bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nitrogen addition amplified water effects on species composition shift and productivity increase
Authors: Zhang Xiaolin , Hasi Muqier , Li Ang , Tan Yulian , Daryanto Stefani , Wang Lixin , Zhang Xueyao , Chen Shiping , Huang Jianhui 
Published: March 2021

Abstract

Aims
Water and nitrogen (N) are two key resources in dryland ecosystems, but they may have complex interactive effects on the community structure and ecosystem functions. How future precipitation (rainfall vs snowfall) change will impact aboveground net primary production (ANPP) is far from clear, especially when combined with increasing N availability.

Methods
In this study, we investigated changes in community productivity, abundance and aboveground biomass of two dominant plant functional groups (PFGs), i.e. perennial rhizome grasses (PR) and perennial bunchgrasses (PB) under the impacts of increased precipitation (rainfall vs snowfall) combined with N addition in a semiarid temperate steppe.

Important Findings
Summer rainfall augmentation marginally increased community ANPP, whereas it significantly increased the abundance and aboveground biomass of PR, but not those of PB. Summer rainfall addition increased the fraction of PR biomass (fPR) while decreased that of PB (fPB). Spring snow addition had no effect on aboveground biomass of either compositional PFG although it marginally increased community ANPP. Nitrogen addition significantly increased community ANPP with greater increase in PR under summer rainfall addition, indicating strong interactive effects on community ANPP largely by enhancing PR biomass. We also found a nonlinear increase in the positive effect of nitrogen addition on productivity with the increased precipitation amount. These findings indicate an amplified impact of precipitation increase on grassland productivity under the accelerated atmospheric N deposition in the future.
Evaluation of novel X-ray protective eyewear in reducing the eye dose to interventional radiology physicians
Authors: Endo Mime , Haga Yoshihiro , Sota Masahiro , Tanaka Akiko , Otomo Kazuki , Murabayashi Yuuki , Abe Mitsuya , Kaga Yuji , Inaba Yohei , Suzuki Msatoshi , Meguro Taiichiro , Chida Koichi 
Published: March 2021

Abstract
The new recommendation of the International Commission on Radiological Protection for occupational eye dose is an equivalent dose limit to the eye of 20 mSv year–1, averaged over a 5-year period. This recommendation is a drastic reduction from the previous limit of 150 mSv year–1. Hence, it is important to protect physicians’ eyes from X-ray radiation. Particularly in interventional radiology (IVR) procedures, many physicians use protective lead (Pb) glasses to reduce their occupational exposure. This study assessed the shielding effects of novel 0.07 mm Pb glasses.
The novel glasses (XR-700) have Pb–acrylic lens molded in three dimensions. We studied the novel type of 0.07 mm Pb glasses over a period of seven consecutive months. The eye dose occupational radiation exposure of seven IVR physicians was evaluated during various procedures. All IVR physicians wore eye dosimeters (DOSIRIS™) close to the left side of the left eye. To calculate the shielding effects of the glasses, this same type of eye dosimeter was worn both inside and outside of the Pb lenses.
The average shielding effect of the novel glasses across the seven physicians was 61.4%. Our results suggest an improved shielding effect for IVR physicians that use these glasses. No physician complained that the new glasses were uncomfortable; therefore comfort is not a problem.
The lightweight glasses were acceptable to IVR physicians, who often must perform long procedures. Thus, the novel glasses are comfortable and reasonably protective. Based on the results of this study, we recommend that IVR physicians use these novel 0.07 mm Pb glasses to reduce their exposure.
An evaluation of DNA double strand break formation and excreted guanine species post whole body PET/CT procedure
Authors: Mondal Tanmoy , Nautiyal Amit , Ghosh Somiranjan , Loffredo Christopher A , Mitra Deepanjan , Saha Chabita , Dey Subrata Kumar 
Published: March 2021

