bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluating habitat, prey, and mesopredator associations in a community of marine birds
Authors: Goyert Holly F , Gardner Beth , Veit Richard R , Gilbert Andrew T , Connelly Emily , Duron Melissa , Johnson Sarah , Williams Kathryn 
Published: February 2018

Abstract
Offshore wind energy development on the US Atlantic Continental Shelf has brought attention to the need for marine spatial planning efforts to reduce potential conflict between wind turbines and marine animals, including seabirds. We evaluated the effects of marine mammals, fishes, and habitat characteristics on the distribution and relative abundance of marine birds off the coast of Delaware, Maryland, and Virginia. From May 2012 to 2014, we collected line transect data from 14 shipboard surveys, and novel high-resolution digital videography data from 14 aerial surveys. We compiled five habitat covariates: three static (distance to shore, sea floor slope, and sediment grain size), and two dynamic (sea surface temperature, salinity). We additionally analysed two seabird community covariates: the density of observed marine mammals and detected fish. Using zero-altered models, we tested our hypothesis that plunge-diving seabird species would show positive associations with marine mammals. Our results provide statistical evidence that, alongside competition, facilitative interactions occur among pelagic communities, where subsurface predators improve the detectability and accessibility of prey to surface-feeding seabirds. This study highlights the importance of quantifying community and ecological influences on avian abundance, particularly in predicting the potential exposure of marine birds and mammals to offshore development.
NGC628 with SITELLE: I. Imaging spectroscopy of 4285 H ii region candidates
Authors: Rousseau-Nepton L , Robert C , Martin R P , Drissen L , Martin T 
Published: February 2018

Abstract
This is the first paper of a series dedicated to nebular physics and the chemical evolution of nearby galaxies by investigating large samples of H ii regions with the Canada–France–Hawaii Telescope imaging spectrograph SITELLE (Spectro-Imageur à Transformée de Fourier pour l’Étude en Long et en Large des raies d’Émission). We present a technique adapted to imaging spectroscopy to identify and extract parameters from 4285 H ii region candidates found in the disc of NGC 628. Using both the spatial and spectral capabilities of SITELLE, our technique enables the extraction of the position, dust extinction, velocity, H α profile, diffuse ionized gas (DIG) background, luminosity, size, morphological type, and the emission-line fluxes for individual spaxels and the integrated spectrum for each region. We have produced a well-sampled H ii region luminosity function and studied its variation with galactocentric radius and level of the DIG background. We found a slope α of −1.12 ± 0.03 with no evidence of a break at high luminosity. Based on the width of the region profile, bright regions are rather compact, while faint regions are seen over a wide range of sizes. The radius function reveals a slope of −1.81 ± 0.02. BPT diagrams of the individual spaxels and integrated line ratios confirm that most detections are H ii regions. Also, maps of the line ratios show complex variations of the ionization conditions within H ii regions. All this information is compiled in a new catalogue for H ii regions. The objective of this data base is to provide a complete sample which will be used to study the whole parameter space covered by the physical conditions in active star-forming regions.
Web-Enabled Mechanistic Case Diagramming: A Novel Tool for Assessing Students’ Ability to Integrate Foundational and Clinical Sciences
Authors: Ferguson Kristi J. , Kreiter Clarence D. , Haugen Thomas H. , Dee Fred R. 
Published: February 2018

Problem
As medical schools move from discipline-based courses to more integrated approaches, identifying assessment tools that parallel this change is an important goal.

Approach
The authors describe the use of test item statistics to assess the reliability and validity of web-enabled mechanistic case diagrams (MCDs) as a potential tool to assess students’ ability to integrate basic science and clinical information. Students review a narrative clinical case and construct an MCD using items provided by the case author. Students identify the relationships among underlying risk factors, etiology, pathogenesis and pathophysiology, and the patients’ signs and symptoms. They receive one point for each correctly identified link.

Outcomes
In 2014–2015 and 2015–2016, case diagrams were implemented in consecutive classes of 150 medical students. The alpha reliability coefficient for the overall score, constructed using each student’s mean proportion correct across all cases, was 0.82. Discrimination indices for each of the case scores with the overall score ranged from 0.23 to 0.51. In a G study using those students with complete data (n = 251) on all 16 cases, 10% of the variance was true score variance, and systematic case variance was large. Using 16 cases generated a G coefficient (relative score reliability) equal to 0.72 and a Phi equal to 0.65.

