bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cultural Prototypes and Differences in Simulation Debriefing
Authors: Ulmer Francis F. , Sharara-Chami Rana , Lakissian Zavi , Stocker Martin , Scott Ella , Dieckmann Peter 
Published: April 2018

Introduction
Culture is believed to play a role in education, safety, and patient outcome in healthcare. Hofstede’s culture analysis permits a quantitative comparison between countries, along different culture dimensions, including power distance (PD). Power distance index (PDI) is a value reflecting social hierarchy in a country. We sought to explore the relation between PDI and self-reported behavior patterns of debriefers during simulation debriefings. We determined six culture-relevant debriefing characteristics and formulated six hypotheses on how these characteristics correlate with national PDIs.

Methods
Low-PDI countries have a PDI of 50 or less, and high-PDI countries have a PDI of 51 or greater as defined by Hofstede. Interviews with simulation debriefers were used to investigate culture-relevant debriefing characteristics: debriefer/participant talking time, debriefer/participant interaction pattern, debriefer/participant interaction style, debriefer/participant initiative for interactions, debriefing content, and difficulty with which nontechnical skills can be discussed.

Results
During debriefing, in low-PDI countries, debriefers talked less and used more open-ended questions and focused more on nontechnical issues than on medical knowledge and simulation participants initiated most interactions. In low-PDI countries, debriefers felt that participants interacted more with each other and found it easier to address nontechnical skills such as speaking-up.

Conclusions
Our results supported our hypotheses. National culture is related to debriefing practice. There is a clear relation between PDI and debriefer-participant behavior patterns as described by debriefers. The higher the PDI of a country, the more the debriefer determines the course of the debriefing and the more difficult it becomes to address nontechnical skills.
Prospective evaluation of low health literacy and its impact on outcomes in trauma patients
Authors: Swartz Tianyi , Jehan Faisal , Tang Andrew , Gries Lynn , Zeeshan Muhammad , Kulvatunyou Narong , Hamidi Mohammad , O’Keeffe Terence , Joseph Bellal 
Published: April 2018

BACKGROUND
Health literacy is an emerging focus of interest in public health and is evolving as an important component of national health policy. Low health literacy (LHL) is associated with poor outcomes. We aimed to identify factors associated with LHL and its relationship with health outcomes in trauma patients.

METHODS
We prospectively enrolled all adult trauma patients (age, > 18 years) in our analysis. Patients were surveyed at discharge and followed up at 4 weeks postdischarge. At discharge, patient’s health literacy was assessed using the Short-Assessment of Health Literacy score. Low health literacy was defined as Short-Assessment of Health Literacy score less than 14. Patients were surveyed regarding their understanding of their injuries, treatment received, discharge instructions, and interaction with the physician. Four weeks postdischarge, all patients were inquired about clinic follow-up details and recovery.

RESULTS
We enrolled 140 patients, of which 70% were white. Mean age was 45 ± 20 years, and median Injury Severity Score was 10 (6–12). Overall, 24% (34) patients had LHL. There was no difference in the Injury Severity Score between LHL and health literate (HL) patients (p = 0.41). The LHL patients were more likely to be Hispanic-white (78% vs. 41%, p = 0.02), had lower socioeconomic status (91% vs. 51%, p = 0.01), uninsured (45% vs. 18%, p = 0.01), and were less likely to have graduated (0% vs. 49%, p = 0.01) compared with the HL patients. At discharge, both groups were satisfied with the time spent by a physician to explain the condition, however, the LHL patients were less likely to recall their injuries (p = 0.03) or how they were treated (p = 0.01). Patients with LHL had lower follow-up rates (p = 0.01) with no difference in the readmission rate (p = 0.71) compared with HL.

CONCLUSION
Every 1 in 4 trauma patients have LHL. Low health literacy is associated with poor understanding of injuries and treatment provided to them, leading to a decrease in compliance with discharge instructions and longer time to recovery. Identifying LHL in high-risk patients and developing appropriate intervention before discharge may help improve outcomes.

