bluuebunny/crossref_metadata_2025_split huggingface dataset:
An international systems-theoretic comparison of hospital accreditation: developing an implementation typology
Authors: Chuang Sheuwen , Howley Peter P , Gonzales Shawon S 
Published: August 2018

Abstract

Objective
The integration of quality indicators into the accreditation process has been recognized as a promising strategy worldwide. This study was to explore the implementation patterns of hospital accreditation through the lens of a systems-theory based model, and determine an international accreditation implementation typology.

Design
A qualitative comparative study of five established international hospital accreditation systems was undertaken based on a systems-theoretic holistic healthcare systems relationship model. A set of key attributes relevant to three systems-theoretic model relationships guided data collection, comparison and synthesis.

Setting
Hospital accreditation systems in five countries: America, Canada, Australia, Taiwan and France.

Results
An accreditation implementation typology was developed based on the data synthesis of the similarities and differences among the relationships. A typology including five implementation types of hospital accreditation systems (TYPE I–V) was induced. TYPE I is a basic stand-alone accreditation system. The higher types represent stronger relationships among accreditation system, healthcare organizations and quality measurement systems. The five settings have shifted their accreditation approaches from the basic type (TYPE I).

Conclusions
The implementation typology of hospital accreditation could serve as a roadmap for refining hospital accreditation systems toward an integrative approach for continuous quality improvement.
Advance Care Planning Education Sessions During Pulmonary Rehabilitation in Ireland
Authors: Korn Bettina , Bailey-Scanlan Maria , Ribeiro Leo Honse , Broderick Julie 
Published: August 2018

Purpose:
This study aimed to investigate the practice of advance care planning (ACP) education within pulmonary rehabilitation programs (PRPs) in Ireland.

Methods:
All 27 PRPs in the Republic of Ireland were surveyed between May and September 2015, eliciting detailed quantitative and qualitative information about ACP education delivery. Data were analyzed using SPSS statistical software and content analysis.

Results:
Twenty-two PRPs (82%) took part in the survey, with 86% (n = 19) of these being delivered in a hospital setting. Forty-five percent (n = 10) included ACP education of at least 20-min duration (n = 5) or as part of another session (n = 5). ACP topics discussed differed significantly across PRP sites. Sessions were delivered by respiratory nurses, physiotherapists, physicians, or palliative care physicians. Of the 12 sites currently not providing ACP education, almost half (n = 5) indicated a willingness to include this in the near future. Respondents identified enablers and barriers to ACP education, as well as staff education and service delivery gaps.

Conclusions:
Results demonstrate an overwhelmingly positive attitude toward ACP education. There is a need for ACP-specific education for all staff members involved in PRPs. Practical guidance on how to deliver this patient education component needs to be developed.
CORRELATIONS BETWEEN CHOROIDAL STRUCTURES AND VISUAL FUNCTIONS IN EYES WITH RETINITIS PIGMENTOSA
Authors: Egawa Mariko , Mitamura Yoshinori , Niki Masanori , Sano Hiroki , Miura Gen , Chiba Akihiro , Yamamoto Shuichi , Sonoda Shozo , Sakamoto Taiji 
Published: August 2018

Purpose:
To investigate the choroidal structures in the enhanced depth imaging optical coherence tomographic images in eyes with retinitis pigmentosa (RP) and to determine correlations between the choroidal structures and visual functions.

Methods:
The enhanced depth imaging optical coherence tomographic images of 100 eyes with typical RP and 60 age-, sex-, and axial length–matched normal eyes were binarized using ImageJ. The cross-sectional luminal and stromal areas of the inner and outer subfoveal choroid of 1,500-µm width were measured. The inner choroid included the choriocapillaris and medium vessel layer, and the outer choroid included the larger vessel layer.

Results:
In the inner choroid, the luminal area and the ratio of luminal/total choroidal area (L/C ratio) were significantly smaller in RP than in controls (P = 0.010, P < 0.001, respectively), whereas the stromal area was not significantly different (P = 0.114). The inner choroidal L/C ratio was significantly correlated with the best-corrected visual acuity, mean deviation, foveal sensitivity, width of the ellipsoid zone, and central foveal thickness in RP after adjusting for the axial length, age, and sex (all P < 0.005).