Next Steps
The next phase of the project will involve deploying MCDs in higher-stakes settings to determine whether similar results can be achieved. Further analyses will determine whether these assessments correlate with other measures of higher-order thinking skills.
Hospitalized Patients With and Without Hemodialysis Have Markedly Different Vancomycin Pharmacokinetics: A Population Pharmacokinetic Model-Based Analysis
Authors: Goti Vineet , Chaturvedula Ayyappa , Fossler Michael J. , Mok Steve , Jacob Jesse T. 
Published: February 2018

Background:
Despite being in clinical use for about 6 decades, vancomycin dosing remains perplexing and complex.

Methods:
A population pharmacokinetic modeling and simulation approach was used to evaluate the efficiency of the current nomogram-based dosing of vancomycin. Serum vancomycin concentrations were obtained as a part of routine therapeutic drug monitoring from two 500-bed academic medical centers. A population pharmacokinetic model was first built using these therapeutic drug monitoring data. Population pharmacokinetic modeling was conducted using NONMEM (7.2 and 7.3). The forward addition–backward elimination approach was used to test the covariate effects. Appropriate numerical and visual criteria were used as model diagnostics for checking model appropriateness and model qualification. The current nomogram efficiency was evaluated by determining the percentage of subjects in the therapeutic range (10–20 mg/L).

Results:
A 2-compartment model with between-subject variability on clearance (CL), central volume of distribution (Vc), and peripheral volume of distribution best fit the data. Blood urea nitrogen, age, creatinine clearance, and hemodialysis status were significant covariates on clearance. Hemodialysis status was a significant covariate on Vc and peripheral volume of distribution. In the final model, creatinine clearance was retained as a covariate on CL whereas hemodialysis status was retained as covariate on both CL and Vc. Using Monte Carlo simulations, the current nomogram was optimized by the addition of a loading dose and reducing the maintenance doses. The current nomogram is suboptimal. Optimization of the nomogram resulted in >40% subjects consistently being in the therapeutic range at troughs collected after the first 6 doses.

Conclusions:
CL and Vc differ markedly between patients undergoing hemodialysis and those not undergoing hemodialysis. Dosing nomogram based on these covariate relationships may potentially help in accurate dosing of vancomycin.
Neoadjuvant chemotherapy and the complexity of operative procedure in advanced epithelial ovarian cancer: a retrospective analysis
Authors: Refky Basel , Elalfy Amr , Nabil Hanan , El-Emam Doaa , Abdelwahab Khaled M. , Malik Eduard , Soliman Amr A. 
Published: February 2018

Introduction:
Complete tumor resection for epithelial ovarian cancer (EOC) generally incorporates complex surgical maneuvers, especially bowel resection. This study retrospectively analyzed the impact of neoadjuvant chemotherapy (NAC) on complexity of surgical procedures for EOC (represented by bowel resection) and postoperative morbidity.

Methods:
We retrospectively recruited all patients with Fédération Internationale de Gynécologie et d'Obstétrique (FIGO) stages IIIC–IVB EOC who were treated in our center between 2011 and 2016. Patients were divided into those who received primary debulking followed by chemotherapy (group A), and those who received NAC followed by interval debulking (group B). Patient age, tumor stage, grade, dates of commencement and completion of therapy, intraoperative events, completion of surgical resection, and postoperative events were evaluated.

Results:
Of 92 patients, 42 were assigned to group A and 50 to group B. Their FIGO stages were group A—stages IIIC: 34 (80.9%), IVA: 6 (14.3%), and IVB: 2 (4.8%); and group B—stages IIIC: 45 (90%), IVA: 5 (10%), and IVB: 0 (0%). The 2 groups did not significantly differ in completeness of surgical cytoreduction or rates of bowel resection, intraoperative complications, or postoperative morbidities.

