bluuebunny/crossref_metadata_2025_split huggingface dataset:
Experiences of Transgender Men in Accessing Care in Gynecology Clinics [24G]
Authors: Frecker Helena , Scheim Ayden , Leonardi Mathew , Yudin Mark 
Published: April 2018

INTRODUCTION:
Transgender, or “trans,” individuals face barriers to accessing medical care, however little is known regarding trans men’s experiences in accessing gynecologic care in particular. This study sought to determine if trans men in Ontario avoid presenting for gynecologic care and to gain understanding of their experiences in accessing this care.

METHODS:
Trans men ≥18 years old and living in Ontario were invited to participate in an online questionnaire. The study poster with questionnaire URL was distributed in both physical and online spaces frequented by the trans community.

RESULTS:
Of 89 respondents, 84/87 (97%) reported using a pronoun different from that associated with their birth-assigned gender, 71/87 (82%) reported current or past testosterone use, and 46/85 (54%) had undergone gender confirming surgery. 72/78 (92%) felt anxious about seeking gynecologic care and 43/79 (54%) had avoided attending gynecologic care settings because they were trans, citing the following reasons: encountering gendered forms (50%), sitting in a waiting room with cis women (54%), being misgendered (59%), having to educate providers (70%), and undergoing the gynecologic exam itself (86%). Many respondents found the gynecologic exam physically (60%) and emotionally (75%) distressing. Respondents endorsed options for an improved exam experience, including providers using gender non-specific language (85%), explaining each step before it occurs (55%), and having a support person present (47%).

CONCLUSION:
This study has highlighted areas for improvement in care provision that can be adopted by gynecologic care providers in order to make the experiences of trans men more inclusive, safe, and positive.
Antibiotic Prophylaxis in Surgical Sterilization: Following the Recommendations [29G]
Authors: Saunders Kelley T. , Slaughter Geoffrey T. , Mercer Laura , Gerkin Richard 
Published: April 2018

INTRODUCTION:
Surgical site infections are the most common surgical complication. Antibiotic administration perioperatively has been shown to reduce associated morbidity, however, indiscriminate use has been associated with adverse outcomes. Selective antibiotic prophylaxis guidelines have been published by the American College of Obstetricians and Gynecologists (ACOG) for gynecologic procedures. Little is known regarding adherence to these recommendations. The primary objective was to determine adherence to ACOG recommendations for antibiotic prophylaxis in surgical sterilization. The secondary objective was to evaluate the patterns and predictors of appropriate antibiotic prophylaxis.

METHODS:
A retrospective chart review of preoperative antibiotics for laparoscopic and hysteroscopic sterilization procedures was performed at a single institution, Banner University Medical Center - Phoenix (BUMCP), from 01/01/2014 to 12/31/2014. Descriptive data were analyzed using chi-squared for categorical variables and Student t-test for continuous variables. P-values <.05 were considered significant.

RESULTS:
Of 165 women who met inclusion criteria, 50.9% received antibiotic prophylaxis outside of ACOG guidelines. Patient age, race and insurance status were not predictive of inappropriate prophylaxis. Women who underwent hysteroscopic sterilization were less likely to receive inappropriate prophylaxis compared to laparoscopic sterilization (18.6% vs 68.9%, P<.001). Antibiotic administration was less likely in cases assisted by lower-level residents compared to cases assisted by upper-level residents (46.4% vs 69.4%, P=.02). The number of years of attending experience was not predictive of adherence.

CONCLUSION:
There is widespread misuse of perioperative antibiotics for surgical sterilizations. Increased education and quality improvement is needed within BUMCP (our institution) to align practice patterns with evidence based recommendations.
Pregnant Women's Attitudes Toward Zika Virus Vaccine Study Participation [8J]
Authors: Goldfarb Ilona , Jaffe Elana , Lyerly Anne 
Published: April 2018

INTRODUCTION:
Preventing Zika Virus (ZIKV) infection by vaccinating women may decrease risk of congenital Zika syndrome. Clinical trials are underway for inactivated, live attenuated, and DNA ZIKV vaccines. We sought to describe pregnant women’s attitudes toward participation in ZIKV vaccine research involving different vaccine platforms and to identify participation predictors and barriers.

