bluuebunny/crossref_metadata_2025_split huggingface dataset:
Rectal Dissection Simulator for da Vinci Surgery: Details of Simulator Manufacturing With Evidence of Construct, Face, and Content Validity
Authors: Melich George , Pai Ajit , Shoela Ramy , Kochar Kunal , Patel Supriya , Park John , Prasad Leela , Marecik Slawomir 
Published: March 2018

BACKGROUND:
Apprenticeship in training new surgical skills is problematic, because it involves human subjects. To date there are limited inanimate trainers for rectal surgery.

OBJECTIVE:
The purpose of this article is to present manufacturing details accompanied by evidence of construct, face, and content validity for a robotic rectal dissection simulation.

DESIGN:
Residents versus experts were recruited and tested on performing simulated total mesorectal excision. Time for each dissection was recorded. Effectiveness of retraction to achieve adequate exposure was scored on a dichotomous yes-or-no scale. Number of critical errors was counted. Dissection quality was tested using a visual 7-point Likert scale. The times and scores were then compared to assess construct validity. Two scorer results were used to show interobserver agreement. A 5-point Likert scale questionnaire was administered to each participant inquiring about basic demographics, surgical experience, and opinion of the simulator. Survey data relevant to the determination of face validity (realism and ease of use) and content validity (appropriateness and usefulness) were then analyzed.

SETTINGS:
The study was conducted at a single teaching institution.

SUBJECTS:
Residents and trained surgeons were included.

INTERVENTION:
The study intervention included total mesorectal excision on an inanimate model.

MAIN OUTCOME MEASURES:
Metrics confirming or refuting that the model can distinguish between novices and experts were measured.

RESULTS:
A total of 19 residents and 9 experts were recruited. The residents versus experts comparison featured average completion times of 31.3 versus 10.3 minutes, percentage achieving adequate exposure of 5.3% versus 88.9%, number of errors of 31.9 versus 3.9, and dissection quality scores of 1.8 versus 5.2. Interobserver correlations of R = 0.977 or better confirmed interobserver agreement. Overall average scores were 4.2 of 5.0 for face validation and 4.5 of 5.0 for content validation.

LIMITATIONS:
The use of a da Vinci microblade instead of hook electrocautery was a study limitation.

CONCLUSIONS:
The pelvic model showed evidence of construct validity, because all of the measured performance indicators accurately differentiated the 2 groups studied. Furthermore, study participants provided evidence for the simulator’s face and content validity. These results justify proceeding to the next stage of validation, which consists of evaluating predictive and concurrent validity. See Video Abstract at http://links.lww.com/DCR/A551.
Effects of Team-Based Learning on the Core Competencies of Nursing Students: A Quasi-Experimental Study
Authors: Lee Kyung Eun 
Published: March 2018

ABSTRACT

Background:
An important goal of nursing education is helping students achieve core competencies efficiently. One proposed way of improving nursing education is team-based learning (TBL).

Purpose:
The aim of this study was to assess the comparative effectiveness of TBL and lecture-style classes in terms of teaching core competencies in nursing education, which include clinical competence skills, problem-solving ability, communication competencies, critical thinking ability, and self-leadership.

Methods:
This quasi-experimental study enrolled 183 students as participants, with 95 and 88 in the experimental and control groups, respectively. These two groups attended 6 hours (2 hours weekly for 3 weeks) of TBL and lecture-style classes, respectively. Differences in core competencies between the two groups were compared before and after the intervention.

Results:
The experimental group achieved significantly higher scores for clinical competence skills, communication competence, critical thinking ability, and self-leadership at posttest than at pretest, whereas the control group achieved significantly higher scores for clinical competence skills and critical thinking ability at posttest than at pretest. After the intervention, the experimental group had significantly better clinical competence skills, communication competence, and self-leadership than the control group.

