bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors associated with the true location of ingested fishbones
Authors: Lu Yen-Ting , Chen Hung-Wen , Tseng Yao-Ying , Chen Chia-Hsi , Lu Ying-Chou 
Published: December 2017

Objectives
Fishbone ingestion is a common problem worldwide, and the first step for managing this condition is to locate the fishbone precisely. However, until now, no study has analysed the true location of fishbone and its associated factors. Thus, this study identified the factors predicting the true location of fishbone and subsequently attempted to provide a management algorithm for fishbone ingestion.

Patients and methods
This retrospective study was carried out at St Martin De Porres Hospital, Taiwan, between January 2015 and January 2016. All patients were diagnosed as having fishbone ingestion within the pharynx and underwent fishbone removal.

Results
This study included 198 consecutive patients with a mean age of 43.1 years (range: 1–84 years). The sensitivity of lateral neck radiography in the diagnosis of fishbone in the pharynx was only 22%. The fishbone locations were as follows: the tonsil in 72 (36.4%) patients, the tongue base / vallecula in 112 (56.6%) and the hypopharynx in 14 (7.0%). Multiple logistic regression analysis showed that patient age and fishbone length were significant independent risk factors associated with the true location of fishbone ingestion. Among all patients, fishbone was removed transorally under direct vision in 73 (36.9%) patients and using flexible nasopharyngoscopy in 125 (63.1%) patients.

Conclusion
Patient age and fishbone length are important independent factors associated with the location of ingested fishbone. Lateral neck radiography is not beneficial for diagnosing fishbone ingestion within the pharynx. Flexible nasopharyngoscopy, by contrast, is an important method for the diagnosis and treatment of fishbone ingestion within this location.
Assessing the Organizational Characteristics Influencing Quality Improvement Implementation in Saudi Hospitals
Authors: Shamsuddin Alaraki Mohammad 
Published: December 2017

Background:
The health care system in Saudi Arabia has serious problems with quality and safety that can be reduced through systematic quality improvement (QI) activities. Despite the use of different QI models to improve health care in Saudi hospitals during the last 2 decades, consistent improvements have not yet been achieved and the results are still far below expectations. This may reflect a problem in introducing and implementing the QI models in the local contexts. The objective of this study is to assess the extent of QI implementation in Saudi hospitals and to identify the organizational characteristics that make Saudi hospitals particularly challenging for QI. Understanding these characteristics can inform efforts to improve them and may lead to more successful implementation.

Methods:
A mixed-methods approach was conducted using 2 data collection tools: questionnaires and interviews. The quantitative phase (questionnaires) aimed to uncover the current level of QI implementation in Saudi hospital as measured by 7 critical dimensions adapted from the literature. The qualitative phase (interviews) aimed to understand the organizational characteristics that impede or underpin QI in Saudi hospitals.

Results and Discussion:
The QI implementation was found to be significantly poor across the 7 dimensions with average score ranging between 22.80 ± 0.57 and 2.11 ± 0.69 on a 5-point Likert scale and with P value of less than .05. We also found that the current level of QI implementation helped Saudi hospitals neither to improve “customer satisfaction” nor to achieve measurable improvements in “quality results” scoring significantly low at 2.11 ± 0.69 with P value of .000 and 2.47 ± 0.57 with P value of .000, respectively. Our study confirms the presence of a multitude of organizational barriers that impede QI in Saudi hospitals. These are related to organizational culture, human resources management, processes and systems, and structure. These 4 were found to have the strongest impact on QI in Saudi hospitals.

Conclusion:
It appears that the most important contributing factors to the successful implementation of QI in Saudi hospitals are proper human resources utilization and effective quality management. Through careful planning, change management, proper utilization of human resources, supportive quality information systems, focus on processes and systems, structural support, and an organizational culture that is compatible with QI philosophy, Saudi hospitals will be more capable in achieving sustained measureable improvements in the quality and safety of patient care.
Framework for Research on Implementation of Process Redesigns
Authors: Ashok Mahima , Hung Dorothy , Rojas-Smith Lucia , Halpern Michael T. , Harrison Michael 
Published: December 2017

Background:
Complex system interventions benefit from close attention to factors affecting implementation and resultant outcomes. This article describes a framework for examining these factors in process redesign (PR) and for assessing PR outcomes.

