bluuebunny/crossref_metadata_2025_split huggingface dataset:
Standardized, Patient-specific, Postoperative Opioid Prescribing After Inpatient Orthopaedic Surgery
Authors: Chen Eric Y. , Betancourt Lauren , Li Lulu , Trucks Emma , Marcantonio Andrew , Tornetta Paul 
Published: July 2019

Background:
Opioid-related mortality has increased over the past 2 decades, leading to the recognition of a nationwide opioid epidemic and prompting physicians to reexamine their opioid prescribing practices. At our institutions, we had no protocol for prescribing opioids upon discharge after inpatient orthopaedic surgery, resulting in inconsistent and potentially excessive prescribing. Here, we report the results of the implementation of a patient-specific protocol using an opioid taper calculator to standardize opioid prescribing at discharge after inpatient orthopaedic surgery.

Methods:
The opioid taper calculator is a tool that creates a patient-specific opioid taper based on each patient's 24-hour predischarge opioid utilization. We implemented this taper for patients discharged after inpatient orthopaedic surgery at our two institutions (Boston Medical Center and Lahey Hospital and Medical Center—Burlington Campus). We compared discharge opioid quantities between orthopaedic patients postimplementation and quantities prescribed preimplementation. We also compared discharge opioid quantities between orthopaedic and nonorthopaedic surgical services over the same time period.

Results:
Nine-months postimplementation, a patient-specific taper was used in 74% of eligible discharges, resulting in a 24% reduction in opioids prescribed at discharge, along with a 35% reduction in variance. Over the same time frame, a smaller reduction (9%) was seen in the opioids prescribed at discharge by nonorthopaedic services. The most notable reductions were seen after total joint arthroplasty and spinal fusions. Despite this reduction, most patients (65%) reported receiving sufficient opioids, and no substantial change was observed in 30-day postdischarge opioid prescription refills after versus before protocol implementation (1.58 versus 1.71 fills per discharge).

Discussion:
Using the opioid taper calculator, a patient-specific taper can be successfully used to standardize opioid prescribing at discharge after inpatient orthopaedic surgery without a substantial risk of underprescription.

Level of Evidence:
Level II
The Impact of a Play-Based Training Program on Reducing the Negative Effects of Students Abuse and Improving Their Self-Esteem
Authors: Aldmour Hisham Ali 
Published: July 2019

The aim of this study was to investigate the effect of a play-based program on reducing the effects of student’s abuse and to improving their self-esteem. To achieve this goal, a sample was selected and composed of 60 male and female abused students. They were divided into two groups: control group and experimental group which both consisted of 30 students. The experimental group was divided into two groups: the first consisted of 15 male students, while the second consisted of 15 female students. The measure of exposure to abuse and the self-assessment scale were applied as an anterior and posterior test of both experimental and control groups. The experimental group was only exposed to training through the training program.
After completing the data collection, the means and standard deviations of the performance of the experimental and control groups were calculated on the study scales. The multivariate variance analysis was also conducted to identify the impact of the training program on gender. The results of this study showed statistically significant differences at the mean level (α ≤ 0.05) between the performance mean of experimental and control groups. These differences were in favor of the experimental group that improved their level of self-esteem and decreased the level of exposure to abuse. The results also showed that there were no statistically significant differences at the level of significance (α ≤ 0.05) between the female and male performance means.
Novel Approach to Introducing an Ultrasonography Curriculum With Limited Instructor Resources
Authors: Evans Danika K. , Thiessen Molly E.W. 
Published: July 2019

Abstract

Context
Ultrasonography is becoming more prevalent in clinical practice, but medical schools looking to implement preclinical training are limited by financial and faculty resources.

Objective
To design a single-instructor model to save faculty resources and to determine whether this model is effective at teaching ultrasonography to preclinical medical students.

