bluuebunny/crossref_metadata_2025_split huggingface dataset:
Quadruped and Dermal Bridge Flap for Nipple Reconstruction
Authors: Fujisawa Daisuke , Asato Hirotaka , Suzuki Yasutoshi , Hasegawa Koki 
Published: September 2018

Background:
This report describes the authors' novel preferred method of nipple reconstruction over 10 years.

Methods:
The procedure was used in 39 patients (unilateral 38, bilateral 1). The circle is designed as the new nipple cap. Then, 4 fan-shapes (one-quarter of the circle) are drawn so that the base portion is in contact with the circumference. These fanshapes are deepithelialized, and their linear portions are cut with full thickness of skin and elevated as dermal flaps. Then, the cross-type flap is elevated with sufficient subcutaneous fat. The two pairs of dermal flaps are sutured to each other on a diagonal line. Double-layer dermal bridge flaps sustain the base of the pocket. As a result, the cross flap becomes a birdcage-like tower. The rolled auricular cartilage is placed into the pocket.

Results:
In one early case, the cartilage was exposed. Early postoperatively, the other three cases underwent reoperation during other procedures because the reconstructed nipple was too large or too small. The projection of the flap was designed to be 7–15 mm (average, 9.3 mm). The average follow-up period was 25.7 ± 22.0 months. The reconstructed nipple projection was maintained at 4.4 ± 2.4 mm (maintenance rate, 48.4% ± 27.0%).

Conclusions:
All scars were contained within the periareolar region and thus could be completely camouflaged by tattooing. The perfusion of the skin flap is stable because of sufficient circulation from quadruped pedicle. The cartilage supported by the double-layered dermal bridge flaps contributes to nipple projection. We recommend it for patients seeking nipple reconstruction.
The Expanding Role of Diagnostic Ultrasound in Plastic Surgery
Authors: Swanson Eric 
Published: September 2018

Background:
Ultrasound in plastic surgery is quickly finding new applications. Ultrasound surveillance may replace ineffective individual risk stratification and chemoprophylaxis for deep venous thromboses. Abdominal penetration can be a catastrophic complication of liposuction. Preoperative screening for fascial defects may reduce risk. Limiting buttock fat injections to the subcutaneous plane is critical for patient safety, but it is difficult to know one’s injection plane.

Methods:
The author’s use of diagnostic ultrasound was evaluated from May 2017 to May 2018. Ultrasound scans were used routinely to detect deep venous thromboses. Patients undergoing abdominal liposuction and/or abdominoplasty were scanned for possible hernias. Other common applications included the evaluation of breast implants, breast masses, and seroma management. The device was used in surgery in 3 patients to assess the plane of buttock fat injection.

Results:
One thousand ultrasound scans were performed during the 1-year study period. A distal deep venous thrombosis was detected in 2 patients. In both cases, the thrombosis resolved within 1 month, confirmed by follow-up ultrasound scans. A lateral (tangential) fat injection method was shown to safely deposit fat above the gluteus maximus fascia.

Conclusions:
Ultrasound scans are highly accurate, noninvasive, and well-tolerated by patients. Some of these applications are likely to improve patient safety. Early detection of deep venous thromboses is possible. Unnecessary anticoagulation may be avoided. Subclinical abdominal defects may be detected. Ultrasound may be used in the office to evaluate breast implants, masses, and seromas. In surgery, this device confirms the level of buttock fat injection.
Improving Patient and Caregiver New Medication Education Using an Innovative Teach-back Toolkit
Authors: Prochnow Jenny A. , Meiers Sonja J. , Scheckel Martha M. 
Published: September 2018

Background:
Patients and caregivers are often not adequately informed about new medications. Nurses can lead innovations that improve new medication education.

Local Problem:
Healthcare Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores on medication questions trailed state and national levels in one Midwestern hospital.

Methods:
This quality improvement project, guided by the Ottawa Model of Research Use and the Always Use Teach-back! innovative toolkit, used a 1-group pre- and posteducation design with RNs, patients, and caregivers.

Intervention:
RNs (n = 25) were observed in patient/caregiver education and surveyed in confidence/con-viction in the teach-back method before and after education. Patients' (n = 74) and caregivers' (n = 33) knowledge was assessed.

