bluuebunny/crossref_metadata_2025_split huggingface dataset:
Opiate Pain Medication Consumption in Cigarette Smokers following Total Hip Arthroplasty
Authors: Etcheson Jennifer , Gwam Chukwuweike , George Nicole , Walia Naval , Jerjian Christophe , Han Ga-ram , Virani Sana , Miller Seth , Delanois Ronald 
Published: October 2018

Purpose The purpose of the present study was to assess perception of pain and pain management in smokers versus nonsmokers who received a total hip arthroplasty (THA).
Methods Patients who underwent THA from 2010 to 2016 were propensity score matched 1:1 based on race, body mass index, age, and sex. This yielded 124 smokers and 124 nonsmokers. Pain intensity was quantified using area under the curve for visual analog scale pain scores. Opioid consumption was determined using a morphine milliequivalent (mEq) conversion algorithm. An independent samples t-test and Chi-square analysis was conducted to assess continuous and categorical variables respectively.
Results Smokers experienced a nonsignificantly increased pain intensity (198.1 vs. 185.7; p = 0.063). Smokers demonstrated significantly higher opioid consumption in both immediate postoperative (65.9 vs. 59.3 mEq; p = 0.045) and 90 days postoperative periods (619.9 vs. 458.9 mEq; p = 0.029).
Conclusion Our study demonstrated a nonsignificantly increased pain intensity, and (in both the immediate and 90 days postoperative periods) a significantly higher opioid consumption following THA in patients who smoke cigarettes. This may be due to a relatively small effect size, warranting the need for larger prospective studies. Nevertheless, arthroplasty surgeons should encourage preoperative smoking cessation and alternative nonopioid analgesics to smoking patients receiving THA.
Level of Evidence This is a level III, retrospective cohort study.
The Effect of Blood Loss on Cefazolin Levels in Women Undergoing Cesarean Delivery
Authors: Dotters-Katz Sarah K. , Smid Marcela C. , Grace Matthew R. , Gunatilake Ravindu P. , Sykes Craig , Blake Kimberly , Boggess Kim A. , Patil Avinash S. , Manuck Tracy 
Published: October 2018

Objective To quantify the effects of operative blood loss during cesarean on tissue and plasma cefazolin concentrations.
Study Design This was a prospective observational study of singleton pregnancies undergoing scheduled cesarean between 34 and 40 weeks. Cefazolin administered prior to skin incision. Maternal plasma samples were obtained (Time 1[T1]: immediately, T2: 20 minutes, T3: 40 minutes, and T4: 60 minutes after cefazolin infusion). Subcutaneous adipose tissue sampled before and after fascia. Primary outcome was subcutaneous adipose cefazolin level after fascial closure. Formal quantitative blood loss (QBL) performed. Women with higher QBL, those at/above 75% of QBL in this population, were compared with those with lower QBL (QBL below 75%). Data analyzed using bivariable statistics.
Results Ninety-two women were screened, 32 were eligible, and 20 enrolled. Median QBL was 630 mL (interquartile range [IQR]: 473–818) and 1,160 mL (IQR: 1,000–1,560) in the low and high QBL groups, respectively. Demographics and operative characteristics were similar. Median adipose cefazolin level after fascial closure did not differ between the groups (3.5 vs. 3.9 μg/g, p = 0.75). No differences in maternal plasma cefazolin concentrations between the groups at any time point or in pharmacokinetic parameters were seen.
Conclusion Intraoperative maternal plasma concentrations and adipose levels of cefazolin are similar between women with high and low blood loss at the time of cesarean delivery.
Qualitätsmanagement: Kollegiales Peer-Review-Verfahren in der Intensivmedizin
Authors: Muhl Elke 
Published: October 2018

AbstractWe report on the German Peer Review procedure for the quality management of Intensive Care Wards. The third up-date of the quality-indicators was published in 2017. The Peer Review Procedure, its organization, the development of quality indicators in Germany and their benefit for the patients is introduced.
A comprehensive review of computational prediction of genome-wide features
Authors: Xu Tianlei , Zheng Xiaoqi , Li Ben , Jin Peng , Qin Zhaohui , Wu Hao 
Published: October 2018