Methods
This single-instructor model included 3 components: (1) flipped classroom, where students watched an online lecture covering examination techniques; (2) in-person scanning sessions, where students scanned each other after the instructor went through lecture content and pathologic images, a video camera to show probe placement and examination technique, and a live feed from an ultrasonography demonstration; and (3) feedback on written examination questions and course evaluations.

Results
When compared with a traditional ultrasonography curriculum, which requires approximately 600 instruction hours annually, this program required 96 hours. Students reported appreciation of exposure to ultrasonography but expressed desire for smaller group sizes and greater individual instruction. Students performed well on written test questions, with the first-year class answering 88% correctly and the second-year class answering 90.6% correctly.

Conclusions
Although this educational format was used successfully to teach introductory ultrasonography to preclinical students, feedback suggested that students would prefer more individual instruction. The authors look toward implementing a peer-instructor format, forming smaller laboratory groups, and improving skill assessment.
Identification of cecum time-location in a colonoscopy video by deep learning analysis of colonoscope movement
Authors: Cho Minwoo , Kim Jee Hyun , Hong Kyoung Sup , Kim Joo Sung , Kong Hyoun-Joong , Kim Sungwan 
Published: July 2019

BackgroundCecal intubation time is an important component for quality colonoscopy. Cecum is the turning point that determines the insertion and withdrawal phase of the colonoscope. For this reason, obtaining information related with location of the cecum in the endoscopic procedure is very useful. Also, it is necessary to detect the direction of colonoscope’s movement and time-location of the cecum.MethodsIn order to analysis the direction of scope’s movement, the Horn–Schunck algorithm was used to compute the pixel’s motion change between consecutive frames. Horn–Schunk-algorithm applied images were trained and tested through convolutional neural network deep learning methods, and classified to the insertion, withdrawal and stop movements. Based on the scope’s movement, the graph was drawn with a value of +1 for insertion, −1 for withdrawal, and 0 for stop. We regarded the turning point as a cecum candidate point when the total graph area sum in a certain section recorded the lowest.ResultsA total of 328,927 frame images were obtained from 112 patients. The overall accuracy, drawn from 5-fold cross-validation, was 95.6%. When the value of “t” was 30 s, accuracy of cecum discovery was 96.7%. In order to increase visibility, the movement of the scope was added to summary report of colonoscopy video. Insertion, withdrawal, and stop movements were mapped to each color and expressed with various scale. As the scale increased, the distinction between the insertion phase and the withdrawal phase became clearer.ConclusionInformation obtained in this study can be utilized as metadata for proficiency assessment. Since insertion and withdrawal are technically different movements, data of scope’s movement and phase can be quantified and utilized to express pattern unique to the colonoscopist and to assess proficiency. Also, we hope that the findings of this study can contribute to the informatics field of medical records so that medical charts can be transmitted graphically and effectively in the field of colonoscopy.
Genetic diversity in natural populations of noble crayfish (Astacus astacusL.) in north-western Poland on the basis of combined SSR and AFLP data
Authors: Panicz Remigiusz , Napora-Rutkowski Łukasz , Keszka Sławomir , Skuza Lidia , Szenejko Magdalena , Śmietana Przemysław 
Published: July 2019

BackgroundConservation of noble crayfish (Astacus astacus) populations is becoming particularly important since the number of individuals is rapidly declining across the distribution range of the species in Europe. Five crayfish populations in northwestern Poland have been constantly monitored for two decades. However, the genetic structure of these populations has not been analysed, although this information is important to devise effective conservation strategies.MethodsNoble crayfish were collected in the autumn of 2014 by scuba diving in Lakes Graniczne, Babinki, Biwakowe, Sęki and Kwisno, all of which are situated in the Bytów Lakeland of northwestern Poland. Genetic diversity of the five populations was assessed based on allele variability in nine SSR regions and six AFLP primer combinations.ResultsMicrosatellite results analysed with AMOVA showed that the diversity between populations corresponds to 18% of total variability, which was confirmed by similar results obtained using AFLP. Additionally, significant genetic diversity was revealed by high average FSTvalues. All of the studied crayfish populations significantly deviated from the expected Hardy–Weinberg genetic equilibrium and were characterised by negative values of inbreeding coefficient (FIS).DiscussionThe invariably negative inbreeding coefficients (FIS) suggest a low number of mating individuals, a possible consequence of the phenomenon known as genetic bottleneck. However, additional comprehensive analyses are needed to assess the genetic structure, origin and vulnerability of the remaining populations of noble crayfish in the Bytów Lakeland of northwestern Poland, which have high conservation value and are particularly important as a live genetic bank for breeding and restitution purposes.
Mobile learning in dentistry: usage habits, attitudes and perceptions of undergraduate students
Authors: Suner Aslı , Yilmaz Yusuf , Pişkin Beyser 
Published: July 2019

