bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk factors for thirty‐day readmission following flap reconstruction of oncologic defects of the head and neck
Authors: Osborn Heather A. , Rathi Vinay K. , Tjoa Tjoson , Goyal Neerav , Yarlagadda Bharat B. , Rich Debbie L. , Emerick Kevin S. , Lin Derrick T. , Deschler Daniel G. , Durand Marlene L. 
Published: August 2017

ObjectivesUnplanned 30‐day readmission rate following hospital discharge is an important metric of healthcare quality. This study sought to characterize the rate, risk factors, and common causes of readmission in head and neck cancer patients following free or pedicled flap reconstruction.Study DesignRetrospective cohort study.MethodsCharts were reviewed of all patients who underwent free or pedicled flap reconstruction following resection of head and neck cancer at the Massachusetts Eye and Ear Infirmary 2009 to 2014. Readmission risk factors were evaluated by univariate and multivariate analysis.ResultsOf 682 patients with free (76%) or pedicled flap reconstruction, 135 patients (19.8%) were readmitted. Factors not associated with readmission included age, gender, American Society of Anesthesiologists status, operative time, prior radiation therapy, primary cancer site, and free (vs. pedicled) flap type. Significant readmission risk factors included surgical site infections (SSI) (45.2% vs. 9.9%), use of hardware (18.5% vs. 11.3%), and clean–contaminated or contaminated surgery (15.2% vs. clean 8.2%). Surgical site infections (P < 0.001) and use of hardware (P = 0.03) remained predictive of readmission on multiple regression analysis. Primary reasons for readmission included wound complications (61.5%) and supportive care (15.6%). The median time to readmission was 8 days, and 41% of readmissions occurred within 1 week. Seventy percent of readmissions occurred within 2 weeks, including 77% of readmissions for SSIs and 86% for supportive care.ConclusionReadmissions occurred in nearly one‐fifth of patients following flap surgery. SSIs and use of hardware were risk factors, whereas wound complications were the most common cause of readmission.Level of Evidence4. Laryngoscope, 128:343–349, 2018
A three‐objective user equilibrium model: Time surplus maximisation under uncertainty
Authors: Wang Judith Y. T. , Ehrgott Matthias 
Published: August 2017

AbstractIn this paper, we propose a user equilibrium model considering the 3 most important factors influencing route choice behaviour in a road network, namely, travel time, travel time reliability, and monetary cost. We further develop the time surplus maximisation bi‐objective user equilibrium model and incorporate the concept of travel time budget to model how users might react to uncertainty induced by day‐to‐day variability in travel time caused by traffic incidents. This results in a three‐objective user equilibrium model, which has a possibly infinite set of equilibrium flows. To compute equilibrium flows, we introduce time budget surplus defined as the maximum travel time a user is willing to spend minus the actual time budget required for a desired level of travel time reliability. At equilibrium, for each origin–destination pair, all individuals are travelling on the path with the highest time budget surplus value among all the efficient paths between this origin‐destination pair. This becomes a time budget surplus maximisation three‐objective user equilibrium model (TBSmaxTUE). We show that the TBSmaxTUE model is a special case of three‐objective user equilibrium considering minimisation of expected travel time, travel time variance, and toll (monetary cost) as objectives. We illustrate the model and our results on a small network.
Inferior vena cava atresia predisposing to acute lower extremity deep vein thrombosis in children: A descriptive dual‐center study
Authors: Tarango Cristina , Kumar Riten , Patel Manish , Blackmore Anne , Warren Patrick , Palumbo Joseph S. 
Published: August 2017