Results:
RNs reported significant increases in conviction in the importance of (P < .0001), confidence in using (P < .0001), and frequency in using (P < .0001) teach-back. With teach-back, both patients and caregivers recalled the purpose and side effects of new medications. Specific HCAHPS scores increased from 6% to 10%.

Conclusion:
The teach-back method strengthened safe nursing practice and enhanced quality in new medication education.
Video Monitoring for Fall Prevention and Patient Safety
Authors: Sand-Jecklin Kari , Johnson Jennifer , Tringhese Amanda , Daniels Christine , White Freda 
Published: September 2018

Background:
Although video monitoring has been shown to reduce falls among at-risk hospitalized patients, there are no identified best practices for the monitoring process.

Purpose:
The purpose of this study was to evaluate the monitoring process at a large teaching hospital, with the goal of making improvements and standardizing monitoring practices.

Methods:
Patients and nursing staff perceptions about the video monitoring process were elicited via survey, and perceptions of monitor technicians were obtained through structured interview.

Results:
Video monitoring was perceived by all groups as effective in promoting patient safety. Nursing staff and monitor technicians also indicated that monitoring protects patient safety in other high-risk situations. Suggestions for improvement and standardization in the monitoring process were made by study participants.

Conclusions:
Suggested changes and standardization of the monitoring process have been implemented in the study facility. Insights are provided for other facilities considering video monitoring for patient safety.
Quality Improvement Project to Manage Workplace Violence in Hospitals
Authors: Schwartz Franklin , Bjorklund Pamela 
Published: September 2018

Background:
The study of workplace violence has focused on quantifying the problem and profiling perpetrators and victims. Intervention studies are scarce. The diverse nature of violence risk in hospitals highlights the need for broad training in risk recognition and de-escalation.

Local Problem:
A violence management program was piloted on a general medical unit following staff requests for measures to protect them from patient and visitor violence.

Methods:
An independent pre/posttest design measured changes in participant knowledge. The Staff Observation Assessment Scale Revised (SOAS-R) was used for data collection on aggression pre- and postimplementation.

Interventions:
The violence management training program included in situ simulation training in de-escalation techniques.

Results:
Knowledge of de-escalation techniques to reduce violence risk increased. Important lessons were learned for ongoing program implementation.

Conclusions:
Violence management programs can lead to more effective risk management. Instruments to collect data on aggression should be linked to mandatory incident reporting, and existing behavioral response teams should be involved in incident tracking.
Quiet Time Improves the Patient Experience
Authors: Hedges Christine , Hunt Candice , Ball Pamela 
Published: September 2018

Background:
A quiet environment promotes rest and healing but is often challenging to provide in a busy acute care setting. Improving quiet in the hospital for designated hours improves patient satisfaction. Such efforts have typically been the primary responsibility of the nursing staff.

Local Problem:
Two medical units with consistently low Hospital Consumer Assessment of Health Care Providers and Systems (HCAHPS) “always quiet” scores were chosen for this study.

Methods:
A multidisciplinary team used Lean methods and the Model for Improvement to test interventions for quiet time (QT) and used HCAHPS “always quiet” scores as the primary outcome measure.

Interventions:
The team instituted nighttime and afternoon QT supported by rounding and scripting, dimming lights, lowering staff voices, offering a sleep menu at night, and replacing noisy wheels.

Results:
Quiet scores improved on both units after 11 months.

Conclusions:
Noise in hospitals is often beyond the scope of nurse-driven improvement; however, a QT protocol led by nurses, developed by multiple stakeholders, and focused on changing expectations for quiet can lead to measurable improvements in patient perception of quiet.
Nursing Students' Transfer of Learning During a Disaster Tabletop Exercise
Authors: Evans Cathleen A. , Baumberger-Henry Mary , Schwartz Rose , Veenema Tener 
Published: September 2018

Background
Disasters require nurses to make decisions. A tabletop exercise, used in disaster education, is a classroom activity for solving problems.

Purpose
The study purposes were to (1) describe, as scores, the transfer of learning from basic medical-surgical coursework to student decisions made during a disaster scenario tabletop exercise and (2) identify students' attitudes about their use of their previous learning during this experience.

Method
Researcher-designed instruments and a tabletop exercise were used to measure prelicensure students' transfer of select basic medical-surgical learning to their decisions during the exercise.

