bluuebunny/crossref_metadata_2025_split huggingface dataset:
Experiences of Burnout among Drug Counselors in A Large Opioid Treatment Program: A Qualitative Investigation
Authors: Beitel Mark , Oberleitner Lindsay , Muthulingam Dharushana , Oberleitner David , Madden Lynn M. , Marcus Ruthanne , Eller Anthony , Bono Madeline H. , Barry Declan T. 
Published: March 2018

Background Little is known about possible experiences of burnout among drug counselors in opioid treatment programs that are scaling up capacity to address the current opioid treatment gap. Methods Participants in this quality improvement study were 31 drug counselors employed by large opioid treatment programs whose treatment capacities were expanding. Experiences of burnout and approaches for managing and/or preventing burnout were examined using individual semi-structured interviews, which were audiotaped, transcribed, and systematically coded by a multidisciplinary team using grounded theory. Results Rates of reported burnout (in response to an open-ended question) were lower than expected, with approximately 26% of participants reporting burnout. Counselor descriptions of burnout included cognitive, affective, behavioral, and physiological symptoms; and job-related demands were identified as a frequent cause. Participants described both self-initiated (e.g., engaging in pleasurable activities, exercising, taking breaks during workday) and system-supported strategies for managing or preventing burnout (e.g., availing of supervision and paid time off). Counselors provided recommendations for system-level changes to attenuate counselor risk of burnout (e.g., increased staff-wide encounters, improved communication, accessible paid time off, and increased clinical supervision). Conclusions Findings suggest that drug counselor burnout is not inevitable, even in opioid treatment program settings whose treatment capacities are expanding. Organizations might benefit from routinely assessing counselor feedback about burnout and implementing feasible recommendations to attenuate burnout and promote work engagement.
Pteris multifida, Cortex phellodendri, and probiotics attenuated inflammatory status and immunity in mice with a Salmonella enterica serovar Typhimurium infection
Authors: Yin Mei-Chin , Chang Chiung-Hung , Su Chiu-Hsian , Yu Bi , Hsu Yuan-Man 
Published: March 2018

Abstract
Pteris multifida (PM) and Cortex phellodendri (CP) are medicinal foods used for gastrointestinal protection. Lactic-acid bacteria are probiotics. Salmonella Typhimurium strain ST21-infected mice were used to examine the alleviative effects of two lactic-acid bacteria (LAB) as well as aqueous extracts of PM and CP for a 4-day treatment. CP and LAB decreased fecal ST counts. CP and PM reduced the ST21 count in the blood, intestine, and liver. LAB lowered the ST21 count in the intestine and spleen. CP and LAB decreased the IFN-gamma level; PM lowered the TNF-alpha level; and both LAB and PM reduced the IL-1beta level in serum. PM and CP lowered the IgG level in serum. The data in a macrophage infection model indicate that TNF-alpha was partial involved in this alleviative effects, other mechanisms might be involved. In sum, these novel findings suggest that PM, CP, and LAB probiotics are potential anti-Salmonellae agents.
‘You Think You Know a Story…’: Reframing the Tudors on Television in the Twenty-First Century
Authors: Mullin Romano 
Published: March 2018

AbstractOver the past 10 years, there has been an explosion in the number of television dramas about Tudor England. These programmes have been engaged in a re-visioning of history that prioritizes a heterogeneous approach to the past, adapting historical themes, figures, and events in order to challenge existing conceptions about the nature of history. By using Showtime’s The Tudors (2007–2010) and the BBC’s Wolf Hall 2015 as examples, this paper explores how both series reimagine the Tudor era by destabilising traditional modes of historical engagement and emphasizing the shared narrative lineage of historiography and history as entertainment. Ultimately, the paper argues that these programmes are responding not only to new ways of accessing the past, but also by adapting a period which is central to an Anglocentric cultural identity, they are responding to the crises and political faultlines that have marked the twenty-first century.
Repeat-aware evaluation of scaffolding tools
Authors: Mandric Igor , Knyazev Sergey , Zelikovsky Alex 
Published: March 2018