METHODS:
Women attending prenatal care in June and July 2017 were offered enrollment in an anonymous survey which asked women their views about participating in hypothetical ZIKV vaccine research scenarios during pregnancy. Demographics and Zika exposure during pregnancy were obtained.

RESULTS:
Of 129 women, 70% expressed concern about ZIKV infection during pregnancy and 44% changed travel plans. Given the study scenarios, 68% stated they would consider an inactivated vaccine trial compared to 19% willing to participate in a live attenuated vaccine trial (p-value <0.0001). DNA vaccine trial acceptance was 51.6%. 57% of women believed the inactivated vaccine during pregnancy was safe for their baby compared to 26% for a live attenuated (p-value 0.012). Willing trial participants were most motivated by a desire to protect their babies from ZIKV, fewer were strongly motivated by a desire to contribute to science.

CONCLUSION:
Inclusion of pregnant women in ZIKV vaccine trials is imperative to ensure vaccines are safe, effective, and acceptable in pregnancy. A majority of women in our cohort would accept participation in inactivated and DNA vaccine trials during pregnancy while fewer would participate in a trial of a live attenuated vaccine. Understanding women’s motivations for trial participation is critical to vaccine trial design.
Metabolism of the oocyte and the preimplantation embryo: implications for assisted reproduction
Authors: Scott Richard , Zhang Man , Seli Emre 
Published: April 2018

Purpose of review
To discuss the common aspects of energy generation in the cell, substrate utilization by the oocyte and the preimplantation embryos, metabolic characteristics of the reproductive tract, and how metabolic characteristics of an embryo can be exploited to assess viability.

Recent findings
Utilization of pyruvate, lactate and glucose by the oocyte and the preimplantation embryo seems to be tightly controlled by the most essential molecular regulatory pathways.

Summary
Accumulating data on the metabolic needs of the preimplantation embryo and the substrate concentrations in the reproductive tract guide us in improving in-vitro culture conditions, and provide potential biomarkers of embryo viability.
Fertility, IVF and reproductive genetics
Authors: Varela Elisa , Sánchez-de-Puerta Irene , García-Velasco Juan A. 
Published: April 2018

Purpose of review
Telomere attrition and dysfunction has become a well established pathway involved in organismal aging, not only because it imposes a limitation to cell division and therefore, tissue regeneration but also because telomere homeostasis influences other pathways involved in aging. However, the implication of telomere biology in ovarian aging and fertility is barely starting to be unveiled.

Recent findings
During the last years, mounting evidence in favor of the relationship between the accumulation of short telomeres and ovarian senescence has emerged. Telomere attrition and the loss of telomerase activity in ovarian cell types is a common characteristic of female infertility.

Summary
Recent findings regarding telomere attrition in the ovary open the possibility of both, finding new molecular biomarkers related to telomere homeostasis that make possible the early detection of ovarian dysfunction before the ovarian reserve has vanished, and the search of new therapies to preserve or set up ovarian cell types so that new and better quality oocytes can be generated in aged ovaries to improve IVF outcomes.
The case against endometrial ablation for treatment of heavy menstrual bleeding
Authors: Louie Michelle , Wright Kelly , Siedhoff Matthew T. 
Published: April 2018

Purpose of review
Endometrial ablation is a common treatment for heavy menstrual bleeding, but serious limitations and long-term complications exist. Our purpose is to summarize the use of endometrial ablation devices, potential short-term and long-term complications, cost effectiveness, and quality of life in relation to alternative treatments.

Recent findings
There is insufficient evidence to strongly recommend one endometrial ablation device over another. Providers should consider and discuss with their patients, complications including risk of future pregnancy, endometrial cancer, and hysterectomy for continued bleeding or pain. Patient selection is key to reducing postablation pain and failure; patients with a history of tubal ligation and dysmenorrhea should consider alternative treatments. All patients should also be counseled that the levonorgestrel intrauterine device is a cost-effective alternative with higher quality of life and fewer complications. Hysterectomy is definitive treatment with higher quality of life and fewer complications.