Results
Mean (SD) student scores during the tabletop exercise were as follows—Tabletop Matrix: infection, 17.61 (6.03); bleeding, 14.93 (5.36); pain, 11.17 (5.08); electrolyte, 13.73 (6.19); disaster knowledge: 19.46 (3.08); and attitudes: 51.41 (5.43).

Conclusion
During this tabletop exercise, students demonstrated transfer of learning.
The Effect of Static Stretching of Peroneal and Tibialis Anterior Muscles on Reaction Time
Authors: Sekir Ufuk , Arslan Gufat , Ilhan Osman , Akova Bedrettin 
Published: September 2018

Objective
The aim of this study was to investigate the acute and chronic effects of static stretching on peroneal and tibialis anterior reaction characteristics.

Design
All 23 participants who volunteered for this study were randomly divided into static (n = 12) and control (n = 11) groups. The subjects in the static stretching group performed stretching exercises for the ankle evertor and dorsiflexor muscles 5 days a week for 6 wks. Peroneal and tibialis anterior muscle reaction characteristics were evaluated at the beginning (2 times for acute effect) and end of this period. Electromyographic activity parameters of the muscles were measured using an ankle inversion tilting platform that simulated a sudden ankle inversion. The following were the four different ankle inversion conditions: (a) ankle-neutral, 15-degree inversion; (b) ankle-neutral, 30-degree inversion; (c) ankle–20-degree plantarflexion, 15-degree inversion; and (d) ankle–20-degree plantarflexion, 30-degree inversion.

Results
Either in terms of acute or chronic effects, no significant differences were found after static stretching exercises for peroneal and tibialis anterior muscle reaction time, reaction duration, and muscle activity evaluated in four positions on the ankle inversion simulation platform (P > 0.05).

Conclusions
In light of these results, it is possible to state that the short duration of static stretching exercises can still be applied before sports activities.
Availability of researcher-led eHealth tools for pain assessment and management: barriers, facilitators, costs, and design
Authors: Higgins Kristen S. , Tutelman Perri R. , Chambers Christine T. , Witteman Holly O. , Barwick Melanie , Corkum Penny , Grant Doris , Stinson Jennifer N. , Lalloo Chitra , Robins Sue , Orji Rita , Jordan Isabel 
Published: September 2018

Abstract
Introduction: Numerous eHealth tools for pain assessment and management have been developed and evaluated with promising results regarding psychometric properties, efficacy, and effectiveness. Although considerable resources are spent on developing and evaluating these tools with the aim of increasing access to care, current evidence suggests they are not made available to end users, reducing their impact and creating potential research waste. Methods: This study consisted of 2 components: (1) a systematic review of eHealth tools for pediatric pain assessment and/or management published in the past 10 years, and (2) an online survey, completed by the authors of identified tools, of tool availability, perceived barriers or facilitators to availability, grant funding used, and a validated measure of user-centeredness of the design process (UCD-11). Results: Ninety articles (0.86% of citations screened) describing 53 tools met inclusion criteria. Twenty-six survey responses were completed (49.06%), 13 of which (50.00%) described available tools. Commonly endorsed facilitators of tool availability included researchers' beliefs in tool benefits to the target population and research community; barriers included lack of infrastructure and time. The average cost of each unavailable tool was $314,425.31 USD ($3,144,253.06 USD total, n = 10). Authors of available tools were more likely to have followed user-centered design principles and reported higher total funding. Conclusion: Systemic changes to academic and funding structures could better support eHealth tool availability and may reduce potential for research waste. User-centered design and implementation science methods could improve the availability of eHealth tools and should be further explored in future studies.
Bovine blastocyst development depends on threonine catabolism
Authors: Najafzadeh V , Henderson H , Martinus R , Oback B 
Published: September 2018

