bluuebunny/crossref_metadata_2025_split huggingface dataset:
Why Do We Need a New Clinical Practice Guideline for Moderate to Severe Traumatic Brain Injury?
Authors: Swaine Bonnie , Bayley Mark Theodore , Marshall Shawn , Kua Ailene , Marier-Deschênes Pascale , Allaire Anne-Sophie , Kagan Corinne , Truchon Catherine , Janzen Shannon , Teasell Robert , Lamontagne Marie-Eve 
Published: September 2018

Objective:
Clinical practice guidelines (CPGs) aim to improve quality and consistency of healthcare services. A Canadian group of researchers, clinicians, and policy makers developed/adapted a CPG for rehabilitation post–moderate to severe traumatic brain injury (MSTBI) to respond to end users' needs in acute care and rehabilitation settings.

Methods:
The rigorous CPG development process began assessing needs and expectations of end users, then appraised existing CPGs, and, during a consensus conference, produced fundamental and priority recommendations. We also surveyed end users' perceptions of implementation gaps to determine future implementation strategies to optimize adherence to the CPG.

Results:
The unique bilingual (French and English) CPG consists of 266 recommendations (of which 126 are new recommendations), addressing top priorities for MSTBI, rationale, process indicators, and implementations tools (eg, algorithms and benchmarks).

Conclusion:
The novel approach of consulting and working with end users to develop a CPG for MSTBI should influence knowledge uptake for clinicians wanting to provide evidence-based care.
A Phenotype of Primary Open-angle Glaucoma With Systemic Vasospasm
Authors: Alizadeh Reza , Vickers Laura , Hirunpatravong Pradtana , Romero Pablo , Lin Mark C. , Sharifipour Farideh , Caprioli Joseph 
Published: September 2018

Purpose:
Primary open-angle glaucoma (POAG) patients constitute a heterogenous group. Identification of phenotypic subtypes among these patients may provide a deeper understanding of the disease and aid associations with genotypes. We describe a phenotype of POAG patients associated with a constellation of systemic disorders; patients with this phenotype seem to be vulnerable to optic nerve damage at low intraocular pressures.

Materials and Methods:
In this retrospective study, we evaluated the medical records of active Jules Stein Eye Institute glaucoma patients from January 1996 to 2017 and included subjects with POAG, acquired pits of the optic nerve (APON), and at least one of the following: systolic blood pressure persistently ≤100 mm Hg, history of migraine headaches or migraine variant, and the Raynaud syndrome.

Results:
Of 87 patients (125 eyes) with APON, 37 patients (55 eyes) met the study criteria. In total, 34 patients were female (92%). The median age at the time of diagnosis was 55 years. Nineteen patients (73%) had low systolic blood pressures, same number had Raynaud syndrome, and 25 (68%) had a history of migraine.

Conclusions:
We describe a POAG subtype with APON and systemic vascular instability, predominantly female in their sixth decade of life who demonstrate progressive glaucomatous visual field damage at low intraocular pressure. We suggest that this clinical picture represents an important phenotype of POAG, and that identification and further study of it will help guide diagnosis and development of individualized treatments.
Association of Patient-reported Experiences and Surgical Outcomes Among Group Practices
Authors: Liu Jason B. , Pusic Andrea L. , Gibbons Christopher J. , Opelka Frank G. , Sage Jill S. , Thompson Vanessa M. , Ko Clifford Y. , Hall Bruce L. , Temple Larissa K. 
Published: September 2018

Objective:
The aim of the study was to determine the association of patient-reported experiences (PREs) and risk-adjusted surgical outcomes among group practices.

Background:
The Centers for Medicare and Medicaid Services required large group practices to submit PREs data for successful participation in the Physician Quality Reporting System (PQRS) using the Consumer Assessment of Healthcare Providers and Systems for PQRS survey. Whether these PREs data correlate with perioperative outcomes remains ill defined.

