bluuebunny/crossref_metadata_2025_split huggingface dataset:
Aviation‐based teamwork skills work for surgeons: time for an ‘aviation bundle’?
Authors: Pal Atanu , Lal Roshan , Frizelle Frank 
Published: October 2018

BackgroundAviation systems were developed to improve safety and have achieved remarkable results. Medicine has looked to replicate these systems; however, the gap in outcomes between the two industries remains vast. Bridging this chasm requires an in‐depth analysis of the applicability of the aviation safety model in surgery. This study uses qualitative methods to explore how aviation‐based practices may be adapted and applied more effectively in theatre.MethodsData were collected using multiprofessional focus groups in a single centre. The focus groups involved discussion around teamwork and aviation‐based non‐technical skills. With consent, audio recordings were anonymized and transcribed. Qualitative (thematic) analysis was used to identify themes.ResultsFive focus groups were conducted. Eight themes emerged, with a total of 18 sub‐themes. Themes were: current practice, customization, applicability, team performance, human factors, analogy, incidents and integration of skills. Extent and limitations of the aviation surgery analogy also emerged.ConclusionsThe new insights gained through this qualitative analysis highlight the need to tailor aviation‐based practices to the operating theatre. To achieve this, we propose the ‘aviation bundle’ of non‐technical skills. This blueprint aims to promote a culture of safety and efficiency in surgical practice and could be developed into a training programme for theatre staff.
Clinical value of preoperative CA19‐9 levels in evaluating resectability of gallbladder carcinoma
Authors: Liu Fei , Wang Jun‐Ke , Ma Wen‐Jie , Yang Qin , Hu Hai‐Jie , Li Fu‐Yu 
Published: October 2018

BackgroundThis study evaluated the predictive ability of preoperative carbohydrate antigen 19‐9 (CA19‐9) level in assessing tumour resectability in patients with gallbladder carcinoma (GBC).MethodsWe retrospectively analysed preoperative serum levels of CA19‐9 in 292 patients with potentially resectable GBC between January 2000 and March 2016 in our institution. All final diagnoses were confirmed by pathological examination. The optimal cut‐off point of the CA19‐9 for predicting resectability was determined by the receiver operating characteristic curve. The univariate analysis and multivariate Cox regression model were applied to assess the relationship between the parameters to resectability.ResultsA total of 292 patients with surgical treatment were included, of whom 195 were identified as curative resection (R0 resection), 69 were classified as R1/2 resection and the remaining 28 patients were operated on with palliative surgery. The receiver operating characteristic curve analysis calculated the best CA19‐9 cut‐off point of 98.91 U/mL in the prediction of resectability. Meanwhile, the sensitivity, specificity, positive predictive value and negative predictive value were 76.3%, 70.8%, 85.7% and 56.5%, respectively. In the multivariate logistic regression analysis, CA19‐9 >98.91 U/mL (odds ratio (OR) 6.339, 95% confidence interval (CI) 3.562–11.284, P < 0.001), tumour located on hepatic side (OR 1.787, 95% CI 1.022–3.123, P = 0.042) and advanced American Joint Committee on Cancer stage (OR 2.156, 95% CI 1.180–3.940, P = 0.013) were independent determinants of resectability in patients diagnosed as GBC.ConclusionPreoperative CA19‐9 predicts resectability in patients with radiological resectable GBC. Increased preoperative CA19‐9 is related to poor resectability rate.
The Impact of Autonomy‐Framed and Control‐Framed Implementation Intentions on Snacking Behaviour: The Moderating Effect of Eating Self‐Efficacy
Authors: Churchill Susan , Pavey Louisa , Sparks Paul 
Published: October 2018

BackgroundAutonomy‐supportive implementation intention exercises have been shown to facilitate goal‐directed behaviour (Koestner et al., ). The current study explored whether eating self‐efficacy moderated the impact of autonomy‐framed versus control‐framed implementation intentions to reduce high‐calorie snack intake.MethodsThe study employed a randomised prospective design, involving two waves of data collection conducted in 2016. At Time 1, UK participants (N = 300) completed an online questionnaire which asked them to report their snacking behaviour over the previous 7 days. Participants were subsequently asked to form either an autonomy‐framed implementation intention or a control‐framed implementation intention. Seven days later, participants reported their consumption of high‐calorie snacks and completed a measure of eating self‐efficacy.ResultsHierarchical multiple regression analysis revealed that eating self‐efficacy moderated the effects of implementation intention framing. Autonomy‐framed implementation intentions had a greater impact on the avoidance of snacking for high eating self‐efficacy participants than did control‐framed implementation intentions. In contrast, for low eating self‐efficacy participants, control‐framed implementation intentions had more impact than did autonomy‐framed implementation intentions.ConclusionsThe results suggest that if implementation intentions to promote healthy diet are to be effective, the role of eating self‐efficacy should be considered, and the design of interventions adapted accordingly.
Rational targeting Cdc42 restrains Th2 cell differentiation and prevents allergic airway inflammation
Authors: Yang Jun‐Qi , Kalim Khalid W. , Li Yuan , Duan Xin , Nguyen Phuong , Khurana Hershey Gurjit K. , Kroner John , Ruff Brandy , Zhang Li , Salomonis Nathan , Rochman Mark , Wen Ting , Zheng Yi , Guo Fukun 
Published: October 2018

