bluuebunny/crossref_metadata_2025_split huggingface dataset:
Double-strand breaks induce short-scale DNA replication and damage amplification in the fully grown mouse oocytes
Authors: Ma Jun-Yu , Feng Xie , Xie Feng-Yun , Li Sen , Chen Lei-Ning , Luo Shi-Ming , Yin Shen , Ou Xiang-Hong 
Published: April 2021

Abstract
Break-induced replication (BIR) is essential for the repair of DNA double-strand breaks (DSBs) with single ends. DSBs-induced microhomology-mediated BIR (mmBIR) and template-switching can increase the risk of complex genome rearrangement. In addition, DSBs can also induce the multi-invasion-mediated DSB amplification. The mmBIR-induced genomic rearrangement has been identified in cancer cells and patients with rare diseases. However, when and how mmBIR is initiated have not been fully and deeply studied. Furthermore, it is not well understood about the conditions for initiation of multi-invasion-mediated DSB amplification. In the G2 phase oocyte of mouse, we identified a type of short-scale BIR (ssBIR) using the DNA replication indicator 5-ethynyl-2’-deoxyuridine (EdU). These ssBIRs could only be induced in the fully grown oocytes but not the growing oocytes. If the DSB oocytes were treated with Rad51 or Chek1/2 inhibitors, both EdU signals and DSB marker γH2A.X foci would decrease. In addition, the DNA polymerase inhibitor Aphidicolin could inhibit the ssBIR and another inhibitor ddATP could reduce the number of γH2A.X foci in the DSB oocytes. In conclusion, our results showed that DNA DSBs in the fully grown oocytes can initiate ssBIR and be amplified by Rad51 or DNA replication.
Regulatory approaches to managing artificial intelligence systems in autonomous vehicles in Australia
Authors: Thiele-Evans Lilla , Pepper Blake , Zeleznikow John , Foster Neil , Sourdin Tania 
Published: April 2021

Abstract
This article explores the emergence of Automated Vehicles (AVs) in Australia. It will investigate the legal and regulatory terrain. International and domestic approaches are examined to determine potential responses. The regulatory issues emerge partly due to the varied nature of artificial intelligence systems and processes that enable AVs to function. The variations may be due to the chosen domain model, software development processes, or the development of biases that may occur during code development for the underlying artificial intelligence system. Such variations can create difficulties in the application of road rules, safety requirements, and the legal and regulatory requirements. They may give rise to significant issues relating to driver classification and licensing for AVs, due to the varied levels of control and involvement in the driving process. For this reason, legislative reform at specific jurisdictional levels is suggested together with clearer international standards as a pathway to ensure the safe and effective integration of autonomous vehicles into society.
Impact of COVID-19 pandemic on healthcare providers: save the frontline fighters
Authors: Al-Jumaili Ali Azeez , Al-Fatlawi Bashar G , Al-Jalehawi Ahmad K , Al-Hamadani Fadya Yaqoob , Alsawad Oday Sajjad 
Published: April 2021

AbstractObjectivesThe objective of this study was to assess the impact of the COVID-19 pandemic on healthcare providers (HCPs) at personal and professional levels.MethodsThis was a cross-sectional descriptive study. It was conducted using an electronic format survey through Qualtrics Survey Software in English. The target participants were HCPs working in any healthcare setting across Iraq. The survey was distributed via two professional Facebook groups between 7 April and 7 May 2020. The survey items were adopted with modifications from three previous studies of Severe Acute Respiratory Syndrome (SARS) and Avian Influenza Outbreak. Kruskal–Wallis test was conducted to determine the difference in the pandemic impact according to the dealing with COVID-19 cases.Key findingsThe authors received 430 surveys from HCPs representing 14 provinces. Approximately 60% of the participants were dealing with diagnosis or treatment of COVID-19 cases. More than 80% perceived high risk of infection and stress due to the COVID-19 pandemic. Additionally, 85.9% of the HCPs had concerns of putting family and close friends at risk due to their job during the COVID-19 crisis. HCPs working in a setting dealing with diagnosis/treatment of COVID-19 cases experienced significantly higher concerns about personal and family safety compared with other HCPs.ConclusionsWorking during COVID-19 pandemic has several negative impacts on HCPs including mental and physical health and an overwhelming work environment. Thus, social and emotional support is needed to help HCPs to cope with such stressful conditions. Finally, providing adequate PPE can help to minimise concerns of getting infected in the workplace.
An evolutionary game theoretic model of whistleblowing behaviour in organizations
Authors: Quinteros María J , Villena Marcelo J , Villena Mauricio G 
Published: April 2021