Methods:
Operations between January 1, 2014 and December 31, 2016 in the American College of Surgeons’ National Surgical Quality Improvement Program registry were merged with 2015 Consumer Assessment of Healthcare Providers and Systems for PQRS survey data. Hierarchical logistic models were constructed to estimate associations between 7 subscales and 1 composite score of PREs and 30-day morbidity, unplanned readmission, and unplanned reoperation, separately, while adjusting for patient- and procedure mix.

Results:
Among 328 group practices identified, patients reported their experiences with clinician communication the highest (mean ± standard deviation, 82.66 ± 3.10), and with attention to medication cost the lowest (25.96 ± 5.14). The mean composite score was 61.08 (±6.66). On multivariable analyses, better PREs scores regarding medication cost, between-visit communication, and the composite score of experience were each associated with 4% decreased odds of morbidity [odds ratio (OR) 0.96, 95% confidence interval (CI) 0.92–0.99], readmission (OR 0.96, 95% CI 0.93–0.99), and reoperation (OR 0.96, 95% CI 0.93–0.99), respectively. In sensitivity analyses, better between-visit communication remained significantly associated with fewer readmissions.

Conclusions:
In these data, patients’ report of better between-visit communication was associated with fewer readmissions. More sensitive, surgery-specific PRE assessments may reveal additional unique insights for improving the quality of surgical care.
Nutritional Status is Associated With Severe Dementia and Mortality
Authors: Sanders Chelsea L. , Wengreen Heidi J. , Schwartz Sarah , Behrens Stephanie J. , Corcoran Chris , Lyketsos Constantine G. , Tschanz JoAnn T. 
Published: September 2018

Purpose:
Studies have reported faster cognitive/functional decline in persons with dementia (PWD) with malnutrition. We investigated whether baseline nutritional status predicted severe dementia and mortality in a population-based sample.

Patients:
A maximum of 300 PWD were assessed annually for up to 8.6 years.

Methods:
Nutritional status was assessed using a modified Mini-Nutritional Assessment (mMNA). Severe dementia was defined as: “severe” rating on the Clinical Dementia Rating or Mini-Mental State Examination score ≤10. Using Cox proportional hazards models, we examined the association between baseline mMNA score (or its subcomponents) with each outcome. Covariates included demographics; dementia onset age, type, and duration; APOE genotype; and residency with caregiver.

Results:
Compared with “well-nourished,” “malnourished” PWD had 3-4 times the hazard of severe dementia [hazard ratio (HR), 4.31; P=0.014] and death (HR, 3.04; P<0.001). Those “at risk for malnutrition” had twice the hazard of severe dementia (HR, 1.98; P=0.064) and 1.5 times the hazard of death (HR, 1.46; P=0.015). mMNA subcomponents of food group intake, weight loss, body mass index, mobility, health status, protein consumption, and mid-arm circumference predicted one or both outcomes.

Conclusions:
Nutritional status is an important predictor of clinical outcomes in dementia and may provide an avenue for intervention.
Rationale and Design of a Novel Method to Assess the Usability of Body-Worn Absorbent Incontinence Care Products by Caregivers
Authors: Kanerva Rice Sophie , Pendrill Leslie , Petersson Niclas , Nordlinder Jesper , Farbrot Anne 
Published: September 2018

PURPOSE:
The purpose of this study was to develop and test a new method to measure the usability of absorbent incontinence care products from the caregivers' perspective and to investigate if the method can be used to differentiate between product types in a product change.

DESIGN:
Process evaluation and validation study.

SUBJECTS AND SETTING:
Product developers and end users participated in designing the new method. Thereafter, professional caregivers acted as testers of the new method, ranking usability when performing absorbent product changes on patients in a simulated nursing home care environment, assisted by third-party research institute moderators.