Summary
Although endometrial ablation can offer adequate symptom control for patients who have failed medical therapy, desire uterine preservation, or who are high-risk surgical candidates, patients should be appropriately selected and counseled regarding the potential for treatment failure and long-term complications.
Frequency of Complications During Preparation of Corneal Lamellae Used in Posterior Lamellar Keratoplasty Using the Pneumodissection Technique (Big Bubble)
Authors: Studeny Pavel , Netukova Magdalena , Hlozanek Martin , Bednar Jan , Jirsova Katerina , Krizova Deli 
Published: April 2018

Purpose:
To determine the frequency of formation of various types of bubbles and the potential impact of donor and lamella parameters on this frequency, and to identify possible risk factors of unsuccessful “big-bubble” creation in preparation of pre-Descemet endothelial keratoplasty and Descemet membrane endothelial keratoplasty with peripheral stromal support.

Methods:
Donor age and sex, death to preservation time (DPT), storage time, presence of corneal scars (mainly a condition after cataract surgery), and endothelial cell density of 256 donor corneas were assessed before Descemet membrane endothelial keratoplasty with peripheral stromal support or pre-Descemet endothelial keratoplasty lamella preparation using the big-bubble technique.

Results:
Mean donor age was 62.3 ± 8.5 years (28.3% women and 71.7% men). Mean endothelial cell density of the donor graft was 2866 ± 255 cells/mm2. Mean DPT was 10.12 ± 4.88 hours, and mean storage time of the transplant before surgery was 6.5 ± 4.8 days. Corneal scars were present in 17 donor grafts (6.6%) after cataract surgery. Eleven corneas were devalued because of Descemet membrane rupture during preparation (4.3%). In 182 corneas, standard bubble type I was created (71.7%); in 27 corneas, bubble type II was created; eventually, both types of bubbles formed simultaneously (10.5%); in 47 corneas, no bubble was created (18.4%).

Conclusions:
We identified higher endothelial cell density, shorter DPT, and the presence of corneal scars after cataract surgery as risk factors threatening successful bubble formation. The only risk factor for creating type II bubbles was higher donor age in our study.
Exploring Women’s Support Needs After Breast Reconstruction Surgery
Authors: Carr Tracey L. , Groot Gary , Cochran David , Vancoughnett Mikaela , Holtslander Lorraine 
Published: April 2018

Background
The procedures for breast reconstruction (BR) after mastectomy frequently initiate a difficult recovery period. A better understanding of women’s support needs after surgery would improve patient care.

Objective
The aim of this study was to identify patients’ support needs after BR.

Methods
In a retrospective study design, 21 participants described their support experiences after BR, including their sources of support and the impact of support on their recovery in a semistructured interview. Transcriptions of the interviews were analyzed using thematic analysis.

Results
Four support needs were identified and were composed of elements of instrumental, emotional, and informational support. These needs were addressed to varying degrees by healthcare providers, family members, and other women who had BR experience.

Conclusion
Women’s experience of BR and their ability to cope are markedly better when their support needs are effectively addressed. Greater attention to their needs for support has the potential to improve patient care.

Implications for Practice
Nurses play a pivotal role in providing information to women who are recovering from BR. Improved access to communication channels between nurses and patients would likely improve patients’ support experiences. In addition, nurses can assess the women’s specific support needs and partner with families to help them understand how best to support women during recovery.
Effect of Neuromuscular Electrical Stimulation on Labial and Lingual Weakness
Authors: Safi Mohammed F. , Wright-Harp Wilhelmina , Lucker Jay R. , Payne Joan C. , Harris Ovetta 
Published: April 2018

Objective:
This study explored the effect of facial and submental neuromuscular electrical stimulation (NMES) in individuals with lingual, labial and buccal weakness.

Method:
An ABC/ACB design was used. Two male participants who acquired cerebrovascular accident (60 years) involved in this study. Both engaged in 2 treatment phases. One phase included performing an oral motor exercise program in conjunction with the NMES. Second phase included performing only oral motor exercise program.

