bluuebunny/crossref_metadata_2025_split huggingface dataset:
Kindling the Creative Potential
Authors: Gaur Shubhra P 
Published: December 2016

‘There’s a way to do it better—find it’—Thomas Edison In this competitive era, it becomes vital for organizations to be innovative in their businesses and employees of an organization play a crucial role towards this goal. Hence, it becomes pertinent for any organization to encourage employees to come up with creative ideas, strategies and solutions to sustain the business. The context of this study is advertising agencies which fall under the category of creative industry and employ creative people in all critical functions. The study aims to identify the personality traits, behavioural attributes and communication patterns (as perceived and reported by subordinates) which are critical for effective leadership in terms of fostering creative outcomes from subordinates in advertising agencies. It attempts to highlight the role of superiors (bosses) in fostering creativity amongst their subordinates. The study was conducted on employees in leading advertising agencies of India. The methodology used for the research is qualitative. The data were collected in three different stages and the tool used for collecting data was in-depth interviews. Qualitative content analysis was done on the interview protocols. Data interpretation was done using open, axial and selective coding. The findings led to the formulation of a three-factor model for fostering creative outcomes in subordinates, using grounded theory approach.
Effect of deslorelin acetate treatment in oocyte recovery and in vitro embryo production in domestic cats
Authors: Ackermann Camila Louise , Trevisol Eduardo , Crocomo Leticia Ferrari , Rascado Tatiana da Silva , Volpato Rodrigo , Guaitolini Carlos Renato de Freitas , Lopes Carlize , Costa Talita de Almeida , Lopes Maria Denise 
Published: December 2016

Objectives The present study investigated the effect of contraceptive treatment with deslorelin acetate on in vitro embryo production and oocyte recovery in domestic queens. Methods Twenty-one mature domestic cats were used. Eleven queens (treated group) and one tom were kept in an experimental cattery, and 10 queens were privately owned (control group). When in interestrus or diestrus (day 0) a deslorelin acetate implant (Suprelorin, 4.7 mg/animal) was inserted into the subcutaneous tissue of the interscapular region in all queens in the treated group. After 6 months of treatment, all animals were ovariohysterectomized, and the ovaries were used for in vitro embryo production. Percentage of cleavage was determined 18 h after oocyte insemination and blastocyst formation was assessed on the eighth day of culture. The rate of cumulus-oocyte complexes (COCs) recovery was analyzed by an unpaired t-test. The cleavage and blastocyst rates were expressed as percentages and analyzed by Fisher’s exact test. All analyses were performed using GraphPad Prism v5.0, with P <0.05 set as the level of significance. Results In the treated group, we recovered 8.3 ± 1.15 grade I COCs per queen; the cleavage rate was 60% and the blastocyst rate was 36%. In the control group, we recovered 18.4 ± 3.21 grade I COCs per queen; the cleavage rate was 55.97% and the blastocyst rate was 34%. Forty percent of treated females did not produce any blastocysts. In the treated group, we observed a significant decrease in COC recovery. Although there was no significant difference in cleavage and blastocyst rates between groups, 40% of treated females did not produce any blastocysts. Conclusions Recovery of grade I COCs is negatively affected by deslorelin treatment in domestic cats. Regarding embryo production, new studies are still necessary to evaluate the success of this technique owing to the individual effect caused by deslorelin acetate.
Frailty Assessment in Hospitalized Older Adults Using the Electronic Health Record
Authors: Lekan Deborah A. , Wallace Debra C. , McCoy Thomas P. , Hu Jie , Silva Susan G. , Whitson Heather E. 
Published: December 2016