METHODS:
Design and evaluation of a new method designed to assess the usability of body-worn absorbent incontinence care products for lay caregivers were completed. The evaluation included formative and summative evaluations of effectiveness (product fit), efficiency (time and physical workload), and satisfaction. A person-centered approach aimed at including all subjects and settings to generate a single usability score for decision making and product benchmarking. Experienced caregivers changed 4 types of products: (1) disposable body-worn pads with mesh briefs (2-piece system); (2) disposable all-in-one briefs; (3) disposable, T-shaped, and belted brief; and (4) disposable pull-up pants on simulated patients in standing or lying position. Each product change was performed by 1 unassisted experienced caregiver. The probability of success as a score for each product type was calculated across the 4 metrics and reported with 95% confidence intervals (CIs). Descriptive and inferential statistics were developed assuming a binary statistical model, using the weighted scores from each of the factors. An overall usability score was calculated.

RESULTS:
The method we developed discriminated between usability of different product types. The overall score for the disposable pull-up product (90%; CI: 83%-97%) was better (P < .05) than for the disposable T-shaped brief (83%; CI: 77%-89%), the disposable brief (53%; CI: 45%-61%), and the disposable body-worn pad with mesh pant (61%; CI: 56%-66%) in standing patients. For lying patients, the overall score for the disposable T-shaped brief product (81%; CI: 73%-89% was better (P < .05) than the disposable brief (65%; CI: 45%-61%) and the disposable body-worn pads with mesh brief (62%; CI: 55%-69%). Reliability was evaluated quantitatively in terms of measurement uncertainties in the results.

CONCLUSION:
The method we described demonstrated differentiation of usability based on product type indicating concurrent validity. Further testing in diverse real-world care environments is needed to evaluate and confirm the validity and to assess reliability of this method in the research setting.
Advanced Techniques in the Use of Negative Pressure Wound Therapy for Closure of Complex Neonatal Abdominal Wounds
Authors: Bayci Andrew , Akay Begum 
Published: September 2018

BACKGROUND:
Negative pressure wound therapy (NPWT) has been described for closure of complex neonatal abdominal wounds, but advanced techniques for stoma or fistula control, skin protection, and the use of high pressure therapy not as well established.

CASES:
We identified neonatal patients at our institution who received NPWT for a complex abdominal wound, defined as a wound associated with a stoma or fistula with partial or complete dehiscence of the abdominal fascia or skin. We then reviewed techniques for decreasing wound contamination and protecting the newborn's skin. One patient had an especially complex wound; she was born at ∼23 weeks' gestational age (birth weight 580 g). She developed necrotizing enterocolitis and strictures, requiring multiple surgeries to relieve obstruction, ultimately resulting in an end ileostomy with mucous fistula. She suffered from wound dehiscence and retraction of her surgically created stoma, resulting in a complex abdominal wound with significant damage to the surrounding skin. We used advanced NPWT techniques to heal her wound, including topical skin protectants, placement of an adhesive dressing over the skin prior to placement of negative pressure dressing, placement of a negative pressure sponge directly on the wound bed and stoma, diversion of enteric contents away from the wound using a Malecot catheter, and an increase in the negative pressure applied.

CONCLUSION:
Complex neonatal abdominal wounds can be treated effectively using NPWT. The techniques we describe divert enteric contents away from the wound bed while maintaining negative pressure and protecting the surrounding skin. In addition, we used negative pressure up to −125 mm Hg and found it was well tolerated by our patients.
Towards understanding cancer stem cell heterogeneity in the tumor microenvironment
Authors: Bocci Federico , Gearhart-Serna Larisa , Boareto Marcelo , Ribeiro Mariana , Ben-Jacob Eshel , Devi Gayathri R. , Levine Herbert , Nelson Onuchic José , Jolly Mohit Kumar 
Published: September 2018