AbstractPurposeThrombosis in the healthy pediatric population is a rare occurrence. Little is known about the optimal treatment or outcomes of children with unprovoked acute lower extremity (LE) deep vein thrombosis (DVT) associated with atresia of the inferior vena cava (IVC).MethodsWe retrospectively analyzed the records of patients with acute LE DVT subsequently found to have IVC atresia who presented to two tertiary pediatric institutions between 2008 and 2016. Data were reviewed for thrombophilia risk factors, treatment, and outcomes.ResultsEighteen patients, aged 13–18 years (median: 16 years), presenting with acute LE DVT were found to have IVC atresia. Three patients also presented with pulmonary embolism. Fourteen patients underwent site‐directed thrombolysis in addition to anticoagulation. Five patients (28%) had confirmed or suspected recurrent thrombosis. Thirteen patients (72%) had no identified provocation for DVT. Ten patients (56%) had post‐thrombotic syndrome, and 17 of 18 patients remain on indefinite anticoagulation.ConclusionThis study suggests that IVC atresia is a risk factor for LE DVT and pulmonary embolism in otherwise healthy children and highlights the importance of dedicated imaging of the IVC in young patients with unprovoked LE DVT. Indefinite anticoagulation may be considered in pediatric patients presenting with unprovoked thrombosis secondary to an atretic IVC.
Mutational status of NRAS, KRAS, and PTPN11 genes is associated with genetic/cytogenetic features in children with B‐precursor acute lymphoblastic leukemia
Authors: Liang Der‐Cherng , Chen Shih‐Hsiang , Liu Hsi‐Che , Yang Chao‐Ping , Yeh Ting‐Chi , Jaing Tang‐Her , Hung Iou‐Jih , Hou Jen‐Yin , Lin Tung‐Huei , Lin Chun‐Hui , Shih Lee‐Yung 
Published: August 2017

AbstractBackgroundWe aimed to investigate the frequencies and the association with genetic/cytogenetic abnormalities as well as prognostic relevance of RAS pathway mutations in Taiwanese children with B‐precursor acute lymphoblastic leukemia (ALL), the largest cohort in Asians.ProcedureBetween 1995 and 2012, marrow samples at diagnosis from 535 children were studied for NRAS, KRAS, and PTPN11 mutations. The mutational status of each gene was correlated with the clinico‐hematological features, recurrent genetic abnormalities, and outcomes for those treated with TPOG‐ALL‐2002 protocol (n = 346).ResultsThe frequencies of NRAS, KRAS, and PTPN11 mutations were 10.8% (57/530), 10.2% (54/530), and 3.0% (16/526), respectively. NRAS mutations were associated with a higher frequency of hyperdiploidy (P = 0.01) and lower frequency of ETV6‐RUNX1 (P < 0.01), whereas KRAS mutations were associated with younger age (P < 0.01), a higher frequency of KMT2A rearranged (P < 0.01) but no significant difference if infants with ALL were excluded, and inferior event‐free survival (66.6% vs. 80.5%, P = 0.04). None of patients with TCF3‐PBX1 had KRAS mutation (P = 0.02).ConclusionsOur study showed that the frequency of KRAS mutations in Taiwan was significantly higher than that reported in Caucasians. The occurrence of RAS pathway mutations was associated with recurrent genetic/cytogenetic abnormalities in pediatric B‐precursor ALL.
NMR secondary structure and interactions of recombinant human MOZART1 protein, a component of the gamma‐tubulin complex
Authors: Cukier Cyprian D. , Tourdes Audrey , El‐Mazouni Dounia , Guillet Valérie , Nomme Julian , Mourey Lionel , Milon Alain , Merdes Andreas , Gervais Virginie 
Published: August 2017

AbstractMitotic‐spindle organizing protein associated with a ring of γ‐tubulin 1 (MOZART1) is an 8.5 kDa protein linked to regulation of γ‐tubulin ring complexes (γTuRCs), which are involved in nucleation of microtubules. Despite its small size, MOZART1 represents a challenging target for detailed characterization in vitro. We described herein a protocol for efficient production of recombinant human MOZART1 in Escherichia coli and assessed the properties of the purified protein using a combination of size exclusion chromatography coupled with multiangle light scattering (SEC‐MALS), dynamic light scattering (DLS), and nuclear magnetic resonance (NMR) experiments. MOZART1 forms heterogeneous oligomers in solution. We identified optimal detergent and buffer conditions for recording well resolved NMR experiments allowing nearly full protein assignment and identification of three distinct alpha‐helical structured regions. Finally, using NMR, we showed that MOZART1 interacts with the N‐terminus (residues 1–250) of GCP3 (γ‐tubulin complex protein 3). Our data illustrate the capacity of MOZART1 to form oligomers, promoting multiple contacts with a subset of protein partners in the context of microtubule nucleation.
Electronic and optical properties of pyrrole and thiophene oligomers: A density functional theory study
Authors: Chen Juan , Zhu Xingfeng , Luo Chenglin , Dai Yafei 
Published: August 2017

