bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessing Infrastructure to Care for Pediatric Patients in the Prehospital Setting
Authors: Ely Michael , Edgerton Elizabeth A. , Telford Russell , Page Kent , Hemingway Craig , Vernon Donald , Olson Lenora M. 
Published: November 2018

Objectives
Pediatric patients represent a small proportion of emergency medical services (EMS) calls, challenging providers in maintaining skills in treating children. Having structural capacity to appropriately diagnose and treat pediatric patients is critical. Our study measured the availability of off-line and on-line medical direction and recommended pediatric equipment at EMS agencies.

Methods
A Web-based survey was sent to EMS agencies in 2010 and 2013, and results were analyzed to determine availability of medical direction and equipment.

Results
Approximately 5000 agencies in 32 states responded, representing over 80% response. Availability of off-line medical direction increased between years (78% in 2010 to 85% in 2013), was lower for basic life support (BLS) (63% and 72%) than advanced life support (ALS) agencies (90% and 93%), and was generally higher in urban than rural or frontier locations. On-line medical direction was consistently available (90% both years) with slight increases for BLS agencies (87% to 90%) and slightly greater availability for urban and rural compared with frontier agencies. The majority of agencies carried most recommended equipment; however, less than one third of agencies reported carrying all equipment. Agencies with off-line medical direction, on-line medical direction, and with both off-line and on-line medical direction were respectively 1.69, 1.31, and 2.21 times more likely to report carrying all recommended equipment.

Conclusions
Basic structural capacity exists in EMS for treating children, with improvements seen over time. However, gaps remain, particularly for BLS and nonurban agencies. Continuous attention to infrastructure is necessary, and the recent development of national performance measures should further promote quality emergency care for all children.
Evaluating for Racial Differences in Pain Management of Long-Bone Fractures in a Pediatric Rural Population
Authors: Liao Lucia , Reyes Lilia 
Published: November 2018

Objectives
The aim of this study was to determine if a racial disparity exists in the administration of an analgesic, time to receiving analgesic, and type of analgesic administered to children with long-bone fractures. Prior studies have reported the existence of racial disparity but were mostly in adult and urban populations.

Methods
This is a retrospective chart review of 727 pediatric patients (aged 2–17 years) with International Classification of Diseases, Ninth Revision (or 10th revision) codes for long-one fractures in an emergency department that cares for a suburban and rural population between January 2013 and January 2016. Logistic regression was used to estimate the odds ratio of receiving no analgesic versus receiving an analgesic and receiving a nonopioid versus opioid drug. Linear regression analysis was performed to study the relationship between race and time to receive the analgesic, after adjusting for sex, age, insurance type, and mechanism of injury.

Results
Of the 727 children, 27% of them did not receive analgesics regardless of race. 27% (164/605) of white children, 25% (8/31) of African American children, and 24% (12/49) of Hispanic children did not receive analgesics. African Americans are 12% more likely (odds ratio [OR], 1.12; 95% confidence interval [CI], 0.48–2.61) to receive an analgesic compared with whites, and Hispanics are 22% more likely (OR, 1.22; 95% CI, 0.60–2.45) to receive an analgesic than whites. African Americans are 26% less likely (OR, 0.74; 95% CI, 0.31–1.75) to receive an opioid versus a nonopioid compared with whites, and Hispanics are 92% more likely (OR, 1.92; 95% CI, 0.91–4.17). Mean wait time across all races was 69 minutes, with no statistical difference between groups.

Conclusions
This study showed no statistical significance in the receipt or type of analgesic or wait time for pediatric long-bone fractures between race in a major academic level 1 trauma children's hospital, despite previous literature citing otherwise. This study augments to the few studies conducted in a rural setting. It is also one of the few studies that analyzed pain management in a large pediatric population as well as used waiting time to receive analgesic as an outcome measure. Overall, we found a mean wait time of 69 minutes for analgesic administration regardless of race, suggesting the need for more prompt pain management across all races for the management of long-bone fracture in the pediatric population.
Challenges of Clinical Management of Adolescent and Young Adults With Bone and Soft Tissue Sarcoma
Authors: Ferrari Andrea , Gasparini Patrizia , Gill Jonathan , Gorlick Richard 
Published: November 2018