Abstract
There are significant correlations among different types of genetic, genomic and epigenomic features within the genome. These correlations make the in silico feature prediction possible through statistical or machine learning models. With the accumulation of a vast amount of high-throughput data, feature prediction has gained significant interest lately, and a plethora of papers have been published in the past few years. Here we provide a comprehensive review on these published works, categorized by the prediction targets, including protein binding site, enhancer, DNA methylation, chromatin structure and gene expression. We also provide discussions on some important points and possible future directions.
Investigating the Impact of Early Valve Surgery on Survival in Staphylococcus aureus Infective Endocarditis Using a Marginal Structural Model Approach: Results of a Large, Prospectively Evaluated Cohort
Authors: Rieg Siegbert , von Cube Maja , Kaasch Achim J , Bonaventura Bastian , Bothe Wolfgang , Wolkewitz Martin , Peyerl-Hoffmann Gabriele , Deppe Antje-Christin , Wahlers Thorsten , Beyersdorf Friedhelm , Seifert Harald , Kern Winfried V 
Published: October 2018

Abstract

Background
The impact of valve surgery on outcomes of Staphylococcus aureus infective endocarditis (SAIE) remains controversial. We tested the hypothesis that early valve surgery (EVS) improves survival by using a novel approach that allows for inclusion of major confounders in a time-dependent way.

Methods
EVS was defined as valve surgery within 60 days. Univariable and multivariable Cox regression analyses were performed. To account for treatment selection bias, we additionally used a weighted Cox model (marginal structural model) that accounts for time-dynamic imbalances between treatment groups. To address survivor bias, EVS was included as a time-dependent variable. Follow-up of patients was 1 year.

Results
Two hundred and three patients were included in the analysis; 50 underwent EVS. All-cause mortality at day 30 was 26%. In the conventional multivariable Cox regression model, the effect of EVS on the death hazard was 0.85 (95% confidence interval [CI], .47–1.52). Using the weighted Cox model, the death hazard rate (HR) of EVS was 0.71 (95% CI, .34–1.49). In subgroup analyses, no survival benefit was observed in patients with septic shock (HR, 0.80 [CI, .26–2.46]), in NVIE (HR, 0.76 [CI, .33–1.71]) or PVIE (HR, 1.02 [CI, .29–3.54]), or in patients with EVS within 14 days (HR, 0.97 [CI, .46–2.07]).

Conclusions
Using both a conventional Cox regression model and a weighted Cox model, we did not find a survival benefit for patients who underwent EVS in our cohort. Until results of randomized controlled trials are available, EVS in SAIE should be based on individualized decisions of an experienced multidisciplinary team.

Clinical Trials Registration
German Clinical Trials registry (DRKS00005045).
Elucidation of the O-antigen structure of Escherichia coli O63
Authors: Ståhle Jonas , Fontana Carolina , Weintraub Andrej , Widmalm Göran 
Published: October 2018

AbstractThe structure of the O-antigen polysaccharide (PS) from the Shiga-toxin producing Escherichia coli O63 has been elucidated using a combination of bioinformatics, component analyses and NMR spectroscopy. The O-antigen is comprised of tetrasaccharide repeating units with the following structure: →2)-β-d-Quip3N(d-allo-ThrAc)-(1→2)-β-d-Ribf-(1→4)-β-d-Galp-(1→3)-α-d-GlcpNAc-(1→ in which the N-acetylated d-allo-threonine is amide-linked to position 3 of the 3-amino-3-deoxy-d-Quip sugar residue. The presence of a predicted flippase and polymerase encoded in the O63 gene cluster is consistent with the Wzx/Wzy biosynthetic pathway and consequently the biological repeating unit has likely an N-acetyl-d-glucosamine residue at its reducing end. A bioinformatics approach based on predictive glycosyltransferase function present in ECODAB (E. coli O-antigen database) suggested the structural element β-d-Galp-(1→3)-d-GlcpNAc in the O-antigen. Notably, multiple gene sequence alignment of fdtA and qdtA from E. coli to that in E. coli O63 resulted in discrimination between the two, confirmation of the latter in E. coli O63, and consequently, together with qdtB, biosynthesis of dTDP-d-Quip3N. The E. coli O63 O-antigen polysaccharide differs in two aspects from that of E. coli O114 where the latter carries instead an l-serine residue, and the glycosidic linkage positions to and from the Quip3N residue are both changed. The structural characterization of the O63 antigen repeat supports the predicted functional assignment of the O-antigen cluster genes.
Adapting the dynamic energy budget (DEB) approach to include non-continuous growth (moulting) and provide better predictions of biological performance in crustaceans
Authors: Talbot S Elizabeth , Widdicombe Stephen , Hauton Chris , Bruggeman Jorn 
Published: October 2018