AbstractThe conductive mechanism of pyrrole (Py) and thiophene (Th) oligomers is investigated in the framework of density functional theory. Geometric constructions and electronic structures of neutral n‐Py/n‐Th and oxidized n‐Pym+/n‐Thm+ oligomers (6 ≤ n ≤ 48, 2 ≤ m ≤ 18) are reported as a function of oligomer length. The charges in the oxidized oligomers have a localized distribution along the oxidized n‐Pym+/n‐Thm+ oligomers, and each set of two positive charges is localized in one area. Therefore, the charge carriers in oxidized n‐Pym+/n‐Thm+ oligomers are bipolarons. Furthermore, the nonlinear optical properties of the n‐Py/n‐Th oligomers are investigated, for which the static polarizability α, the first polarizability β, and the second polarizability γ are calculated. When the ratio of m/n is 1/3, the static polarizability <α> and the polarizability anisotropy Δα are maximized. In addition, neutral n‐Py/n‐Th oligomers have maximum <γ> values. The values of β were determined mainly by the dipole of the molecule, while the values of γ were closely related to the aromaticity of the oligomer. The stronger the aromaticity, the bigger the γ value. All calculations indicate that the polarizability and absorption spectrum can be tuned by controlling the oxidation level, making these oligomers applicable as good nonlinear optical materials.
Joining statistics and geophysics for assessment and uncertainty quantification of three‐dimensional seismic Earth models
Authors: Larmat Carène , Maceira Monica , Higdon David M. , Anderson Dale N. 
Published: August 2017

Seismic inversions produce seismic models, which are 3‐dimensional (3D) images of wave velocity of the entire planet retrieved by fitting seismic measurements made on records of past earthquakes or other seismic events. Computing power of the TeraFlop era, along with the dataflow from new, very dense, seismic arrays, has led to a new generation of 3D seismic Earth models with an unprecedented level of resolution.Here we compare two recent models of western United States from the Dynamic North America (DNA) seismic imaging effort. The two models only differ in the wave propagation that was used for their inversion: one is based on ray theory (RT), and the other on finite frequency (FF). We evaluate the two models using an independent numerical method and statistical tests. We show that they differ in how they produce seismic signals from a subset of earthquakes that were used in the original inversion and were recorded on the US array. This is especially true for measurements done in the Yellowstone area which has a large negative seismic anomaly. This result is of importance for seismologists who have been debating on the practical benefit of using FF in ill‐posed Earth inversions. Model evaluation, such as the one reported here, represents an opportunity for collaboration between geophysical and statistical communities. More opportunities should arise with the upcoming Exascale era, which will provide enough computational power to explore together several sources of errors in models with thousands of parameters, opening the way of uncertainty quantification of seismic models.
Is feedback to medical learners associated with characteristics of improved patient care?
Authors: Hayes Victoria , Bing-You Robert , Varaklis Kalli , Trowbridge Robert , Kemp Heather , McKelvy Dina 
Published: August 2017

Purpose To investigate the association of medical learner feedback with patient management and outcomes.
Methods The authors investigated 27 articles that utilized patient data or chart reviews as a subset of a prior feedback scoping review. Data extraction was completed by two authors and all authors reviewed the descriptive data analysis.
Results The studies were predominantly short-term investigations conducted in the US at academic teaching hospitals (89%) with one medical discipline (78%), most commonly internal medicine (56%). Patient-related outcomes primarily involved improved documentation (26%) and adherence to practice guidelines (19%) and were mostly measured through chart reviews (56%) or direct observation (15%). The primary method of feedback delivery involved a written format (30%). The majority of the studies showed a positive effect of feedback on the patient-oriented study outcomes (82%), although most involved a non-rigorous study design.
Conclusions Published studies focusing on the relationship between medical learner feedback and patient care are sparse. Most involve a single discipline at a single institution and are of a non-rigorous design. Measurements of improved patient outcomes are restricted to changes in management, procedures and documentation. Well-designed studies that directly link learner feedback to patient outcomes may help to support the use of feedback in teaching clinical outcomes improvement in alignment with competency-based milestones.
The Effect of Education on Chlorhexidine Use in a Neonatal Intensive Care Unit
Authors: Pettit Janet Delong , Sharpe Elizabeth Li 
Published: August 2017