Conclusion:
TBL is an effective approach method to teaching core competencies in nursing education.
Childhood Trauma, Perceived Stress, and Hair Cortisol in Adults With and Without Cardiovascular Disease
Authors: Bossé Stéphanie , Stalder Tobias , D'Antono Bianca 
Published: March 2018

ABSTRACTObjectiveChildhood trauma has been associated with greater psychological and physical morbidity, including a greater risk of developing cardiovascular disease (CVD). This may partially reflect trauma-induced disturbances in how stress is later perceived and regulated. This study evaluated the associations of childhood trauma with perceived stress and hair cortisol concentrations (HCC) in a large sample of adults with coronary artery disease (CAD) and in non-CVD patients experiencing other nonfatal illnesses. Whether sex, age, or CVD status influenced these associations was also examined.MethodsA total of 1124 men and women (aged 65.2 [6.9] years) recruited from a hospital cohort completed the Childhood Trauma and Perceived Stress Questionnaires, whereas hair samples were obtained from 598 participants. Health status was confirmed via medical records.ResultsModerate to severe childhood trauma was experienced by 359 participants. Childhood trauma was associated with greater perceived stress levels for the past 2 years (r= .308,p= .01; β = 0.263,p< .001), but not 3-month cortisol secretion in hair. Perceived stress correlated negatively with age (r= −.241,p< .001). In secondary analyses, age moderated the relation between sexual abuse and perceived stress (β = −0.067,p= .016). Although sexual abuse was associated with greater levels of perceived stress among all participants, this relation was strongest in younger individuals.ConclusionsParticipants who experienced trauma in their youth reported greater levels of perceived stress, but not HCC, in late adulthood. Whether this suggests intact hypothalamic-pituitary-adrenal regulation in those exposed to childhood trauma or whether this reflects the characteristics of our sample requires further investigation.
Residual Symptoms After Treatment for Depression in Patients With Coronary Heart Disease
Authors: Carney Robert M. , Freedland Kenneth E. , Steinmeyer Brian C. , Rubin Eugene H. , Rich Michael W. 
Published: March 2018

ABSTRACT

Objective
Depression is associated with an increased risk of mortality in patients with coronary heart disease (CHD). The risk may be reduced in patients who remit with adequate treatment, but few patients achieve complete remission. The purpose of this study was to identify the symptoms that persist despite aggressive treatment for depression in patients with CHD.

Methods
One hundred twenty-five patients with stable CHD who met the DSM-IV criteria for a moderate-to-severe major depressive episode completed treatment with cognitive behavior therapy, either alone or combined with an antidepressant, for up to 16 weeks. Depression symptoms were assessed at baseline and after 16 weeks of treatment.

Results
The M (SD) Beck Depression Inventory scores were 30.0 (8.6) at baseline and 8.3 (7.5) at 16 weeks. Seventy seven (61%) of the participants who completed treatment met remission criteria (Hamilton Rating Scale for Depression ≤7) at 16 weeks. Loss of energy and fatigue were the most common posttreatment symptoms both in remitters (n = 44, 57%; n = 34, 44.2%) and nonremitters (n = 42, 87.5%; n = 35, 72.9%). These symptoms were not predicted by baseline depression severity, anxiety, demographic, or medical variables including inflammatory markers or cardiac functioning or by medical events during depression treatment.

Conclusions
Fatigue and loss of energy often persist in patients with CHD even after otherwise successful treatment for major depression. These residual symptoms may increase the risks of relapse and mortality. Development of effective interventions for these persistent symptoms is a priority for future research.
Catatonic Stupor in Schizophrenic Disorders and Subsequent Medical Complications and Mortality
Authors: Funayama Michitaka , Takata Taketo , Koreki Akihiro , Ogino Satoyuki , Mimura Masaru 
Published: March 2018

ABSTRACT

Objective
Although catatonia can occur secondary to a general medical condition, catatonia itself has been known to lead to various medical compolications. Although case reports on the association of catatonia with subsequent medical complications have been documented, no comprehensive large-scale study has been performed. To investigate specific medical complications after catatonia, we conducted a retrospective cohort study of specific medical complications of schizophrenia patients with catatonia.

Methods
The 1719 schizophrenia inpatients in our study were categorized into two groups: the catatonia group, i.e., those who exhibited catatonic stupor while they were hospitalized, and the noncatatonia group, i.e., those who never exhibited catatonic stupor. Differences between the two groups in the occurrence of subsequent medical complications were examined using linear and logistic regression analyses, and models were adjusted for potentially confounding factors.