Abstract
Dynamic energy budget (DEB) theory offers a comprehensive framework for understanding the overall physiological performance (growth, development, respiration, reproduction, etc.) of an organism over the course of its life cycle. We present here a simplified DEB model for the swimming crab Liocarcinus depurator. To the best of our knowledge, this is the first to be presented for this species. Most applications of the standard DEB model assume continuous growth in all size metrics (length, wet mass, carbon content) of the modelled species. However, in crustaceans growth, measured as an increase of carapace length/width, occurs periodically via moult. To account for this, we have extended the model to track the continuous increase in carbon mass as well as the episodic increase in physical size. Model predictions were consistent with the patterns in the observed data, predicting both the moult increment and the intermoult period of an individual. In addition to presenting the model itself, we also make recommendations for further development, and evaluate the potential applications of such a model, both at the individual level (e.g. aquaculture) and as a potential tool for population level dynamics (e.g. fisheries stock assessment).
On the logic that preserves degrees of truth associated to involutive Stone algebras
Authors: Cantú Liliana M , Figallo Martín 
Published: October 2018

AbstractInvolutive Stone algebras (or S-algebras) were introduced by R. Cignoli and M. Sagastume in connection to the theory of $n$-valued Łukasiewicz–Moisil algebras. In this work we focus on the logic that preserves degrees of truth associated to S-algebras named Six. This follows a very general pattern that can be considered for any class of truth structure endowed with an ordering relation, and which intends to exploit many-valuedness focusing on the notion of inference that results from preserving lower bounds of truth values, and hence not only preserving the value $1$. Among other things, we prove that Six is a many-valued logic (with six truth values) that can be determined by a finite number of matrices (four matrices). Besides, we show that Six is a paraconsistent logic. Moreover, we prove that it is a genuine Logic of Formal Inconsistency with a consistency operator that can be defined in terms of the original set of connectives. Finally, we study the proof theory of Six providing a Gentzen calculus for it, which is sound and complete with respect to the logic.
Management of Giant Thoracic Disc Herniation by Thoracoscopic Approach: Experience of 53 Cases
Authors: Brauge David , Horodyckid Catherine , Arrighi Marta , Reina Vincent , Eap Christophe , Mireau Etienne , Bertrand Baussart , Aldéa Sorin , Gaillard Stephan 
Published: October 2018

Abstract

BACKGROUND
Giant thoracic disc herniation (gTDH) is a rare condition. It is defined by a herniation that occupies at least 40% of the thoracic spinal canal and is usually calcified. Several surgical techniques have been described to date but this surgery remains a technically difficult procedure.

OBJECTIVE
To report the long-term outcome of 53 patients with myelopathy due to gTDH who were operated on by a thoracoscopic approach. The technical details of the preoperative assessment and the surgical procedure are presented.

METHOD
We present a retrospective study of a database of 53 patients operated for symptomatic gTDH by a thoracoscopic approach. The following clinical parameters were assessed initially and used during follow-up: Frankel grade and JOA score adapted to the thoracic spine (mJOA), pain in the lower limbs and limitation of the walking perimeter to less than 500 meters. The quality of spinal cord decompression was assessed postoperatively by magnet resonance imaging (MRI).

RESULTS
The mean follow-up was 78.1 mo (SD 49.4). At the last follow-up visit, clinical examination showed a mean improvement of 0.91 Frankel grade (P < 0.001) and 2.56 mJOA score respectively (P < 0.001). Lower limb pain and walking perimeter were also improved. Postoperative MRI revealed that the resection was complete in 35 cases, subtotal in 13 cases, and incomplete in 5 cases.