Abstract
Ionizing radiation-induced oxidation and formation of deoxyribonucleic acid (DNA) double strand breaks (DSBs) are considered the exemplar of genetic lesions. Guanine bases are most prone to be oxidized when DNA and Ribonucleic acid (RNA) are damaged. The repair processes that are initiated to correct this damage release multiple oxidized guanine species into the urine. Hence, the excretion of guanine species can be related with the total repair process. Our study quantified the total DSBs formation and the amount of guanine species in urine to understand the DNA break and repair process after whole body (WB) exposure to 18F-FDG positron emission tomography/computed tomography (PET/CT). A total of 37 human participants were included with control and test groups and the average radiation dose was 27.50 ± 2.91 mSv. γ-H2AX foci assay in the collected blood samples was performed to assess the DSBs, and excreted guanine species in urine were analyzed by a competitive ELISA method. We observed a significant increase of DNA damage that correlated well with the increasing dose (p-value 0.009) and body weight (p-value 0.05). In the test group, excreted guanine species in urine sample significantly increased (from 24.29 ± 5.82 to 33.66 ± 7.20 mg/mmol creatinine). A minimum (r2 = 0.0488) correlation was observed between DSBs formation and excreted guanine species. A significant difference of DNA damage and 8-OHdG formation was seen in the test group compared to controls. Larger population studies are needed to confirm these observations, describe the fine-scale timing of changes in the biomarker levels after exposure, and further clarify any potential risks to patients from PET/CT procedures.
Endoscopic sleeve gastroplasty requiring conversion to partial gastrectomy with paraesophageal hernia repair
Authors: Grille Victoria J , You David , Kipnis Seth 
Published: March 2021

Abstract
Endoluminal bariatric surgery has lower costs and perceived risks compared to traditional surgery. Endoluminal procedures are a newer approach to weight loss but long-term outcomes and complications continue to emerge. This case report is an endoscopic sleeve gastroplasty that resulted in a paraesophageal hernia repair with removal of gastroplasty sutures and partial gastrectomy.
An Effective Strategy to Combat Hospital Infections
Authors: Meddings Jennifer , Chopra Vineet , Saint Sanjay 
Published: March 2021

Abstract
Healthcare-associated infection takes a heavy toll on patients, and negatively affects hospitals themselves, both financially and psychologically. Proven technical approaches to prevent infection have often faltered because of the failure of hospital staff to adopt them. This book focuses on these adaptive problems, particularly as experienced during efforts to combat catheter-associated urinary tract infection (CAUTI), central line–associated bloodstream infection (CLABSI), and Clostridioides difficile infection (CDI). It provides a step-by-step description of a model quality improvement intervention, explaining why clinicians neglect or actively oppose such initiatives and how to change their minds. The focus is on preventing CAUTI, which has proven far more resistant to quality improvement efforts than CLABSI. The CAUTI intervention framework is also broadly applicable to a variety of other hospital issues, including preventing falls and CDI. The solutions presented grow out of the extensive research by the clinical authors and their colleagues at the University of Michigan and VA Ann Arbor Healthcare System.
Types of Interventions
Authors: Meddings Jennifer , Chopra Vineet , Saint Sanjay 
Published: March 2021

Abstract
Infection prevention programs were slow to develop—they were a rarity as recently as the 1950s—but they have become a staple of modern-day hospitals. Great strides have been made in identifying clinician activities that can control or prevent various healthcare-associated infections. This chapter describes the contents of an infection prevention bundle for catheter-associated urinary tract infection (CAUTI). In the case of CAUTI, the so-called bladder bundle sets forth appropriate and inappropriate use of indwelling catheters. A nursing checklist, on paper or as a template in the electronic medical record, is used to track patients’ daily urinary catheter status. Doctors and nurses are asked to rethink when a Foley is called for, what alternatives should be considered, what catheter equipment should be used, and how long the Foley should remain in place.
The Importance of Leadership and Followership
Authors: Meddings Jennifer , Chopra Vineet , Saint Sanjay 
Published: March 2021