Results:
Submental NMES did not have any effect on lingual strength. However, facial NMES had positive effect on labial strength in the 2 participants.
An examination of multivariable Mendelian randomization in the single sample and two-sample summary data settings
Authors: Sanderson Eleanor , Davey Smith George , Windmeijer Frank , Bowden Jack 
Published: April 2018

AbstractBackgroundMendelian Randomisation (MR) is a powerful tool in epidemiology which can be used to estimate the causal effect of an exposure on an outcome in the presence of unobserved confounding, by utilising genetic variants that are instrumental variables (IVs) for the exposure. This has been extended to Multivariable MR (MVMR) to estimate the effect of two or more exposures on an outcome.Methods/ResultsWe use simulations and theory to clarify the interpretation of estimated effects in a MVMR analysis under a range of underlying scenarios, where a secondary exposure acts variously as a confounder, a mediator, a pleiotropic pathway and a collider. We then describe how instrument strength and validity can be assessed for an MVMR analysis in the single sample setting, and develop tests to assess these assumptions in the popular two-sample summary data setting. We illustrate our methods using data from UK biobank to estimate the effect of education and cognitive ability on body mass index.ConclusionMVMR analysis consistently estimates the effect of an exposure, or exposures, of interest and provides a powerful tool for determining causal effects in a wide range of scenarios with either individual or summary level data.
Colistin resistance prevalence in Escherichia coli from domestic animals in intensive breeding farms of Jiangsu Province, China
Authors: Zhang X. , Zhang B. , Yu Z. , Guo Y. , Wang J. , Zhao P. , Liu J. , He K. 
Published: April 2018

AbstractThe global dissemination of colistin resistance has received a great deal of attention. Recently, the plasmid-mediated colistin resistance encoded by mcr-1 and mcr-2 genes in Escherichia coli (E.coli) strains from animals, food, and patients in China have been reported continuously. To make clear the colisin resistance and mcr gene spread in domestic animals in Jiangsu Province, we collected fecael swabs from pigs, chicken and cattle at different age distributed in intensive feeding farms. The selected chromogenic agar and mcr-PCR were used to screen the colisin resistance and mcr gene carriage. Colistin resistant E.coli colonies were identified from 54.25 % (440/811) pig faecal swabs, from 35.96 % (443/1232) chicken faecal swabs, and 26.92 % (42/156) from cattle faecal swabs. Of all the colisin resistant E.coli colonies, the positive amplifications of mcr-1 were significantly higher than mcr-2. The mcr-1 prevalence was 68.86 % (303/440) in pigs, 87.58 % (388/443) in chicken, and 71.43 % (30/42), compared with 46.82 % (206/440) in pigs, 14.90 % (66/443) in chicken, and 19.05 % (8/42) in cattle of prevalence of mcr-2. Co-occurrence of mcr-1 and mcr-2 was identified in 20 % (88/440) in pigs, 7.22 % (32/443) in chickens, and in 9.52 % (4/42) cattle. These data indicate that mcr was the most important colistin resistance mechanism. Interventions and alternative options are necessary to minimise further dissemination of mcr between food-producing animals and human.IMPORTANCEColistin is recognized one of the last defence lines for the treatment of highly resistant bacteria, but the emergence of resistance that conferred by a transferable plasmid-mediated mcr genes to this vital antibiotic is extremely disturbing. Here, we used E. coli as an index to monitor drug resistance in domestic animals (pigs, chicken and cattle). It was found that the colistin resistance widely occurred at all ages of domestic animals and the mcr-dependent mechanism dominated in E.coli. We also found that the elder and adult animals were a reservoir of resistant strains, suggesting a potential food safety issue and greater public health problems.
From Synchrony to Asynchrony: Cerebellar-Basal Ganglia Functional Circuits in Young and Older Adults
Authors: Hausman Hanna K. , Jackson T. Bryan , Goen James R.M. , Bernard Jessica A. 
Published: April 2018