LEVEL OF EVIDENCE
Prognostic study, level I.
Meta-analysis of perioperative outcomes of acute laparoscopic versus open repair of perforated gastroduodenal ulcers
Authors: Cirocchi Roberto , Soreide Kjetil , Di Saverio Salomone , Rossi Elena , Arezzo Alberto , Zago Mauro , Abraha Iosief , Vettoretto Nereo , Chiarugi Massimo 
Published: April 2018

BACKGROUND
Surgery is the treatment of choice for perforated peptic ulcer disease. The aim of the present review was to compare the perioperative outcomes of acute laparoscopic versus open repair for peptic ulcer disease.

METHODS
A systematic literature search was performed for randomized controlled trials (RCTs) published in PubMed, SCOPUS, and Web of Science.

RESULTS
The search included eight RCTs: 615 patients comparing laparoscopic (307 patients) versus open peptic perforated ulcer repair (308 patients). Only few studies reported the Boey score, the Acute Physiologic Assessment and Chronic Health Evaluation score, and the Mannheim Peritonitis Index. In the RCTs, there is a significant heterogeneity about the gastric or duodenal location of peptic ulcer and perforation size. All trials were with high risk of bias. This meta-analysis reported a significant advantage of laparoscopic repair only for postoperative pain in first 24 hours (−2.08; 95% confidence interval, −2.79 to −1.37) and for postoperative wound infection (risk ratio, 0.39; 95% confidence interval, 0.23–0.66). An equivalence of the other clinical outcomes (postoperative mortality rate, overall reoperation rate, overall leaks of the suture repair, intra-abdominal abscess rate, operative time of postoperative hospital stay, nasogastric aspiration time, and time to return to oral diet) was reported.

CONCLUSION
In this meta-analysis, there were no significant differences in most of the clinical outcomes between the two groups; there was less early postoperative pain and fewer wound infections after laparoscopic repair. The reported equivalence of clinical outcomes is an important finding. These results parallel the results of several other comparisons of open versus laparoscopic general surgery operations—equally efficacious with lower rates of wound infection and improvement in some measures of enhanced speed or comfort in recovery. Notably, the trials included have been published throughout a considerable time span during which several changes have occurred in most health care systems, not least a widespread use of laparoscopy and increase in the laparoscopic skills.

LEVEL OF EVIDENCE
Systematic review and meta-analysis, level III.
Evaluation and management of abdominal stab wounds: A Western Trauma Association critical decisions algorithm
Authors: Martin Matthew J. , Brown Carlos V.R. , Shatz David V. , Alam Hasan B. , Brasel Karen J. , Hauser Carl J. , de Moya Marc , Moore Ernest E. , Rowell Susan E. , Vercruysse Gary A. , Baron Bonny J. , Inaba Kenji 
Published: April 2018

ABSTRACT
This is a recommended management algorithm from the Western Trauma Association addressing the management of adult patients with abdominal stab wounds. Because there is a paucity of published prospective randomized clinical trials that have generated Class I data, these recommendations are based primarily on published observational studies and expert opinion of Western Trauma Association members. The algorithm and accompanying comments represent a safe and sensible approach that can be followed at most trauma centers. We recognize that there will be patient, personnel, institutional, and situational factors that may warrant or require deviation from the recommended algorithm. We encourage institutions to use this as a guideline to develop their own local protocols.
Frailty screening and a frailty pathway decrease length of stay, loss of independence, and 30-day readmission rates in frail geriatric trauma and emergency general surgery patients
Authors: Engelhardt Kathryn E. , Reuter Quentin , Liu Jessica , Bean Jonathan F. , Barnum Joliette , Shapiro Michael B. , Ambre Allison , Dunbar Amanda , Markzon Mara , Reddy Tara N. , Schilling Christine , Posluszny Joseph A. 
Published: April 2018

BACKGROUND
Frail geriatric trauma and emergency general surgery (TEGS) patients have longer lengths of stay (LOS), more readmissions, and higher rates of postdischarge institutionalization than their nonfrail counterparts. Despite calls to action by national trauma coalitions, there are few published reports of prospective interventions. The objective of this quality improvement project was to first develop a frailty screening program, and, then, if frail, implement a novel frailty pathway to reduce LOS, 30-day readmissions, and loss of independence.

