bluuebunny/crossref_metadata_2025_split huggingface dataset:
Preseason changes in markers of lower body fatigue and performance in young professional rugby union players
Authors: Roe Gregory A. B. , Darrall‐Jones Joshua D. , Till Kevin , Jones Ben 
Published: May 2016

AbstractThis study investigated the changes in measures of neuromuscular fatigue and physical performance in young professional rugby union players during a preseason training period. Fourteen young (age: 19.1 ± 1.2 years) professional rugby union players participated in the study. Changes in measures of lower body neuromuscular fatigue (countermovement jump (CMJ) mean power, mean force, flight‐time) and physical performance (lower body strength, 40 m sprint velocity) were assessed during an 11‐week preseason period using magnitude‐based inferences. CMJ mean power was likely to very likely decreased during week 2 (−8.1 ± 5.5% to −12.5 ± 6.8%), and likely to almost certainly decreased from weeks 5 to 11 (−10 ± 4.3% to −14.7 ± 6.9%), while CMJ flight‐time demonstrated likely to very likely decreases during weeks 2, and weeks 4–6 (−2.41 ± 1% to −3.3 ± 1.3%), and weeks 9–10 (−1.9 ± 0.9% to −2.2 ± 1.5%). Despite this, possible improvements in lower body strength (5.8 ± 2.7%) and very likely improvements in 40 m velocity (5.5 ± 3.6%) were made. Relationships between changes in CMJ metrics and lower body strength or 40 m sprint velocity were trivial or small (<0.22). Increases in lower body strength and 40 m velocity occurred over the course of an 11‐week preseason despite the presence of neuromuscular fatigue (as measured by CMJ). The findings of this study question the usefulness of CMJ for monitoring fatigue in the context of strength and sprint velocity development. Future research is needed to ascertain the consequences of negative changes in CMJ in the context of rugby‐specific activities to determine the usefulness of this test as a measure of fatigue in this population.
The Medical Science DMZ
Authors: Peisert Sean , Barnett William , Dart Eli , Cuff James , Grossman Robert L , Balas Edward , Berman Ari , Shankar Anurag , Tierney Brian 
Published: May 2016

Abstract
Objective We describe use cases and an institutional reference architecture for maintaining high-capacity, data-intensive network flows (e.g., 10, 40, 100 Gbps+) in a scientific, medical context while still adhering to security and privacy laws and regulations.
Materials and Methods High-end networking, packet filter firewalls, network intrusion detection systems.
Results We describe a “Medical Science DMZ” concept as an option for secure, high-volume transport of large, sensitive data sets between research institutions over national research networks.
Discussion The exponentially increasing amounts of “omics” data, the rapid increase of high-quality imaging, and other rapidly growing clinical data sets have resulted in the rise of biomedical research “big data.” The storage, analysis, and network resources required to process these data and integrate them into patient diagnoses and treatments have grown to scales that strain the capabilities of academic health centers. Some data are not generated locally and cannot be sustained locally, and shared data repositories such as those provided by the National Library of Medicine, the National Cancer Institute, and international partners such as the European Bioinformatics Institute are rapidly growing. The ability to store and compute using these data must therefore be addressed by a combination of local, national, and industry resources that exchange large data sets. Maintaining data-intensive flows that comply with HIPAA and other regulations presents a new challenge for biomedical research. Recognizing this, we describe a strategy that marries performance and security by borrowing from and redefining the concept of a “Science DMZ”—a framework that is used in physical sciences and engineering research to manage high-capacity data flows.
Conclusion By implementing a Medical Science DMZ architecture, biomedical researchers can leverage the scale provided by high-performance computer and cloud storage facilities and national high-speed research networks while preserving privacy and meeting regulatory requirements.
CLABSI Reduction Strategy
Authors: Wilder Kerry A. , Wall Brittany , Haggard David , Epperson Tiffany 
Published: May 2016

Background:
Central line–associated bloodstream infections (CLABSIs) are the most common hospital-acquired infections costing hospitals millions of dollars annually. An evidence-based practice literature review revealed that utilizing a systematic team approach for proper line maintenance is effective in reducing CLABSI rates.