AbstractClinical management of adolescents and young adults with bone and soft tissue sarcomas is quite challenging, mainly because of different chemotherapy approaches adopted by pediatric and adult oncologists and tumor-associated factors related to this peculiar age group. Overcoming these barriers is essential for adolescent and young adult patients, whose survival and long-term physical effects are worse than their pediatric counterparts. Nowadays, constant efforts from international collaborations between pediatric and adult oncologists of sarcoma groups have optioned in converging toward a common therapeutic strategy, while improving quality of treatment, as well as research advances dedicated to this at-risk age group of patients with sarcomas.
Modifiable Risk Factors for the Development of Breast Cancer in Young Women
Authors: Cathcart-Rake Elizabeth J. , Ruddy Kathryn J. , Johnson Rebecca H. 
Published: November 2018

Introduction
Breast cancer is the most common malignancy among adolescents and young adults (AYAs) women aged 15 to 39 years at diagnosis. An improved understanding of modifiable factors that mitigate the risks of the development of breast cancer may allow for future strategies to reduce the incidence of AYA breast cancer.

Method
A literature review was conducted to report upon associations between modifiable lifestyle factors and breast cancer risk.

Results
Higher levels of physical activity, lower red meat intake, and higher intake of plants appear to decrease the risk of developing AYA breast cancer, whereas associations between obesity and AYA breast cancer risk were less straightforward.

Conclusions
Further research, ideally in large prospective trials, is needed to truly understand modifiable risk factors for the development of AYA breast cancer.
Dynamics and Challenges of Clinical Trials in Adolescents and Young Adults With Cancer
Authors: Fern Lorna A. , Bleyer Archie 
Published: November 2018

Abstract
Inclusion in cancer clinical trials is considered the optimal standard of care, offering improved patient experience and progressive survival gains for subsequent generations of patients. Adolescent and young adult (AYA) patients are underrepresented in cancer research; consequently, improvements in outcomes for AYAs lag behind their pediatric and adult counterparts. Despite international evidence of underrepresentation in research, systematically tested interventions to improve recruitment for AYAs do not exist, and recruitment rates for AYAs continue to be lower than those for children. We review recruitment of AYAs into trials and discuss barriers and facilitators.
Establishing a Culture of Patient Safety, Quality, and Service in Plastic Surgery: Integrating the Fractal Model
Authors: Manahan Michele A. , Aston Jeffrey W. , Bello Ricardo J. , Siotos Charalampos , Demski Renee , Cooney Carisa M. , Pronovost Peter J. , Rosson Gedge D. 
Published: November 2018

Problem
There are obstacles to effective nationwide implementation of a culture of patient safety. Plastic surgery faces unique challenges in this area because quality measures are not as well-established as in other fields. Plastic surgery may also require emphasis on patient-reported outcomes as a quality-of-life specialty with distinct concomitant analytical methods.

Approach
We devised a dynamic framework, based on our 3-year experience using a Comprehensive Unit-Based Safety Program—a formal quality improvement committee structure, literature review, and work from The Johns Hopkins Armstrong Institute for Patient Safety and Quality. This framework is specific and exportable to the field of plastic surgery. Monthly patient safety, quality, and service committee meetings encourage multilevel participation in a bottom-up fashion, while connecting with other departments and entities in Johns Hopkins Medicine. Our model focuses our work in the following four domains: (1) safety, (2) external measures, (3) patient experience, and (4) value. Our framework identifies and communicates clear goals, creates necessary infrastructure, identifies opportunities and needs, uses robust performance to develop and implement interventions, and includes analytics to track improvement plans and results.