Results
The catatonia group had an increased risk for mortality (odds ratio = 4.8, 95% confidence interval = 2.0–10.6, p < .01) and certain specific medical complications, i.e., pneumonia, urinary tract infection, sepsis, disseminated intravascular coagulation, rhabdomyolysis, dehydration, deep venous thrombosis, pulmonary embolism, urinary retention, decubitus, arrhythmia, renal failure, neuroleptic malignant syndrome, hypernatremia, and liver dysfunction (all p values < .01, except for deep venous thrombosis, p = .04 in the multiple linear regression analysis).

Conclusions
Catatonic stupor in schizophrenia substantially raises the risk for specific medical complications and mortality. Hyperactivity of the sympathetic nervous system, dehydration, and immobility, which are frequently involved in catatonia, might contribute to these specific medical complications. In catatonia, meticulous care for both mental and medical conditions should be taken to reduce the risk of adverse medical consequences.
Incidence and Causes of Adverse Events in Diagnostic Radiological Studies Requiring Anesthesia in the Wake-Up Safe Registry
Authors: Khawaja Asad A. , Tumin Dmitry , Beltran Ralph J. , Tobias Joseph D. , Uffman Joshua C. 
Published: March 2018

Objectives
General anesthesia or sedation can facilitate the completion of diagnostic radiological studies in children. We evaluated the incidence, predictors, and causes of adverse events (AEs) when general anesthesia is provided for diagnostic radiological imaging.

Methods
Deidentified data from 24 pediatric tertiary care hospitals participating in the Wake-Up Safe registry during 2010–2015 were obtained for analysis. Children 18 years or younger receiving general anesthesia for radiological procedures were identified using Current Procedural Terminology codes, and reported AEs were analyzed if they were associated with anesthetic care at magnetic resonance imaging or computed tomography locations. Logistic regression was used to determine predictors of AE occurrence in cases with complete covariate data.

Results
We identified 175,486 anesthetics for diagnostic radiological exams, compared with 83 AEs in magnetic resonance imaging or computed tomography locations (AE incidence of 0.05%). In multivariable analysis, AEs were more likely among patients with American Society of Anesthesiologists physical status IV compared with American Society of Anesthesiologists physical status I patients (adjusted odds ratio, 8.9; 95% confidence interval, 2.8–28.0; P < 0.001). Twenty-three AEs resulted in harm to the patient, whereas 32 AEs required unplanned hospital or intensive care unit admission. Anesthetic complications or issues were the most common cause of AEs (n = 52).

Conclusions
Anesthesia provided for pediatric radiological studies is very safe and with an overall low AE incidence. The contribution of anesthetic complications to reported AEs suggests opportunities for further process improvement in this setting.
Trophic factors in the treatment and prevention of alimentary tract mucositis
Authors: Rathe Mathias , Shen Rene L. , Sangild Per T. 
Published: March 2018

Purpose of review
Mucositis is a common adverse effect of cytotoxic anticancer treatment with serious implications for the quality of life, morbidity and mortality of cancers patients. Although, evidence supporting the use of certain treatments exists there is no gold standard for preventing or treating mucositis. Current management strategies are scarce with recommendations referring primarily to specific cytotoxic treatment regimens in certain clinical scenarios.

Recent findings
Trophic factors may contribute to preserve epithelial integrity, function, and accelerate regeneration after chemotherapeutic treatment. Accordingly, various growth factors have been evaluated in the prevention or treatment of alimentary tract mucositis. However, in spite of often showing promising results in preclinical testing currently perlifermin is the only trophic factor recommended for the prevention of mucositis.

Summary
More knowledge from representative preclinical models, and testing growth factor interventions across different models, may be the key to advance the field from basic science to clinical application of new growth factors. For promising new therapies, subsequent establishment of adequately powered clinical trials and uniform reporting of mucositis, are important elements to help establish new standard interventions that can be included into the continuously updated clinical recommendations for treatment of mucositis.
Factors Associated With Healthcare-Acquired Catheter-Associated Urinary Tract Infections
Authors: Park Jung In , Bliss Donna Z. , Chi Chih-Lin , Delaney Connie W. , Westra Bonnie L. 
Published: March 2018

PURPOSE:
The purpose of this study was to identify factors associated with healthcare-acquired catheter-associated urinary tract infections (HA-CAUTIs) using multiple data sources and data mining techniques.