Methods:
Using literature scans and expert comment on draft frameworks based on the Consolidated Framework for Implementation Research, a team of researchers developed the PR framework for the Agency for Healthcare Research and Quality. As a case study, an independent team of researchers in a large care system subsequently applied the PR framework to implementation of Lean-based primary care redesigns.

Results:
The PR framework adds 2 domains to the Consolidated Framework for Implementation Research, focused on relevant measures of implementation and outcomes, as well as some new constructs to the Consolidated Framework for Implementation Research. Using the PR framework to guide a study of primary care PR, researchers found that the health care reform environment encouraged staff recognition of need for redesign, but physicians worried about key redesign issues, including colocation with care team partners and the competencies of the individuals assigned to manage new workflows. Team member acceptance of the redesign was also influenced by other features of the implementation process and contextual features, including the decision style of the local clinic.

Conclusions:
The PR framework helped guide the qualitative study and aided researchers in informing their leadership about critical issues affecting PR implementation.
Rapid Patient Discharge Contribution to Bed Surge Capacity During a Mass Casualty Incident: Findings From an Exercise With New York City Hospitals
Authors: Jacobs-Wingo Jasmine L. , Cook Heather A. , Lang William H. 
Published: December 2017

Background:
Mass casualty incidents may increase patient volume suddenly and dramatically, requiring hospitals to expeditiously manage bed inventories to release acute care beds for disaster victims. Electronic patient tracking systems combined with unit walk-throughs can identify patients for rapid discharge. The New York City (NYC) Department of Health and Mental Hygiene's 2013 Rapid Patient Discharge Assessment (RPDA) aimed to determine the maximum number of beds NYC hospitals could make available through rapid patient discharge and to characterize discharge barriers.

Methods:
Unit representatives identified discharge candidates within normal operations in round 1 and additional discharge candidates during a disaster scenario in round 2. Descriptive statistics were performed.

Results:
Fifty-five NYC hospitals participated in the RPDA exercise; 45 provided discharge candidate counts in both rounds. Representatives identified 4225 patients through the RPDA: among these, 1138 (26.9%) were already confirmed for discharge; 1854 (43.9%) were round 1 discharge candidates; and 1233 (29.2%) were round 2 discharge candidates. These 4225 patients represented 21.4% of total bed capacity. Frequently reported barriers included missing prescriptions for aftercare or discharge orders.

Conclusion:
The NYC hospitals could implement rapid patient discharge to clear one-fifth of occupied inpatient beds for disaster victims, given they address barriers affecting patients' safe and efficient discharge.
Attitudes Toward and Management of Fibromyalgia
Authors: Agarwal Arnav , Oparin Yvgeniy , Glick Lauren , Fitzcharles Mary-Ann , Adachi Jonathan D. , Cooper Matthew D. , Gallo Lucas , Wong Laura , Busse Jason W. 
Published: December 2017

Background
Canadian rheumatologists' attitudes toward and management of fibromyalgia remain uncertain.

Objective
The aim of this study was to explore management strategies and attitudes of Canadian rheumatologists toward fibromyalgia and concordance with guideline recommendations.

Methods
We administered a 17-item cross-sectional survey to Canadian rheumatologists and explored the concordance between respondents' management practices with the 2012 Canadian Guidelines for the diagnosis and management of fibromyalgia.

Results
Among 331 Canadian rheumatologists who were approached, 140 returned the survey for a 42% response rate. The majority felt that fibromyalgia was a useful clinical diagnosis (110/138 [80%]) but was divided as to whether fibromyalgia was objectively defined (75/138 [54%]) or a psychosocial condition (42/138 [30%]) or could result in an inability to work (37/138 [27%]). Contrary to guideline recommendations, most (82/134 [61%]) endorsed that tender points were useful for diagnosis. Half endorsed potentially refusing consultations with fibromyalgia patients, and only 42% (59/139) agreed that there were effective therapies for this syndrome. Consistent with the guideline, most respondents managed fibromyalgia with education, exercise therapy, antidepressants, and nonnarcotic analgesics (≥89% for all); however, fewer than half agreed that any of these modalities were effective (endorsement ranged from 9% to 47%). Assessment of the 2012 guideline revealed a number of important limitations.