ABSTRACTIncreasing evidence suggests that pluripotency is a metabolically specialised state. In mouse, inner cell mass (ICM) cells and ICM-derived pluripotent stem cells (PSCs) critically depend on catabolising the amino acid threonine, while human PSCs require leucine, lysine, methionine or tryptophan. However, little is known about the specific amino acid requirements of putative pluripotent cells in bovine. We selectively depleted candidate essential amino acids (EAAs) from individually cultured bovine embryos to study their role in blastocyst development. Depleting one (-T, -M), two (-MT, -CM, -CT, -IL, -IK, -KL) or three (-CMT, -IKL) EAAs from chemically defined protein-free culture medium did not affect the morula-to-blastocyst transition from day five (D5) to D8 in vitro. By contrast, removing six (-CIKLMT, -FHRYVW), nine (+CMT, +IKL), eleven EAAs (+T, +M) or all twelve EAAs increasingly impaired blastocyst development. As no clear candidate emerged from this targeted screen, we focussed on threonine dehydrogenase (TDH), which catalyses threonine catabolism. TDH mRNA and protein was present at similar levels in trophectoderm (TE) and ICM but absent from several adult somatic tissues. We then treated morulae with an inhibitor (Qc1) that blocks TDH from catabolising threonine. Continuous exposure to Qc1 reduced total and high-quality blastocyst development from 37% to 26% and 18% to 8%, respectively (P<0.005). This was accompanied by ∼2-fold decrease in ICM, TE and total cell numbers (P<0.005), which was due to increased autophagy (P<0.05). At the same time, ICM-(NANOG) and TE-restricted (KRT8) genes were up-and down-regulated, respectively (P<0.05). In summary, bovine blastocyst viability depended on TDH-mediated threonine catabolism. However, ICM and TE cells did not metabolically differ in this regard, highlighting species-specific connections between metabolism and pluripotency regulation in mouse vs cattle.
Genome-wide association studies on endometriosis and endometriosis-related infertility
Authors: Galarneau Geneviève , Fontanillas Pierre ,   the Celmatix Research Team,   the 23andMe Research Team, Clementi Caterina , Hu-Seliger Tina , Parfitt David-Emlyn , Tung Joyce Y. , Beim Piraye Yurttas 
Published: September 2018

AbstractEndometriosis affects ∼10% of women of reproductive age. It is characterized by the growth of endometrial-like tissue outside the uterus and is frequently associated with severe pain and infertility. We performed the largest endometriosis genome-wide association study (GWAS) to date, with 37,183 cases and 251,258 controls. All women were of European ancestry. We also performed the first GWAS of endometriosis-related infertility, including 2,969 cases and 3,770 controls. Our endometriosis GWAS study replicated, at genome-wide significance, seven loci identified in previous endometriosis GWASs (CELA3A-CDC42, SYNE1, KDR, FSHB-ARL14EP, GREB1, ID4, andCEP112) and identified seven new candidate loci with genome-wide significance (NGF, ATP1B1-F5, CD109, HEY2, OSR2-VPS13B, WT1, andTEX11-SLC7A3). No loci demonstrated genome-wide significance for endometriosis-related infertility, however, the three most strongly associated loci (MCTP1, EPS8L3-CSF1, andLPIN1) were in or near genes associated with female fertility or embryonic lethality in model organisms. These results reveal new candidate genes with potential involvement in the pathophysiology of endometriosis and endometriosis-related infertility.
Chromatic bacteria – A broad host-range plasmid and chromosomal insertion toolbox for fluorescent protein expression in bacteria
Authors: Schlechter Rudolf O. , Jun Hyunwoo , Bernach Michał , Oso Simisola , Boyd Erica , Muñoz-Lintz Dian A. , Dobson Renwick C. J. , Remus Daniela M. , Remus-Emsermann Mitja N. P. 
Published: September 2018

AbstractDifferential fluorescent labelling of bacteria has become instrumental for many aspects of microbiological research, such as the study of biofilm formation, bacterial individuality, evolution, and bacterial behaviour in complex environments. We designed a variety of plasmids, each bearing one of eight unique, constitutively expressed fluorescent protein genes in conjunction with one of four different antibiotic resistance combinations. The fluorophores mTagBFP2, mTurquoise2, sGFP2, mClover3, sYFP2, mOrange2, mScarlet-I, and mCardinal, encoding for blue, cyan, green, green-yellow, yellow, orange, red, and far-red fluorescent proteins, respectively, were combined with selectable markers conferring tetracycline, gentamicin, kanamycin, and/or chloramphenicol resistance. These constructs were cloned into three different plasmid backbones: a broad host-range plasmid, a Tn5transposon delivery plasmid, and a Tn7transposon delivery plasmid. The utility of the plasmids and transposons was tested in bacteria from the phyla Actinobacteria, Proteobacteria, and Bacteroidetes. We were able to tag representatives from the phylum Proteobacteria at least via our Tn5transposon delivery system. The here constructed plasmids are available to the community and provide a valuable tool to investigate bacteria-bacteria, bacteria-host, and bacteria-environmental interactions.
Social integration predicts mitochondrial DNA copy number in rhesus macaques
Authors: Debray Reena , Snyder-Mackler Noah , Kohn Jordan , Wilson Mark , Barreiro Luis , Tung Jenny 
Published: September 2018