AbstractThe Epithelial-Mesenchymal Transition (EMT) and Cancer Stem Cell (CSC) formation are two paramount processes driving tumor progression, therapy resistance and cancer metastasis. Some recent experiments show that cells with varying EMT and CSC phenotypes are spatially segregated in the primary tumor. The underlying mechanisms generating such spatiotemporal dynamics and heterogeneity in the tumor micro-environment, however, remain largely unexplored. Here, we show through a mechanism-based dynamical model that the diffusion of EMT-inducing signals such as TGF-β in a tumor tissue, together with non-cell autonomous control of EMT and CSC decision-making via juxtacrine signaling mediated via the Notch signaling pathway, can explain experimentally observed disparate localization of subsets of CSCs with varying EMT states in the tumor. Our simulations show that the more mesenchymal CSCs lie at the invasive edge, while the hybrid epithelial/mesenchymal (E/M) CSCs reside in the tumor interior. Further, motivated by the role of Notch-Jagged signaling in mediating EMT and stemness, we investigated the microenvironmental factors that promote Notch-Jagged signaling. We show that many inflammatory cytokines that can promote Notch-Jagged signaling such as IL-6 can (a) stabilize a hybrid E/M phenotype, (b) increase the likelihood of spatial proximity of hybrid E/M cells, and (c) expand the fraction of CSCs. To validate the predicted connection between Notch-Jagged signaling and stemness, we knocked down JAG1 in hybrid E/M SUM149 human breast cancer cellsin vitro. JAG1 knockdown significantly restricted organoid formation, confirming the key role that Notch-Jagged signaling can play in tumor progression. Together, our integrated computational-experimental framework reveals the underlying principles of spatiotemporal dynamics of EMT and CSCs in the tumor microenvironment.Significance statementThe presence of heterogeneous subsets of cancer stem cells (CSCs) remains a clinical challenge. These subsets often occupy different regions in the primary tumor and have varied epithelial-mesenchymal phenotypes. Here, we device a theoretical framework to investigate how the tumor microenvironment (TME) modulates this spatial patterning. We find that a spatial gradient of EMT-inducing signal, coupled with juxtacrine Notch-JAG1 signaling triggered by inflammatory cytokines in TME, explains this spatial heterogeneity. Finally,in vitroJAG1 knockdown experiments in triple negative breast cancer cells severely restricts the growth of tumor organoid, hence validating the association between JAG1 and CSC fraction. Our results offer insights into principles of spatiotemporal patterning in TME, and identifies a relevant target to alleviate multiple CSC subsets – JAG1.
Mitochondrial network state scales mtDNA genetic dynamics
Authors: Aryaman Juvid , Bowles Charlotte , Jones Nick S. , Johnston Iain G. 
Published: September 2018

AbstractMitochondrial DNA (mtDNA) mutations cause severe congenital diseases but may also be associated with healthy aging. MtDNA is stochastically replicated and degraded, and exists within organelles which undergo dynamic fusion and fission. The role of the resulting mitochondrial networks in the time evolution of the cellular proportion of mutated mtDNA molecules (heteroplasmy), and cell-to-cell variability in heteroplasmy (heteroplasmy variance), remains incompletely understood. Heteroplasmy variance is particularly important since it modulates the number of pathological cells in a tissue. Here, we provide the first wide-reaching theoretical framework which bridges mitochondrial network and genetic states. We show that, under a range of conditions, the (genetic) rate of increase in heteroplasmy variance andde novomutation are proportionally modulated by the (physical) fraction of unfused mitochondria, independently of the absolute fission-fusion rate. In the context of selective fusion, we show that intermediate fusion/fission ratios are optimal for the clearance of mtDNA mutants. Our findings imply that modulating network state, mitophagy rate and copy number to slow down heteroplasmy dynamics when mean heteroplasmy is low could have therapeutic advantages for mitochondrial disease and healthy aging.
Toward a political economy of corporate governance change and stability in family business groups
Authors: Ahmed Shaila , Uddin Shahzad 
Published: September 2018