Abstract
Background: Neonates are at greater risk for central-line-associated bloodstream infection due to prolonged vascular access for nutrition and medications. Skin antisepsis using chlorhexidine gluconate (CHG), particularly the formulation with alcohol (CHG/alcohol), during central line insertion and maintenance activities is a key clinical care process associated with central line-associated bloodstream infection reduction. One area of ongoing confusion for many clinicians is whether to adhere to the manufacturer's recommendations that CHG remain on the skin following the procedure to promote persistent microbicidal effects, or to foster product removal in hopes of preventing skin-related complications.
Purpose: Determine the effect of a targeted education program on the knowledge and attitudes of nurses who place peripherally inserted central catheters in the neonatal intensive care unit regarding the use and removal of CHG antiseptic.
Methods: A quasiexperimental presurvey/postsurvey quality improvement project recruited participants from the electronic mailing list of a national neonatal nursing organization.
Results: There was a statistically significant deficiency in knowledge or misinformation related to the use of CHG/alcohol on the presurvey assessment. Eight questions reflecting knowledge consistent with most recent evidence were answered correctly only 11.4%–25.7% of the time, all of which were considered statistically significant. Following completion of the education program, a nearly 100% correct response rate on all but 3 postsurvey questions resulted.
Conclusions: This quality improvement project demonstrated success in the ability to change knowledge surrounding the removal of CHG/alcohol from the skin of babies in a neonatal intensive care unit following completion of a targeted education program, and the effectiveness of targeted web-based educational programs.
Nursing Specialty Certification and Patient Outcomes: What We Know in Acute Care Hospitals and Future Directions
Authors: Boyle Diane K. 
Published: August 2017

Abstract
Purpose: To discuss the current research evidence about the relationship of nursing specialty certification and patient outcomes in acute care hospitals, interpret research findings within Needleman's Expanded Conceptual Model for Credentialing Research, provide future direction for research using Needleman's model, and discuss how Needleman's model applies to vascular access certification.
Review of Literature: Studies have found relationships between higher rates of nursing specialty certification and lower rates of total patient falls, pressure injuries, selected hospital-acquired infections, failure to rescue, and death. Inconsistent or contradictory evidence exists for the association of specialty certified nurses and lower total patient fall rates, selected hospital-acquired infection rates, and hospital-acquired pressure injuries. In addition, many of the significant associations supporting a relationship between specialty certified nurses and better patient outcomes are weak and may not be clinically meaningful. Many completed studies were not guided by a conceptual framework or model.
Conclusions: Needleman's Expanded Conceptual Model for Credentialing Research provides a mechanism for driving theory-based research about the association of specialty certification and patient outcomes by providing specific intervening variables: invisible architecture, work organization, and performance. Specific aspects of the model can be studied using large datasets such as the National Database of Nursing Quality Indicators.
Empowering Women Through Corporate Social Responsibility: A Feminist Foucauldian Critique
Authors: McCarthy Lauren 
Published: August 2017

ABSTRACT:Corporate social responsibility (CSR) has been hailed as a new means to address gender inequality, particularly by facilitating women’s empowerment. Women are frequently and forcefully positioned as saviours of economies or communities and proponents of sustainability. Using vignettes drawn from a CSR women’s empowerment programme in Ghana, this conceptual article explores unexpected programme outcomes enacted by women managers and farmers. It is argued that a feminist Foucauldian reading of power as relational and productive can help explain this since those involved are engaged in ongoing processes of resistance and self-making. This raises questions about the assumptions made about women and what is it that such CSR programmes aim to empower them ‘from’ or ‘to.’ Empowerment, when viewed as an ethic of care for the self, is better understood as a self-directed process, rather than a corporate-led strategy. This has implications for how we can imagine the achievement of gender equality through CSR.
A survey of feeding, activity, supplement use and energy consumption in North American agility dogs
Authors: Dinallo Gina K. , Poplarski Jennifer A. , Van Deventer Gretchen M. , Eirmann Laura A. , Wakshlag Joseph J. 
Published: August 2017