SummaryBackgroundAsthma is an allergic airway inflammation‐driven disease that affects more than 300 million people world‐wide. Targeted therapies for asthma are largely lacking. Although asthma symptoms can be prevented from worsening, asthma development cannot be prevented. Cdc42 GTPase has been shown to regulate actin cytoskeleton, cell proliferation and survival.ObjectivesTo investigate the role and targeting of Cdc42 in Th2 cell differentiation and Th2‐mediated allergic airway inflammation.MethodsPost‐thymic Cdc42‐deficient mice were generated by crossing Cdc42flox/flox mice with dLckicre transgenic mice in which Cre expression is driven by distal Lck promoter. Effects of post‐thymic Cdc42 deletion and pharmacological targeting Cdc42 on Th2 cell differentiation were evaluated in vitro under Th2‐polarized culture conditions. Effects of post‐thymic Cdc42 deletion and pharmacological targeting Cdc42 on allergic airway inflammation were evaluated in ovalbumin‐ and/or house dust mite‐induced mouse models of asthma.ResultsPost‐thymic deletion of Cdc42 led to reduced peripheral CD8+ T cells and attenuated Th2 cell differentiation, with no effect on closely related Th1, Th17 and induced regulatory T (iTreg) cells. Post‐thymic Cdc42 deficiency ameliorated allergic airway inflammation. The selective inhibition of Th2 cell differentiation by post‐thymic deletion of Cdc42 was recapitulated by pharmacological targeting of Cdc42 with CASIN, a Cdc42 activity‐specific chemical inhibitor. CASIN also alleviated allergic airway inflammation. CASIN‐treated Cdc42‐deficient mice showed comparable allergic airway inflammation to vehicle‐treated Cdc42‐deficient mice, indicative of negligible off‐target effect of CASIN. CASIN had no effect on established allergic airway inflammation.Conclusion and Clinical RelevanceCdc42 is required for Th2 cell differentiation and allergic airway inflammation, and rational targeting Cdc42 may serve as a preventive but not therapeutic approach for asthma control.
Prolonged hospital stay and readmission rate in an enhanced recovery after surgery cohort undergoing colorectal cancer surgery
Authors: Bennedsen A. L. B. , Eriksen J. R. , Gögenur I. 
Published: October 2018

AbstractAimThe present database study aimed to identify patients with a longer postoperative length of stay (LOS) or patients readmitted and to characterize both groups based on perioperative factors.MethodA retrospective review of the Danish Colorectal Cancer Group database and a local database was performed of all patients undergoing elective resection for colorectal cancer in a 25‐month period. The primary outcome was the number of patients with a prolonged hospital stay (LOS ≥ 10 days after the primary operation) and readmissions within 30 days after discharge.ResultsA total of 372 patients with colon resection and 215 patients with rectal resection were included. Patients undergoing colonic resection had a rate of prolonged hospital stay of 10.6% and a readmission rate of 13.7%; prolonged hospital stay was significantly associated with age ≥ 76 years and those who underwent a conversion from a laparoscopic procedure. Patients undergoing rectal cancer resection had a rate of prolonged hospital stay of 17.7% and a readmission rate of 14.0%; Charlson comorbidity score (CCS) ≥ 2, total mesorectal excision (TME) and laparoscopic conversion were significantly associated with prolonged hospital stay, and American Society of Anesthesiologists (ASA) score ≥ 3, TME and a duration of surgery ≥ 300 min were significantly associated with readmission.ConclusionIn patients with colon cancer, older age and conversion to open surgery were associated with prolonged hospital stay. In patients with rectal cancer, CCS ≥ 2, TME and conversion were associated with prolonged hospital stay, and a preoperative ASA score ≥ 3, TME and a duration of surgery ≥ 300 min were associated with readmission.
Metabolic syndrome is associated with decreased heart rate variability in a sex‐dependent manner: a comparison between 252 men and 249 women
Authors: Kangas Pauliina , Tikkakoski Antti , Uitto Marko , Viik Jari , Bouquin Heidi , Niemelä Onni , Mustonen Jukka , Pörsti Ilkka 
Published: October 2018