Conclusion:
NAC did not reduce rates of bowel resection, intraoperative complications, and postoperative morbidity in advanced EOC compared with primary surgical cytoreduction. Future prospective studies will be required to corroborate our results.
Dihydrotestosterone and cancer risk
Authors: Chan Yi X. , Yeap Bu B. 
Published: February 2018

Purpose of reviewAndrogens have been implicated in prostate growth; however, the role of androgens in prostate cancer development is not clear. Furthermore, studies suggest a role for androgens in female-hormone-dependent cancers and common nonhormone dependent cancers. This study aims to review key studies and more recent studies of dihydrotestosterone (DHT) and cancer risk.Recent findingsEpidemiological studies are reassuring as they have not associated endogenous androgens with prostate cancer risk. Intraprostatic regulation of DHT is becoming recognized as an important area of research to clarify the role of DHT in prostate cancer development. In females, further understanding of intracrine regulation of sex hormones and interactions between androgens and estrogens in influencing breast and endometrial cancer risk are required. Studies show a signal for DHT in modulating lung and colorectal cancer growth; however, research in this area is relatively scarce and further studies are required to clarify these associations.SummaryAlthough concerns of prostate cancer risk remain, there is also potential for androgens to modulate the growth and development of other common cancers. Further research is required as this may have clinical implications.
Digested Early Preterm Human Milk Suppresses Tumor Necrosis Factor–induced Inflammation and Cytotoxicity in Intestinal Epithelial Cells
Authors: Chen Yimin , Patel Aloka , Meier Paula P. , Fantuzzi Giamila 
Published: February 2018

ABSTRACTObjectives:The aim of this study was to determine the effect of digested whole human milk (HM; first sample available after birth from mothers of premature infants) on inflammation, oxidative stress, and cytotoxicity in Caco‐2 human intestinal epithelial cells stimulated with lipopolysaccharides or tumor necrosis factor (TNF) to mimic the potential in vivo insults facing the premature infant's gastrointestinal tract.Methods:Fully differentiated Caco‐2 cells were exposed to digested HM (n = 10; samples from 10 different individuals) before stimulation with lipopolysaccharides, TNF, or no stimulation overnight. Inflammation was determined by production of interleukin‐8, oxidative stress by levels of F2‐isoprostane, and cytotoxicity by released lactate dehydrogenase.Results:HM significantly suppressed interleukin‐8 production and cytotoxicity in TNF‐stimulated cells, while also suppressing cell death under baseline conditions. Individual HM samples differed widely in their ability to modulate cellular responses.Conclusions:Results from this study provide evidence that digested HM can reduce both an exaggerated inflammatory response and intestinal damage that contribute to the pathogenesis of necrotizing enterocolitis.
Competitively Selected Donor Fecal Microbiota Transplantation
Authors: Barnes Danielle , Ng Katharine , Smits Sam , Sonnenburg Justin , Kassam Zain , Park K.T. 
Published: February 2018

ABSTRACTIn this prospective cohort study, we examine the feasibility of a protocol to optimize microbiota for fecal microbiota transplantation (FMT). Donor stool metrics generally accepted as markers of gut health were used to select a stool donor based on superior microbial diversity, balanced constitution of Bacteroidetes versus Firmicutes and high concentration of fecal butyrate. Selected donor microbiota was then administered via FMT. A total of 10 patients with median age of 12 years with recurrent Clostridium difficile infection received the intervention. The rate of recurrence‐free resolution with 1‐2 FMTs was 100% at Week 10. With a single FMT, 80% of patients cleared Clostridium difficile infection without recurrence, whereas 20% of patients required a single re‐treatment. No serious adverse events occurred. Microbiota sequencing revealed that recipients’ gut microbiota phylogenic diversity increased by 72‐hours post‐transplantation, with sustainment over 10‐week follow‐up. This study highlights the feasibility of purposefully selecting the most ideal microbiota for transplantation.
Pregnancy after Solid Organ Transplantation
Authors: Kurz Jane M. 
Published: February 2018

Abstract

Purpose:
To explore the reproductive decision-making process with women who were organ transplant recipients (renal, lung, & heart transplants).

Study Design and Methods:
Grounded theory guided data collection and analyses. Mixed methods with audiotaped telephone interviews and a written survey measuring social support were used. As social support is critical for women who are organ transplant recipients considering pregnancy, a search for disconfirming evidence for social support via a survey and interviews was included.