Conclusion:
The significant correlations between the inner choroidal structures and the visual functions and retinal structures indicate that the choroidal structures are altered in association with the progression of RP.
Geographic Variation in the Initiation of Commonly Used Opioids and Dosage Strength in United States Nursing Homes
Authors: Hunnicutt Jacob N. , Baek Jonggyu , Alcusky Matthew , Hume Anne L. , Liu Shao-Hsien , Ulbricht Christine M. , Tjia Jennifer , Lapane Kate L. 
Published: August 2018

Objectives:
To examine and quantify geographic variation in the initiation of commonly used opioids and prescribed dosage strength among older US nursing home residents.

Methods:
We merged 2011 Minimum Data Set 3.0 to Medicare claims and facility characteristics data to conduct a cross-sectional study among long-stay nursing home residents who initiated short-acting opioids commonly used in nursing homes (oxycodone, hydrocodone, or tramadol). We examined geographic variation in specific opioids initiated and potentially inappropriate doses (≥50 mg oral morphine equivalent/d) across hospital referral regions (HRRs). Multilevel logistic models quantified the proportional change in between-HRR variation and associations between commonly initiated opioids and inappropriate doses after adjusting for resident characteristics, facility characteristics, and state.

Results:
Oxycodone (9.4%) was initiated less frequently than hydrocodone (56.2%) or tramadol (34.5%) but varied dramatically between HRRs (range, 0%–74.5%). In total, resident/facility characteristics and state of residence, respectively explained 84.1%, 58.2%, 59.1%, and 46.6% of the between-HRR variation for initiating oxycodone, hydrocodone, tramadol, and inappropriate doses. In all cases, state explained the largest proportion of between-HRR variation. Relative to hydrocodone, residents initiating oxycodone were more likely (adjusted odds ratio, 5.00; 95% confidence interval, 4.57–5.47) and those initiating tramadol were less likely (adjusted odds ratio, 0.28; 95% confidence interval, 0.25–0.31) to be prescribed potentially inappropriately high doses.

Conclusions:
We documented extensive geographic variation in the opioid and dose initiated for nursing home residents, with state explaining the largest proportion of the observed variation. Further work is needed to understand potential drivers of opioid prescribing patterns at the state level.
Hypothermia as an Outcome Predictor Tool in Pediatric Trauma
Authors: McCarty Thomas R. , Abramo Thomas J. , Maxson Robert T. , Albert Gregory , Rettiganti Mallikarjuna R. , Saylors Marie E. , Orsborn Jonathan W. , Hollingsworth Amanda I. 
Published: August 2018

ObjectiveHypothermia is an independent risk factor for mortality in adult trauma patients. Two small studies have shown similar results in pediatric trauma patients. Temperature is not included in any pediatric trauma assessment scores. This study sought to compare mortality and various descriptive outcomes between pediatric hypothermic and normothermic trauma patients.MethodsData were obtained from the National Trauma Database from 2009 to 2012. Patients meeting inclusion criteria were stratified by presence of isolated head injury, head injury with multiple trauma, and absence of head injury. These groups were then subdivided into hypothermic (temperature ≤36°C) and normothermic groups. We used propensity score matching to 1:1 match hypothermic and normothermic patients. Mortality, neurosurgical interventions, endotracheal intubation, blood transfusion, length of stay, laparotomy, thoracotomy, conversion of cardiac rhythm, and time receiving mechanical ventilation were evaluated.ResultsData from 3,011,482 patients were obtained. There were 414,562 patients who met the inclusion criteria. In all patients meeting inclusion criteria, hypothermia was a significant risk factor in all outcomes measured. Following stratification and 1:1 matching, in all groups, hypothermia was associated with increased mortality (P< 0.0001), increased rate of endotracheal intubation (P< 0.0002), increased need for blood transfusion (P< 0.0025), and conversion of cardiac rhythm (P< 0.0027).ConclusionHypothermia has been shown to be a significant prognostic indicator in the pediatric trauma patient with further potential application. Future studies are indicated to evaluate the incorporation of hypothermia into the Pediatric Trauma Score not only to help predict injury severity and mortality but also to improve appropriate and expeditious patient transfer to pediatric trauma centers and potentially facilitate earlier intervention.
Prediction of Occult Lymph Node Metastasis Using Tumor-to-Blood Standardized Uptake Ratio and Metabolic Parameters in Clinical N0 Lung Adenocarcinoma
Authors: Ouyang Ming-li , Tang Kun , Xu Man-man , Lin Jie , Li Tian-cheng , Zheng Xiang-wu 
Published: August 2018

Purpose
We aimed to investigate whether the tumor-to-blood SUV ratio (SUR) and metabolic parameters of 18F-FDG uptake could predict occult lymph node metastasis (OLM) in clinically node-negative (cN0) lung adenocarcinoma.

