed in the endoscopy suite make up the largest number of nonoperating room closed claims anesthesia cases. Oversedation and subsequent inadequate oxygenation/ventilation account for the majority of malpractice claims. Conclusions from the current literature emphasize the importance of complying with monitoring standards and having well prepared providers to improve patient outcomes in nonoperating room locations.
Point-of-care ultrasound in pregnancy: gastric, airway, neuraxial, cardiorespiratory
Authors: Van de Putte Peter , Vernieuwe Lynn , Bouchez Stefaan 
Published: April 2020

Purpose of review
This review focuses on the use of point-of-care ultrasound (PoCUS) in the obstetric context for airway management and assessment of aspiration risk, the placement of neuraxial blocks and the diagnosis and follow-up of cardiorespiratory dysfunction.

Recent findings
Gastric ultrasound is a useful aspiration risk assessment tool in pregnant patients. Total gastric fluid assessment models and specific cut-offs between high-risk and low-risk stomachs are presented. Airway assessment is useful to detect specific changes in pregnancy and to guide airway management. Handheld ultrasound devices with automated neuraxial landmark detection capabilities could facilitate needle placement in the future. Lung and cardiac ultrasonography is useful in the management of preeclampsia, pulmonary arterial hypertension and peripartum cardiomyopathy.

Summary
Owing to its noninvasiveness, ease of accessibility and lack of exposure to radiation, PoCUS plays an increasing and essential role in aspiration risk assessment, airway management, neuraxial anaesthesia and cardiorespiratory diagnosis and decision-making during pregnancy.
NICU Nurses' Knowledge and Attitudes Regarding 2-Month Immunizations
Authors: Macintosh Janelle L. B. , Eden Lacy M. , (Beth) Luthy Karlen E. , Beckstrand Renea 
Published: April 2020

Background:
Nurses are an integral part of the healthcare team. Parents rely on nurses for information regarding the plan of care for their child. Medically stable infants under supervision in a newborn intensive care unit (NICU) can and should be immunized.

Purpose:
The purpose of this study was to explore attitudes and knowledge in NICU nurses regarding 2-month immunizations.

Methods:
Participants were attendees of the National Association of Neonatal Nurses (NAAN) 33rd Annual Conference. Participants responded to a survey that focused on knowledge and attitudes regarding 2-month immunizations.

Findings/Results:
A total of 188 nurses attending the NAAN conference completed the survey. Most nurses had positive attitudes regarding immunizations. A majority (n = 117, 62.5%) of NICU nurses knew that immunizations should be given to medically stable infants in a NICU. However, as few as 27% of participants were able to identify recommended 2-month immunizations. Almost two-thirds of participants (n = 115, 61.1%) did not know current guidelines regarding minimum age at the time of administration of immunizations, although NPs were more likely to know current guidelines. Nurse practitioners were more comfortable talking family about immunizations and were more likely to view that the illnesses prevented by vaccines as serious.

Implications for Practice:
NICU nurses would benefit from continued education focused on Centers for Disease Control and Prevention (CDC) guidelines for 2-month immunizations. Additionally, as a primary source of information for parents, NICU nurses should be encouraged to practice teaching parents and family about immunizations. This practice could reinforce nurse knowledge.

Implications for Research:
Further research regarding the effect of education, simulation, and yearly reinforcement of CDC guidelines could further enlighten our knowledge on this topic.
Stage-specific Conditional Survival Among Young (Age Below 50 y) Versus Older (Age 50 y and Above) Adults With Colorectal Cancer in the United States
Authors: Sanford Nina N. , Ahn Chul , Beg Muhammad S. , Sanjeevaiah Aravind , Kazmi Syed A. , Folkert Michael R. , Aguilera Todd A. , Sher David J. 
Published: April 2020

Background:
Conditional survival (CS) is a relevant prognostic measure and may be particularly important for young adult patients with colorectal cancer (CRC), whose incidence is rising. We sought to compare CS among young versus older adults with CRC.