Outcomes
We have gradually implemented this quality improvement structure into the Johns Hopkins Department of Plastic and Reconstructive Surgery successfully since 2012. Outcomes have improved in externally reported measures of patient safety, quality, and service. We have demonstrated exemplary National Surgical Quality Improvement Program performance for morbidity, return to operating room, and readmission rates. Patient satisfaction surveys show improvement related to the high-level patient experience.
Transoral Robotic Surgery With Transoral Retropharyngeal Lymph Node Dissection in Patients With Tonsillar Cancer: Anatomical Points, Surgical Techniques, and Clinical Usefulness
Authors: Park Young Min , Cha Dongchul , Koh Yoon Woo , Choi Eun Chang , Kim Se-Heon 
Published: November 2018

Objective:
The purpose of this study was to evaluate the clinical usefulness of TORS and transoral robotic retropharyngeal lymph node (RPLN) dissection in tonsillar cancer patients with suspicious RPLN metastasis.

Methods:
From April 2008 to March 2014, 71 patients with tonsillar cancer underwent transoral robotic surgery and standard neck dissection at the Yonsei Head and Neck Cancer Center.

Results:
Three patients underwent transoral robotic ropharyngectomy with transoral robotic RPLN dissection because of suspicious RPLN metastasis. The mean age of the patients was 42 years (range, 31–50 years). There were no cases of wound infection or serious complications related to wound healing. Mild nasal regurgitation was observed during an oral diet immediately after surgery, but all patients spontaneously resolved without surgical treatment. There was no significant bleeding due to great vessel injury during surgery or swallowing difficulty due to cranial nerve IX injury.

Conclusion:
Although the oncologic stability and usefulness of this technique should be confirmed based on large-scale research, RPLN can be easily accessed and resected through our approach with less morbidity compared to the conventional surgical approach. In addition, because RPLN metastasis can be performed pathologically based on obtained specimens, it will be helpful to explore whether to perform adjuvant radiation.
Induced and endogenous acoustic oscillations in granular faults
Authors: de Arcangelis L. , Lippiello E. , Pica Ciamarra M. , Sarracino A. 
Published: November 2018

The frictional properties of disordered systems are affected by external perturbations. These perturbations usually weaken the system by reducing the macroscopic friction coefficient. This friction reduction is of particular interest in the case of disordered systems composed of granular particles confined between two plates, as this is a simple model of seismic fault. Indeed, in the geophysical context frictional weakening could explain the unexpected weakness of some faults, as well as earthquake remote triggering. In this manuscript, we review recent results concerning the response of confined granular systems to external perturbations, considering the different mechanisms by which the perturbation could weaken a system, the relevance of the frictional reduction to earthquakes, as well as discussing the intriguing scenario whereby the weakening is not monotonic in the perturbation frequency, so that a re-entrant transition is observed, as the system first enters a fluidized state and then returns to a frictional state.
This article is part of the theme issue ‘Statistical physics of fracture and earthquakes’.
Effect of disorder on the spatial structure of damage in slowly compressed porous rocks
Authors: Kun Ferenc , Pál Gergő , Varga Imre , Main Ian G. 
Published: November 2018

Faults and damage zone properties control a range of important phenomena, from the hydraulic properties of underground reservoirs to the physics of earthquakes on a larger scale. Here, we investigate the effect of disorder of porous rocks on the spatial structure of damage emerging under compression. Model rock samples are numerically generated by sedimenting particles where the amount of disorder is controlled by the particle size distribution. To obtain damage bands with a sufficiently large length along axis, we performed simulations of ‘Brazilian’-type compression tests of cylindrical samples. As failure is approached, damage localization leads to the formation of two conjugate shear bands. The orientation angle of bands to the loading direction increases with disorder, implying a decrease in the internal coefficient of friction. The width of the damage band scales as a power law of the degree of disorder. Inside the damage band, the sample is crushed into a large number of pieces with a power law mass distribution. The shape of fragments undergoes a crossover at a disorder-dependent size from the isotropy of small pieces to the anisotropic flattened form of the large ones. The results provide important constraints in understanding the role of disorder in geological fractures.
This article is part of the theme issue ‘Statistical physics of fracture and earthquakes’.
Statistical physics models for aftershocks and induced seismicity
Authors: Luginbuhl Molly , Rundle John B. , Turcotte Donald L. 
Published: November 2018