SUBJECTS AND SETTING:
Three data sets were integrated for analysis: electronic health record data from a university hospital in the Midwestern United States was combined with staffing and environmental data from the hospital's National Database of Nursing Quality Indicators and a list of patients with HA-CAUTIs.

METHODS:
Three data mining techniques were used for identification of factors associated with HA-CAUTI: decision trees, logistic regression, and support vector machines.

RESULTS:
Fewer total nursing hours per patient-day, lower percentage of direct care RNs with specialty nursing certification, higher percentage of direct care RNs with associate's degree in nursing, and higher percentage of direct care RNs with BSN, MSN, or doctoral degree are associated with HA-CAUTI occurrence. The results also support the association of the following factors with HA-CAUTI identified by previous studies: female gender; older age (>50 years); longer length of stay; severe underlying disease; glucose lab results (>200 mg/dL); longer use of the catheter; and RN staffing.

CONCLUSIONS:
Additional findings from this study demonstrated that the presence of more nurses with specialty nursing certifications can reduce HA-CAUTI occurrence. While there may be valid reasons for leaving in a urinary catheter, findings show that having a catheter in for more than 48 hours contributes to HA-CAUTI occurrence. Finally, the findings suggest that more nursing hours per patient-day are related to better patient outcomes.
Ostomy Creation for Palliative Care of Patients With Nonresectable Colorectal Cancer and Bowel Obstruction
Authors: Pickard Colette , Thomas Rachel , Robertson Isabell , Macdonald Angus 
Published: March 2018

PURPOSE:
The purpose of this study was to review our experience with palliative ostomy surgery in patients with bowel obstruction and advanced stage colorectal cancer.

DESIGN:
A descriptive, retrospective review of data from a prospectively collected clinical database.

SUBJECTS AND SETTING:
The sample comprised 86 patients (55 male) who underwent palliative surgery between October 1998 and January 2009.

METHODS:
All patients undergoing palliative stoma formation without resection for colorectal carcinoma were identified from a prospectively compiled colorectal cancer database. Patients having colorectal stent placement and bypass surgery were excluded from analysis.

RESULTS:
The median age at surgery was 71 years (interquartile range, 65-79 years). The median survival following ostomy creation was 103 days (interquartile range, 19-263 days). Sixty-nine percent of participants (n = 59) survived 30 days and 18% (n=16) survived 12 months.

CONCLUSIONS:
Our results confirm that patients undergoing palliative stoma formation have limited life expectancy. Nevertheless, these findings are encouraging when compared to the anticipated outcomes of untreated bowel obstruction.
Genetic basis of thermal plasticity variation inDrosophila melanogasterbody size
Authors: Lafuente E , Duneau D , Beldade P 
Published: March 2018

ABSTRACTBody size is a quantitative trait that is closely associated to fitness and under the control of both genetic and environmental factors. While developmental plasticity for this and other traits is heritable and under selection, little is known about the genetic basis for variation in plasticity that can provide the raw material for its evolution. We quantified genetic variation for body size plasticity inDrosophila melanogasterby measuring thorax and abdomen length of females reared at two temperatures from a panel representing naturally segregating alleles, the Drosophila Genetic Reference Panel (DGRP). We found variation between genotypes for the levels and direction of thermal plasticity in size of both body parts. We then used a Genome-Wide Association Study (GWAS) approach to unravel the genetic basis of inter-genotype variation in body size plasticity, and used different approaches to validate selected QTLs and to explore potential pleiotropic effects. We found mostly “private QTLs”, with little overlap between the candidate loci underlying variation in plasticity for thorax versus abdomen size, for different properties of the plastic response, and for size versus size plasticity. We also found that the putative functions of plasticity QTLs were diverse and that alleles for higher plasticity were found at lower frequencies in the target population. Importantly, a number of our plasticity QTLs have been targets of selection in other populations. Our data sheds light onto the genetic basis of inter-genotype variation in size plasticity that is necessary for its evolution.Significance StatementThe environmental conditions under which development takes place can affect developmental outcomes and lead to the production of phenotypes adjusted to the environment adults will live in. This developmental plasticity, which can help organisms cope with environmental heterogeneity, is heritable and under selection. Plasticity can itself evolve, a process that will be partly dependent on the available genetic variation for this trait. Using a wild-derivedD. melanogasterpanel, we identified DNA sequence variants associated to variation in thermal plasticity for body size. We found that these variants correspond to a diverse set of gene functions. Furthermore, their effects differ between body parts and properties of the thermal response, which can, therefore, evolve independently. Our results shed new light onto a number of key questions about the long discussed genes for plasticity.
Gene regulatory network analysis identifies sex-linked differences in colon cancer drug metabolism processes
Authors: Lopes-Ramos Camila M. , Kuijjer Marieke L. , Ogino Shuji , Fuchs Charles , DeMeo Dawn L. , Glass Kimberly , Quackenbush John 
Published: March 2018