Abstract
Leadership in a hospital setting differs substantially from that in a for-profit corporation, regarding both mission and practice; that is evident during a quality improvement initiative. Top administrative and clinical leaders need to continually communicate the value and scientific validity of the project to staff members by all available means—including personal cheerleading. Project managers and team champions have to energize the staff with their own enthusiasm for the initiative, capitalizing on the trust and respect they have earned. What is called for is transformational leadership and substantial emotional intelligence. Leaders on all levels need to devote themselves to helping colleagues become exemplary followers. The major characteristics of the leaders of successful infection prevention projects are described.
Common Problems, Realistic Solutions
Authors: Meddings Jennifer , Chopra Vineet , Saint Sanjay 
Published: March 2021

Abstract
A hospital-wide intervention is rolled out. There are changes in the team leadership and many operational adjustments: supplies ordered, procedures redesigned, nursing assignments altered. Three major types of troublemakers are described: the active resisters, the organizational constipators, and the time-servers. Motivations range from opposition to any kind of change to a personal animus toward the project champions to a determination to do as little extra work as possible. Requests by patients and their families may be used to try to get around bladder bundle items or a member of the project team may approach nurses with a patronizing attitude. The team cheers short-term progress to encourage staff compliance, solicits concrete criticism as a path to improvement, and adjusts the implementation process to allow for special circumstances. Efforts to use the electronic medical record to game the system must be squelched. Unfortunately, these challenges are all too common when implementing an infection prevention initiative—but there are solutions.
Toward Sustainability
Authors: Meddings Jennifer , Chopra Vineet , Saint Sanjay 
Published: March 2021

Abstract
After the formal initiative is finished, the project team continues working to secure and perpetuate the progress made in reducing Foley usage and institutionalizing the bladder bundle checklist. Members put into effect plans formulated during the initiative’s early days. The evaluation of catheter use and of infection rates goes on, though the data collection intervals are farther apart. Successes are promoted throughout the hospital, a reminder that the initiative continues. A major mission is to identify backsliders and realign them. Because of the possibility that champions will leave the hospital or be reassigned, current champions are urged to develop their replacements. The team makes sure that the orientation process for new arrivals to the hospital includes prevention information related to catheter-associated urinary tract infection and the hospital’s protocols concerning Foley insertion and removal.
The Future of Infection Prevention
Authors: Meddings Jennifer , Chopra Vineet , Saint Sanjay 
Published: March 2021

Abstract
The technical advances described in this chapter could markedly aid the struggle to prevent healthcare-associated infection. They range from nanomedicine to oral doses of probiotics and IBM’s Watson computer as diagnostician. The adaptive possibilities include further empowerment of the patient on the one hand and new approaches to bring hard-pressed clinicians emotional relief and improve their interactions with patients on the other hand. Studies have shown that large numbers of physicians have suffered burnout. Many doctors and nurses are not fully attentive in their encounters with patients. Growing numbers of clinicians have begun practicing mindfulness, and a model designed to show how a mindful focus can help clinicians in implementing infection prevention initiatives is presented.
Psychological and Psychiatric Issues in Patients with Chronic Pain
Authors: Doleys Daniel M. 
Published: March 2021

Abstract
This book presents a variety of real-life case studies encountered in the context of treating patients complaining of chronic pain. It highlights the complexity of chronic pain and its management. At times, progress can be slow and tedious, but achievable. Both clinician and patient must be clear and realistic about the therapeutic goal(s). Many of the interventions discussed are based on scientifically sound behavioral/psychological principles. However, many of these techniques can be successfully implement by the front-line clinician. Pain Psychology for the Clinician (Cinafrini et al, Oxford University Press, 2021) could be considered a companion volume, as it provides detailed illustrations of how to engage in meaningful clinician–patient interaction. Each case presented herein involves several sections: background information, how to approach assessment, and treatment recommendations; key points are provided for each case. The case studies are designed to be very succinct. The final three chapters provide a detailed discussion of topics including psychogenic pain, description of various psychological/behavioral therapies, and opioid tapering. These chapters can be read before or after the cases studies. They provided useful background information and context within which to understand the approach taken with each individual case.
Scope and Complexities of the Clinical Issues
Authors: Doleys Daniel M. , Doleys Nicholas D. 
Published: March 2021