Conclusions
Canadian rheumatologists largely do not provide primary care for fibromyalgia. Most adhere to guideline recommendations for management of fibromyalgia, but few endorse these interventions as effective. Further research, including updating of the 2012 Canadian Guidelines for the diagnosis and management of fibromyalgia, is required to inform this disconnect.
Metabolomics and Precision Medicine in Trauma: The State of the Field
Authors: Jayaraman Sudha P. , Anand Rahul J. , DeAntonio Jonathan H. , Mangino Martin , Aboutanos Michel B. , Kasirajan Vigneshwar , Ivatury Rao R. , Valadka Alex B. , Glushakova Olena , Hayes Ronald L. , Bachmann Lorin M. , Brophy Gretchen M. , Contaifer Daniel , Warncke Urszula O. , Brophy Donald F. , Wijesinghe Dayanjan S. 
Published: December 2017

ABSTRACT
Trauma is a major problem in the United States. Mortality from trauma is the number one cause of death under the age of 45 in the United States and is the third leading cause of death for all age groups. There are approximately 200,000 deaths per year due to trauma in the United States at a cost of over $671 billion in combined healthcare costs and lost productivity. Unsurprisingly, trauma accounts for approximately 30% of all life-years lost in the United States. Due to immense development of trauma systems, a large majority of trauma patients survive the injury, but then go on to die from complications arising from the injury. These complications are marked by early and significant metabolic changes accompanied by inflammatory responses that lead to progressive organ failure and, ultimately, death. Early resuscitative and surgical interventions followed by close monitoring to identify and rescue treatment failures are key to successful outcomes. Currently, the adequacy of resuscitation is measured using vital signs, noninvasive methods such as bedside echocardiography or stroke volume variation, and other laboratory endpoints of resuscitation, such as lactate and base deficit. However, these methods may be too crude to understand cellular and subcellular changes that may be occurring in trauma patients. Better diagnostic and therapeutic markers are needed to assess the adequacy of interventions and monitor responses at a cellular and subcellular level and inform clinical decision-making before complications are clinically apparent. The developing field of metabolomics holds great promise in the identification and application of biochemical markers toward the clinical decision-making process.
Vigabatrin: Lessons Learned From the United States Experience
Authors: Foroozan Rod 
Published: December 2017

Abstract:
Vigabatrin was introduced as an antiseizure medication in the United Kingdom in 1989 and was extensively used until 1997 when concerns arose regarding peripheral visual field loss. When the drug was approved in the United States in 2009, it carried a black box warning for the risk of permanent visual loss, and the pharmaceutical company was mandated to create a drug registry to assess for visual deficits. The vigabatrin drug registry has documented a relatively large percentage (37%) of preexisting, baseline visual deficits and a paucity (2%) of potential new visual findings. The vigabatrin vision study, a prospective, longitudinal, single-arm, open-label study, confirmed that adult patients with refractory complex partial seizures had a large number of visual deficits at baseline. An unexpected finding during the first year of therapy with vigabatrin was an increase in retinal thickness on optical coherence tomography. The experience from vigabatrin in the United States emphasizes the importance of baseline eye findings when considering the potential of drug toxicity involving the visual pathways.
Arabidopsis leaf hydraulic conductance is regulated by xylem-sap pH, controlled, in turn, by a P-type H+-ATPase of vascular bundle sheath cells
Authors: Grunwald Yael , Wigoda Noa , Sade Nir , Yaaran Adi , Torne Tanmayee , Gosa Sanbon Chaka , Moran Nava , Moshelion Menachem 
Published: December 2017