Abstract

Summary
Genomic sequences are assembled into a variable, but large number of contigs that should be scaffolded (ordered and oriented) for facilitating comparative or functional analysis. Finding scaffolding is computationally challenging due to misassemblies, inconsistent coverage across the genome and long repeats. An accurate assessment of scaffolding tools should take into account multiple locations of the same contig on the reference scaffolding rather than matching a repeat to a single best location. This makes mapping of inferred scaffoldings onto the reference a computationally challenging problem. This paper formulates the repeat-aware scaffolding evaluation problem, which is to find a mapping of the inferred scaffolding onto the reference maximizing number of correct links and proposes a scalable algorithm capable of handling large whole-genome datasets. Our novel scaffolding validation framework has been applied to assess the most of state-of-the-art scaffolding tools on the representative subset of Genome Assembly Golden-Standard Evaluations (GAGE) datasets and some novel simulated datasets.

Availability and implementation
The source code of this evaluation framework is available at https://github.com/mandricigor/repeat-aware. The documentation is hosted at https://mandricigor.github.io/repeat-aware.

Supplementary information
Supplementary data are available at Bioinformatics online.
The Uniformed Services University of the Health Sciences, F. Edward Hébert School of Medicine: Status of the Federal Medical School after 25 Years
Authors: Gardner John W. , Harmon Susan , Stavish Peter J. 
Published: March 2018

Abstract
In its first 25 years, the Uniformed Services University of the Health Sciences (USUHS) has become a quality institution of medical education that provides a steady flow of career physicians for the military. It compares favorably with U.S. medical school averages in all aspects of undergraduate medical education: faculty, teaching facilities, matriculants, curriculum, student performance, and cost. USUHS provides excellent medical education and adds unique preparation for uniformed public service. It also provides military-specific graduate education, graduate medical education, continuing health education, medical research, clinical services, consultation, public service, and ties with international military, medical, and research institutions.
Generalizability in Pregnancy and Work Research
Authors: Evans Mary Ann 
Published: March 2018

Abstract
Generalizability of findings is a critical issue in research on pregnancy and work. The characteristics of a sample of 350 pregnant military women were compared with those of the populations of active duty women and active duty pregnant women. The sample was fairly representative in terms of minority status and age. The sample differed somewhat in terms of branch of service, rank, and marital status. Comparisons of demographics and pregnancy planning between military and civilian pregnant women supported generalizability. Unique aspects of military service and different access to health care among civilian pregnant women warrant caution in generalizing of findings.
Safety and Efficacy of DEET and Permethrin in the Prevention of Arthropod Attack
Authors: Young G. David , Evans Sandra 
Published: March 2018

Abstract
Many preventable diseases affecting troop strength are directly attributed to disease-carrying insects. The first line of defense against arthropod vectors is the use of personal protective measures. The concurrent application of DEET (N,N-diethyl-m-toluamide) repellent on the skin and permethrin [(3-phenoxy-phenyl)methyl(±)cis,trans-3-(2,2-dichloroethenyl)-2,2-dimethylcyclopropane-carboxylate] insecticide on the battle dress uniform, while the uniform is worn properly, is a personal protective strategy officially known as the DOD Insect Repellent System. It is important for troop commanders and field leaders to enforce the use of personal protective measures to prevent insect-borne infectious diseases and to ensure troop and soldier readiness. DEET is a safe and effective repellent. Permethrin is a synthetic pyrethroid insecticide and repellent. Used in conjunction with proper clothing and other personal protective equipment, these repellents provide the best known protection available and are critical in minimizing the occupational health threat of arthropod-borne diseases to troops in the field.
Acute Necrotizing Ulcerative Gingivitis-Periodontitis: A Literature Review
Authors: Wade Douglas N. , Kerns David G. 
Published: March 2018

Abstract
Acute necrotizing ulcerative gingivitis-periodontitis (ANUG/ NUP) is a relatively uncommon periodontal disease characterized by gingival necrosis and ulceration, pain, and bleeding. The purpose of this paper is to provide a review of current knowledge on ANUG/NUP. Current literature on the epidemiology, pathogenesis, immunology, predisposing factors, and treatment of ANUG/NUP is reviewed.
Ejection of rocky and icy material from binary star systems: implications for the origin and composition of 1I/‘Oumuamua
Authors: Jackson Alan P , Tamayo Daniel , Hammond Noah , Ali-Dib Mohamad , Rein Hanno 
Published: March 2018