Abstract
Individuals with chronic pain are a very diverse group of patients. The etiology of their pain may be very complex and difficult to identify using traditional diagnostic studies. Furthermore, many of these patients manifest very complicated and dynamic psychological/psychiatric issues. Patients present to a variety of settings, including pain clinics and the primary care office. No matter the level of training or experience, clinicians are confronted with all manner of diagnostic and therapeutic dilemmas. For some patients, their psychological/psychiatric issues dominate their presentation, requiring immediate, and often long-term, attention. Community resources may be limited, leaving the clinician feeling beleaguered. However, equipping oneself with some basic principles and strategies can contribute to developing meaningful and beneficial therapeutic relationships. The goals of treatment have to be considered very careful and may require some flexibility. Firm, yet compassionate, care and skillful communication offer the best opportunity for success.
A Broken Life
Authors: Doleys Daniel M. , Doleys Nicholas D. 
Published: March 2021

Abstract
This case represents an all too frequent, and tragic, example of the devastating effects of chronic pain following an injury. The problem impacts all aspects of the individual’s life, including the family. Repeated failure of various medical/surgical treatments, intending to be corrective, can result in despair, hopelessness, and anger. Even the most stoic are prone to depression. It is important to recognize and address these issues early. There are some simple strategies that can guide assessment and treatment. It can take years for such a person to “reinvent” themselves. The aware clinician can be a great source of solace and hope.
The Hand That Wouldn’t Move
Authors: Doleys Daniel M. , Doleys Nicholas D. 
Published: March 2021

Abstract
Symptoms that seem very uncharacteristic, if not exaggerated, and those appearing to be neurological in nature but without any apparent neurological explanation, have baffled clinicians and researchers for centuries. Patients often seems very sincere, but some are uncharacteristically indifferent. Somatic intervention can further complicate the problem of conversion disorder (CD). There is an unfortunate tendency to discount the patient with a CD. The assessment and the treatment can be complex. In most cases, referral to a specialist is indicated. A compassionate and understanding attitude will be more impactful than accusation of malingering (ie, willful deception).
Please, Find It and Fix It
Authors: Doleys Daniel M. , Doleys Nicholas D. 
Published: March 2021

Abstract
The setting appropriate treatment goals and expectations cannot be overemphasized when confronted with patients in this category. In some instances, the demand for a cure is a manipulative tactic. In other cases, it can a profound preoccupation ones symptoms, their cause, and eradication. Pain catastrophizing, repeated submission to, if not a request for, unproven and unconventional diagnostic testing and treatments is not uncommon. Reassurance, and diagnostic testing that fails to reveal a catastrophic cause are dismissed. Patients with some forms of somatization disorder suffer from an underlying psychiatric/psychological problem. Their willingness to undergo potential destructive procedures, such as surgery, in the search of a cure puts them at great peril for worsening of their condition.
There Are Not Enough Sheep
Authors: Doleys Daniel M. , Doleys Nicholas D. 
Published: March 2021

Abstract
It is difficult to overemphasize the potential impact of sleep and sleep disorders on chronic pain. Indeed, there are data indicating that sleep disturbance mat be a significant causal factor in the development and maintenance of chronic pain. One would think that daytime pain would predict degree of sleep. But, in fact, it is the opposite; sleep is better predictor of daytime pain intensity. The factor associated with poor sleep are many and varied. Ruling out sleep apnea should be a priority. The availability of in-home studies simplifies the assessment/screening, and may engender greater cooperation. Sleep apnea contributes to hypogonadism, which, in turn, impact a number of physical factor that influence mood, function, and pain. There is a number of approaches that can be implemented in the primary care and pain clinic setting to address the problem of sleep disorders in the patient with chronic pain.
No Way That’s My Drug Screen
Authors: Doleys Daniel M. , Doleys Nicholas D. 
Published: March 2021

