bluuebunny/crossref_metadata_2025_split huggingface dataset:
Using pharmacists’ documentation of clinical activities to reclaim employees and reposition the department
Authors: McDaniel Michael R. , DeJong Douglas J. 
Published: February 2019

Abstract
The use of documentation on pharmacist clinical activities to encourage greater hospital investment in a department is described.
From 1983 through 1988, the number of full-time-equivalent (FTE) positions in the pharmacy department at a 468-bed medical center was reduced from 63 to 39.4. To cope with the challenge of a sharply reduced staff, the department established a permanent pharmacy-nursing task force, developed a pharmacy strategic plan, used total quality management, recruited the best staff possible when openings appeared, and held staff retreats. In addition, measures were taken to begin documenting all pharmacist clinical activities online. As data were accumulated, it became clear that more pharmacist involvement in patient care areas was needed and that more resources would be necessary to achieve that. Presentations were made to hospital administration to demonstrate the existing and potential contributions of the department; the presentations drew heavily on the clinical documentation. Formal reports were also submitted. As a result, the department received approval for a pharmacist career ladder, an increase of 1.6 pharmacist FTEs for the evening shift, a large salary-range adjustment for staff pharmacists, and an increase of 1 pharmacist FTE to focus on antimicrobial use.
A pharmacy department successfully used documentation of its clinical activities to make a case to administration for reclaiming some of the pharmacist FTEs lost through downsizing.
Power-Assisted Liposuction and Lipofilling: Techniques and Experience in Large-Volume Fat Grafting
Authors: Abboud Marwan H , Dibo Saad A , Abboud Nicolas M 
Published: February 2019

Abstract

Background
Power-assisted liposuction and lipofilling (PALL) is a simple and reproducible surgical technique for large volume fat grafting.

Objectives
The authors share their 7-year experience with their large-volume fat transfer technique, PALL.

Methods
A total of 417 patients who underwent PALL-related surgeries involving the breast and buttock were evaluated in a retrospective study. Liposculpting and fat harvesting were performed with power-assisted liposuction. Fat was transferred with simultaneous power-assisted vibration and tunnelization to provoke expansion of the recipient site. Following lipofilling, additional external vibration of the recipient site was performed to enhance diffusion of the injected fat.

Results
Liposuction volumes up to 5000 mL were recorded, and injection volumes ranged from 300 to 900 mL per side for each session. Operating times ranged from 45 to 120 minutes. Patients were followed-up for 1 to 4 years. No major complications were recorded.

Conclusions
PALL is an efficient, safe, and reproducible procedure with myriad applications in aesthetic and reconstructive surgery.

Level of Evidence: 4
Multispectral tracing in densely labeled mouse brain with nTracer
Authors: Roossien Douglas H , Sadis Benjamin V , Yan Yan , Webb John M , Min Lia Y , Dizaji Aslan S , Bogart Luke J , Mazuski Cristina , Huth Robert S , Stecher Johanna S , Akula Sriakhila , Shen Fred , Li Ye , Xiao Tingxin , Vandenbrink Madeleine , Lichtman Jeff W , Hensch Takao K , Herzog Erik D , Cai Dawen 
Published: February 2019

Abstract

Summary
This note describes nTracer, an ImageJ plug-in for user-guided, semi-automated tracing of multispectral fluorescent tissue samples. This approach allows for rapid and accurate reconstruction of whole cell morphology of large neuronal populations in densely labeled brains.

Availability and implementation
nTracer was written as a plug-in for the open source image processing software ImageJ. The software, instructional documentation, tutorial videos, sample image and sample tracing results are available at https://www.cai-lab.org/ntracer-tutorial.

Supplementary information
Supplementary data are available at Bioinformatics online.
Beyond the Deficit Model: The Ambassador Approach to Public Engagement
Authors: Nadkarni Nalini M , Weber Caitlin Q , Goldman Shelley V , Schatz Dennis L , Allen Sue , Menlove Rebecca 
Published: February 2019