IntroductionThe aim of this study was to evaluate usage habits, attitudes and perceptions towards mobile learning (m-learning), as well as to identify variables related to those attitudes amongst undergraduate dental students.Materials and MethodsThe study consists of 81 dental undergraduate students who who volunteered to participate. The data collection tool consists of an m-learning attitude scale, a questionnaire, and open-ended questions. To compare the total scores and factors of m-learning attitude scale for demographic information and mobile technology usage habits of the students; the Mann–WhitneyUtest was used for two independent groups such as gender, presence of electronic devices, and places of Internet usage. The Kruskal–Wallis test was also used to compare the total scores and factors of m-learning attitude scale for more than two independent groups including internet usage purposes and opinions. Spearman’s correlation coefficient was performed, and linear regression analysis was used to predict the change in total score according to the purposes of Internet usage.ResultsThe majority of students thought that the use of mobile devices in dentistry courses was useful and their attitudes towards m-learning were high. The students generally use the Internet for online shopping, connecting to social networks, and communication. They tend to use mobile technologies for personal use, followed by educational purposes. There were significant differences found in the m-learning attitudes for gender, having a portable power supply and use of mobile devices in dentistry courses. Communication was found significant in predicting the change in total score for the m-learning attitude scale according to the purpose of Internet usage.ConclusionDental students have generally positive attitudes towards m-learning. Students raise awareness towards the promise of m-learning in order to apply their individual technology use and learning behaviours. Designing learning materials and applications for mobile devices may increase students’ performances.
Integrative analysis of transcriptome-wide association study and gene expression profiling identifies candidate genes associated with stroke
Authors: Yang Jian , Yan Bin , Fan Yajuan , Yang Lihong , Zhao Binbin , He Xiaoyan , Ma Qingyan , Wang Wei , Bai Ling , Zhang Feng , Ma Xiancang 
Published: July 2019

Background
Stroke is a major public health burden worldwide. Although genetic variation is known to play a role in the pathogenesis of stroke, the specific pathogenic mechanisms are still unclear. Transcriptome-wide association studies (TWAS) is a powerful approach to prioritize candidate risk genes underlying complex traits. However, this approach has not been applied in stroke.

Methods
We conducted an integrative analysis of TWAS using data from the MEGASTROKE Consortium and gene expression profiling to identify candidate genes for the pathogenesis of stroke. Gene ontology (GO) enrichment analysis was also conducted to detect functional gene sets.

Results
The TWAS identified 515 transcriptome-wide significant tissue-specific genes, among which SLC25A44 (P = 5.46E−10) and LRCH1 (P = 1.54E−6) were significant by Bonferroni test for stroke. After validation with gene expression profiling, 19 unique genes were recognized. GO enrichment analysis identified eight significant GO functional gene sets, including regulation of cell shape (P = 0.0059), face morphogenesis (P = 0.0247), and positive regulation of ATPase activity (P = 0.0256).