SummaryImpaired heart rate variability (HRV) is associated with increased risk of cardiovascular disease, but evidence regarding alterations of HRV in metabolic syndrome (MetS) remains elusive. In order to examine HRV in MetS, we subjected 501 volunteers without atherosclerosis, diabetes or antihypertensive medication, mean age 48 years, to passive head‐up tilt. The subjects were divided to control men (n = 131), men with MetS (n = 121), control women (n = 191) and women with MetS (n = 58) according to the criteria by Alberti et al. (Circulation, 2009, 120, 1640). In unadjusted analyses (i) men and women with MetS had lower total power and high‐frequency (HF) power of HRV than controls whether supine or upright (P<0·05 for all). (ii) Supine low‐frequency (LF) power of HRV was lower in men (P = 0·012) but not in women (P = 0·064) with MetS than in controls, while men and women with MetS had lower upright LF power of HRV than controls (P <0·01 for both). (iii) The LF:HF ratio did not differ between subjects with and without MetS. After adjustment for age, smoking habits, alcohol intake, height, heart rate and breathing frequency, only the differences in upright total power and HF power of HRV between women with MetS and control women remained significant (P<0·05). In conclusion, reduced total and HF power of HRV in the upright position may partially explain why the relative increase in cardiovascular risk associated with MetS is greater in women than in men. Additionally, the present results emphasize that the confounding factors must be carefully taken into consideration when evaluating HRV.
Emotion‐aware polarity lexicons for Twitter sentiment analysis
Authors: Bandhakavi Anil , Wiratunga Nirmalie , Massie Stewart , P. Deepak 
Published: October 2018

AbstractTheoretical frameworks in psychology map the relationships between emotions and sentiments. In this paper, we study the role of such mapping for computational emotion detection from text (e.g., social media) with an aim to understand the usefulness of an emotion‐rich corpus of documents (e.g., tweets) to learn polarity lexicons for sentiment analysis. We propose two different methods that leverage a corpus of emotion‐labelled tweets to learn word‐polarity lexicons. The proposed methods model the emotion corpus using a generative unigram mixture model, combined with the emotion‐sentiment mapping proposed in psychology for automated generation of word‐polarity lexicons that capture emotion‐rich vocabulary. We comparatively evaluate the quality of the proposed mixture model in learning emotion‐aware sentiment lexicons with those generated using supervised latent dirichlet allocation (sLDA) and word‐document‐frequency (WDF) statistics. Sentiment analysis experiments on benchmark Twitter data sets confirm the quality of our proposed lexicons. Further, a comparative analysis with sLDA, WDF‐based emotion‐aware lexicons, and standard sentiment lexicons that are agnostic to emotion knowledge suggests that the proposed lexicons lead to a significantly better performance in both sentiment classification and sentiment intensity prediction tasks.
Characteristics of the essential pathogenicity factor Rv1828, a MerR family transcription regulator from Mycobacterium tuberculosis
Authors: Singh Suruchi , Sevalkar Ritesh Rajesh , Sarkar Dibyendu , Karthikeyan Subramanian 
Published: October 2018

The gene Rv1828 in Mycobacterium tuberculosis is shown to be essential for the pathogen and encodes for an uncharacterized protein. In this study, we have carried out biochemical and structural characterization of Rv1828 at the molecular level to understand its mechanism of action. The Rv1828 is annotated as helix‐turn‐helix (HTH)‐type MerR family transcription regulator based on its N‐terminal amino acid sequence similarity. The MerR family protein binds to a specific DNA sequence in the spacer region between −35 and −10 elements of a promoter through its N‐terminal domain (NTD) and acts as transcriptional repressor or activator depending on the absence or presence of effector that binds to its C‐terminal domain (CTD). A characteristic feature of MerR family protein is its ability to bind to 19 ± 1 bp DNA sequence in the spacer region between −35 and −10 elements which is otherwise a suboptimal length for transcription initiation by RNA polymerase. Here, we show the Rv1828 through its NTD binds to a specific DNA sequence that exists on its own as well as in other promoter regions. Moreover, the crystal structure of CTD of Rv1828, determined by single‐wavelength anomalous diffraction method, reveals a distinctive dimerization. The biochemical and structural analysis reveals that Rv1828 specifically binds to an everted repeat through its winged‐HTH motif. Taken together, we demonstrate that the Rv1828 encodes for a MerR family transcription regulator.
Single‐stage repair of obliterated anterior urethral strictures using buccal mucosa graft and dorsal penile skin flap
Authors: Kojovic Vladimir , Djordjevic Miroslav L , Vuksanovic Aleksandar 
Published: October 2018