AbstractSignificant sex differences are observed in colon cancer, and understanding these differences is essential to advance disease prevention, diagnosis, and treatment. Males have a higher risk of developing colon cancer and a lower survival rate than women. However, the molecular features that drive these sex differences are poorly understood. We used both transcript-based and gene regulatory network methods to analyze RNA-Seq data from The Cancer Genome Atlas for 445 patients with colon cancer. We compared gene expression between tumors in men and women and found no significant sex differences except for sex-chromosome genes. We then inferred patient-specific gene regulatory networks, and found significant regulatory differences between males and females, with drug and xenobiotics metabolism via cytochrome P450 pathways more strongly targeted in females. This finding was validated in a dataset that included 1,193 patients from five independent studies. While targeting of the drug metabolism pathway did not change the overall survival for males treated with adjuvant chemotherapy, females with greater targeting had an increase in 10-year overall survival probability, with 89% (95% CI: 78%-100%) survival compared to 61% (95% CI: 45%-82%) for women with lower targeting, respectively (p=0.034). Our network analysis uncovered patterns of transcriptional regulation that differentiate male and female colon cancer. Most importantly, targeting of the drug metabolism pathway was predictive of survival in women who received adjuvant chemotherapy. This network-based approach can be used to investigate the molecular features that drive sex differences in other cancers and complex diseases.
Limit distribution of the quartet balance index for Aldous’sβ≥ 0-model
Authors: Bartoszek Krzysztof 
Published: March 2018

AbstractThis paper builds up on T. Martínez-Coronado, A. Mir, F. Rossello and G. Valiente’s work “A balance index for phylogenetic trees based on quartets”, introducing a new balance index for trees. We show here that this balance index, in the case of Aldous’sβ≥ 0-model, convergences weakly to a distribution that can be characterized as the fixed point of a contraction operator on a class of distributions.
Effects of transcranial focused ultrasound on human primary motor cortex using 7T fMRI
Authors: Ai Leo , Bansal Priya , Mueller Jerel K. , Legon Wynn 
Published: March 2018

ABSTRACTBackgroundTranscranial focused ultrasound (tFUS) is a new non-invasive neuromodulation technique that uses mechanical energy to modulate neuronal excitability with high spatial precision. tFUS has been shown to be capable of modulating EEG brain activity in humans that is spatially restricted, and here, we use 7T MRI to extend these findings. We test the effect of tFUS on 7T BOLD fMRI signals from individual finger representations in the human primary motor cortex (M1) and connected cortical motor regions. Participants (N = 5) performed a cued finger tapping task in a 7T MRI scanner with their thumb, index, and middle fingers to produce a BOLD signal for individual M1 finger representations during either tFUS or sham neuromodulation to the thumb representation.ResultsResults demonstrated a statistically significant increase in activation volume of the M1 thumb representation for the tFUS condition as compared to sham. No differences in percent BOLD changes were found. This effect was spatially confined as the index and middle finger M1 finger representations did not show similar significant changes in either percent change or activation volume. No effects were seen during tFUS to M1 in the supplementary motor area (SMA) or the dorsal premotor cortex (PMd).ConclusionsSingle element tFUS can be paired with high field MRI that does not induce significant artifact. tFUS increases activation volumes of the targeted finger representation that is spatially restricted within M1 but does not extend to functionally connected motor regions.