Abstract
In single-star systems like our own Solar system, comets dominate the mass budget of bodies ejected into interstellar space, since they form further away and are less tightly bound. However, 1I/‘Oumuamua, the first interstellar object detected, appears asteroidal in its spectra and lack of detectable activity. We argue that the galactic budget of interstellar objects like 1I/‘Oumuamua should be dominated by planetesimal material ejected during planet formation in circumbinary systems, rather than in single-star systems or widely separated binaries. We further show that in circumbinary systems, rocky bodies should be ejected in comparable numbers to icy ones. This suggests that a substantial fraction of interstellar objects discovered in future should display an active coma. We find that the rocky population, of which 1I/‘Oumuamua seems to be a member, should be predominantly sourced from A-type and late B-star binaries.
Intraoperative Traction May Be a Viable Alternative to Anterior Surgery in Cerebral Palsy Scoliosis ≥100 Degrees
Authors: Jackson Taylor J. , Yaszay Burt , Pahys Joshua M. , Singla Anuj , Miyanji Firoz , Shah Suken A. , Sponseller Paul D. , Newton Peter O. , Flynn John M. , Cahill Patrick J. 
Published: March 2018

Background:
For large scoliosis, 2 strategies to maximize correction include intraoperative traction and/or anterior release. It is unclear which patients will benefit the most form either approach. The purpose of our study is to compare the radiographic, perioperative clinical outcomes, and health-related quality of life (HRQoL) outcomes of 2 approaches when used in severe neuromuscular scoliosis in the setting of cerebral palsy (CP).

Methods:
In total, 23 patients with minimum 2-year follow-up, major curves ≥100 degrees, and in whom treatment included posterior spinal fusion were evaluated. Eighteen were treated with posterior spinal fusion with intraoperative traction and 5 with anterior/posterior spinal fusion (APSF). The baseline characteristics, perioperative outcomes, and preoperative and 2-year follow-up data for HRQoL and radiographic measures were compared.

Results:
The groups had similar age, sex, nutritional and seizure status, GMFCS level, and change in CPCHILD scores. The groups had similar curve magnitude (120 vs. 105 degrees, P=0.330) and flexibility (28% vs. 40%, P=0.090), but the APSF group had less pelvic obliquity (POB) (24 vs. 42 degrees, P=0.009). There were similar postoperative major curves (37 vs. 40 degrees, P=0.350), but greater correction in POB (33.5 vs. 14 degrees of correction, P=0.007) in the traction group. The APSF group had longer anesthesia times (669 vs. 415 min, P=0.005), but similar hospital stays, intensive care unit and days intubated, estimated blood loss, cell saver, and red blood cells used. Although the APSF group had twice the rate of complications (22% vs. 40%) during the first 90 days postoperatively, this did not reach statistical significance.

Conclusions:
Both intraoperative traction and anterior surgery were used to aid correction in severe CP scoliosis. Anterior surgery did not offer superior correction or better HRQoL, and was associated with increased operative times, whereas intraoperative traction was associated with greater correction of POB. Intraoperative traction may be a viable alternative to an anterior release in severe CP scoliosis.

Level of Evidence:
Level II.
Management of Infected Nonunited Femoral Fracture With Large Bone Defects: A Technique
Authors: Ghaffar Khalid Abd El , Diab Ramy , Kotb Ahmed 
Published: March 2018

Background:
Segmental defects created after debridement for infected nonunion of long bones can be managed by external fixation and bone grafting, bone transport, or microvascular free-tissue flaps. Distorted local anatomy with a cumbersome Ilizarov frame, recipient site complications, thrombosis, and graft failure are possible complications of trending treatment modalities. Our 2-staged novel technique offers a simpler, easier, lesser money and time-consuming procedure to combat one of the most difficult orthopedic problems.

Patients and Methods:
Between January 2012 and January 2014, 12 patients, all were male individuals, enrolled in a prospective study underwent a 2-staged operation for infected nonunited femoral fracture with large bone defects. The first stage included radical debridement and sequestrectomy with rush pin fixation to maintain alignment and medullary patency supported by biplanar or limb reconstruction fixator; the second stage included 4 corticocancellous bone graftings. Follow-up was for a duration of a mean of 24±3.4 months; the mean duration for full union was 9.36±1.6 months. Complications included knee flexion deformity managed by flexion deformity graft and pain at site by iliac crest graft.