ObjectiveTo present a single‐stage repair of obliterative urethral strictures by simultaneous use of a buccal mucosa graft and longitudinal dorsal penile skin flap.MethodsBetween February 2007 and October 2016, 51 patients with obliterative anterior urethral stricture underwent single‐stage substitution urethroplasty. A buccal mucosa graft was harvested and fixed to the corpora cavernosa as the dorsal part of the neourethra, and a vascularized dorsal penile skin flap was created, transposed ventrally and sutured to the buccal mucosa graft to form ventral part of the neourethra.ResultsThe follow‐up period was 12–129 months (mean 49 months). The mean age of the patients was 48 years (range 15–71 years). The mean length of the obliterated urethral segment, measured during the operative procedure, was 5.2 cm. The etiology of strictures was: unknown, hypospadias and trauma in 19, 27 and five patients, respectively. Five patients were lost to follow up, and 46 patients were analyzed for the outcome. At the end of the follow‐up period, recurrence of the stricture occurred in seven (15.2%) patients, whereas 39 (84.8%) patients did not develop stricture. An additional three (6.5%) patients developed fistula, resulting in overall successful voiding in 36 (78.3%) patients.ConclusionsA combined buccal mucosa graft and longitudinal dorsal penile skin flap could be a good choice for one‐stage substitution urethroplasty in complex obliterative urethral strictures, with an acceptable complication rate.
Hypertension and diabetes mellitus are not associated with worse renal functional outcome after partial nephrectomy in patients with normal baseline kidney function
Authors: Beksac Alp Tuna , Reddy Balaji N , Martini Alberto , Paulucci David J , Moshier Erin , Abaza Ronney , Eun Daniel D , Hemal Ashok K , Badani Ketan K 
Published: October 2018

ObjectiveTo analyze the association of hypertension and/or diabetes mellitus on renal function after partial nephrectomy in patients with normal baseline kidney function.MethodsWe identified 453 patients with baseline estimated glomerular filtration rate ≥60 that underwent robotic partial nephrectomy for a cT1 renal mass from 2008 to 2014 using a multi‐institutional database. The association between estimated glomerular filtration rate and time (pre‐partial nephrectomy to 24 months post‐partial nephrectomy) was compared between 269 (59.4%) patients with preoperative hypertension and/or diabetes mellitus and 184 (40.6%) patients with neither hypertension nor diabetes mellitus using a multivariable model adjusting for confounders.ResultsThe estimated glomerular filtration rate significantly decreased over time for both groups compared with baseline (average units/month: 1.8974 hypertension/diabetes mellitus, 1.2163 no hypertension/diabetes mellitus; P < 0.0001), and the estimated glomerular filtration rate decrease per month reduced over time (P < 0.0001). The estimated glomerular filtration rate began to increase at approximately 12 months for the hypertension/diabetes mellitus group, and at approximately 18 months for the no hypertension/diabetes mellitus group. Although a greater initial decline in the estimated glomerular filtration rate after partial nephrectomy was observed for the hypertension/diabetes mellitus group (0.68 units/month), this was not statistically significant (P = 0.0842); and while the rate of recovery from this decline was faster for the hypertension/diabetes mellitus group, this also was not statistically significant (P = 0.0653). The predicted estimated glomerular filtration rate was similar (83 mL/min/1.73 m2) for both groups 24 months after partial nephrectomy.ConclusionsThere seems to be no significant association between hypertension, diabetes mellitus and renal functional outcome after partial nephrectomy in patients with normal baseline glomerular filtration rate. Renal function declines after partial nephrectomy, but then it recovers, irrespective of the presence of hypertension or diabetes mellitus.
Uncertainty and Fiscal Cliffs
Authors: DAVIG TROY , FOERSTER ANDREW 
Published: October 2018