AbstractIn many social mammals, social adversity predicts compromised health and reduced fitness. These effects are thought to be driven in part by chronic social stress, but their molecular underpinnings are not well understood. Recent work suggests that chronic stress can affect mitochondrial copy number, heteroplasmy rates, and function. Here, we tested the first two possibilities, for the first time in nonhuman primates. We manipulated dominance rank in captive female rhesus macaques (n=45), where low rank induces chronic social stress, and measured mitochondrial DNA copy number and heteroplasmy in five peripheral blood mononuclear cell types from each study subject. We found no effect of dominance rank on either mtDNA copy number or heteroplasmy rates. However, grooming rates, a measure of affiliative social behavior predicted by high social status, was positively associated with mtDNA copy number in B cells, cytotoxic T cells, and monocytes. Our results suggest that social interactions can influence mtDNA regulation in immune cells. Further, they indicate the importance of considering both affiliative and competitive interactions in investigating this relationship.
Simultaneous single-channel multiplex and quantification of carbapenem-resistant genes using multidimensional standard curves
Authors: Rodriguez-Manzano Jesus , Moniri Ahmad , Malpartida-Cardenas Kenny , Dronavalli Jyothsna , Davies Frances , Holmes Alison , Georgiou Pantelis 
Published: September 2018

ABSTRACTMultiplexing and absolute quantification of nucleic acids, both have, in their own right, significant and extensive use in biomedical related fields, especially in point-of-care applications. Currently, the ability to detect several nucleic acid targets in a single-reaction scales linearly with the number of targets; an expensive and time-consuming feat. Here, we propose a new methodology based on multidimensional standard curves that extends the use of real-time PCR data obtained by common qPCR instruments. By applying this novel methodology, we achieve simultaneous single-channel multiplexing and enhanced quantification of multiple targets using only real-time amplification data. This is obtained without the need of fluorescent probes, agarose gels, melting curves or sequencing analysis. Given the importance and demand for tackling challenges in antimicrobial resistance, the proposed method is applied to the four most prominent carbapenem-resistant genes:blaOXA-48,blaNDM,blaVIMandblaKPC, which account for 97% of the UK’s reported carbapenemase-producing Enterobacteriaceae.
QUBIC2: A novel biclustering algorithm for large-scale bulk RNA-sequencing and single-cell RNA-sequencing data analysis
Authors: Xie Juan , Ma Anjun , Zhang Yu , Liu Bingqiang , Wan Changlin , Cao Sha , Zhang Chi , Ma Qin 
Published: September 2018

ABSTRACTThe combination of biclustering and large-scale gene expression data holds a promising potential for inference of the condition specific functional pathways/networks. However, existing biclustering tools do not have satisfied performance on high-resolution RNA-sequencing (RNA-Seq) data, majorly due to the lack of (i) a consideration of high sparsity of RNA-Seq data, e.g., the massive zeros or lowly expressed genes in the data, especially for single-cell RNA-Seq (scRNA-Seq) data, and (ii) an understanding of the underlying transcriptional regulation signals of the observed gene expression values. Here we presented a novel biclustering algorithm namely QUBIC2, for the analysis of large-scale bulk RNA-Seq and scRNA-Seq data. Key novelties of the algorithm include (i) used a truncated model to handle the unreliable quantification of genes with low or moderate expression, (ii) adopted the mixture Gaussian distribution and an information-divergency objective function to capture shared transcriptional regulation signals among a set of genes, (iii) utilized a Core-Dual strategy to identify biclusters and optimize relevant parameters, and (iv) developed a size-based P-value framework to evaluate the statistical significances of all the identified biclusters. Our method validation on comprehensive data sets of bulk and single cell RNA-seq data suggests that QUBIC2 had superior performance in functional modules detection and cell type classification compared with the other five widely-used biclustering tools. In addition, the applications of temporal and spatial data demonstrated that QUBIC2 can derive meaningful biological information from scRNA-Seq data. The source code for QUBIC2 can be freely accessed at https://github.com/maqin2001/qubic2.