CONCLUSION
gTDH is a condition that often evolves favorably after surgery. The thoracoscopic approach is a feasible alternative technique.
DISTRIBUTIONS OF INDOOR GAMMA DOSE RATES IN RELATION TO GAMMA-RAY EMISSIONS FROM BUILDING MATERIALS: CASE STUDY OF HIGH-RISE CONCRETE BUILDING IN FUKUSHIMA
Authors: Omori Yasutaka , Ishikawa Takuma , Sorimachi Atsuyuki , Ishikawa Tetsuo 
Published: October 2018

Abstract
The spatial distribution of ambient gamma dose rates in a high-rise steel-reinforced concrete building in Fukushima, Japan, was examined relative to the gamma-ray emissions from building materials and radionuclides derived from the 2011 nuclear accident. The results revealed the minor role of accident-derived radionuclides in ambient gamma dose rates ~7 y after the accident. The ambient gamma dose rates were higher in the upper floors because of gamma-ray emissions from natural radionuclides in the floor slabs. The fractional contribution of natural radionuclides to the ambient gamma dose rates indicated compositional differences in concrete between the upper- and lower-floor slabs.
The Influence of High-Fidelity Simulation on Knowledge Gain and Retention
Authors: Zinsmaster Jaime , Vliem Sally 
Published: October 2018

Abstract
Although current research suggests many positive outcomes with the use of high-fidelity simulation (HFS) in nursing education, little is known about the influence of HFS on knowledge retention. This quasiexperimental study examined the effects of HFS on student knowledge acquisition and retention, while validating the simulation quality with established tools on satisfaction, self-efficacy, educational practices, and simulation design. Results indicate that, although HFS had a statistically significant impact on knowledge acquisition, knowledge retention rates were not influenced.
Analyzing Nursing Student Learning Over Time in Simulation
Authors: Ball Lisa S. , Kilger Linda 
Published: October 2018

Abstract
A retrospective, longitudinal pilot analysis was conducted on nursing student evaluation data collected from sequential high-fidelity simulation experiences in an associate degree nursing program. The Sweeney-Clark Simulation Performance Rubric was used to measure students' performance. The overall mean of each of the measured categories increased significantly with each simulation experience. The odds of scores increasing with each subsequent simulation experience ranged from 6.99 to 41.38. Performance improved through sequential simulation experiences. Findings support feasibility and import of providing evidence to support the use of high-fidelity simulation in relation to learning over time.
Low Cost-High Return: Creating an Ideal Pediatric Clinical Experience
Authors: McDonald Susan M. 
Published: October 2018

Abstract
To compensate for a shortage of clinical sites, a clinical was developed on campus to increase student understanding of pediatric nursing care, encourage collegial collaboration, enhance time management skills, and improve documentation. Six pediatric case studies were developed. In small teams, students cared for a panel of children utilizing resources from the simulation laboratory, the Centers for Disease Control and Prevention website, and a community clinic. More than 95 percent of 110 students surveyed found the experience to be beneficial. A low-cost guided learning experience can be beneficial to enhance the learning of students in regions with limited clinical and monetary resources.
Considerations for Introducing Asynchronous Discussion to Enhance Postgraduate Online Learner Engagement
Authors: Dickson Cathy 
Published: October 2018

Abstract
The notion of an online course implies that students and teachers are separate and that there is a feeling of remoteness. Isolation and lack of perceived community have been noted as influences on retention in courses and ultimately on student success. Postgraduate nursing students more than likely attempt to combine families and work commitments with study, thereby increasing the risk of disengagement. Educators responsible for online courses need to be able to provide a learning design that will motivate and connect students, increasing their chance of success.
Knowledge and Attitudes of RN to BSN Students Before and After a Patient Safety Course
Authors: Raines Deborah A. , Grinslade Susan , Fabry Donna , Hewner Sharon , Steeg Linda 
Published: October 2018

Abstract
This pilot study evaluates the effectiveness of a stand-alone safety and quality improvement course and the integration of the Institute for Healthcare Improvement's safety modules into the RN to BSN program curriculum. A pre/postintervention design was used to measure the attitudes of a cohort of students. The results demonstrate gains in all dimensions measured, with statistically significant gains in four areas: safety general, team functioning, patient's role in error, and situational awareness. This study lends support to the value of a course focused on safety and quality and the use of the Institute for Healthcare Improvement modules in the curriculum
An Innovative Classroom Teaching Strategy Using High-Fidelity Patient Simulation
Authors: Turrise Stephanie 
Published: October 2018