Materials and Methods
We retrospectively reviewed 157 patients with cN0 lung adenocarcinoma who underwent both preoperative 18F-FDG PET/CT and surgical resection with the systematic lymph node dissection. The SUVmax, SUVmean, MTV, and total lesion glycolysis (TLG) of the primary tumor was measured on the PET/CT workstation. SURmax, SURmean, and TLGsur were derived from each of them divided by descending aorta SUVmean. These PET parameters and clinicopathological variables were analyzed for OLM.

Results
In our study, OLM was detected in 31 (19.7%) of 157 patients. Significantly higher values of tumor size, SUVmax, SUVmean, MTV, TLGsuv, SURmax, SURmean, and TLGsur were found in patients with OLM. In receiver operating characteristic curve analysis, the optimal cutoff values of the above parameters were 29.50, 4.38, 2.45, 6.37, 44.13, 5.30, 1.86, and 28.24, respectively. The multivariate analysis showed that TLGsur (odds ratio, 1.024; P = 0.002) was the most potent associated factor for the prediction of OLM in cN0 lung adenocarcinoma.

Conclusions
TLGsur showed the most powerful predictive performance than the other PET parameters for the prediction of OLM in cN0 lung adenocarcinoma. This normalized volumetric parameter would be helpful in selection of sublobar resection or aggressive tailored treatments in patients with cN0 lung adenocarcinoma.
Single-axon-resolution intravital imaging reveals a rapid onset form of Wallerian degeneration in the adult neocortex
Authors: Canty A.J. , Jackson J.S. , Huang L. , Trabalza A. , Bass C. , Little G. , De Paola V 
Published: August 2018

ABSTRACTDespite the widespread occurrence of axon degeneration in the injured and diseased nervous system, the mechanisms of the degenerative process remain incompletely understood. In particular, the factors that regulate how individual axons degenerate within their native environment in the mammalian brain are unknown. Longitudinal imaging of >120 individually injured cortical axons revealed a threshold length below which injured axons undergo a rapid-onset form of Wallerian degeneration (ROWD). ROWD consistently starts 10 times earlier and is executed 4 times slower than classic Wallerian degeneration (WD). ROWD is dependent on synaptic density, unlike WD, but is independent of axon complexity. Finally, we provide both pharmacological and genetic evidence that a Nicotinamide Adenine Dinucleotide (NAD+)-dependent pathway controls cortical axon ROWD independent of transcription in the damaged neurons. Thus, our data redefine the therapeutic window for intervention to maintain neurological function in injured cortical neurons, and support the use ofin vivooptical imaging to gain unique insights into the mechanisms of axon degeneration in the brain.
Mining unknown porcine protein isoforms by tissue-based map of proteome enhances the pig genome annotation
Authors: Zhao Pengju , Zheng Xianrui , Yu Ying , Hou Zhuocheng , Diao Chenguang , Wang Haifei , Kang Huimin , Ning Chao , Li Junhui , Feng Wen , Wang Wen , Liu George E. , Li Bugao , Smith Jacqueline , Chamba Yangzom , Liu Jian-Feng 
Published: August 2018

AbstractA lack of the complete pig proteome has left a gap in our knowledge of the pig genome and has restricted the feasibility of using pigs as a biomedical model. We developed the tissue-based proteome maps using 34 major normal pig tissues. A total of 7,319 unknown protein isoforms were identified and systematically characterized, including 3,703 novel protein isoforms, 669 protein isoforms from 460 genes symbolized beginning with LOC, and 2,947 protein isoforms without clear NCBI annotation in current pig reference genome. These newly identified protein isoforms were functionally annotated through profiling the pig transcriptome with high-throughput RNA sequencing (RNA-seq) of the same pig tissues, further improving the genome annotation of corresponding protein coding genes. Combining the well-annotated genes that having parallel expression pattern and subcellular witness, we predicted the tissue related subcellular components and potential function for these unknown proteins. Finally, we mined 3,656 orthologous genes for 49.95% of unknown protein isoforms across multiple species, referring to 65 KEGG pathways and 25 disease signaling pathways. These findings provided valuable insights and a rich resource for enhancing studies of pig genomics and biology as well as biomedical model application to human medicine.
Abundance of Whales in West and East Greenland in Summer 2015
Authors: Hansen Rikke G. , Boye Tenna K. , Larsen Rasmus S. , Nielsen Nynne H. , Tervo Outi , Nielsen Rasmus D. , Rasmussen Marianne H. , Sinding Mikkel H.S. , Heide-Jørgensen Mads Peter 
Published: August 2018