A standard approach to quantifying the seismic hazard is the relative intensity (RI) method. It is assumed that the rate of seismicity is constant in time and the rate of occurrence of small earthquakes is extrapolated to large earthquakes using Gutenberg–Richter scaling. We introduce nowcasting to extend RI forecasting to time-dependent seismicity, for example, during an aftershock sequence. Nowcasting uses ‘natural time’; in seismicity natural time is the event count of small earthquakes. The event count for small earthquakes is extrapolated to larger earthquakes using Gutenberg–Richter scaling. We first review the concepts of natural time and nowcasting and then illustrate seismic nowcasting with three examples. We first consider the aftershock sequence of the 2004 Parkfield earthquake on the San Andreas fault in California. Some earthquakes have higher rates of aftershock activity than other earthquakes of the same magnitude. Our approach allows the determination of the rate in real time during the aftershock sequence. We also consider two examples of induced earthquakes. Large injections of waste water from petroleum extraction have generated high rates of induced seismicity in Oklahoma. The extraction of natural gas from the Groningen gas field in The Netherlands has also generated very damaging earthquakes. In order to reduce the seismic activity, rates of injection and withdrawal have been reduced in these two cases. We show how nowcasting can be used to assess the success of these efforts.
This article is part of the theme issue ‘Statistical physics of fracture and earthquakes’.
Unhealthy Yet Avoidable – How Cognitive Bias Modification Alters Behavioral And Brain Responses To Food Cues In Obesity
Authors: Nora Mehl , Filip Morys , Arno Villringer , Annette Horstmann 
Published: November 2018

AbstractObjectiveObesity is associated with automatically approaching problematic stimuli, such as unhealthy food. Cognitive bias modification (CBM) could beneficially impact on problematic approach behavior. However, it is unclear which mechanisms are targeted by CBM in obesity: Candidate mechanisms include (1) altering reward value of food stimuli or (2) strengthening inhibitory abilities.Methods33 obese people completed either CBM or sham training during fMRI scanning. CBM consisted of an implicit training to approach healthy and avoid unhealthy foods.ResultsAt baseline, approach tendencies towards food were present in all participants. Avoiding vs. approaching food was associated with higher activity in the right angular gyrus (rAG). CBM resulted in a diminished approach bias towards unhealthy food, decreased activation in the rAG, and increased activation in the anterior cingulate cortex. Relatedly, functional connectivity between the rAG and right superior frontal gyrus increased. Analysis of brain connectivity during rest revealed training-related connectivity changes of the inferior frontal gyrus and bilateral middle frontal gyri.ConclusionTaken together, CBM strengthens avoidance tendencies when faced with unhealthy foods and alters activity in brain regions underpinning behavioral inhibition.
Positive linkage between bacterial social traits reveals that homogeneous rather than specialized behavioral repertoires prevail in natural Pseudomonas communities
Authors: Kramer Jos , López Carrasco Miguel Ángel , Kümmerli Rolf 
Published: November 2018

ABSTRACTBacteria frequently cooperate by sharing secreted metabolites such as enzymes and siderophores. The expression of different ‘public good’ traits can be interdependent, and studies on laboratory systems have shown that such trait linkage affects eco-evolutionary dynamics within bacterial communities. Here, we examine whether linkage among social traits occurs in natural Pseudomonas communities by examining investment levels and correlations between five public goods: biosurfactants, biofilm components, proteases, pyoverdines, and toxic compounds. Our phenotypic assays involving 315 isolates from soil and freshwater communities revealed that their social trait expression profiles varied dramatically, and that correlations between traits were frequent, exclusively positive, and sometimes habitat-specific. Our results indicate that Pseudomonas communities are dominated by isolates lying on a continuum between a ‘social’ type producing multiple public goods, and an ‘asocial’ type showing low investment into social traits. This segregation into different social types could reflect local adaptation to different microhabitats, or emerge from competition between different (social) strategies. Moreover, our results show that isolates with specialized trait repertoires are rare, suggesting limited scope for the mutual exchange of different public goods between isolates. Overall, our work indicates that complex interdependencies among social traits influence the evolution of microbial lifestyles in nature.
The Set1 complex is dimeric and acts with Jhd2 demethylation to convey symmetrical H3K4 trimethylation
Authors: Choudhury Rupam , Singh Sukhdeep , Arumugam Senthil , Roguev Assen , Stewart A. Francis 
Published: November 2018