Abstract
The majority of simulations in our prelicensure program take place in the simulation learning center as clinical experiences. Students request more simulation exposure, but space and time limitations prohibit this. The purpose of this activity was to engage students in active learning that allowed them to practice clinical decision-making using high-fidelity patient simulation in the classroom.
Innovations to Support Frontline Health Care Workers Aspiring to Become Baccalaureate-Prepared Nurses
Authors: Atkins Robert L. , Estrada Erik Juan Jose , Hagerman Diane , Ellis Milton R. , Wilson Randall , Maguire Patricia 
Published: October 2018

Abstract
In July 2014, New Jersey Health Initiatives, a statewide grant-making program of the Robert Wood Johnson Foundation, funded five higher education–health care system partnerships to develop and implement innovative models supporting frontline health care workers aspiring to become baccalaureate-prepared nurses. Discussed in this brief are achievements from the first year of the initiative. The innovative supports include mentoring, tutoring, and policy changes designed to address the academic, financial, and psychosocial challenges faced by adult learners. The potential impact of this initiative on the nursing shortage and increasing cultural diversity are discussed.
Work Role Perspectives of Clinical Instructors From Three Countries
Authors: Zlotnick Cheryl , Jones Sharon M. , Koren Ainat , Peters Anya , Saffer Cheryl , Torsvik Malvin , Wilhelm Dalit 
Published: October 2018

Abstract

BACKGROUND
Educational institutions partner with health facilities to provide clinical education, but the impact of these partnerships on clinical instructors is rarely examined.

METHOD
A cross-sectional study was used to obtain surveys from a convenience sample of clinical instructors (n = 135) working in Israel, Norway, and the United States. The Nursing Clinical Instruction Role Assessment Tool (N-CIRAT) was developed to elicit clinical instructors’ perspectives on the importance and nature of their work roles.

FINDINGS
The N-CIRAT exhibited good reliability and revealed three different work roles: educator, hospital partner, and patient advocate. The educator work role did not differ by primary employer; it did for the work role of hospital partner (p < .05) and patient advocate (p < .05). Patient advocate work role importance was rated high for all clinical instructors.

CONCLUSION
The educator role of clinical nurse educators, including being a role model and encouraging reflection, is universal among clinical instructors.
Infographic Development by Accelerated Bachelor of Science in Nursing Students: An Innovative Technology-Based Approach to Public Health Education
Authors: Falk Nancy L. 
Published: October 2018

Abstract
Health communications and baccalaureate nursing education are increasingly impacted by new technological tools. This article describes how an Accelerated Bachelor of Science in Nursing program incorporates an infographic assignment into a graduate-level online health information and technology course. Students create colorful, engaging infographics using words and visuals to communicate public health information. The assignment, which incorporates the use of data and evidence, provides students the opportunity to acquire new research and technology skills while gaining confidence creating and innovating. The finished products may be disseminated, serving as vehicles to influence public health and well-being.
Reality Check: Preparing Nursing Students to Respond to Ebola and Other Infectious Diseases
Authors: McNiel Paula L. , Elertson Kathleen M. 
Published: October 2018

Abstract
Escalating uncertainty regarding the international impact of Ebola virus disease and other infectious diseases prompted educators to develop interactive, multidisciplinary training for senior-level baccalaureate nursing students. A three-hour clinical learning session was scheduled within the curriculum. Nurse faculty utilized 11 activities to increase students’ awareness and understanding of the potential and actual impact of Ebola virus disease and other infectious diseases. Feedback reflected a positive student experience highlighting several key areas related to increased knowledge and confidence. This session highlighted the importance of adjusting focus and priorities within curricula to meet core baccalaureate essentials and address current public health needs.
Student Developed and Led Simulation Scenarios
Authors: Gwin Teresa , Villanueva Celeste , Wong Jeanette 
Published: October 2018

Abstract
Use of simulation in teaching is well established as a viable educational technique. Flipped classroom techniques using technology have been shown to enhance and deepen knowledge of content. This educational innovation utilized both techniques in a second-semester prelicensure nursing course to allow students to gain a broader focus on complex patient scenarios and a better understanding of simulation as a teaching/learning tool. The project was an assigned simulation expectation for a medical-surgical nursing course. Students developed a simulation based on the care of patients from their clinical site.