Introduction: Frailty, a clinical syndrome of decreased physiologic reserve and dysregulation in multiple physiologic systems, is associated with increased risk for adverse outcomes. Purpose: The aim of this retrospective, cross-sectional, correlational study was to characterize frailty in older adults admitted to a tertiary-care hospital using a biopsychosocial frailty assessment and to determine associations between frailty and time to in-hospital mortality and 30-day rehospitalization. Methods: The sample included 278 patients ≥55 years old admitted to medicine units. Frailty was determined using clinical data from the electronic health record (EHR) for symptoms, syndromes, and conditions and laboratory data for four serum biomarkers. A frailty risk score (FRS) was created from 16 risk factors, and relationships between the FRS and outcomes were examined. Results: The mean age of the sample was 70.2 years and mean FRS was 9.4 ( SD, 2.2). Increased FRS was significantly associated with increased risk of death (hazard ratio = 1.77−2.27 for 3 days ≤ length of stay (LOS) ≤7 days), but depended upon LOS ( p < .001). Frailty was marginally associated with rehospitalization for those who did not die in hospital (adjusted odds ratio = 1.18, p = .086, area under the curve [AUC] = 0.66, 95% confidence interval for AUC = [0.57, 0.76]). Discussion: Clinical data in the EHR can be used for frailty assessment. Informatics may facilitate data aggregation and decision support. Because frailty is potentially preventable and treatable, early detection is crucial to delivery of tailored interventions and optimal patient outcomes.
Cost–benefit analysis of telehealth in pre-hospital care
Authors: Langabeer James R , Champagne-Langabeer Tiffany , Alqusairi Diaa , Kim Junghyun , Jackson Adria , Persse David , Gonzalez Michael 
Published: December 2016

Objective There has been very little use of telehealth in pre-hospital emergency medical services (EMS), yet the potential exists for this technology to transform the current delivery model. In this study, we explore the costs and benefits of one large telehealth EMS initiative. Methods Using a case-control study design and both micro- and gross-costing data from the Houston Fire Department EMS electronic patient care record system, we conducted a cost–benefit analysis (CBA) comparing costs with potential savings associated with patients treated through a telehealth-enabled intervention. The intervention consisted of telehealth-based consultation between the 911 patient and an EMS physician, to evaluate and triage the necessity for patient transport to a hospital emergency department (ED). Patients with non-urgent, primary care-related conditions were then scheduled and transported by alternative means to an affiliated primary care clinic. We measured CBA as both total cost savings and cost per ED visit averted, in US Dollars ($USD). Results In total, 5570 patients were treated over the first full 12 months with a telehealth-enabled care model. We found a 6.7% absolute reduction in potentially medically unnecessary ED visits, and a 44-minute reduction in total ambulance back-in-service times. The average cost for a telehealth patient was $167, which was a statistically significantly $103 less than the control group ( p < .0001). The programme produced a $928,000 annual cost savings from the societal perspective, or $2468 cost savings per ED visit averted (benefit). Conclusion Patient care enabled by telehealth in a pre-hospital environment, is a more cost effective alternative compared to the traditional EMS ‘treat and transport to ED’ model.
Effects of exendin-4 on the intrarenal renin-angiotensin system and interstitial fibrosis in unilateral ureteral obstruction mice: Exendin-4 and unilateral ureteral obstruction
Authors: Le Ying , Zheng Zongji , Xue Junyu , Cheng Mengling , Guan Meiping , Xue Yaoming 
Published: December 2016

Objective: The objective of this article is to investigate the renoprotecive effects of exendin-4 in a mouse model of unilateral ureteral obstruction (UUO) and explore the putative mechanisms. Methods: Male Balbc mice underwent sham operation or UUO surgery, and then received intraperitoneal injection of vehicle or exendin-4, respectively. After 14 days, mice were sacrificed and the left kidneys were collected and analyzed by histology, immunohistochemistry, Western blot, quantitative real-time reverse transcription polymerase chain reaction, radioimmunoassay and enzyme-linked immunosorbent assay. Results: As compared to the sham group, mice that underwent UUO surgery developed more severe tubular injury and interstitial fibrosis, as well as higher expression of fibronectin (FN), collagen-1 (Col-1) and α-smooth muscle actin (α-SMA). Also, we observed higher expression of angiotensin-converting enzyme (ACE) while lower expression of angiotensin-converting enzyme 2 (ACE2), higher levels of intrarenal angiotensin II (Ang II) while lower levels of intrarenal angiotensin-(1–7), and higher expression of transforming growth factor β1 (TGF-β1) and phosphorylation of Smad3 (p-Smad3) in the obstructed kidneys. Impressively, these pathologic changes were significantly attenuated in the mice group of UUO treated with exendin-4. Conclusion: Our present study indicates for the first time that exendin-4 exerts renoprotective effects in an experimental model of UUO, partly through regulating the balance of the intrarenal renin-angiotensin system and then inhibiting the Ang II-mediated TGF-β1/Smad3 signaling pathway.
Involvement of Recipient Transplant Coordinators in Transplant Outpatient Clinics in Japan
Authors: Hagiwara Kuniko , Seto Natsuko , Shimizu Yasuko , Takahara Shiro 
Published: December 2016