Conclusions:
Our method of treatment presents a new approach for management of one of the most complicated orthopedic problems ever. Our method is economic, and cost and time saving, consuming less time and materials needed for the operation.
Treatment and Spiritual Care in Mental Health
Authors: Neathery Melissa 
Published: March 2018

ABSTRACT:
Recovery in mental illness is a person-oriented process that involves self-determination/choice, and growth potential. This article discusses eight components of recovery-oriented treatment, and how nurses in any setting can facilitate recovery and encourage the healthy role of spirituality in clients' lives during the recovery process. Biblical references relating to each component of the recovery-oriented process are offered.
Authentic Leadership
Authors: Hughes Vickie 
Published: March 2018

ABSTRACT:
Integrity is a highly desired leadership trait. Authentic leaders reflect on their behavior and seek feedback about how their actions affect others. How can a nurse develop as an authentic leader who consistently demonstrates integrity? The following are discussed: Reflection; Connection to Christ and others; Social and Emotional Intelligence providing perceptive competency and social awareness; Aesthetic Qualities whereby leaders apply experiential knowing in leadership situations; and effective expression of Gratitude as a meaningful act of valuing others.
Journeys to Jamaica
Authors: Whelan Margaret , Ulrich Ethel , Ginty Joan , Walsh Denise 
Published: March 2018

ABSTRACT:
Nurse practitioner and doctor of nursing practice students gain cultural awareness and primary care experience on biannual medical mission trips to Jamaica. Faith-based Molloy College's partnership with professional medical volunteers enables students to apply clinical skills, express compassion, and gain interprofessional experience. Volunteers provide care and education for the high prevalence of noncommunicable conditions found in Jamaica. The program enjoys a positive relationship with Jamaica's Ministry of Health; a research study will assess impact on students and patients.
CLINICAL AND GENETIC CHARACTERISTICS OF MALE PATIENTS WITH RPGR-ASSOCIATED RETINAL DYSTROPHIES
Authors: Talib Mays , van Schooneveld Mary J. , Thiadens Alberta A. , Fiocco Marta , Wijnholds Jan , Florijn Ralph J. , Schalij-Delfos Nicoline E. , van Genderen Maria M. , Putter Hein , Cremers Frans P. M. , Dagnelie Gislin , ten Brink Jacoline B. , Klaver Caroline C. W. , van den Born L. Ingeborgh , Hoyng Carel B. , Bergen Arthur A. , Boon Camiel J. F. 
Published: March 2018

Purpose:
To describe the phenotype and clinical course of patients with RPGR-associated retinal dystrophies, and to identify genotype–phenotype correlations.

Methods:
A multicenter medical records review of 74 male patients with RPGR-associated retinal dystrophies.

Results:
Patients had retinitis pigmentosa (RP; n = 52; 70%), cone dystrophy (COD; n = 5; 7%), or cone-rod dystrophy (CORD; n = 17; 23%). The median follow-up time was 11.6 years (range 0–57.1). The median age at symptom onset was 5.0 years (range 0–14 years) for patients with RP and 23.0 years (range 0–60 years) for patients with COD/CORD. The probability of being blind (best-corrected visual acuity <0.05) at the age of 40 was 20% and 55% in patients with RP and COD/CORD, respectively. RPGR-ORF15 mutations were associated with high myopia (P = 0.01), which led to a faster best-corrected visual acuity decline in patients with RP (P < 0.001) and COD/CORD (P = 0.03). Patients with RP with RPGR-ORF15 mutations had a faster visual field decline (P = 0.01) and thinner central retina (P = 0.03) than patients with mutations in exon 1 to 14.

Conclusion:
Based on best-corrected visual acuity survival probabilities, the intervention window for gene therapy for RPGR-associated retinal dystrophies is relatively broad in patients with RP. RPGR-ORF15 mutations were associated with COD/CORD and with a more severe phenotype in RP. High myopia is a risk factor for faster best-corrected visual acuity decline.
LARGE UVEAL MELANOMA (≥10 MM THICKNESS)
Authors: Shields Carol L. , Sioufi Kareem , Robbins Justin S. , Barna Laura E. , Harley Maxwell R. , Lally Sara E. , Say Emil Anthony T. , Mashayekhi Arman , Shields Jerry A. 
Published: March 2018

Purpose:
To analyze the clinical features and rate of metastatic disease in eyes with large (≥10 mm thickness) uveal melanoma.