METHODS
This was a before-after study of a prospective cohort of all geriatric (≥65-years-old) patients admitted to the TEGS service from October 2016 to October 2017. All patients were screened for frailty for 3 months (preintervention) to obtain baseline outcomes. Subsequently, frail patients were entered into our frailty pathway (postintervention). Nonparametric statistical tests were used to assess significant differences in continuous variables; χ2 and Fisher exact tests were used for categorical variables, where appropriate. Both process and outcome measures were evaluated.

RESULTS
Of 239 geriatric TEGS patients screened, 70 (29.3%) were frail. All TEGS geriatric patients were screened within 24 hours of admission. Following frailty pathway implementation, median LOS for frail patients decreased from 9 to 6 days (p = 0.4), readmissions decreased from 36.4% to 10.2% (p = 0.04), and loss of independence decreased by 40%, (100% vs 60%; p = 0.01). Outcomes for nonfrail geriatric patients did not differ between cohorts.

CONCLUSIONS
Screening for frailty followed by implementing a frailty pathway decreased LOS, loss of independence, and 30-day readmission rates for frail geriatric TEGS patients at a single urban academic institution. The pathway required no additional resources; rather, we shifted focus toward frail patients without negatively affecting outcomes in nonfrail geriatric TEGS patients. Implementation of this pathway with larger patient cohorts and in varied settings is needed to confirm a causal relationship between our intervention and improved outcomes.

LEVEL OF EVIDENCE
Therapeutic study, level IV.
External validation of a five-variable clinical prediction rule for identifying children at very low risk for intra-abdominal injury after blunt abdominal trauma
Authors: Arbra Chase A. , Vogel Adam M. , Plumblee Leah , Zhang Jingwen , Mauldin Patrick D. , Dassinger Melvin S. , Russell Robert T. , Blakely Martin L. , Streck Christian J. 
Published: April 2018

BACKGROUND
A clinical prediction rule was previously developed by the Pediatric Surgery Research Collaborative (PedSRC) to identify patients at very low risk for intra-abdominal injury (IAI) and intra-abdominal injury receiving an acute intervention (IAI-I) who could safely avoid abdominal computed tomography (CT) scans after blunt abdominal trauma (BAT). Our objective was to externally validate the rule.

METHODS
The public-use dataset was obtained from the Pediatric Emergency Care Applied Research Network (PECARN) Intra-abdominal Injury Study. Patients 16 years of age and younger with chest x-ray, completed abdominal history and physical examination, aspartate aminotransferase (AST), and amylase or lipase collected within 6 hours of arrival were included. We excluded patients who presented greater than 6 hours after injury or missing any of the five clinical prediction variables from the PedSRC prediction rule.

RESULTS
We included 2,435 patients from the PECARN dataset, with a mean age of 9.4 years. There were 235 patients with IAI (9.7%) and 60 patients with IAI-I (2.5%). The clinical prediction rule had a sensitivity of 97.5% for IAI and 100% for IAI-I. In patients with no abnormality in any of the five prediction rule variables, the rule had a negative predictive value of 99.3% for IAI and 100.0% for IAI-I. Of the “very low-risk” patients identified by the rule, 46.8% underwent abdominal CT imaging.

CONCLUSIONS
A highly sensitive clinical prediction rule using history and abdominal physical examination, laboratory values, and chest x-ray was successfully validated using a large public-access dataset of pediatric BAT patients.

LEVEL OF EVIDENCE
Epidemiologic/prognostic study, level III; therapeutic care/management study, level IV.
Functional characterization of sensory neuron membrane proteins (SNMPs)
Authors: Zhang Hui-Jie , Xu Wei , Chen Quan-mei , Sun Le-Na , Anderson Alisha , Xia Qing-You , Papanicolaou Alexie 
Published: April 2018