Context: Transplant recipients require long-term immunosuppressive therapy, so continued medical follow-up is necessary for long-term survival. Objective: To investigate the current role of recipient transplant coordinators (RTCs) in the outpatient care of organ transplant recipients in Japan. Methods: We sent a questionnaire survey to doctors in transplant facilities affiliated with the Japan Society for Transplantation probing attitudes on the role of RTCs in outpatient clinics. The questionnaire assessed responses using an ordinal scale of 5 ranks. Results: In total, 139 responses were obtained from 233 transplant facilities. Respondents were divided into 2 groups, doctors currently working with RTCs (group A) and doctors not currently working with RTCs (group B). Differences in response rates between groups were analyzed using the Mann-Whitney U test. The overall attendance rate of RTCs in outpatient clinics was only 45%. Of all items on transplant outpatient clinics, group A exhibited a significantly higher response rate of “strongly agree” for “The involvement of an RTC in outpatient work can be expected to help prevent complications in transplant patients” ( P < .01) and “The involvement of an RTC in outpatient work can be expected to help prevent or reduce drug-related side effects in transplant patients” ( P < .01). Those with the highest rate of “strongly agree” were “It is necessary for RTCs to provide outpatient follow-up for transplant patients alongside doctors” (82.1% vs 67.3%, P < .07). Conclusion: We suggest that Japanese RTCs must participate more frequently in posttransplant outpatient care.
The pressure reduction coefficient: A new parameter to assess aneurysmal blood stasis induced by flow diverters/disruptors
Authors: Gascou Gregory , Ferrara Riccardo , Ambard Dominique , Sanchez Mathieu , Lobotesis Kyriakos , Jourdan Franck , Costalat Vincent 
Published: December 2016

Background and purpose Pore density (PD), surface metal coverage (SMC) and the number of wires are all different parameters which can influence the efficacy of a flow disruptor/diverter. Nevertheless, the relative importance of a parameter to induce intra-aneurysmal blood stasis is still poorly evaluated. Therefore, comparison between devices based on a unique value is not reliable. The aim of this study was to propose a new bench top parameter (the pressure reduction coefficient (PRC; ξ)) in order to assess the global haemodynamic effect of each flow diverter/disruptor to slow flow. Methods Eight devices were tested in vitro during three different flow conditions. For the eight devices, the PRC was computed at different volumetric flow rates to characterise flow reduction. Comparison was made with SMC, PD and the number of wires. Results The PRC obtained for flow disruptors was on average 1.5 times more efficient in reducing flow compared to flow diverters. PD (mm2) ranged from 24 to 38 for flow diverters and did not independently correlate with the PRC. The SMC of flow diverters ranged from 25% to 70%, and ranged from 20% to 100% for flow disruptors, without independent correlation to the PRC. The number of wires ranged from 48 to 96 for the flow diverters and did not correlate independently to the PRC. Conclusion There were no direct correlations between individual device characteristics and the PRC, suggesting a multifaceted and interrelating association of the overall design of each implant. Hence, the PRC could be used as a simple, reliable parameter to assess the overall capacity of flow disruptors/diverters to induce intra-aneurysmal blood stasis.
Treatment of upper extremity venous aneurysms with a polytetrafluoroethylene-covered stent
Authors: Parizh David , Victory Jesse , Rizvi Syed Ali , Hingorani Anil , Ascher Enrico 
Published: December 2016