Design:
Retrospective noncomparative case series.

Participants:
There were 1,311 consecutive patients.

Methods:
Retrospective medical chart review.

Main outcome measures:
Clinical features and rate of metastatic melanoma.

Results:
Of 1,311 patients with large melanoma, the mean age was 59 years (median 60, range 6–98 years) and 95% were white. Mean tumor basal dimension was 17 mm (median 17, range 7–25 mm), and mean tumor thickness was 12 mm (median 12, range 10–24 mm). Mean distance to the foveola was 6 mm (median 6, range 0–19 mm) and to optic nerve was 6 mm (median 5, range 0–19 mm). Of all eyes, using Kaplan–Meier analysis, metastasis occurred in 11, 30, 45, and 52% at 1, 3, 5, and 7 years, respectively. According to tumor thickness (10.0–11.0, 11.1–12.0, 12.1–13.0, 13.1–14.0, 14.1–15.0, 15.1–16.0, and >16.0 mm), metastasis at 1 year was found in 7, 12, 13, 15, 18, 22, and 20%; metastasis at 3 years was 24, 27, 37, 35, 51, 69, and 57%; metastasis at 5 years was 38%, 42%, 56%, 48%, 61%, not available, and 66%; and metastasis at 7 years was 47%, 47%, 61%, 57%, 61%, not available, and 66%. Clinical features associated with fewer metastatic events included Bruch membrane rupture (7-year metastasis at 48%, P = 0.018) and macular location (7-year metastasis at 32%, P = 0.014), whereas those with worse outcome included extraocular extension (7-year metastasis at 79%, P < 0.001). There was no significant difference in rate of melanoma-related metastasis for patients treated with plaque radiotherapy versus enucleation.

Conclusion:
Large uveal melanoma demonstrates 7-year rate of metastasis at 52%, with generalized increasing risk per 1-mm or 2-mm thickness increments. Extraocular extension was associated with greater metastatic rate, whereas Bruch membrane rupture and macular location demonstrated lower rate.
Long-term Clinical Outcomes of Pars Plana Versus Anterior Chamber Placement of Glaucoma Implant Tubes
Authors: Qin Vivian L. , Kaleem Mona , Conti Felipe F. , Rockwood Edward J. , Singh Annapurna , Sood-Mendiratta Shalini , Sears Jonathan E. , Silva Fabiana Q. , Eisengart Jonathan , Singh Rishi P. 
Published: March 2018

Purpose:
To compare long-term surgical outcomes and complications of pars plana (PP) tube implantation with conventional anterior chamber (AC) tube implantation.

Materials and Methods:
Records of patients undergoing glaucoma tube implant surgery at a single institution between 2007 and 2015 were retrospectively reviewed. Eyes were matched for glaucoma diagnosis and patient age. Demographics, baseline characteristics, and treatment outcomes were recorded. Surgical success was defined as intraocular pressure (IOP) between 6 and 21 mm Hg, no subsequent glaucoma surgeries performed, and at least light perception vision.

Results:
Fifty-seven eyes that underwent Ahmed or Baerveldt glaucoma drainage device surgery with PP tube placement were compared with 57 eyes with AC tube placement. Mean follow-up was 43.5 months in the PP group and 35.3 months in the AC group (P=0.02). Forty-nine (86.0%) PP eyes and 46 (80.7%) AC eyes achieved surgical success (P=0.45). At last follow-up, mean IOP decreased from 29.0 to 15.1 mm Hg in the PP group (P<0.01) and from 32.7 to 15.6 mm Hg in the AC group (P<0.01). Mean number of medications decreased from 2.9 to 1.1 in the PP group (P<0.01) and from 2.8 to 1.3 in the AC group (P<0.01). Mean IOP and number of medications were similar between PP and AC groups at baseline, last follow-up, and all interim time points (P>0.05 for all). There were 16 complications in the PP group and 14 in the AC group (P=0.67).

Conclusions:
Long-term results of glaucoma tube implant surgery with PP versus AC implantation shows effective IOP control with similar rates of surgical success.