AbstractLarge pending fiscal policy changes, such as in the United States in 2012 or in Japan with consumption taxes, often generate considerable uncertainty. “Fiscal cliff” episodes have several features: an announced possible future change, a skewed set of possible outcomes, the possibility that implementation may not actually occur, and a known resolution date. This paper develops a model capturing these features and studies their impact. Fiscal cliff uncertainty shocks have immediate impact, with a magnitude that depends on the probability of implementation, which generates economic volatility. The possibility of fiscal cliffs lowers economic activity even in periods of relative certainty.
Hypoxia‐mediated alteration in cholesterol oxidation and raft dynamics regulates BDNF signalling and neurodegeneration in hippocampus
Authors: Sharma Deepti , Barhwal Kalpana Kumari , Biswal Surya Narayan , Srivastava Anup Kumar , Bhardwaj Pushpendar , Kumar Ashish , Chaurasia Om Prakash , Hota Sunil Kumar 
Published: October 2018

AbstractBrain‐derived neurotrophic factor (BDNF) which is primarily associated with neuronal survivability, differentiation and synaptic plasticity has been reported to mediate neurodegeneration in hypoxia through its p75 Neurotrophin receptors (p75NTR). The molecular events promoting BDNF‐mediated pro‐death signalling in hypoxia, however, still remain an enigma. This study attempts towards deciphering the signalling cascades involved in alteration of BDNF isoforms and its cognate receptor subtypes leading to neurodegeneration in hypoxia. Adult Sprague–Dawley rats were exposed to global hypobaric hypoxia simulating an altitude of 7620 m at standard temperature and humidity. Chronic hypoxic exposure for 7 days resulted in higher expression of pro‐BDNF and alteration in N‐linked glycosylation in hippocampus along with increased expression of endoplasmic reticulum stress markers viz., glucose‐regulated protein (Grp78), calnexin and changes in the endoplasmic reticulum morphology. Our findings reveal enriched expression of p75NTR in lipid rafts and higher expression of tyrosine receptor kinase β (Trkβ) in non‐raft regions following hypoxic exposure. Further investigations on membrane properties revealed decline in membrane fluidity along with increased cholesterol oxidation resulting in reduced translocation of Trkβ from non‐raft to raft regions. Supplementation of vitamin E during hypoxic exposure on the other hand reduced cholesterol oxidation and increased translocation of Trkβ from non‐raft to raft regions and promoted neuronal survival. Hence, our findings suggest a novel mechanism of cholesterol oxidation‐induced alteration in raft dynamics which is promotes p75 receptor‐mediated death signalling in hippocampal neurons during chronic hypoxia.
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Sticky Expectations and the Profitability Anomaly
Authors: BOUCHAUD JEAN‐PHILIPPE , KRÜGER PHILIPP , LANDIER AUGUSTIN , THESMAR DAVID 
Published: October 2018

ABSTRACTWe propose a theory of the “profitability” anomaly. In our model, investors forecast future profits using a signal and sticky belief dynamics. In this model, past profits forecast future returns (the profitability anomaly). Using analyst forecast data, we measure expectation stickiness at the firm level and find strong support for three additional model predictions: (1) analysts are on average too pessimistic regarding the future profits of high‐profit firms, (2) the profitability anomaly is stronger for stocks that are followed by stickier analysts, and (3) the profitability anomaly is stronger for stocks with more persistent profits.
Correlates of Patient‐Centered Medical Home Recognition in School‐Based Health Centers
Authors: Gregg Abbey , Chen Li‐Wu , Kim Jungyoon 
Published: October 2018

ABSTRACTBACKGROUNDThe patient‐centered medical home (PCMH) is promoted as a way to improve access to care, health care outcomes, and control costs. The organizational, environmental, and patient characteristics associated with school‐based health centers (SBHCs) obtaining PCMH recognition is currently unknown. A multitheoretical approach was used to explore the correlates of formal PCMH recognition in SBHCs.METHODSThe 2013‐2014 National Census of School‐Based Health Centers was used as the primary data source for this analysis. Multivariable logistic regression was used to assess the odds of an SBHC obtaining any type of PCMH recognition, and obtaining national PCMH recognition.RESULTSOnly 29% of SBHCs had received any type of recognition as a PCMH and 17% reported receiving national‐level recognition. School‐based health centers that were managed care preferred providers, received Health Resources and Services Administration SBHC Capital Funding, and based in schools without adolescents had greater odds of both types of PCMH recognition outcomes. High levels of revenue from patient billing and more staff were also associated with national PCMH recognition.CONCLUSIONSFinancial and personnel resources are needed for national‐level PCMH recognition, and managed care is supportive of PCMH implementation. Efforts should be made to increase medical home activity in SBHCs that serve adolescents.