ABSTRACTAn aerial line transect survey of whales in West and East Greenland was conducted in August-September 2015. The survey covered the area between the coast of West Greenland and offshore (up to 100 km) to the shelf break. In East Greenland, the survey lines covered the area from the coast up to 50 km offshore crossing the shelf break. A total of 423 sightings of 12 cetacean species were obtained and abundance estimates were developed for common minke whale, from now on called minke whale, (Balaenoptera acutorostrata)(32 sightings), fin whale (Balaenoptera physalus) (129 sightings), humpback whale (Megaptera novaeangliae)(84 sightings), harbour porpoise (Phocoena phocoena)(55 sightings), long-finned pilot whale, from now on called pilot whale, (Globicephala melas)(42 sightings) and white-beaked dolphins (Lagenorhynchus albirostri)(50 sightings). The developed at-surface abundance estimates were corrected for both perception bias and availability bias if possible. Data on surface corrections for minke whales and harbour porpoises were collected from whales instrumented with satellite-linked time-depth-recorders. Options for estimation methods are presented and the preferred estimates are: Minke whales: 5,095 (95% CI: 2,171-11,961) in West Greenland and 2,762 (95% CI: 1,160-6,574) in East Greenland, fin whales: 2,215 (95% CI: 1,017-4,823) in West Greenland and 6,440 (95% CI: 3,901-10,632) in East Greenland, humpback whales: 993 (95% CI: 434-2,272) in West Greenland and 4,223 (95%CI: 1,845-9,666) in East Greenland, harbour porpoise: 83,321 (95% CI: 43,377-160,047) in West Greenland and 1,642 (95% CI: 319-8,464) in East Greenland, pilot whales: 9,190 (95% CI: 3,635-23,234) in West Greenland and 258 (95% CI: 50-1,354) in East Greenland, white-beaked dolphins 15,261 (95% CI: 7,048-33,046) in West Greenland and 11,889 (95% CI: 4,710-30,008) in East Greenland. The abundance of cetaceans in coastal areas of East Greenland has not been estimated before, but the limited historical information from the area indicate that the achieved abundance estimates were remarkably high. When comparing the abundance estimates from 2015 in West Greenland with a similar survey conducted in 2007 there is a clear trend towards lower densities in 2015 for the three baleen whale species and white-beaked dolphins. Harbour porpoises and pilot whales however, did not show a similar decline. The decline in baleen whale and white-beaked dolphin abundance is likely due to emigration to the East Greenland shelf areas where recent climate driven changes in pelagic productivity may have accelerated favourable conditions for these species.
The sterol-responsive RNF145 E3 ubiquitin ligase mediates the degradation of HMG-CoA reductase together with gp78 and Hrd1
Authors: Menzies Sam A. , Volkmar Norbert , van den Boomen Dick J. , Timms Richard T. , Dickson Anna S. , Nathan James A. , Lehner Paul J. 
Published: August 2018

ABSTRACTHMG-CoA reductase (HMGCR), the rate-limiting enzyme of the cholesterol biosynthetic pathway and the therapeutic target of statins, is post-transcriptionally regulated by sterol-accelerated degradation. Under cholesterol-replete conditions, HMGCR is ubiquitinated and degraded, but the identity of the E3 ubiquitin ligase(s) responsible for mammalian HMGCR turnover remains controversial. Using systematic, unbiased CRISPR/Cas9 genome-wide screens with a sterol-sensitive endogenous HMGCR reporter, we comprehensively map the E3 ligase landscape required for sterol-accelerated HMGCR degradation. We find that RNF145 and gp78, independently co-ordinate HMGCR ubiquitination and degradation. RNF145, a sterol-responsive ER-resident E3 ligase, is unstable but accumulates following sterol depletion. Sterol addition triggers RNF145 recruitment to HMGCR and Insig-1, promoting HMGCR ubiquitination and proteasome-mediated degradation. In the absence of both RNF145 and gp78, Hrd1, a third UBE2G2-dependent ligase partially regulates HMGCR activity. Our findings reveal a critical role for the sterol-responsive RNF145 in HMGCR regulation and elucidate the complexity of sterol-accelerated HMGCR degradation.
Intracellular mechanisms of fungal space searching in microenvironments
Authors: Held Marie , Kaspar Ondrej , Edwards Clive , Nicolau Dan V. 
Published: August 2018