AbstractThe leaf vascular bundle sheath cells (BSCs) that tightly envelop the leaf veins, are a selective and dynamic barrier to xylem-sap water and solutes radially entering the mesophyll cells. Under normal conditions, xylem-sap pH of <6 is presumably important for driving and regulating the transmembranal solute transport. Having discovered recently a differentially high expression of a BSCs proton pump, AHA2, we now test the hypothesis that it regulates this pH and leaf radial water fluxes.We monitored the xylem-sap pH in the veins of detached leaves of WT Arabidopsis, AHA mutants, andaha2mutants complemented withAHA2gene solely in BSCs. We tested an AHA inhibitor and stimulator, and different pH buffers. We monitored their impact on the xylem-sap pH and the whole leaf hydraulic conductance (Kleaf), and the effect of pH on the water osmotic permeability (Pf) of isolated BSCs protoplasts.Our results demonstrated that AHA2 is necessary for xylem-sap acidification, and in turn, for elevating Kleaf. Conversely, knocking out AHA2 alkalinized the xylem-sap. Also, elevating xylem sap pH to 7.5 reduced Kleafand elevating external pH to 7.5 decreased the BSCs Pf.All these demonstrate a causative link between AHA2 activity in BSCs and leaf radial water conductance.One-sentence summaryBundle-sheath cells can control the leaf hydraulic conductance by proton-pump-regulated xylem sap pH
High-throughput optical mapping of replicating DNA
Authors: De Carli Francesco , Menezes Nikita , Berrabah Wahiba , Barbe Valérie , Genovesio Auguste , Hyrien Olivier 
Published: December 2017

AbstractDNA replication is a crucial process for the universal ability of living organisms to reproduce. Existing methods to map replication genome-wide use large cell populations and therefore smooth out variability between chromosomal copies. Single-molecule methods may in principle reveal this variability. However, current methods remain refractory to automated molecule detection and measurements. Their low throughput has therefore precluded genome-wide analyses. Here, we have repurposed a commercial optical DNA mapping device, the Bionano Genomics Irys system, to map the replication signal of single DNA molecules onto genomic position at high throughput. Our methodology (HOMARD) combines fluorescent labelling of replication tracks and nicking endonuclease (NE) sites with DNA linearization in nanochannel arrays and dedicated image processing. We demonstrate the robustness of our approach by providing an ultra-high coverage (23,311 x) replication map of bacteriophage λ DNA in Xenopus egg extracts. HOMARD opens the way to genome-wide analysis of DNA replication at the single-molecule level.
Genetic Analysis ofcallusinitiation inGossypium tomentosumandGossypium darwinii
Authors: Yelena Kolezeva , Vasilyev Nikolay , Alpatov Ivan 
Published: December 2017

AbstractWild cotton species can contribute a valuable gene pool for the genetic improvement of cultivated tetraploid cultivars. But the obstacle is the reproductive isolation of different species. Somatic embryogenesis offers a temporary status for genetic manipulation such as somatic hybridization. The present studies aimed at optimizing the conditions for regeneration of wild species of cotton. Callus were successfully induced from hypocotyls ofGossypium tomentosum(C1genome) andGossypium darwinii(D5genome) on MSB5(MS salts and B5vitamins) medium supplemented with 0.01mg/L 2, 4-D (2, 4-dichlorophenoxyacetic acid), 0.01mg/L KT (kinetin), 0.01mg/L IAA (3-indoleacetlc acid) and 0.60mg/L 2, 4-D, 0.25mg/L KT, respectively. Plant growth regulators (PGRs) combinations, adding high inorganic salt stress, and carbohydrate were used to induce embryogenic callus from nonembryogenic callus. Embryogenic cultures were induced from the two cotton species. Based on studying the effect of PGRs, nitrogen sources, molysite, CuSO4and pH value on somatic embryogenesis (SE), we obtained somatic embryogenesis in theG. tomentosumon the medium with 0.1 mg/L 2, 4-D, 0.1 mg/L KT while deprivation of KNO3. The result gives out new exploration on somatic embryogenesis in cotton to create new germplasm sources.
Cdk9, Spt5 and histone H2B mono-ubiquitylation cooperate to ensure antisense suppression by the Clr6-CII/Rpd3S HDAC complex
Authors: Sansó Miriam , Pinto Daniel , Svensson Peter , Pagé Viviane , Parua Pabitra , Bitton Danny A. , Mbogning Jean , Garcia Patricia , Hidalgo Elena , Robert François , Bähler Jürg , Tanny Jason C. , Fisher Robert P. 
Published: December 2017