AbstractSensory neuron membrane proteins (SNMPs) play a critical role in the insect olfactory system but there is a deficit of functional studies beyond Drosophila. Here, we provide functional characterisation of insect SNMPs through the use of bioinformatics, genome curation, transcriptome data analysis, phylogeny, expression profiling, and RNAi gene knockdown techniques. We curated 81 genes from 35 insect species and identified a novel lepidopteran SNMP gene family, SNMP3. Phylogenetic analysis shows that lepidopteran SNMP3, but not the previously annotated lepidopteran SNMP2, is the true homologue of the dipteran SNMP2. Digital expression, microarray and qPCR analyses show that the lepidopteran SNMP1 is specifically expressed in adult antennae. SNMP2 is widely expressed in multiple tissues while SNMP3 is specifically expressed in the larval midgut. Microarray analysis suggest SNMP3 may be involved in the silkworm immunity response to virus and bacterial infections. We functionally characterised SNMP1 in the silkworm using RNAi and behavioural assays. Our results suggested that Bombyx mori SNMP1 is a functional orthologue of the Drosophila melanogaster SNMP1 and plays a critical role in pheromone detection. Split-ubiquitin yeast hybridization study shows that BmorSNMP1 has a protein-protein interaction with the BmorOR1 pheromone receptor, and the BmorOrco co-receptor. Concluding, we propose a novel molecular model in which BmorOrco, BmorSNMP1 and BmorOR1 form a heteromer in the detection of the silkworm sex pheromone bombykol.
Rational design of a compact CRISPR-Cas9 activator for AAV-mediated delivery
Authors: Vora Suhani , Cheng Jenny , Xiao Ru , VanDusen Nathan J. , Quintino Luis , Pu William T. , Vandenberghe Luk H. , Chavez Alejandro , Church George 
Published: April 2018

AbstractAkin to Zinc Finger and Transcription Activator Like Effector based transcriptional modulators, nuclease-null CRISPR-Cas9 provides a groundbreaking programmable DNA binding platform, begetting an arsenal of targetable regulators for transcriptional and epigenetic perturbation, by either directly tethering, or recruiting, transcription enhancing effectors to either component of the Cas9/guide RNA complex. Application of these programmable regulators is now gaining traction for the modulation of disease-causing genes or activation of therapeutic genes, in vivo. Adeno-Associated Virus (AAV) is an optimal delivery vehicle for in vivo delivery of such regulators to adult somatic tissue, due to the efficacy of viral delivery with minimal concerns about immunogenicity or integration. However, present Cas9 activator systems are notably beyond the packaging capacity of a single AAV delivery vector capsid. Here, we engineer a compact CRISPR-Cas9 activator for convenient AAV-mediated delivery. We validate efficacy of the CRISPR-Cas9 transcriptional activation using AAV delivery in several cell lines.
Coordinating the in vivo processes for minicircle production - a novel approach to large scale manufacturing
Authors: Mayrhofer Peter , Jug Hana , Štrancar Aleš , Di Paolo Alexandre , Jost Laurent , Zimmermann Alice , Redl Heinz 
Published: April 2018

ABSTRACTSafety as well as efficiency issues in connection with bacterial backbone sequences should be carefully considered when designing new DNA vaccines or non-viral gene therapy approaches. Bacterial backbone sequences like antibiotic resistance markers or regulatory bacterial elements constitute biological safety risks and reduce the overall efficiency of the DNA agent. To overcome these problems the minicircle technology has been developed. But, despite all the obvious advantages, minicircles have so far not replaced their problem laden conventional counterpart in gene transfer applications what can be contributed to efficiency issues in large scale manufacturing. In this article we describe the combined efforts of experts in the field of minicircle development, large scale biomanufacturing and downstream process development to provide a new approach. The Recombination Based Plasmid Separation (RBPS) Technology, which has already solved crucial problems associated with minicircle-DNA production, has been developed further for this purpose. A novel parental plasmid exploiting advanced in vivo process coordination for restriction and subsequent degradation of miniplasmid-DNA will be introduced. Furthermore we describe the scale-up of minicircle-DNA production by fermentation in combination with high performance downstream processes including purification by ion exchange and hydrophobic interaction chromatography on monolithic material.
Wanting to like: Motivation influences behavioral and neural responses to social feedback
Authors: Hughes Brent L. , Leong Josiah K. , Shiv Baba , Zaki Jamil 
Published: April 2018