Purpose:
The purpose of this quality improvement initiative was to reduce the CLABSI rate in the neonatal intensive care unit from 3.9 per 1000 line days in 2011 by at least 50% in 2014. Policies, protocols, team members utilized, competencies, and techniques were created and a formal line-rounding and dressing change competency was established. The competency included specific criteria for performing daily line rounds and a 2-person sterile technique for dressing changes.

Findings/Results:
Central line–associated bloodstream infection rate was effectively reduced from 3.9 in 2011 to 0.3 per 1000 line days in 2014, with an overall 92% improvement.

Implications for Practice:
Introduction of a dedicated CLABSI team has been shown to be effective in the reduction of CLABSI rates in the neonatal intensive care unit.

Implications for Research:
Further research is needed to evaluate how a team approach could be used to reduce other hospital-acquired conditions; catheter-associated urinary tract infection, and hospital-acquired pressure ulcers.
Developmental Care in North American Pediatric Cardiac Intensive Care Units
Authors: Sood Erica , Berends Wilma M. , Butcher Jennifer L. , Lisanti Amy J. , Medoff-Cooper Barbara , Singer Jayne , Willen Elizabeth , Butler Samantha 
Published: May 2016

Background:
Developmental care practices across pediatric cardiac intensive care units (CICUs) have not previously been described.

Purpose:
To characterize current developmental care practices in North American CICUs.

Methods:
A 47-item online survey of developmental care practices was developed and sent to 35 dedicated pediatric CICUs. Staff members who were knowledgeable about developmental care practices in the CICU completed the survey.

Findings/Results:
Completed surveys were received from 28 CICUs (80% response rate). Eighty-nine percent reported targeted efforts to promote developmental care, but only 50% and 43% reported having a developmental care committee and holding developmental rounds, respectively. Many CICUs provide darkness for sleep (86%) and indirect lighting for alertness (71%), but fewer provide low levels of sound (43%), television restrictions (43%), or designated quiet times (21%). Attempts to cluster care (82%) and support self-soothing during difficult procedures (86%) were commonly reported, but parental involvement in these activities is not consistently encouraged. All CICUs engage in infant holding, but practices vary on the basis of medical status and only 46% have formal holding policies.

Implications for Practice:
Implementation of developmental care in the CICU requires a well-planned process to ensure successful adoption of practice changes, beginning with a strong commitment from leadership and a focus on staff education, family support, value of parents as the primary caregivers, and policies to increase consistency of practice.

Implications for Research:
Future studies should examine the short- and long-term effects of developmental care practices on infants born with congenital heart disease and cared for in a pediatric CICU.
Neonatal Resuscitation Training
Authors: Jnah Amy J. , Newberry Desi M. , Trembath Andrea N. , Robertson Tracey , Downing April , Greene Miriam , Sewell Kerry 
Published: May 2016

Background:
The Neonatal Resuscitation Program's (NRP's) Sixth Edition introduced simulation-based training (SBT) into neonatal life support training. SBT offers neonatal emergency response teams a safe, secure environment to rehearse coordinated neonatal resuscitations. Teamwork and communication training can reduce tension and anxiety during neonatal medical emergencies.

Purpose:
To discuss the implications of variability in number and type of simulation scenario, number and type of learners who comprise a course, and their influence upon scope of practice, role confusion, and role ambiguity.

Methods:
Relevant articles from MEDLINE, CINAHL, EMBASE, Google Scholar, the World Health Organization, the American Heart Association, and NRP were included in this integrative review of the literature.

Findings/Results:
Purposeful synergy of optimal SBT course construct with teamwork and communication can resist discipline compartmentalization, role confusion, and role ambiguity. Five key themes were identified and coined the “5 Rights” of NRP SBT. These “5 Rights” can guide healthcare institutions with planning, implementation, and evaluation of NRP SBT courses.