Abstract
We present a theoretical model of corruption in organizations. Our specific focus is the role of incentives that aim to encourage whistleblowing behaviour. Corruption is modelled as a social norm of behaviour using evolutionary game theory. In particular, the dynamics of whistleblowing behaviour is captured using the replicator dynamics equation with constant and quadratic monitoring costs. We formally explore the local asymptotic stability of the equilibria. Our findings indicate that the traditional recommendations of the Beckerian approach are usually too expensive and/or unstable. We argue that an efficient mechanism for controlling corruption can be achieved by maintaining efficient salaries and imposing high rewards for whistleblowers when they detect wrongdoing. In the long term, employees can only be honest, or corrupt, or corrupt and whistleblowers; honest and whistleblowing behaviour will not coexist in the long run, since one of these two strategies is always dominated by the other.
A method-of-lines formulation for a model of reactive settling in tanks with varying cross-sectional area
Authors: Bürger Raimund , Careaga Julio , Diehl Stefan 
Published: April 2021

Abstract
Reactive settling denotes the process of sedimentation of small solid particles dispersed in a viscous fluid with simultaneous reactions between the components that constitute the solid and liquid phases. This process is of particular importance for the simulation and control of secondary settling tanks (SSTs) in water resource recovery facilities (WRRFs), formerly known as wastewater treatment plants. A spatially 1D model of reactive settling in an SST is formulated by combining a mechanistic model of sedimentation with compression with a model of biokinetic reactions. In addition, the cross-sectional area of the tank is allowed to vary as a function of height. The final model is a system of strongly degenerate parabolic, nonlinear partial differential equations that include discontinuous coefficients to describe the feed, underflow and overflow mechanisms, as well as singular source terms that model the feed mechanism. A finite difference scheme for the final model is developed by first deriving a method-of-lines formulation (discrete in space, continuous in time) and then passing to a fully discrete scheme by a time discretization. The advantage of this formulation is its compatibility with common practice in development of software for WRRFs. The main mathematical result is an invariant-region property, which implies that physically relevant numerical solutions are produced. Simulations of denitrification in SSTs in WRRFs illustrate the model and its discretization.
Coproducing value during the COVID-19 pandemic
Authors: Forcino Rachel C , Von Plessen Christian 
Published: April 2021

Abstract
Service users, professionals, and civil society all contribute to public health. Inclusion of all relevant actors in a network community coproduction approach can improve public health crisis responses. Using the Swiss canton of Vaud's COVID-19 response as an example, we describe ways in which a network approach can add value to public health services.
Quality as strategy, the evolution of co-production in the Region Jönköping health system, Sweden: a descriptive qualitative study
Authors: Persson Sofia , Andersson Ann-Christine , Kvarnefors Annmargreth , Thor Johan , Andersson Gäre Boel 
Published: April 2021

Abstract

Background
Pursuing the vision ‘for a good life in an attractive region,’ the Region Jönköping County (RJC) in Sweden oversees public health and health-care services for its 360 000 residents. For more than three decades, RJC has applied ‘quality as strategy,’ which has included increasing involvement of patients, family and friends and citizens. This practice has evolved, coinciding with the growing recognition of co-production as a fundamental feature in health-care services. This study views co-production as an umbrella term including different methods, initiatives and organizational levels. When learning about co-production in health-care services, it can be helpful to approach it as a dynamic and reflective process.

Objective
This study aims to describe the examples of key developmental steps toward co-production as a system property and to highlight ‘lessons learned’ from a Swedish health system’s journey.

Method
This qualitative descriptive study draws on interviews with key stakeholders and on documents, such as local policy documents, project reports, meeting protocols and presentations. Co-production initiatives were defined as strategies, projects, quality improvement (QI) programs or other efforts, which included persons with patient experience and/or their next of kin (PPE). We used directed manifest content analysis to identify initiatives, timelines and methods and inductive conventional content analysis to capture lessons learned over time.

Results
The directed content analyses identified 22 co-production initiatives from 1997 until today. Methods and approaches to facilitate co-production included development of personas, storytelling, person-centered care approaches, various co-design methods, QI interventions, harnessing of PPEs in different staff roles, and PPE-driven improvement and networks. The lessons learned included the following aspects of co-production: relations and structure; micro-, meso- and macro-level approaches; attitudes and roles; drivers for development; diversity; facilitating change; new perspectives on current work; consequences; uncertainties; theories and outcomes; and regulations and frames.

Conclusions
Co-production evolved as an increasingly significant aspect of services in the RJC health system. The initiatives examined in this study provide a broad overview and understanding of some of the RJC co-production journey, illustrating a health system’s approach to co-production within a context of long-standing application of QI and microsystem theories.
The main lessons include the constancy of direction, the strategy for improvement, engaged leaders, continuous learning and development from practical experience, and the importance of relationships with national and international experts in the pursuit of system-wide health-care co-production.
5 Examining ‘Return to Productivity’ Among People Living with Burn Injury: A Burn Model System National Database Report
Authors: Sheckter Clifford C , Carrougher Gretchen J , Smith Mallory B , Wolf Steven E , Schneider Jeffrey C , Gibran Nicole S , Stewart Barclay T 
Published: April 2021

Abstract

Introduction
Burn injuries can be life-altering events that involve intensive healthcare, changes in body image, psychological stress and financial toxicity. Burn survivors frequently experience numerous and varied barriers to returning to work. For those who return to work, little is known regarding whether they achieve pre-injury productivity (i.e., equivalent work output and/or pay). Understanding return to productivity and patients at risk of not achieving pre-injury productivity is important for targeting services that support this population and their families.