Analyses:
Verbatim responses were analyzed through the constant comparative method using open, axial, and selective coding. Trustworthiness was established through prolonged engagement, member checking, and thick descriptions.

Results:
Participants included 10 women who were solid organ recipients (2 lung, 1 heart, and 7 renal transplant recipients). The core theme was Wanting a child. Other themes included Getting information, Advocating, Dealing with problems, Preparing, Talking, Supporting, Coping, and Advising
others. There was no evidence of a lack of social support as evaluated via the survey or interviews.

Clinical Implications:
This study provides new knowledge on clinical decision-making about pregnancy for women who are solid organ recipients and for healthcare professionals. Nurses can use these data to help guide women on how to obtain the most accurate information to make a personal decision about pregnancy and to develop support from their healthcare team and family.
Facilitating Early Breast Milk Expression in Mothers of Very Low Birth Weight Infants
Authors: Parker Leslie Ann , Hoffman Jacqueline , Darcy-Mahoney Ashley 
Published: February 2018

Abstract

Background:
Although early initiation of human milk (HM) expression after birth is known to increase lactation success in mothers of very low birthweight (VLBW) infants, initiation is frequently delayed, potentially decreasing both short- and long-term HM production. Obstetrical (OB) nurses are typically the healthcare provider responsible for facilitating the initial HM expression session. As delays in initiation are common, it is likely that nurses experience obstacles to facilitation of an early initiation of HM expression. The purpose of this study was to determine barriers OB nurses perceive in facilitating early initiation of HM expression in mothers of VLBW infants.

Study Design and Methods:
An online survey was administered to nurses from three tertiary care OB units in Florida to determine perceived barriers to early initiation of HM expression in mothers of VLBW infants.

Results:
Eighty-three nurses completed the survey. The following barriers were identified: (1) lack of time and personnel to assist mothers with HM expression, (2) nurse's perception of the mother's acuity level, and (3) nurse's perception of maternal pain and stress. Discrepancies between nursing judgment, action, and knowledge of unit policies were evident.

Clinical Implications:
Obstetric nurses encounter barriers when facilitating early HM expression in mothers giving birth to VLBW infants. It is possible these barriers could be removed through improvements in education, use of innovative staffing strategies, and maintenance of evidence-based policies.
The Business, Ethics, and Quality Cases for Consumer Engagement in Nursing
Authors: Hassmiller Susan , Bilazarian Ani 
Published: February 2018

OBJECTIVE
The aims of this study were to illustrate the quality, safety, cost-effectiveness, and ethics of consumer engagement initiatives and identify promising practices and leadership strategies used by nursing leaders.

METHODS
A literature review was performed with supplementary interviews conducted with 25 key nursing informants including nursing executives and chief nursing officers at acute care hospitals, community health centers, policy institutions, and quality and safety organizations. A narrative synthesis approach was used to identify and compare existing measures of consumer engagement and compassionate care in acute care settings. One-hour semistructured interviews were performed, and information was gathered by notes and audio recordings.

RESULTS
Consumer engagement activities focusing on compassionate patient and provider interactions involving patients and family as partners on the care team are associated with increases in treatment savings and patient safety in terms of length of stay and reduced medication errors. Engagement initiatives support employee health and reduce compassion fatigue.

CONCLUSION
Findings illustrate the impact of patients and family engagement in decision making and promising organizational practices that reinforce engagement.
Old Pathogen, New Challenges: A Narrative Review of the Multilevel Drivers of Syphilis Increasing in American Men Who Have Sex With Men
Authors: Mayer Kenneth H. 
Published: February 2018