Implications for Practice:
NRP SBT can facilitate optimal team function and reduce errors when teams of learners and varied scenarios are woven into the course construct. The simulated environment must be realistic and fully equipped to encourage knowledge transfer and attainment of the NRP's key behavioral outcomes.

Implications for Research:
Investigation of teamwork and communication training with NRP SBT, course construct, discipline compartmentalization, and behavioral and clinical outcomes is indicated. Investigation of outcomes of SBT using a team-teaching model, combining basic and advanced practice NRP instructors, is indicated.
Perceptions of Palliative Care in the NICU
Authors: Falck Alison J. , Moorthy Sheela , Hussey-Gardner Brenda 
Published: May 2016

Background and Purpose:
The American Academy of Pediatrics supports palliative care (PC) for all children with life-threatening illnesses. Thus, many neonatal intensive care unit (NICU) patients and their families could benefit from PC. Our study objective was to examine provision of PC as experienced by mothers and healthcare providers (HCPs) of NICU patients with life-threatening illnesses. Palliative care components explored included communication, choices, comfort, psychosocial and spiritual needs, and coordination of care.

Methods:
In this qualitative, descriptive study, we conducted semistructured interviews with mothers of infants with life-threatening illnesses and NICU HCPs who cared for these infants. Mothers selected HCPs who were key figures during their infant's NICU stay to participate. Interviews were transcribed and manually coded until themes emerged and theoretical saturation was achieved. Researchers reviewed charts for demographics and notes pertaining to PC. Triangulation of maternal interviews, HCP interviews, and chart notes was performed.

Results:
Theoretical saturation was achieved after 12 interviews. Mothers identified 5 nurses and 1 physician to be interviewed. Five themes were identified following data analysis and triangulation: (1) communication, (2) privacy, (3) continuity of care and relationship building, (4) maternal knowledge seeking, and (5) emotional turmoil.

Implications for Practice and Research:
Of domains of pediatric PC explored, participants emphasized transparent communication, family meetings as a venue for collaboration and shared decision making, the significance of psychosocial support for maternal emotional distress, and the importance of continuity of care across an often long and stressful hospitalization. Although mothers desired privacy, participants valued the security of the open-room NICU design. Future research should address components of PC that predominate in this specialized population.
Clavicle Fracture Is Not Predictive of the Need for Microsurgery in Brachial Plexus Birth Palsy
Authors: Leshikar Holly B. , Bauer Andrea S. , Lightdale-Miric Nina , Molitor Fred , Waters Peter M. 
Published: May 2016

Background:
Brachial plexus birth palsy (BPBP) and clavicle fractures occur concurrently as well as in isolation during difficult deliveries. The concept that concurrent clavicle fracture may spare nerve injury has been advocated. Our aim was to compare those children with BPBP presenting to a tertiary care center with and without concurrent clavicle fractures and assess the utility of the presence of a clavicle fracture as a predictor of injury severity in children with BPBP.

Methods:
Records of all patients belonging to a large prospective multicenter cohort study of infants with BPBP (Treatment and Outcomes of Brachial Plexus Injuries study) were analyzed for demographic information and birth information including risk factors, comorbidity, presence of clavicle fracture, and injury severity.

Results:
The records of 639 children with BPBP were examined. Thirteen patients were excluded for incomplete data. Ninety-six children who sustained concurrent birth fracture and BPBP were identified (15%). Of these, 57 sustained clavicle fractures (9%), 44 sustained humerus fractures, and 4 sustained other fractures. Of the demographic factors analyzed, only the presence of gestational diabetes was found to be significantly higher in those children with fractures versus those without. The presence of a clavicle fracture did not change the rate of microsurgical intervention, nor did clavicle fracture rates differ by Toronto score, suggesting that there was no difference in injury severity between the 2 groups.

Conclusions:
In a large multicenter prospective study, 9% of children presenting with BPBP also sustained a clavicle fracture at birth. The presence of a clavicle fracture did not correlate with the severity of brachial plexus injury. We suggest that in study populations of children with severe enough BPBP to present to a tertiary care center, compared with studies collected in the obstetric population, the presence of a clavicle fracture is neither protective from nerve injury nor predictive of injury severity.