Methods:
Patients diagnosed with CRC between 2004 and 2010 were identified from the Surveillance, Epidemiology, and End Results registry. Smoothed yearly hazards of death due to CRC, other causes and any cause were estimated, stratified by age at diagnosis (below 50 vs. 50 y and above) and stage (I-III vs. IV). Stage-specific conditional 5-year overall survival and cancer-specific survival given that patients had already survived 1 to 5 years after diagnosis was calculated.

Results:
Among 161,859 patients with median follow-up of 54 months, 35,411 (21.9%) were aged below 50 years. For older adults with nonmetastatic CRC, hazards of death due to noncancer causes exceeded that of rectal and colon cancer ∼6.1 and 3.8 years after diagnosis, respectively. Patients experienced improved CS over time with greater improvement seen for more advanced stages. However, young adults had less CS improvement over time than older adults. For example, the 5-year cancer-specific survival for stage IV colon cancer improved from 15.6% to 77.2% (change=61.6%) 0 to 5 years after diagnosis for older adults but only 20.3% to 67.7% (change=47.4%) for young adults.

Conclusions:
Prognosis for CRC improves over time for all patients, although the increase in survival appears to be less for young than older adults. Up to 10 years after diagnosis, the primary cause of death in young adults with CRC remains their incident cancer.
Syphilitic Chancre of the Lip
Authors: Calvo Davinia F. , Cassarino David , Fernandez-Flores Angel 
Published: April 2020

Abstract:
Syphilis is a sexually transmitted disease caused by Treponema pallidum. The primary stage of the disease (the chancre) mainly involves the genital areas. Extragenital areas are involved in 5%–14% of cases, many of which occur in the oral cavity. Among the extragenital locations, the lip is the most frequent; however, despite this, published cases of the chancre of the lip are few. We present a case of a chancre presenting on the lip of a nonimmunocompromised 55-year-old male patient with immunohistochemical confirmation.
Topical hemostatic and tissue-sealing agents in gynecologic surgery
Authors: Cullifer Rachel M. , Makai Gretchen , Pacis Michelle , Huynh Terri 
Published: April 2020

Purpose of review
To review current topical hemostatic agent use and how it pertains to gynecologic surgery.

Recent findings
Recent literature suggests some benefit of topical hemostatic agents (THA). THAs confer reduced bleeding and shorter operating room time in women undergoing hysterectomy for cancer and in abdominal myomectomy. THA use in women undergoing ovarian cystectomy is associated with a decreased reduction in ovarian reserve. Potential complications of THA use include abscess formation, small bowel obstruction, inflammation, allergic reaction, and transmission of blood-borne pathogens. Evidence for use of THA in benign minimally invasive gynecologic surgery (MIGS) procedures is lacking.

Summary
Although evidence exists for the efficacy of THA in reducing blood loss and operating times across surgical subspecialties, specific, appropriate, and efficacious use of THAs in gynecologic surgery remains ill-defined. Knowledge of their mechanisms of action and potential complications should enable surgeons to optimize desired effects and minimize harm.
Lymphatic System Transfer for Lymphedema Treatment: Transferring the Lymph Nodes with Their Lymphatic Vessels
Authors: Yoshimatsu Hidehiko , Visconti Giuseppe , Karakawa Ryo , Hayashi Akitatsu 
Published: April 2020

Background:Vascularized lymph node transfer is the most common physiological procedure indicated for severe lymphedema. We describe a new physiological treatment strategy for lymphedema, lymphatic system transfer (LYST), which comprises transfer of the vascularized afferent lymphatic vessels along with their draining lymph nodes.Methods:All patients undergoing LYST for treatment of lymphedema from 2017 to 2018 were identified. Patient demographics, intraoperative factors, and postoperative outcomes were reviewed.Results:Three patients underwent LYST. Average patient age and body mass index were 65.3 years and 23.6 kg/m2, respectively. Indications for LYST were upper extremity lymphedema following mastectomy, radiation, and lymphadenectomy (2) and unilateral lower extremity lymphedema following total hysterectomy and bilateral pelvic lymphadenectomy (1). In all patients, lymphatic vessels could not be visualized by preoperative lymphoscintigraphy. All LYST flaps were procured from the groin region. A superficial circumflex iliac artery perforator flap, including the afferent lymphatic vessels and their draining lymph nodes, was elevated. A large portion of the skin paddle was deepithelialized, and the LYST flap was inset into a subcutaneous tunnel made in the lymphedematous limb. All LYST flaps survived completely. No donor site complications were observed. The average rate of estimated volume decrease in the patients at eighth month follow-up was 21.9%. Average follow-up was 11 months.Conclusions:Because the afferent lymphatic vessels are transferred with the lymph nodes, a presumably lesser degree of lymphangiogenesis is required for a LYST flap to commence its physiological function. Its real-time physiological lymphatic drainage is demonstrated in a video.
Surgical Outcomes in Prepectoral Breast Reconstruction
Authors: Urquia Lindsey N. , Hart Alexandra M. , Liu Daniel Z. , Losken Albert 
Published: April 2020