Abstract
Scientists are increasingly motivated to engage the public, particularly those who do not or cannot access traditional science education opportunities. Communication researchers have identified shortcomings of the deficit model approach, which assumes that skepticism toward science is based on a lack of information or scientific literacy, and encourage scientists to facilitate open-minded exchange with the public. We describe an ambassador approach, to develop a scientist's impact identity, which integrates his or her research, personal interests and experiences to achieve societal impacts. The scientist identifies a community or focal group to engage, on the basis of his or her impact identity, learns about that group, and promotes inclusion of all group members by engaging in venues in which that group naturally gathers, rather than in traditional education settings. Focal group members stated that scientists communicated effectively and were responsive to participant questions and ideas. Scientists reported professional and personal benefits from this approach.
Control of blood pressure and risk of mortality in a cohort of older adults: the Berlin Initiative Study
Authors: Douros Antonios , Tölle Markus , Ebert Natalie , Gaedeke Jens , Huscher Dörte , Kreutz Reinhold , Kuhlmann Martin K , Martus Peter , Mielke Nina , Schneider Alice , Schuchardt Mirjam , van der Giet Markus , Schaeffner Elke 
Published: February 2019

Abstract

Aims
To assess whether blood pressure (BP) values below 140/90 mmHg during antihypertensive treatment are associated with a decreased risk of all-cause mortality in community-dwelling older adults.

Methods and results
Within the Berlin Initiative Study, we assembled a cohort of patients ≥70 years treated with antihypertensive drugs at baseline (November 2009–June 2011). End of prospective follow-up was December 2016. Cox proportional hazards models yielded adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of all-cause mortality associated with normalized BP [systolic BP (SBP) &lt;140 mmHg and diastolic BP (DBP) &lt;90 mmHg] compared with non-normalized BP (SBP ≥140 mmHg or DBP ≥90 mmHg) overall and after stratification by age or previous cardiovascular events. Among 1628 patients (mean age 81 years) on antihypertensive drugs, 636 exhibited normalized BP. During 8853 person-years of follow-up, 469 patients died. Compared with non-normalized BP, normalized BP was associated with an increased risk of all-cause mortality (incidence rates: 60.3 vs. 48.5 per 1000/year; HR 1.26; 95% CI 1.04–1.54). Increased risks were observed in patients ≥80 years (102.2 vs. 77.5 per 1000/year; HR 1.40; 95% CI 1.12–1.74) and with previous cardiovascular events (98.3 vs. 63.6 per 1000/year; HR 1.61; 95% CI 1.14–2.27) but not in patients aged 70–79 years (22.6 vs. 22.7 per 1000/year; HR 0.83; 95% CI 0.54–1.27) or without previous cardiovascular events (45.2 vs. 44.4 per 1000/year; HR 1.16, 95% CI 0.90–1.48).

Conclusion
Blood pressure values below 140/90 mmHg during antihypertensive treatment may be associated with an increased risk of mortality in octogenarians or elderly patients with previous cardiovascular events.
Pesticide use and risk of non-Hodgkin lymphoid malignancies in agricultural cohorts from France, Norway and the USA: a pooled analysis from the AGRICOH consortium
Authors: Leon Maria E , Schinasi Leah H , Lebailly Pierre , Beane Freeman Laura E , Nordby Karl-Christian , Ferro Gilles , Monnereau Alain , Brouwer Maartje , Tual Séverine , Baldi Isabelle , Kjaerheim Kristina , Hofmann Jonathan N , Kristensen Petter , Koutros Stella , Straif Kurt , Kromhout Hans , Schüz Joachim 
Published: February 2019

Abstract

Background
Pesticides are commonly used in agriculture, and previous studies endorsed the need to further investigate the possible association between their use and risk of lymphoid malignancies in agricultural workers.

Methods
We investigated the relationship of ever use of 14 selected pesticide chemical groups and 33 individual active chemical ingredients with non-Hodgkin lymphoid malignancies (NHL) overall or major subtypes, in a pooled analysis of three large agricultural worker cohorts. Pesticide use was derived from self-reported history of crops cultivated combined with crop-exposure matrices (France and Norway) or self-reported lifetime use of active ingredients (USA). Cox regression models were used to estimate cohort-specific hazard ratios (HRs) and 95% confidence intervals (CIs), which were combined using random effects meta-analysis to calculate meta-HRs.

Results
During follow-up, 2430 NHL cases were diagnosed in 316 270 farmers accruing 3 574 815 person-years under risk. Most meta-HRs suggested no association. Moderately elevated meta-HRs were seen for: NHL and ever use of terbufos (meta-HR = 1.18, 95% CI: 1.00–1.39); chronic lymphocytic leukaemia/small lymphocytic lymphoma and deltamethrin (1.48, 1.06–2.07); and diffuse large B-cell lymphoma and glyphosate (1.36, 1.00–1.85); as well as inverse associations of NHL with the broader groups of organochlorine insecticides (0.86, 0.74–0.99) and phenoxy herbicides (0.81, 0.67–0.98), but not with active ingredients within these groups, after adjusting for exposure to other pesticides.