Methods
Burn survivors with complete occupational and personal income data through 24 months post-injury were extracted from the NIDILRR Burn Model System National Database. Participant annual income was reported in six groups: &lt; $25k, $25k-50k, $50k-99k, $100k-149k, $150k-199k, $ &gt;199k. Participants were classified by their change in income at each follow up (i.e., gain, loss, equivalent). Explanatory variables of interest included demographics, payer, job type, and injury characteristics. Logistic regression modeled return to productivity (i.e., equivalent or gain in income compared to pre-injury status) at each follow up interval.

Results
Data from 402 participants were analyzed. At 6-, 12-, and 24-months post-injury, 77%, 79%, and 71% of participants reported equivalent or gain in income, respectively. Physical and labor-based jobs were reported by 60% of participants who had return to productivity versus 63% of those who lost income. Demographics, payer, and job type were not significantly associated with differences in return to productivity. Mean %TBSA burn size was 17.4% in those who returned to productivity versus 26.1% among those who did not. Burn size ≥50% TBSA was the only predictor of decreased likelihood for return to productivity (OR 0.24, 95%CI 0.06–0.90). Post hoc comparison to participants who did not have complete financial data demonstrated that participants with complete data were significantly more likely to be older, white, have smaller burns, and carry private insurance.

Conclusions
Most burn survivors returned to pre-injury productivity by 24-months after injury regardless of demographics, job type, and payer status. Burn survivors who experienced ≥50% TBSA burns were much more likely to not return to pre-injury productivity.
16 Sustained Low Efficiency Dialysis (SLED) in Burn Patients with Acute Kidney Injury
Authors: Kassay Andrea Danielle , Adibfar Alexander , Cartotto Robert 
Published: April 2021

Abstract

Introduction
Acute Kidney Injury (AKI) is common among patients with major burns and may require treatment with renal replacement therapy (RRT). Although continuous renal replacement therapy (CRRT) modalities are widely used and offer many advantages over traditional intermittent hemodialysis (IHD), CRRT is expensive, labour-intensive, and may not be available in some burn centers. Sustained Low Efficiency Dialysis (SLED) is a moderately efficient alternative to IHD, but its use in burn patients with AKI has not been described. The purpose of this study was to review our experience with SLED.

Methods
Retrospective review of adult burn patients with AKI treated by SLED between 07/2013 and 03/2020 at an adult regional ABA-verified burn center. Data was obtained from the electronic medical record including daily dialysis forms completed by the nephrology service. Values are shown as mean +/- SD or median (IQR) as appropriate.

Results
We evaluated 367 distinct SLED sessions provided to 33 patients [age 55.8 +/- 14 yrs., %TBSA burn 33 +/-19, % TBSA full thickness burn 10.5 (0, 35.8), and 54.5% with inhalation injury]. The serum creatinine (sCr) prior to the start of SLED was 2.96 (2.3, 4.17) mg/dL. SLED was initiated 5 (3, 10.8) days (range 0–24 d) post burn, and 7 (3.3, 12.8) sessions (range 1–44) with a duration of 4 (4,6) hours each were given per patient. Heparinization was required in 22 sessions (6%), and 46 sessions (12.5%) were aborted, most commonly due to clotting of the lines or circuit, and rarely (4%) due to hypotension. The net ultrafiltrate removal was 1.2 (0.7–2) L, with a dialysate flow rate of 350 (350, 500) mL/min. Among 208 sessions where patients were not on vasopressors (VPs) Pre-SLED, one or more VPs were required in 19 sessions (9%) during or at the termination of SLED. Among 116 sessions where patients were receiving norepinephrine (NEpi) infusions pre-SLED, the NEpi dose dropped from 7.3 +/- 4.2 µgm/min to 6 +/- 4.5 µgm/min (p=0.03). Pre and Post SLED values for blood pressure, creatinine, and potassium are shown in the table. The mortality rate was 36.4%, hospital length of stay was 42 (20.5, 61.5) days, and among surviving patients, 2 (9.5%) required dialysis post discharge.