PurposeThe purpose of this paper is to elaborate a political economy of corporate governance (CG) change and stability in family business groups (BGs) and assist in explaining why certain CG reforms fail in one context but work in others.Design/methodology/approachThree BGs in Bangladesh are studied. A mixture of data sources is used, namely interviews, observations of practices, historical documentation, company reports and research papers and theses. The results are analysed by applying Archer’s morphogenetic approach, focussing on both macro- and micro-processes of change.FindingsA newly-adopted CG framework, which created incentives and pressures for family directors to act in the best interests of general shareholders, did not seem to alter apparently simple but complex internal structural set-ups. Thus, regulatory efforts to empower general shareholders did not produce the expected results. Following Archer’s morphogenetic approach, the authors identify key structural conditioning or emergent properties and agential strategies to explain why and how BGs opted for symbolic compliance and achieved lax regulation and enforcement.Research limitations/implicationsThe paper opens up a new methodological and theoretical space for future CG research, especially by applying a meta-theoretical guideline such as the morphogenetic approach, for nuanced explanation and a more inclusive understanding of CG practices, reform and change in different organisational and institutional settings.Originality/valueThe morphogenetic approach aids in developing a political economy of CG change and stability and provides a nuanced explanation of CG practices. This is illustrated through an exploration of CG change initiatives in Bangladeshi BGs.
Motion in frequency domain for harmonic balance simulation of electrical machines
Authors: Wick Markus , Grabmaier Sebastian , Juettner Matthias , Rucker Wolfgang 
Published: September 2018

Purpose
The high computational effort of steady-state simulations limits the optimization of electrical machines. Stationary solvers calculate a fast but less accurate approximation without eddy-currents and hysteresis losses. The harmonic balance approach is known for efficient and accurate simulations of magnetic devices in the frequency domain. But it lacks an efficient method for the motion of the geometry.

Design/methodology/approach
The high computational effort of steady-state simulations limits the optimization of electrical machines. Stationary solvers calculate a fast but less accurate approximation without eddy-currents and hysteresis losses. The harmonic balance approach is known for efficient and accurate simulations of magnetic devices in the frequency domain. But it lacks an efficient method for the motion of the geometry.

Findings
The three-phase symmetry reduces the simulated geometry to the sixth part of one pole. The motion transforms to a frequency offset in the angular Fourier series decomposition. The calculation overhead of the Fourier integrals is negligible. The air impedance approximation increases the accuracy and yields a convergence speed of three iterations per decade.

Research limitations/implications
Only linear materials and two-dimensional geometries are shown for clearness. Researchers are encouraged to adopt recent harmonic balance findings and to evaluate the performance and accuracy of both formulations for larger applications.

Practical implications
This method offers fast-frequency domain simulations in the optimization process of rotating machines and so an efficient way to treat time-dependent effects such as eddy-currents or voltage-driven coils.

Originality/value
This paper proposes a new, efficient and accurate method to simulate a rotating machine in the frequency domain.
The power of localism during the long-term disaster recovery process
Authors: Marchezini Victor 
Published: September 2018

Purpose
The purpose of this paper is to analyze some barriers and the “drivers of localism” during the long-term disaster recovery process. The main question is: what types of discourses and practices about localism are being heard and revealed in the frontline?

Design/methodology/approach
Fieldwork, which was conducted from January 2010 to June 2013, consisted of participant observation and qualitative data collection. The authors opted for an approach that privileges narrative and observation, dialoguing with participants to gather local knowledge and information. Data were analyzed in light of the disaster recovery literature, focusing on disaster recovery as an expression of power relations.

Findings
Localism has been framed in diverse ways according to the interests of social groups placed in contextual meanings and, sometimes, in different phases of risk and disaster management. One important driver of localism is disaster narrative framing that allowed identification of how localism is composed, by whom and how.

Research limitations/implications
One important aspect that needs further research is longitudinal studies to investigate how the barriers are changing between the generations, and how intergenerational dialogues can be promoted to sustain long-term participation and localism.

Originality/value
This study recommends the need to identify who is talking about the importance of local and how localism has been framed in policy and action. It is important to empower localism in order to provide ways for local people sharing what is going on in the frontline. But it is also essential to provide funding and means of implementation for local initiatives regarding advocating, researching and proposing disaster recovery interventions led by people.