AbstractResting state functional magnetic resonance imaging (rs-fMRI) has indicated disruptions in functional connectivity in older (OA) relative to young adults (YA). While age differences in cortical networks are well studied, differences in subcortical networks are poorly understood. Both the cerebellum and the basal ganglia are of particular interest given their role in cognitive and motor functions, and work in non-human primates has demonstrated direct reciprocal connections between these regions. Here, our goal was twofold. First, we were interested in delineating connectivity patterns between distinct regions of the cerebellum and basal ganglia, known to have topologically distinct connectivity patterns with cortex. Our second goal was to quantify age-differences in these cerebellar-striatal circuits. We performed a targeted rs-fMRI analysis of the cerebellum and basal ganglia in 33 YA and 31 OA individuals. In the YA, we found significant connectivity both within and between the cerebellum and basal ganglia, in patterns supporting semi-discrete circuits that may differentially subserve motor and cognitive performance. We found a shift in connectivity, from one of synchrony in YA, to asynchrony in OA, resulting in substantial age differences. Connectivity was also associated with behavior. These findings significantly advance our understanding of cerebellar-basal ganglia interactions in the human brain.
A rapid and robust method for single cell chromatin accessibility profiling
Authors: Chen Xi , Miragaia Ricardo J , Natarajan Kedar Nath , Teichmann Sarah A 
Published: April 2018

AbstractThe assay for transposase-accessible chromatin using sequencing (ATAC-seq) is widely used to identify regulatory regions throughout the genome. However, very few studies have been performed at the single cell level (scATAC-seq) due to technical challenges. Here we developed a simple and robust plate-based scATAC-seq method, combining upfront bulk Tn5 tagging with single-nuclei sorting. We demonstrated that our method worked robustly across various systems, including fresh and cryopreserved cells from primary tissues. By profiling over 3,000 splenocytes, we identify distinct immune cell types and reveal cell type-specific regulatory regions and related transcription factors.
From urban exploration to ruin tourism: a geographical analysis of contemporary ruins as new frontiers for urban tourism
Authors: Le Gallou Aude 
Published: April 2018

Purpose
Despite the increasing academic interest for urban ruins and evolutions of urban tourism, research on ruin tourism as an emergent form of urban tourism practice is still lacking. Drawing on existing works on urban exploration, the purpose of this paper is to provide a first geographical insight into ruin tourism and its spatial implications in terms of imaginaries, practices and regulation of urban space.

Design/methodology/approach
Drawing on an urban and cultural geography approach, the research is based on a mix of empirical methodologies. Participant observation of organized ruin tours as well as formal and informal interviews with participants, organizers, institutional actors and inhabitants have been conducted during fieldwork completed in Berlin and Detroit. This paper also draws on the analysis of additional data provided by online material, especially official websites of tour organizers, forum threads and comments posted on different websites.

Findings
The research shows that ruin tourism can be analyzed as a new practice of urban tourism based on the reappropriation and commodification of alternative practices developing in marginalized urban areas. The paper provides evidence of ruin tourism’s contribution to the normalization of urban space through tourism conquest of new urban territories. It also shows that the practice fosters contested material and symbolic appropriations of place.

Originality/value
This paper contributes to current research on alternative tourism practices in marginalized urban areas as well as on tourist appropriation of liminal spaces. It provides a first analysis of ruin tourism and underscores its potential as a geographical object for the investigation of a wide range of urban issues.
Global supply chain network design problem with rules of origin and limited import quotas
Authors: Cheng Xinxuan , Yang Guoqing , Fan Longfei 
Published: April 2018

PurposeThis paper aims to develop an uncertain global supply chain network design (GSCND) model with rules of origin (RoOs) and limited import quotas, and to discuss the international factors’ effects on location decisions.Design/methodology/approachThe authors establish an uncertain GSCND model with the international factors. The transportation costs and customers’ demands are characterized as random variables. To deal with the risk of uncertainty, the authors introduce the customers’ demand service level. A sample approximation approach (SAA) is used to deal with the service level constraint and turn the proposed model into a mixed integer programming. On the basis of the properties of the proposed model, a hybrid memetic algorithm (MA) is designed to solve it.FindingsThe authors find that the proposed MA is efficient to the real supply chain network design problem. Besides, the RoOs and limited import quotas can affect the optimal choices of plant and distribution center locations.Originality/valueThe authors propose an uncertain GSCND model with RoOs and limited import quotas. An MA with SAA is designed to solve the proposed model. The authors apply the proposed model into a real global supply chain of an apparel corporation in East Asia, and give some managerial insights.