Conclusions
Associations of pesticides with NHL appear to be subtype- and chemical-specific. Non-differential exposure misclassification was an important limitation, showing the need for refinement of exposure estimates and exposure–response analyses.
Observations of photospheric magnetic structure below a dark filament using the Hinode Spectro-Polarimeter
Authors: Yokoyama Takaaki , Katsukawa Yukio , Shimojo Masumi 
Published: February 2019

Abstract
The structure of the photospheric vector magnetic field below a dark filament on the Sun is studied using the observations of the Spectro-Polarimeter attached to the Solar Optical Telescope onboard Hinode. Special attention is paid to discriminating between two suggested models, a flux rope or a bent arcade. “Inverse polarity” orientation is possible below the filament in a flux rope, whereas “normal polarity” can appear in both models. We study a filament in the active region NOAA 10930, which appeared on the solar disk during 2006 December. The transverse field perpendicular to the line of sight has a direction almost parallel to the filament spine with a shear angle of 30°, the orientation of which includes the 180° ambiguity. To know whether it is in the normal orientation or in the inverse one, the center-to-limb variation is used for the solution under the assumption that the filament does not drastically change its magnetic structure during the passage. When the filament is near the east limb, we found that the line-of-site magnetic component below the filament is positive, while it is negative near the west limb.This change of sign indicates that the horizontal photospheric field perpendicular to the polarity inversion line beneath the filament has an “inverse-polarity”, which indicates a flux-rope structure of the filament supporting field.
CO Multi-line Imaging of Nearby Galaxies (COMING). VI. Radial variations in star formation efficiency
Authors: Muraoka Kazuyuki , Sorai Kazuo , Miyamoto Yusuke , Yoda Moe , Morokuma-Matsui Kana , Kobayashi Masato I N , Kuroda Mayu , Kaneko Hiroyuki , Kuno Nario , Takeuchi Tsutomu T , Nakanishi Hiroyuki , Watanabe Yoshimasa , Tanaka Takahiro , Yasuda Atsushi , Yajima Yoshiyuki , Shibata Shugo , Salak Dragan , Espada Daniel , Matsumoto Naoko , Noma Yuto , Kita Shoichiro , Komatsuzaki Ryusei , Kajikawa Ayumi , Yashima Yu , Pan Hsi-An , Oi Nagisa , Seta Masumichi , Nakai Naomasa 
Published: February 2019

Abstract
We examined radial variations in molecular-gas based star formation efficiency (SFE), which is defined as star formation rate per unit molecular gas mass, for 80 galaxies selected from the CO Multi-line Imaging of Nearby Galaxies project (Sorai et al. 2019, PASJ, 71, S14). The radial variations in SFE for individual galaxies are typically a factor of 2–3, which suggests that SFE is nearly constant along the galactocentric radius. We found an averaged SFE in 80 galaxies of (1.69 ± 1.1) × 10−9 yr−1, which is consistent with Leroy et al. (2008, AJ, 136, 2782) if we consider the contribution of helium to the molecular gas mass evaluation and the difference in the assumed initial mass function between the two studies. We compared SFE among different morphological (i.e., SA, SAB, and SB) types, and found that SFE within the inner radii (r/r25 &lt; 0.3, where r25 is the B-band isophotal radius at 25 mag arcsec−2) of SB galaxies is slightly higher than that of SA and SAB galaxies. This trend can be partly explained by the dependence of SFE on global stellar mass, which probably relates to the CO-to-H2 conversion factor through the metallicity. For two representative SB galaxies in our sample, NGC 3367 and NGC 7479, the ellipse of r/r25 = 0.3 seems to cover not only the central region but also the inner part of the disk, mainly the bar. These two galaxies show higher SFE in the bar than in the spiral arms. However, we found an opposite trend in NGC 4303; SFE is lower in the bar than in the spiral arms, which is consistent with earlier studies (e.g., Momose et al. 2010, ApJ, 721, 383). These results suggest a diversity of star formation activities in the bar.
Clinical Reasoning Assessment Methods: A Scoping Review and Practical Guidance
Authors: Daniel Michelle , Rencic Joseph , Durning Steven J. , Holmboe Eric , Santen Sally A. , Lang Valerie , Ratcliffe Temple , Gordon David , Heist Brian , Lubarsky Stuart , Estrada Carlos A. , Ballard Tiffany , Artino Anthony R. , Sergio Da Silva Ana , Cleary Timothy , Stojan Jennifer , Gruppen Larry D. 
Published: February 2019

Purpose
An evidence-based approach to assessment is critical for ensuring the development of clinical reasoning (CR) competence. The wide array of CR assessment methods creates challenges for selecting assessments fit for the purpose; thus, a synthesis of the current evidence is needed to guide practice. A scoping review was performed to explore the existing menu of CR assessments.