Abstract
In the process of treating patients with for chronic pain with opioid type medications, the use of urine drug screens (UDS) is considered the standard of care. The frequency with which a UDS is obtained varies across different guidelines and states/medical boards. It is often associated with dosage, risk for aberrant drug behavior assessment, and ongoing compliance. Most clinicians will obtain a UDS two to four times per year, unless the circumstances require otherwise. In general, the point-of care UDS lacks the sensitivity and specificity of confirmatory testing. The prescribing clinician should (i) be familiar with various types of testing, (ii) create a relationship the testing lab performing the confirmatory testing, and (iii) acquire basic interpretation skills. Clinical decisions should be postponed pending the results of confirmatory testing. False positives, and false negatives, do occur. It behooves the clinician to have “all their ducks in row” before confronting the patient and to accurately document the consultation and decision-making process. In some instances, discontinuation of therapy may be necessary and appropriate. Other cases may be subject to remediation.
The Not-So-Perfect Remedy
Authors: Doleys Daniel M. , Doleys Nicholas D. 
Published: March 2021

Abstract
“But nobody ever died from an overdose of marijuana” has become one of the rallying cries of those who support legalization of marijuana for the treatment of chronic pain and a plethora of other disorders. There is little doubt that the Cannabis Sativa and Cannabis Indica plants produce substances that may well have medicinal value. However, much is yet to be learned. The endocannabinoid system, like the plants themselves, is very complex. Hemp oil and cannabidiol are flooding the market. Unregulated by any federal agencies, the claims and labeling are often unsupported and misleading, if not false. The issue of medical marijuana is here to stay. The clinician treating patients with chronic pain needs to become familiar with the nuances of these products and recognize that they are not without side effects and drug-drug interactions.
Fungal taxonomy and nomenclature
Authors: Borman Andrew M. 
Published: March 2021

Abstract
This chapter summarizes historical and modern approaches to fungal taxonomy, the current taxonomic standing of medically important fungi, and the implications for fungal nomenclature following the recent Amsterdam Declaration on Fungal Nomenclature, which prohibits dual nomenclature. Fungi comprise an entire kingdom, containing an estimated 1–10 million species. Traditionally, fungal identification was based on examination of morphological and phenotypic features, including the type of sexual spores they form and method of formation, and structural features of their asexual spores. Thus, many fungi have been described and named independently several times, based on either their sexual or asexual stages, resulting in a single genetic entity having multiple names. Recent molecular approaches to fungal identification have led to profound changes in fungal nomenclature and taxonomy. Certain phyla have now been disbanded, cryptic species have been identified via molecular approaches, and long-recognized species have been transferred to new genera, based on genotypic comparisons.
Enzymatic construction of metal-mediated nucleic acid base pairs
Authors: Flamme Marie , Figazzolo Chiara , Gasser Gilles , Hollenstein Marcel 
Published: March 2021

Abstract
Artificial metal base pairs have become increasingly important in nucleic acids chemistry due to their high thermal stability, water solubility, orthogonality to natural base pairs, and low cost of production. These interesting properties combined with ease of chemical and enzymatic synthesis have prompted their use in several practical applications, including the construction of nanomolecular devices, ions sensors, and metal nanowires. Chemical synthesis of metal base pairs is highly efficient and enables the rapid screening of novel metal base pair candidates. However, chemical synthesis is limited to rather short oligonucleotides and requires rather important synthetic efforts. Herein, we discuss recent progress made for the enzymatic construction of metal base pairs that can alleviate some of these limitations. First, we highlight the possibility of generating metal base pairs using canonical nucleotides and then describe how modified nucleotides can be used in this context. We also provide a description of the main analytical techniques used for the analysis of the nature and the formation of metal base pairs together with relevant examples of their applications.