Conclusions
Our study identified multiple stroke-associated genes and gene sets, and this analysis provided novel insights into the genetic mechanisms underlying stroke.
Analysis of BnMTL, a novel metallothionein‐like protein in the bast fiber crop Ramie (Boehmeria nivea)
Authors: Gao Gang , Chen Jikang , Chen Ping , Chen Kunmei , Abubakar Aminu Shehu , Yu Chunming , Zhu Aiguo 
Published: July 2019

Ramie (Boehmeria nivea) is a perennial herb that is highly tolerant of heavy metals. In the present study, we cloned a novel metallothionein‐like gene from ramie; this gene, termed BnMTL, encodes a putative 46 amino acid protein with a molecular mass of 4.38 kDa. Analysis using quantitative RT‐PCR revealed that cadmium (Cd2+) treatment results in elevated expression of BnMTL in the roots. We heterologously overexpressed BnMTL in Escherichia coli cells to examine its binding to Cd2+ and its possible role in homeostasis. Recombinant E. coli cells expressing BnMTL exhibited a high tolerance of Cd2+ stress up to a concentration of 1 mm, and the observed accumulation of Cd2+ was almost eight‐fold higher than the control. These results demonstrate that BnMTL (i) is highly expressed in the root following exposure to Cd2+ and (ii) encodes a typical metallothionein‐like protein with high cadmium‐binding activity.
Virus Diseases of Potatoes
Authors: Torrance Lesley 
Published: July 2019

Abstract

The cultivated potato (
Solanum tuberosum
L.) is known to be infected by at least 40 viruses. Viruses pose a continuing threat to potato production through yield losses and degrading stocks of seed tubers. Some viruses can be controlled by crop management practices, but the most effective and environmentally beneficial method is through host resistance. Climate change is expected to increase virus disease incidence; however, developments in plant breeding technologies to breed resistant cultivars together with integrated management practices show much potential to control existing and emerging virus diseases.

Key Concepts

The most economically important viruses of potato.

Control of virus disease incidence in potato production systems.

Virus resistance mechanisms.

Methods of virus detection and identification.

Future threats to potato from climate change.
Sex Chromosome Dosage Compensation
Authors: Csankovszki Gyorgyi 
Published: July 2019

Abstract

Organisms that use a chromosome‐based mechanism for sex determination must contend with the resulting sex‐linked gene dosage imbalance between males and females. While some organisms appear to tolerate gene‐dosage differences, others have evolved compensatory processes. The molecular mechanisms behind dosage compensation are only understood in a few organisms. In the fruit fly
Drosophila melanogaster
, XY males upregulate X‐linked gene expression two‐fold by a process that involves histone acetylation. Whether other lineages upregulate the male X is currently highly debated. Then in mammals, XX females inactivate one of their two X chromosomes using the long noncoding RNA
Xist
and repressive chromatin modifications. In the nematode
Caenorhabditis elegans
, XX hermaphrodites downregulate gene expression from both X chromosomes two‐fold by the action of a protein complex resembling the mitotic chromosome compaction machinery. Detailed studies of these mechanisms provided insights into not just dosage compensation, but the broader field of gene regulation in general.

Key Concepts

Differences in sex chromosome dose create a gene expression imbalance.

Some lineages tolerate sex‐chromosome‐linked imbalances, other lineages evolved mechanisms to compensate for the differences in gene dosage.

Complete balance includes balancing the single male X to autosomes and equalising sex‐linked gene dosage between the sexes.

The MSL complex binds to the X chromosome in male
Drosophila
to upregulate gene expression two‐fold.

The MSL subunit MOF acetylates lysine 16 on histone H4 in gene bodies, leading to enhancement of transcription elongation.

The noncoding RNA
Xist
is expressed from the inactive X chromosome of female mammals.

Xist
RNA recruits chromatin‐modifying activities to transcriptionally silence the chromosome.

The condensin‐like DCC binds both X chromosomes of hermaphroditic nematodes to dampen gene expression two‐fold.