Conclusions
SLED was effective and well tolerated. Hemodynamic instability was infrequently encountered.
37 Analysis of the Utility of CO2 and Pulse-Dye Lasers in the Treatment of Hypertrophic Burn Scars
Authors: Cooper Laura E , Bohan Phillip Kemp , Hatem Victoria D , Carlsson Anders H , Cancio Leopoldo C , Chan Rodney K 
Published: April 2021

Abstract

Introduction
Despite advances in burn care, hypertrophic burn scars (HTBS) remain a significant source of morbidity. Treatment often involves use of CO2 lasers to reduce thickness and pulse-dye lasers (PDL) to reduce erythema. Despite frequent utilization, little quantitative data exists. This study seeks to objectively determine the effects of these laser treatments on burn scars.

Methods
Patients found to have HTBS undergoing laser treatments were approached for enrollment. Following enrollment, an area of HTBS outside of the treatment area was divided into 4 equal 3x3cm squares which were randomized to receive either CO2, PDL, CO2+PDL, or no treatment. Patients underwent a total of 3 treatments, 4–6 weeks apart, and were seen for follow-up over 3–6 months. Scar assessments occurred at each visit prior to treatment and consisted of digital photographs, ultrasound assessment for scar thickness, colorimetry, and the Patient and Observer Scar Assessment Score (POSAS).

Results
Twenty-five patients were enrolled at our institution. To date, 12 (48%) have completed all 3 treatments and the remainder are still in their follow-up period. Median initial scar thickness (ST) was 0.3cm. Mean time since injury was 9 months. Overall, there was a significant decrease in ST over time (p=0.0246) but not between treatment groups. There were no significant changes seen in melanin, erythema, or POSAS scores (p=0.9030, 0.6470, and 0.1495, respectively). When separated by ST before initiation of treatment, thin scars (&lt; 3cm) appeared to be overall less erythematous in groups treated with PDL and CO2+PDL and untreated groups (p=0.0358, 0.0027. 0.0118, respectively) as compared to thick scars (≥3cm). Thin scars treated with PDL and CO2+PDL were also less pigmented than thick scars (p=0.0127, 0.0213, respectively). Erythema significantly decreased between the last treatment and the final visit for PDL and CO2+PDL groups (p&lt; 0.0001). Older scars (≥9 months prior to treatment) tended to have a greater reduction in thickness as compared to newer scars but the difference was not significant to date.

Conclusions
Laser therapy is often employed in the treatment of HTBS. However, few studies have determined their objective benefits. Based on a preliminary analysis of our data, we have shown an overall decrease in scar thickness, less pigmentation, and less erythema in thin scars treated with PDL or CO2+PDL. Further analysis will be performed after additional follow-up information is collected.
56 The Impact of a Nurse Morbidity and Mortality Meeting
Authors: Figel Ginny 
Published: April 2021

Abstract

Introduction
Physicians have long held Morbidity and Mortality (M&M) conferences to discuss complications and deaths. The format for these conferences lays out the case, discusses care performed, and generates discussion on areas of opportunity. Physician M&M usually focuses on teaching and the presenter may not be the caregiver. There is not much literature on the use of this teaching methodology in nursing. Due to the strong culture of safety on the unit, it was determined that using a similar format for nursing on the Burn Unit could prove beneficial for discussion of complications, deaths, errors, and good catches.

Methods
Nurse M&M is held monthly for one hour. The nurses are given the opportunity to present the individual case or give personal testimony as to the situation from their point of view. The cases are all presented in the same format. The initial slides cover background, history of present illness, and where the report came from. Next is all of the pertinent review from the electronic charting system and any discussions had with those involved in the case. The presenter then opens up the floor for discussion. If there was a variation in practice, the policy or procedure that relates to the error is reviewed. Topics for Nurse M&M are gathered through many different venues. The hospital uses an online reporting system for electronic submission of adverse events, variations in care, and good catches. The entire multidisciplinary team have all individually reported something they wanted discussed at Nurse M&M. If clarification is needed on a case, the question is punted back to the appropriate decision maker and followed up to the staff.

Results
Nurse M&M is the most highly attended, non-mandatory, meeting held on the unit. The nursing staff was surveyed to determine their perceptions on how the addition of Nurse M&M had effected them. The results were overwhelmingly positive. All nurses surveyed rated the statement, “I feel that Nurse M&M has had a positive outcome on the unit’s collective practice”, as agree or strongly agree. Over time, the notes taken have evolved into a basic table of what was discussed and if there were action items created off of a case. The staff have come to the point where they will self-report events before they are entered into the online system.

Conclusions
In conclusion, the Burn Unit nursing staff are highly engaged Nurse M&M. The staff are open to discussing errors in a way that fosters educational growth and critical thinking development. Even if the case being discussed is because of a personal error, more often than not, the person responsible will discuss why they made the decision they did and facilitate the discussion with their peers as to what could have been done differently. The bedside nurses’ commitment to being present, engaged, and open minded are strong signs of the healthy work environment present on the unit.