Level of Evidence:
Level 2—prognostic.
The surgical management of cephalalgia
Authors: Osborn Timothy M. 
Published: May 2016

Purpose of review
Management of headache disorders is not part of most craniomaxillofacial surgery practices; however there are certain indications for surgical management of headaches by the craniomaxillofacial surgeon.

Recent findings
Migraine headaches are the most amenable to surgical management and while the exact mechanism of migraine is unknown, a central or peripheral trigger such as compressive neuropathy of trigeminal nerve branches leading to neurogenic inflammation has been suggested. The primary management for episodic migraine headache should be lifestyle modification and medication, whereas for chronic migraine (>15 headache days/month) use of medication and botulinum neurotoxin is effective, whereas some patients may choose to explore surgical options. Trigger site decompression for chronic migraine surgically relieves anatomic impingement at various sites and has been shown to reduce by at least 50% the frequency, intensity, and duration of headaches in over 85% and elimination of headaches in almost 60%. Trigger points may also lead to exacerbation of cluster headaches and treatment with botulinum neurotoxin may reduce attacks.

Summary
Trigger site decompression is an effective treatment for chronic migraine, as are botulinum neurotoxin injections in reducing attacks in cluster headaches. The craniomaxillofacial surgeon is uniquely qualified to treat these primary headache disorders.
Redesign of chronic illness care in children and adolescents: evidence for the chronic care model
Authors: Adams John S. , Woods Elizabeth R. 
Published: May 2016

Purpose of review
This article provides an overview of the chronic care model (CCM), examines the evidence for its utility in pediatric and adolescent chronic illness, and discusses practical steps for improving chronic illness care in the pediatric medical home.

Recent findings
Few studies have used the CCM as an improvement framework in pediatrics. However, in recent years, several quality improvement efforts based on the CCM have demonstrated improvement in important process measures or clinical outcomes in pediatric or adolescent obesity, inflammatory bowel disease, attention-deficit/hyperactivity disorder, depression, and asthma.

Summary
The CCM is an improvement framework that has demonstrated success in improving the care of children and adolescents with chronic disease. More research is needed to identify priority conditions for improvement efforts, to better understand the mediators of health outcomes in pediatric chronic disease, and to rigorously demonstrate the effectiveness of new models of chronic illness care. The evidence to date suggests that the CCM may be useful in guiding the redesign of care delivery systems to improve the health outcomes of young people with chronic disease.
The Presence of Pretransplant Antiphospholipid Antibodies IgA Anti-β-2-Glycoprotein I as a Predictor of Graft Thrombosis After Renal Transplantation
Authors: Morales Jose Maria , Serrano Manuel , Martínez-Flores Jose Angel , Pérez Dolores , Castro Maria José , Sánchez Elena , García Florencio , Rodríguez-Antolín Alfredo , Alonso Marina , Gutierrez Eduardo , Morales Enrique , Praga Manuel , González Esther , Andrés Amado , Paz-Artal Estela , Martínez Miguel Angel , Serrano Antonio 
Published: May 2016

Background
Vessel thrombosis is a severe complication after renal transplantation. Antibodies anti-β-2 glycoprotein-I of IgA isotype (IgA-aB2GP1) have been linked to thrombotic events and mortality in hemodialysis patients.

Methods
All kidney transplanted patients from 2000 to 2011 (n = 1375) in our hospital were followed up for 2 years, evaluating 3 time periods.

Results
At transplantation, 401 patients were positive for IgA-aB2GPI (29.2%, group 1), and the remaining patients were negative (group 2). Graft loss at 6 months posttransplantation was higher in group 1 (18% vs 7.2%; P < 0.001). The most frequent cause of early graft loss was vessel thrombosis, especially in group 1 (12.2% vs 2.6% of patients; P < 0.001). In fact, vessel thrombosis was the most important cause of graft loss in the 3 time periods, irrespective of demographic changes and introduction of transplantation with asystolic donors.
Notably, IgA-aB2GP1 was an independent risk factor for graft thrombosis (odds ratio, 5.047; P < 0.001). Furthermore, the presence of IgA-aB2GP1 was associated with early graft loss and delayed graft function. Mortality at 24 months was also higher in group 1.