ABSTRACTEpigenetic modifications can maintain or alter the inherent symmetry of the nucleosome however the mechanisms that deposit and/or propagate symmetry or asymmetry are not understood. Here we report that yeast Set1C/COMPASS is dimeric and consequently symmetrically trimethylates histone 3 lysine 4 (H3K4me3) on promoter nucleosomes. Mutation of the dimer interface to make Set1C monomeric abolished H3K4me3 on most promoters. The most active promoters, particularly those involved in the oxidative phase of the yeast metabolic cycle, displayed H3K4me2, which is normally excluded from active promoters, and a subset of these also displayed H3K4me3. In wild-type yeast, deletion of the sole H3K4 demethylase, Jhd2, has no effect. However in monomeric Set1C yeast, Jhd2 deletion increased H3K4me3 levels on the H3K4me2 promoters. Notably, the association of Set1C with the elongating polymerase was not perturbed by monomerisation. These results imply that symmetrical H3K4 methylation is an embedded consequence of Set1C dimerism and that Jhd2 demethylates asymmetric H3K4me3. Consequently, rather than methylation and demethylation acting in opposition as logic would suggest, a dimeric methyltransferase and monomeric demethylase co-operate to eliminate asymmetry and focus symmetrical H3K4me3 onto selected nucleosomes. This presents a new paradigm for the establishment of epigenetic detail.
Inferring putative transmission clusters with Phydelity
Authors: Han Alvin X. , Parker Edyth , Maurer-Stroh Sebastian , Russell Colin A. 
Published: November 2018

AbstractCurrent phylogenetic clustering approaches for identifying pathogen transmission clusters are limited by their dependency on arbitrarily-defined genetic distance thresholds for within-cluster divergence. Incomplete knowledge of a pathogen’s underlying dynamics often reduces the choice of distance threshold to an exploratory, ad-hoc exercise that is difficult to standardise across studies. Phydelity is a new tool for the identification of transmission clusters in pathogen phylogenies. It identifies groups of sequences that are more closely-related than the ensemble distribution of the phylogeny under a statistically-principled and phylogeny-informed framework, without the introduction of arbitrary distance thresholds. Relative to other distance threshold-based and model-based methods, Phydelity outputs clusters with higher purity and lower probability of misclassification in simulated phylogenies. Applying Phydelity to empirical datasets of hepatitis B and C virus infections showed that Phydelity identified clusters with better correspondence to individuals that are more likely to be linked by transmission events relative to other widely-used non-parametric phylogenetic clustering methods without the need for parameter calibration. Phydelity is generalisable to any pathogen and can be used to identify putative direct transmission events. Phydelity is freely available at https://github.com/alvinxhan/Phydelity.
E-cadherin endocytosis is modulated by p120-catenin through the opposing actions of RhoA and Arf1
Authors: Greig Joshua , Bulgakova Natalia A. 
Published: November 2018

AbstractThe regulation of E-cadherin at the plasma membrane by endocytosis is of vital importance for developmental and disease. p120-catenin, which binds to the E-cadherin C-terminus, can both promote and inhibit E-cadherin endocytosis. However, little is known about what determines the directionality of p120-catenin activity, and the molecules downstream. Here, we have discovered that p120-catenin fine-tunes the clathrin-mediated endocytosis of E-cadherin inDrosophilaembryonic epidermal cells. It simultaneously activated two actin-remodelling pathways with opposing effects: RhoA, which stabilized E-cadherin at the membrane, and Arf1, which promoted internalization. Epistasis experiments revealed that RhoA additionally inhibited Arf1. E-cadherin was efficiently endocytosed only in the presence of intermediate p120-catenin amounts with too little and too much p120-catenin inhibiting E-cadherin endocytosis. Finally, we found that p120-catenin levels altered the tension of the plasma membrane. Altogether, this shows that p120-catenin is a central hub which co-ordinates cell adhesion, endocytosis, and actin dynamics with tissue tension.