Method
Multiple databases were searched from their inception to 2016 following PRISMA guidelines. Articles of all study design types were included if they studied a CR assessment method. The articles were sorted by assessment methods and reviewed by pairs of authors. Extracted data were used to construct descriptive appendixes, summarizing each method, including common stimuli, response formats, scoring, typical uses, validity considerations, feasibility issues, advantages, and disadvantages.

Results
A total of 377 articles were included in the final synthesis. The articles broadly fell into three categories: non-workplace-based assessments (e.g., multiple-choice questions, extended matching questions, key feature examinations, script concordance tests); assessments in simulated clinical environments (objective structured clinical examinations and technology-enhanced simulation); and workplace-based assessments (e.g., direct observations, global assessments, oral case presentations, written notes). Validity considerations, feasibility issues, advantages, and disadvantages differed by method.

Conclusions
There are numerous assessment methods that align with different components of the complex construct of CR. Ensuring competency requires the development of programs of assessment that address all components of CR. Such programs are ideally constructed of complementary assessment methods to account for each method’s validity and feasibility issues, advantages, and disadvantages.
Participation in Physical Activity During Center and Home-Based Pulmonary Rehabilitation for People With COPD
Authors: Lahham Aroub , McDonald Christine F. , Mahal Ajay , Lee Annemarie L. , Hill Catherine J. , Burge Angela T. , Cox Narelle S. , Moore Rosemary , Nicolson Caroline , O'Halloran Paul , Gillies Rebecca , Holland Anne E. 
Published: February 2019

Purpose:
To compare levels of physical activity during center and home-based pulmonary rehabilitation (PR) in people with chronic obstructive pulmonary disease.

Methods:
Forty-five consecutive participants (23 male, n = 20, in the home-based group) with mean age of 68 ± 8 yr and forced expiratory volume in the first second of expiration (FEV1) 53 ± 18% predicted undertook physical activity monitoring using the SenseWear Armband during the final week of the interventions of center or home-based PR. Differences in time spent in total physical activity (≥1.5 METs), time spent in moderate to vigorous intensity physical activity (≥3 METs), and steps were compared.

Results:
Home participants spent a median and interquartile range of 310 (199-328) min/d engaged in total physical activity (29% moderate to vigorous intensity physical activity) compared with 300 (204-370) min/d for the center group (28% moderate to vigorous intensity physical activity, P = .98). Daily step count did not differ between groups (home-based median 5232 [2067-7718] versus center-based median 4049 [1983-6040], P = .66). Of note, center-based participants took 38% more steps on days of program attendance compared with nonattendance days (mean difference: 761 steps/d; 95% CI, −56 to 1579, P = .06).

Conclusion:
For people with chronic obstructive pulmonary disease undertaking PR, no differences in physical activity levels between center and home-based programs were demonstrated. Understanding the impact of the indirect supervision and motivational interviewing technique utilized during home-based PR on levels of physical activity in people with chronic obstructive pulmonary disease may support clinical implementation of the model as an alternative option to traditional care.
The Relationship Between Critical Thinking Skills and Learning Styles and Academic Achievement of Nursing Students
Authors: Shirazi Fatemeh , Heidari Shiva 
Published: February 2019

ABSTRACT

Background:
Academic achievement is one of the most important indicators in evaluating education. Various factors are known to affect the academic achievement of students.

Purpose:
This study was performed to assess the relationship between critical thinking skills and learning styles and the academic achievement of nursing students.

Methods:
In this cross-sectional study, 139 sophomores to senior-year nursing students were selected using a simple random sampling method. The data were gathered using a three-part questionnaire that included a demographic questionnaire, the Kolb's Learning Style Standard Questionnaire, and the California Critical Thinking Skills Questionnaire. The previous semester's grade point average of the students was considered as a measure of academic achievement. The data were analyzed using descriptive and analytical statistics in SPSS 20.