AbstractCyclin-dependent kinase 9 (Cdk9) and histone H2B monoubiquitylation (H2Bub1) are both implicated in elongation by RNA polymerase II (RNAPII). In fission yeast, Cdk9 and H2Bub1 regulate each other through a feedback loop involving phosphorylation of the elongation factor Spt5. Conversely, genetic interactions suggest opposing functions of H2Bub1 and Cdk9 through an Spt5-independent pathway. To understand these interactions, we performed RNA-seq analysis after H2Bub1 loss, Cdk9 inhibition, or both. Either Cdk9 inhibition or H2Bub1 loss increased levels of antisense transcription initiating within coding regions of distinct subsets of genes; ablation of both pathways led to antisense derepression affecting over half the genome. Cdk9 and H2Bub1 cooperate to suppress antisense transcription by promoting function of the Clr6-CII histone deacetylase (HDAC) complex. H2Bub1 plays a second role, in opposition to Clr6-CII, to promote sense transcription in subtelomeric regions. Therefore, functional genomics revealed both collaborative and antagonistic functions of H2Bub1 and Cdk9.
The use of multi‐frequency acquisition to significantly improve the quality of fibre‐optic‐distributed vibration sensing
Authors: Hartog A.H. , Liokumovich L.B. , Ushakov N.A. , Kotov O.I. , Dean T. , Cuny T. , Constantinou A. , Englich F.V. 
Published: December 2017

ABSTRACTUnlike conventional sensors that measure the passage of seismic waves at a single position, distributed vibration sensing systems, also known as distributed acoustic sensing systems, detect the passage of seismic waves by averaging a measurement of strain over a section of fibre‐optic cable. Distributed vibration sensing systems work by transmitting pulses of light down the fibre and measuring the phase of the Rayleigh backscatter. At random positions along the fibre, however, fading occurs; this is where the amplitude of the backscattered signal is very small due to cancellation of the scattered electric fields, resulting in anomalously noisy traces in a common source gather.This paper addresses the problem of fading in a particular form of distributed vibration sensors: a new optical arrangement of the instrumentation is described that allows the measurement to be carried out quasi‐simultaneously at multiple optical interrogation frequencies. The interrogation frequencies are chosen to be sufficiently different that their fading properties are distinct and the diversity thus obtained is used to aggregate the data obtained to substantially reduce the noise caused by fading. As well as reducing the effects of fading, the aggregation of the independent results can also help to reduce the overall noise of the measurement and improve the linearity of the distributed vibration sensing system.
Oil and the Naira: A Markov Switching Perspective
Authors: Ayodeji Idowu Oluwasayo 
Published: December 2017

AbstractUsing a Markov switching regression model, the study investigated the relationship between oil price shocks and exchange rates movements in an oil‐exporting economy. On the strength of theoretical and empirical evidence, Nigerian naira exchange rates to US dollars were decomposed into two segmented time trends of depreciation (state 1) and appreciation (state 2). Empirical results provided evidence that exchange rate returns exhibited an asymmetric response to oil price shocks during depreciation and appreciation. We observed that, while the system is in depreciation, nominal oil prices had a positive influence on nominal USD/NGN, whereas nominal oil price shocks had no significant effect on nominal exchange rate movements during appreciation. In addition, real effective exchange rates appreciate with decreasing real oil prices but its depreciation does not depend significantly on real oil prices. Given that a decrease in nominal oil prices induces rapid naira depreciation and topples exchange rates stability, the study suggested that the government works towards a sustainable diversification of the economy to avoid continued over‐dependence on oil exports. Also, to rigorously pursue a sustainable fiscal policy regime in order to boost local productions, encourage non‐oil commodities exportation, and consequently increase avenues for influx of foreign exchange.