ABSTRACTHuman beings revel in social approval and social connection. For example, individuals want to be liked, and frequently surround themselves with people who provide such positive reinforcement. Past work highlights a “common currency” between social rewards like social approval, and non-social rewards like money. But social and motivational contexts can reshape reward experiences considerably. Here, we examine the boundary conditions that deem social approval subjectively valuable. Participants received feedback about their attractiveness from others. Neural activity in reward-related brain structures (e.g., ventral striatum) increased in response to positive feedback, but only when such feedback came from well-liked targets. These heightened reward responses predicted increases in subsequent attraction to well-liked targets. This work suggests that motivational contexts amplify or diminish the value of social approval in a target-specific manner. The value of social approval is thus defined by the extent to which these experiences bring us closer to people we like.
Pattern-Driven Navigation in 2D Multiscale Visualizations with Scalable Insets
Authors: Lekschas Fritz , Behrisch Michael , Bach Benjamin , Kerpedjiev Peter , Gehlenborg Nils , Pfister Hanspeter 
Published: April 2018

AbstractWe present Scalable Insets, a technique for interactively exploring and navigating large numbers of annotated patterns in multiscale visualizations such as gigapixel images, matrices, or maps. Exploration of many but sparsely-distributed patterns in multiscale visualizations is challenging as visual representations change across zoom levels, context and navigational cues get lost upon zooming, and navigation is time consuming. Our technique visualizes annotated patterns too small to be identifiable at certain zoom levels using insets, i.e., magnified thumbnail views of the annotated patterns. Insets support users in searching, comparing, and contextualizing patterns while reducing the amount of navigation needed. They are dynamically placed either within the viewport or along the boundary of the viewport to offer a compromise between locality and context preservation. Annotated patterns are interactively clustered by location and type. They are visually represented as an aggregated inset to provide scalable exploration within a single viewport. In a controlled user study with 18 participants, we found that Scalable Insets can speed up visual search and improve the accuracy of pattern comparison at the cost of slower frequency estimation compared to a baseline technique. A second study with 6 experts in the field of genomics showed that Scalable Insets is easy to learn and provides first insights into how Scalable Insets can be applied in an open-ended data exploration scenario.
SLC6A4 binding site and acute prosocial effects of (+/-)-3,4-methylendioxymethamphetamine (MDMA) are evolutionarily conserved in Octopus bimaculoides
Authors: Edsinger Eric , Dölen Gül 
Published: April 2018

ABSTRACT:Human and octopus lineages are separated by over 500 million years of evolution, and show divergent anatomical patterns of brain organization. Moreover, while humans exhibit highly complex social behaviors, octopuses are thought to be largely asocial and solitary. Despite these differences, growing evidence suggests that ancient neurotransmitter systems are shared across vertebrate and invertebrate species, and in many cases enable overlapping functions. Here we provide evidence that, as in humans, the atypical amphetamine derivative (+/-)-3,4-methylendioxymethamphetamine (MDMA) enhances acute prosocial behaviors in Octopus bimaculoides. This finding is paralleled by the evolutionary conservation of the serotonin transporter (SERT, encoded by the Slc6A4 gene) binding site of MDMA in the O. bimaculoides genome. Taken together, these data provide evidence that the neural mechanisms subserving social behaviors exist in O. bimaculoides, and indicate that the role of serotonergic neurotransmission in regulating social behaviors is evolutionarily conserved.ONE SENTENCE SUMMARY:Here we provide evidence that the atypical amphetamine derivative (+/-)-3,4-methylendioxymethamphetamine (MDMA) increases acute social approach behaviors in Octopus bimaculoides, a finding that is paralleled by the evolutionary conservation of the SLC6A4 binding site of MDMA.
emeraLD: Rapid Linkage Disequilibrium Estimation with Massive Data Sets
Authors: Quick Corbin , Fuchsberger Christian , Taliun Daniel , Abecasis Gonçalo , Boehnke Michael , Kang Hyun Min 
Published: April 2018

AbstractSummaryEstimating linkage disequilibrium (LD) is essential for a wide range of summary statistics-based association methods for genome-wide association studies (GWAS). Large genetic data sets, e.g. the TOPMed WGS project and UK Biobank, enable more accurate and comprehensive LD estimates, but increase the computational burden of LD estimation. Here, we describe emeraLD (Efficient Methods for Estimation and Random Access of LD), a computational tool that leverages sparsity and haplotype structure to estimate LD orders of magnitude faster than existing tools.Availability and ImplementationemeraLD is implemented in C++, and is open source under GPLv3. Source code, documentation, an R interface, and utilities for analysis of summary statistics are freely available at http://github.com/statgen/emeraLDContactcorbinq@umich.eduSupplementary informationSupplementary data are available at Bioinformatics online.