AbstractThe underlying intracellular mechanisms involved in the fungal growth received considerable attention, but the experimental and theoretical work did not take into account the modulation of these processes by constraining microenvironments similar to many natural fungal habitats. To fill this gap in the scientific knowledge, we used time-lapse live-cell imaging of Neurospora crassa growth in custom-built confining microfluidics environments. We show that the position and dynamics of the Spitzenkörper-microtubules system in constraining environments differs markedly from that associated with unconstrained growth. First, when hyphae encounter an obstacle at shallow angles, the Spitzenkörper moves from its central position in the apical dome off-axis towards a contact with the obstacle, thus functioning as a compass preserving the ‘directional memory’ of the initial growth. The trajectory of Spitzenkörper is also followed by microtubules, resulting in a ‘cutting corners’ pattern of the cytoskeleton in constrained geometries. Second, when an obstacle blocks a hypha at nearnormal incidence, the Spitzenkörper-microtubule system temporarily disintegrates, followed by the formation of two equivalent systems in the proto-hyphae – the basis of obstacle-induced branching. Third, a hypha, passing a lateral opening along a wall, continues to grow largely unperturbed while a lateral proto-hypha gradually branches into the opening, which starts forming its own Spitzenkörper-microtubule system. These observations suggest that the Spitzenkörper-microtubules system conserves the directional memory of the hyphae when they navigate around obstacles, but in the absence of the Spitzenkörper-microtubule system during constrainment-induced apical splitting and lateral branching, the probable driving force of obstacle-induced branching is the isotropic turgor pressure.
Comparing the metabolic fates of BALB/c mice maintained on cafeteria-style diets with differential nutritive values
Authors: Zaid Muhammad , Ameer Fatima , Ali Ayesha , Shoukat Zunaira , Rashid Rida , Iqbal Ibrar , Zaidi Nousheen 
Published: August 2018

AbstractCafeteria (CAF) diet-fed rodents are shown to provide a robust model of metabolic syndrome and human obesity. The carbohydrate/fat-rich food-items provided to the CAF-diet-model more closely approximate the ultra-processed human diet. However, most of the previous studies applied the commercially available rodent chow-diet for the comparative analyses and labeled it as a healthy-diet. The presented work aims to extend the knowledge on CAF-diet model by exposing the mice to human foods with different nutritional values. Our major goal was to study the metabolic fates of mice maintained on human food-items, which depending upon on their macronutrient compositions are categorized as healthy or unhealthy. BALB/c mice were randomly allocated to one of the three dietary intervention groups, standard chow diet; high-sugar/high-fat-cafeteria (HSHF-CAF) diet; or low-sugar/low-fat-cafeteria (LSLF-CAF) diet, for 5 weeks. The differences in multiple metabolic parameters (including food-/energy /macronutrient-intake, body-weight gain rate, organ-to-body weight ratios, plasma lipid profiles, adipocyte physiology, lipid deposition in metabolic tissues and ectopic fat storage in heart and kidney) were compared among the three intervention groups. We did not observe hyperphagia in mice maintained on CAF-diets. Nonetheless, the CAF-diet-fed mice displayed increased weight-gain-rate, adiposity, and adipocyte hypertrophy when compared to the chow-fed mice. However, the mice maintained on the two cafeteria-style diets displayed similar metabolic profiles, with HSHF-CAF-group displaying slightly higher weight-gain-rate. The HSHF-CAF-and LSLF-CAF-diet induced comparable adiposity in BALB/c mice. Further studies, with longer dietary intervention periods, are required to elucidate the effects of differential CAF-diets on the metabolic health of mice.
Mitochondrial DNA and temperature tolerance in lager yeasts
Authors: Baker EmilyClare P. , Peris David , Moriarty Ryan V. , Li Xueying C. , Fay Justin C. , Hittinger Chris Todd 
Published: August 2018

AbstractA growing body of research suggests that the mitochondrial genome (mtDNA) is important for temperature adaptation. In the yeast genusSaccharomyces, species have diverged in temperature tolerance, driving their use in high or low temperature fermentations. Here we experimentally test the role of mtDNA in temperature tolerance in synthetic and industrial hybrids (Saccharomyces cerevisiaexSaccharomyces eubayanus, orSaccharomyces pastorianus), which cold-brew lager beer. We find that the relative temperature tolerances of hybrids correspond to the parent donating mtDNA, allowing us to modulate lager strain temperature preferences. The strong influence of mitotype on the temperature tolerance of otherwise identical hybrid strains provides support for the mitochondrial climactic adaptation hypothesis in yeasts and demonstrates how mitotype has influenced the world's most commonly fermented beverage.One Sentence SummaryMitochondrial genome origin affects the temperature tolerance of synthetic and industrial lager-brewing yeast hybrids.