Conclusions
In conclusion, pretransplant IgA-aB2GP1 was the main risk factor for graft thrombosis and early graft loss. Further research should be made on whether anticoagulation in antibody-positive patients could ameliorate this catastrophic complication.
P2Y2 purinergic receptor is induced following human cytomegalovirus infection and its activity is required for efficient viral replication
Authors: Chen Saisai , Shenk Thomas , Nogalski Maciej T. 
Published: May 2016

AbstractHuman cytomegalovirus (HCMV) manipulates many aspects of host cell biology to create an intracellular milieu optimally supportive of its replication and spread. The current study reveals a role for purinergic signaling in HCMV infection. The levels of several components of the purinergic signaling system, including the P2Y2 receptor, were altered in HCMV-infected fibroblasts. P2Y2 receptor RNA and protein are strongly induced following infection. Pharmacological inhibition of receptor activity or knockdown of receptor expression markedly reduced the production of infectious HCMV progeny. When P2Y2 activity was inhibited, the accumulation of most viral RNAs tested and viral DNA was reduced. In addition, the level of cytosolic calcium within infected cells was reduced when P2Y2 signaling was blocked. The HCMV-coded UL37x1 protein was previously shown to induce calcium flux from the smooth endoplasmic reticulum to the cytosol, and the present study demonstrates that P2Y2 function is required for this mobilization. We conclude that P2Y2 supports the production of HCMV progeny, possibly at multiple points within the viral replication cycle that interface with signaling pathways induced by the purinergic receptor.ImportanceHCMV infection is ubiquitous and can cause life-threatening disease in immunocompromised patients, debilitating birth defects in newborns, and has been increasingly associated with a wide range of chronic conditions. Such broad clinical implications result from the modulation of multiple host cell processes. This study documents that cellular purinergic signaling is usurped in HCMV-infected cells and that the function of this signaling axis is critical for efficient HCMV infection. Therefore, we speculate that blocking P2Y2 receptor activity has the potential to become an attractive novel treatment option for HCMV infection.
A Graph Extension of the Positional Burrows-Wheeler Transform and its Applications
Authors: Novak Adam M. , Garrison Erik , Paten Benedict 
Published: May 2016

1AbstractWe present a generalization of the Positional Burrows-Wheeler Transform (PBWT) to genome graphs, which we call the gPBWT. A genome graph is a collapsed representation of a set of genomes described as a graph. In a genome graph, a haplotype corresponds to a restricted form of walk. The gPBWT is a compressible representation of a set of these graph-encoded haplotypes that allows for efficient subhaplotype match queries. We give efficient algorithms for gPBWT construction and query operations. We describe our implementation, showing the compression and search of 1000 Genomes data. As a demonstration, we use the gPBWT to quickly count the number of haplotypes consistent with random walks in a genome graph, and with the paths taken by mapped reads; results suggest that haplotype consistency information can be practically incorporated into graph-based read mappers.
Business strategy and performance in Indonesia’s service sector
Authors: Yuliansyah Yuliansyah , Rammal Hussain G. , Rose Elizabeth 
Published: May 2016

Purpose
The relationship between strategic choices and performance in service firms in emerging markets has remained largely under-researched. This study aims to address this issue by studying the performance of financial institutions in the context of Indonesia’s political, institutional and socio-cultural environment.

Design/methodology/approach
Using institutional theory, the authors analyzed data collected using surveys and interviews with senior managers in Indonesian financial institutions.

Findings
The authors find that the regulative and normative elements have forced organizations to incorporate the values set by the external institutional bodies. The organizations have undertaken structural isomorphism in response to culture-cognitive elements, and differentiate themselves by focusing on the provision of quality customer service and enhanced customer satisfaction.

Originality/value
The authors provide new insights by studying how the political and institutional environment and choice of strategy influences performance of the services sector in emerging economies.