Background:
Prepectoral breast reconstruction has reemerged as a popular option for prosthetic-based breast reconstruction. Recent published literature highlights good outcomes; however, techniques are evolving and options exist for different technologies. The aim of this study is to evaluate short-term complication rates of prepectoral reconstructions using Cortiva acellular dermal matrix.

Methods:
A multicenter retrospective study was conducted of all patients who underwent mastectomy with immediate direct-to-implant or 2-stage prepectoral breast reconstruction with Cortiva (RTI Surgical, Alachua, Fla.) between January 2016 and September 2018. The incidence of surgical complications was determined and studied against patient demographics and procedural details.

Results:
One-hundred eighteen patients met the inclusion criteria for a total of 183 individual breasts reconstructed with prepectoral implant. Average length of follow-up was 9.26 months (range, 1.0 month to 2.5 years). Thirty-two breasts (17.49%) experienced 1 or more complications. Prepectoral reconstruction was successful 89.07% of the time. Infection was the most common cause of both reoperation and implant failure, with 7.65% of all breasts requiring washout and 5.46% failing prosthetic reconstruction secondary to infection.

Conclusions:
Surgical outcomes for prepectoral breast reconstruction using 2-stage and direct-to-implant are similar and comparable to the literature for dual-plane reconstruction, with infection being the main cause of failure.
Povidone-iodine Does Not Affect Acellular Dermal Matrix Integration in Patients Undergoing 2-staged, Prepectoral, Breast Reconstructive Surgery
Authors: Gabriel Allen , Sigalove Steven , Pfaffenberger Maci , Eldenburg Elizabeth , Gold Rebecca , O’Rorke Erin , Maxwell G. Patrick 
Published: April 2020

Background:
Povidone-iodine has been traditionally used as an antimicrobial agent to irrigate the breast pocket and rinse the prosthesis before placement in the pocket. Use of povidone-iodine with breast implants was banned from 2000 to 2017. During this period, acellular dermal matrix (ADM) was introduced to breast surgery. In nonclinical studies, povidone-iodine can impair collagen synthesis and kill fibroblasts. Cellular repopulation was critical for ADM integration. Whether povidone-iodine impacts ADM integration was unknown.

Methods:
Patients who underwent immediate, prepectoral, 2-staged breast reconstruction were included in this retrospective study. Study population was divided into povidone-iodine–treated patients and triple-antibiotic–treated patients. The breast pockets were rinsed with the antimicrobial agent, and the prostheses and ADMs were presoaked in the agent perioperatively. At implant exchange, the extent of ADM integration was clinically assessed. ADM integration was defined as >25% of matrix vascularization. ADM integration and postoperative complications were compared between the groups.

Results:
A total of 111 patients (257 reconstructions) were included—58 patients (111 reconstructions) were exposed to povidone-iodine and 53 patients (97 reconstructions) to triple-antibiotic solution. ADM integration was noted in 97% of breasts in each group. Integrated matrices appeared healthy, had no signs of foreign body reaction, and demonstrated punctate bleeding. Complications did not differ between the groups, including the rate of infections, seroma, and expander loss.

Conclusion:
Irrigation of the breast pocket and presoaking of the prosthesis and ADM with povidone-iodine appear to have no adverse consequences on clinical outcomes and did not impede matrix integration.