AbstractA survey was designed and administered at eighteen agility competitions across the Northeast and Midwest USA in 2015 to obtain information regarding competition level, training, feeding practices, owner-reported weight, body condition score (BCS) and supplement use. Average energy intake per d from reported consumption was assessed for all dogs in ideal body condition based on manufacturers’ or US Department of Agriculture database information. To assess the respective parameters across competition levels (novice, open, master/elite), non-parametric or parametric ANOVA or χ2 was used to determine significance. There were 494 respondents with usable data. Results showed that approximately 99 % of respondents used treats and 62 % utilised supplements. Of the respondents, 61 % fed primarily commercial dry food. Approximately 25 % of owners fed foods other than commercial dry (i.e. raw/home-prepared or freeze-dried). This 25 % of non-traditional diets included: 11 % home-prepared raw/cooked diets, 11 % commercial raw/cooked diets, and the remaining 3 % were fed commercial freeze-dried raw products. The remaining 14 % fed a mix of commercial dry food and raw/home-cooked blend. Average BCS was 4·7 (sd 1·1). Mean energy consumption of 238 dogs (BCS 4–5/9) was 444 (sd 138) kJ/kg body weight0·75 per d (106 (sd 33) kcal/kg body weight0·75 per d), with no significant differences observed between dogs at different levels of competition. The mean percentage of energy from treats was 15·1 (sd 12·7) % of overall energy consumption.
Effects of different protein sources on fermentation metabolites and nutrient digestibility of brachycephalic dogs
Authors: Urrego Maria Isabel Gonzalez , Matheus Laura Fantucci de O. , de Melo Santos Karine , Ernandes Mariane Ceschin , Monti Mariana , de Souza Danilo Ferreira , Balieiro Júlio Cesar de Carvalho , Araújo Lúcio Francelino , Pontieri Cristiana F. Ferreira , Brunetto Márcio Antonio 
Published: August 2017

AbstractBenefits to microbial fermentation in the colon and as a consequence less flatulence can be promoted for the health of adult dogs according to the amount and protein source. The present study evaluated different protein sources in dry food for brachycephalic dogs regarding microbial fermentation and nutrient digestibility. Four dry dog foods with similar protein content were formulated for adult maintenance: poultry meal (PM) diet; wheat gluten (WG) diet; PM + WG diet; and PM + WG + hydrolysed protein (HP) diet. Eight French bulldog adult dogs were arranged in a 4 × 4 Latin square design during the 28 d trial. Fresh faeces were collected for assessment of nutrient digestibility and analyses of faecal pH, SCFA, biogenic amines, ammonia and lactate. Means were compared by the PROC MIXED procedure of SAS and by Tukey's test, consideringP ≤ 0·05. The animals fed the WG and PM + WG diets showed higher digestibility for DM (P < 0·05), organic matter (P < 0·05), crude protein (P < 0·001) and lower faeces production (P < 0·02) than the PM and PM + WG + HP diets. Feeding diet PM + WG + HP resulted in lower faecal score and pH (P < 0·05) compared with other diets. Concentrations of fermentation metabolites were not statistically significantly different among diets. In conclusion, WG alone or in combination with PM improved protein and DM digestibility. Fermentation products were not affected by protein source.
Nutritional management of search and rescue dogs
Authors: Vassalotti G. , Musco N. , Lombardi P. , Calabrò S. , Tudisco R. , Mastellone V. , Grazioli R. , Bianchi S. , Cutrignelli M. I. 
Published: August 2017

AbstractDogs used for search and rescue (SAR) may experience continuous micro-traumas that predispose them to skeletal disorders. The aim of the present study was to evaluate the effect of diet on osteo-articular apparatus in healthy SAR dogs. A total of sixteen SAR dogs were divided into two groups (low supplementation (LS) and high supplementation (HS)) and were fed for 3 months with two experimental diets, characterised by the same protein and energy density, but different in n-3 PUFA (6·2 v. 8·4 % of metabolisable energy), chondroitin sulfate (219·8 v. 989·0 mg/kg DM) and glucosamine (769·2 v. 1318·7 mg/kg DM) in the LS and HS groups, respectively. At recruitment all dogs showed no joint inflammation signs, except four that showed mild symptoms. Haematology and serum biochemistry were performed every 30 d. Joint status was scored by physical and lameness evaluations. The sampling effect analysis showed potential beneficial effects by a decrease in a specific marker of membrane integrity (creatine kinase; CK). Comparing groups, glucose was significantly higher and CK was significantly lower in the HS group; however, in both cases the levels of these parameters fell in the normal range. At the end of the experiment, erythrocytes, Hb and packed cell volume were significantly higher in the HS compared with the LS group. These could result in an improvement in dogs’ performance, even if this aspect was not investigated in the present study. Concerning joint evaluation (pain on manipulation, lameness and range of motion), no statistically significant differences were detected between the groups and within the experimental period.