Results:
The mean score for critical thinking skills was 6.75 ± 2.16, and the highest and lowest scores among the critical thinking subscales related to the evaluation and analysis subscales, respectively. No relationship between critical thinking and academic achievement was identified. “Diverging” was the most common learning style. The highest mean level of academic achievement was earned by those students who adopted the “accommodating” style of learning. A significant relationship was found between learning style and academic achievement (p < .001).

Conclusions:
According to the findings, the critical thinking skills score of students was unacceptably low. Therefore, it is essential to pay more attention to improving critical thinking in academic lesson planning. As a significant relationship was found between learning style and academic achievement, it is suggested that instructors consider the dominant style of each class in lesson planning and use proper teaching methods that take into consideration the dominant style.
Impact of spontaneous breathing during mechanical ventilation in acute respiratory distress syndrome
Authors: Yoshida Takeshi , Amato Marcelo B.P. , Kavanagh Brian P. , Fujino Yuji 
Published: February 2019

Purpose of review
Facilitating spontaneous breathing has been traditionally recommended during mechanical ventilation in acute respiratory distress syndrome (ARDS). However, early, short-term use of neuromuscular blockade appears to improve survival, and spontaneous effort has been shown to potentiate lung injury in animal and clinical studies. The purpose of this review is to describe the beneficial and deleterious effects of spontaneous breathing in ARDS, explain potential mechanisms for harm, and provide contemporary suggestions for clinical management.

Recent findings
Gentle spontaneous effort can improve lung function and prevent diaphragm atrophy. However, accumulating evidence indicates that spontaneous effort may cause or worsen lung and diaphragm injury, especially if the ARDS is severe or spontaneous effort is vigorous. Recently, such effort-dependent lung injury has been termed patient self-inflicted lung injury (P-SILI). Finally, several approaches to minimize P-SILI while maintaining some diaphragm activity (e.g. partial neuromuscular blockade, high PEEP) appear promising.

Summary
We update and summarize the role of spontaneous breathing during mechanical ventilation in ARDS, which can be beneficial or deleterious, depending on the strength of spontaneous activity and severity of lung injury. Future studies are needed to determine ventilator strategies that minimize injury but maintaining some diaphragm activity.
Independent and Joint Use of Statins and Metformin by Elderly Patients With Diabetes and Overall Survival Following HCC Diagnosis
Authors: Antwi Samuel O. , Li Zhuo , Mody Kabir , Roberts Lewis R. , Patel Tushar 
Published: February 2019

Goal:
To investigate associations of prediagnosis and postdiagnosis use of statins and metformin on overall survival of patients with diabetes who later developed HCC.

Background:
Statins and metformin have received considerable interest as potential chemopreventive agents against hepatocellular carcinoma (HCC) development in individuals with type 2 diabetes mellitus (T2DM); however, their impact on overall survival of patients with T2DM who later develop HCC (diabetic HCC patients) is unclear.

Study:
Data on 2499 elderly diabetic HCC patients obtained from the SEER-Medicare program (2009 to 2013) were analyzed. Patients were categorized based on use of statins only, metformin only, both, or neither (reference for all comparisons). The patients were further categorized based on: (1) metformin dose: ≤1500 or >1500 mg/d; (2) statins functional form: hydrophilic (pravastatin and rosuvastatin) or lipophilic (atorvastatin, fluvastatin, lovastatin, and simvastatin); (3) statins potency: high (atorvastatin, rosuvastatin, and simvastatin) or low (fluvastatin, lovastatin, and pravastatin); and (4) individual statins type. Multivariable-adjusted hazard ratios (HR) and 95% confidence intervals (CIs) were calculated using Cox proportional hazard models.

Results:
Prediagnosis use of metformin dose ≤1500 mg/d was associated with lower risk of death after HCC diagnosis in patients with T2DM (HR, 0.72; 95% CI, 0.58-0.91), adjusting for postdiagnosis metformin dose, diabetes severity, Charlson comorbidity index, tumor characteristics, and other relevant factors. No association was found for prediagnosis metformin dose >1500 mg/d or postdiagnosis metformin use. Further, no association was found for either prediagnosis or postdiagnosis statins use.

Conclusions:
Prediagnosis use of metformin dose ≤1500 mg/d is associated with longer overall survival of elderly diabetic HCC patients.