The DCC remodels and compacts the chromosome and recruits histone‐modifying enzymes to limit RNA Polymerase II loading onto the chromosomes.
Giant Bacteria
Authors: Ionescu Danny , Bizic Mina 
Published: July 2019

AbstractFor almost all bacteria, it is convenient to be very small, but a few highly specialist groups of bacteria have evolved to be orders of magnitude larger than ordinary bacteria. While some of these giant microbes are abnormally large in all dimensions, others are long and thin or consist of assemblages of multiple cells. These giant bacteria are spread across the domain Bacteria and have evolved multiple ways to combat diffusion constrains. Giant bacteria often thrive in nutrient and carbon‐rich environments and/or in steep redox gradients. Genomically, giant bacteria seem all to be polyploid, that is containing multiple copies of their genome. Giant bacteria have been described throughout the history of microbial research but only some of them can be traced in current taxonomy and are being actively studied. Therefore, it is likely there are other giant bacteria in nature, awaiting to be explored.Key ConceptsGrowth and activity of giant bacteria are expected to be constrained by a combination of diffusion of nutrients into the cells as well as intracellular trafficking of solutes by diffusion.Giant bacteria can be divided into ‘truly’ giant, consisting of abnormally large cells on all dimensions, or ‘pseudo‐giant’ consisting of cells abnormally large on one axis or multicellular assemblages of bacteria.‘Pseudo‐giant’ bacteria may not face the same diffusion limitations as ‘truly’ giant bacteria.‘Truly’ giant bacteria likely ‘resolve’ diffusion constrains by one or more methods including, minimising cytoplasmic space by intracellular (pseudo)compartmentalisation, storage vacuoles, rapid swimming.Giant bacteria often grow in carbon‐ and nutrient‐rich environments and/or in steep redox gradients, thus additionally minimising diffusion‐related constraints.Current knowledge suggests that all giant bacteria contain multiple copies of their genomes being oligoploid (3–10 copies) or polyploid (10–1000s of copies).Gigantism in bacteria occurs in multiple phylogenetic lineages covering both Gram‐negative and Gram‐positive taxa.Early descriptions of giant bacteria suggest that the currently studied taxa do not encompass the entire diversity of abnormally large bacteria.
Guard Cell Actin Cytoskeleton
Authors: Jiang Kun , Shimono Masaki , Day Brad 
Published: July 2019

AbstractStomata are adjustable pores found predominantly in the leaf epidermis that control CO2influx into the apoplast and transpirational water loss. Guard cells enclosing the stomatal pore can perceive and respond to diverse stimuli via a complex signalling network: central to this signalling network is the actin cytoskeleton, which has been proposed as a critical component of stomatal guard cell function. Indeed, guard cell actin cytoskeletal filaments undergo dramatic conformational changes during biotic and abiotic stimulus‐induced stomatal movement. As a function of the genetic requirement for these highly regulated conformational changes, disruption of actin filament dynamics using pharmacological or genetic‐based approaches leads to stomatal insensitivity to the opening and closing signals. Recent advances in high‐resolution live‐cell microscopy have enabled the visualisation of the dynamic features of individual actin filaments, and in total, provided new knowledge about the quantitative properties of filament distribution and turnover. Additional studies have also revealed a spectrum of actin regulatory components and stomatal signalling events that are associated with cytoskeletal actin function in guard cells. Future research on stomatal actin signalling mutants will shed light on the mechanisms underlying the regulation of cell physiological processes and activation of responses to external stresses via actin re‐modelling.Key ConceptsThe guard cell actin cytoskeleton serves as a hub of the stomatal signalling network.The cortical actin arrays in guard cells rearrange rapidly to facilitate stomatal movement induced by biotic and abiotic stimuli.Reorganisation of actin filaments in guard cells is orchestrated by a diverse of actin‐binding proteins.The activation and repression of actin‐binding proteins are coordinated by a multitude of early signalling components of the stomatal signalling network.The reorganisation of cytoskeletal actin is mechanistically coupled to key guard cell signalling events such as transmembrane ion flux, membrane recycling and morphological changes of vacuoles.