Abstract
Since the turn of the current century, syphilis incidence and prevalence have been increasing more rapidly among men who have sex with men (MSM) than any other US subpopulation, exceeding their previously high rates in the 1970s and 1980s, before the AIDS epidemic. The reasons for these trends are multifactorial and complex, involving individual behavioral, sociocultural, structural, and biological factors, which will be reviewed in this article. Men who have sex with men tend to have more sexual partners than heterosexuals, and engage in practices (e.g., anal sex) that are highly efficient for syphilis transmission and nondetection of primary chancres. In the era of highly active antiretroviral therapy rendering adherent patients noninfectious and the use of preexposure prophylaxis, there is substantially less concern about HIV transmission and acquisition among MSM, resulting in higher levels of condomless sex. The increased concentration of syphilis among black MSM is partially related to assortative mixing, that is, black MSM being more likely to have other black sex partners, as well as decreased access to preventive services and treatment due to economic marginalization, Societal rejection and discrimination may also potentiate factors that may increase sexual risks resulting in syphilis, for example, depression and substance use. The anticipation of experiencing homophobic discrimination in health care settings may lead many sexually active MSM to delay needed screening and treatment, thus being infectious to partners for longer periods than other populations. To effectively control the syphilis epidemic among MSM, scaling up a combination of programs, ranging from enhanced community education to training clinicians and health care systems to provide culturally competent care, will be necessary.
Near-Infrared Cerebral Oximetry to Predict Outcome After Pediatric Cardiac Surgery: A Prospective Observational Study*
Authors: Flechet Marine , Güiza Fabian , Vlasselaers Dirk , Desmet Lars , Lamote Stoffel , Delrue Heidi , Beckers Marc , Casaer Michaël P. , Wouters Pieter , Van den Berghe Greet , Meyfroidt Geert 
Published: February 2018

Objectives:
To assess whether near-infrared cerebral tissue oxygen saturation, measured with the FORESIGHT cerebral oximeter (CAS Medical Systems, Branford, CT) predicts PICU length of stay, duration of invasive mechanical ventilation, and mortality in critically ill children after pediatric cardiac surgery.

Design:
Single-center prospective, observational study.

Setting:
Twelve-bed PICU of a tertiary academic hospital.

Patients:
Critically ill children and infants with congenital heart disease, younger than 12 years old, admitted to the PICU between October 2012 and November 2015. Children were monitored with the FORESIGHT cerebral oximeter from PICU admission until they were weaned off mechanical ventilation. Clinicians were blinded to cerebral tissue oxygen saturation data.

Interventions:
None.

Measurements and Main Results:
Primary outcome was the predictive value of the first 24 hours of postoperative cerebral tissue oxygen saturation for duration of PICU stay (median [95% CI], 4 d [3–8 d]) and duration of mechanical ventilation (median [95% CI], 111.3 hr (69.3–190.4 hr]). We calculated predictors on the first 24 hours of cerebral tissue oxygen saturation monitoring. The association of each individual cerebral tissue oxygen saturation predictor and of a combination of predictors were assessed using univariable and multivariable bootstrap analyses, adjusting for age, weight, gender, Pediatric Index of Mortality 2, Risk Adjustment in Congenital Heart Surgery 1, cyanotic heart defect, and time prior to cerebral tissue oxygen saturation monitoring. The most important risk factors associated with worst outcomes were an increased sd of a smoothed cerebral tissue oxygen saturation signal and an elevated cerebral tissue oxygen saturation desaturation score.

Conclusions:
Increased sd of a smoothed cerebral tissue oxygen saturation signal and increased depth and duration of desaturation below the 50% saturation threshold were associated with longer PICU and hospital stays and with longer duration of mechanical ventilation after pediatric cardiac surgery.
Small Lymph Node Metastasis Detected by 68Ga–Prostate-Specific Membrane Antigen But Not 18F-Fluciclovine PET/CT in Low–Prostate-Specific Antigen Biochemical Recurrence of Prostate Cancer
Authors: Chaussé Guillaume , Abikhzer Gad , Probst Stephan 
Published: February 2018

Abstract
A 58-year-old man with Gleason 4+3 prostate cancer was initially treated by radical prostatectomy followed by salvage radiotherapy to the prostate bed for postoperative biochemical failure. One year later, 18F-fluorocholine PET/CT detected a pelvic lymph node recurrence, which was treated with radiation therapy and 6 months of androgen deprivation. PSA started to rise again 18 months later, but 18F-fluciclovine PET/CT failed to demonstrate the site of recurrence at a PSA of 0.63 ng/mL. However, 68Ga-PSMA PET/CT revealed a single positive 4-mm perirectal lymph node (PSA 0.80 ng/mL at time of scan), in retrospect anatomically apparent but negative on 18F-fluciclovine PET/CT.