Background Venous aneurysms of the upper torso are uncommon in contrast to the abdomen and lower extremities. Mostly silent, they can cause significant morbidity. Large or symptomatic venous aneurysms are generally treated with open resection. To our knowledge, there are no documented cases of head and neck venous aneurysms treated by a hybrid endovascular and open approach. Case Presentation A 56-year-old female presented with the complaint of pain and increasing size of a supraclavicular mass. Imaging revealed a large saccular aneurysm of the subclavian vein with the presence of a large intramural thrombus on computed tomography scan with contrast. A covered stent was deployed in order to exclude the aneurysm from circulation. Three weeks later, the symptoms continued, and an aneurysmorrhaphy was performed to excise the stent and aneurysm resection. Discussion A combined endovascular and open approach to resection of symptomatic subclavian vein aneurysms is a viable method with minimal morbidity.
Determination of a threshold compromise value for the perfusion index by laser Doppler imaging after digital revascularization
Authors: Chu Y.-Y. , Yu D.-Y. , Chang C.-W. , Fang F. , Liao H.-T. 
Published: December 2016

We have used laser Doppler imaging to monitor the microcirculation of replanted digits during the post-operative period in 103 patients who underwent either replantation after traumatic amputation or toe-to-finger reconstruction. The blood flow (perfusion unit) in each revascularized digit was compared with that of an unaffected digit. The perfusion index was defined as the perfusion value of a revascularized digit divided by the perfusion value of the neighbouring normal digit. The ideal threshold value of the perfusion index (0.397) was calculated by determining the receiver operating characteristic curve with optimal sensitivity and specificity. The corresponding Youden’s index was 0.828. We believe that by establishing a threshold, that laser Doppler imaging should provide a reliable and objective assessment for the development of perfusion compromise in revascularized digits. Level of evidence: III
Best practices in the treatment of early cystic fibrosis lung disease
Authors: Proesmans Marijke 
Published: December 2016

For many years, management of cystic fibrosis (CF) lung disease was focused on symptomatic treatment of chronic lung infection, which is characterized by cough and sputum production, leading to progressive lung damage. With increasing survival and better knowledge of the pathogenesis of CF lung disease, it has become clear that treatment has to start very early because lung damage occurs in young patients, often before obvious symptoms appear. The arrival of new cystic fibrosis transmembrane conductance-regulator (CFTR)-correcting therapies will bring more opportunities to prevent the disease, apart from only treating chronic lung infection. In this review, a summary of the current knowledge of early CF lung disease is provided, based on animal model studies, as well as on data obtained from well structured follow-up programs after newborn screening (NBS). The most important clinical guidelines for treating young CF patients are also summarized.
Direct visual internal urethrotomy for isolated, post-urethroplasty strictures: a retrospective analysis
Authors: Brown Elizabeth Timbrook , Mock Stephen , Dmochowski Roger , Reynolds W. Stuart , Milam Douglas , Kaufman Melissa R. 
Published: December 2016

Background: Urethroplasty is often successful for the treatment of male urethral stricture disease, but limited data exists on recurrence management. Our goal was to evaluate direct visual internal urethrotomy (DVIU) as a treatment option for isolated, recurrent strictures after urethroplasty. Methods: We retrospectively identified male patients who underwent urethroplasty from 1999 to 2013 and developed an isolated, recurrent stricture at the urethroplasty site treated with DVIU. Success was defined as lack of symptomatology and no subsequent intervention. Comparative analysis identified characteristics and stricture properties associated with success. Results: A total of 436 urethroplasties were performed in 401 patients at our institution between 1999 and 2013. Stricture recurrence was noted in 64 (16%) patients. Of these, 47 (73%) underwent a DVIU. A total of 37 patients met inclusion criteria and underwent 50 DVIU procedures at the urethroplasty site. A single DVIU was successful in 13 of 37 patients (35%). A total of 4 of 6 patients required a second DVIU (67%). Overall, 17 of 43 (40%) of the total DVIUs were successful after urethroplasty. Success did not differ by age, stricture length or location, surgical technique, radiation history, prior urethroplasty or DVIU, time to failure, or etiology. Conclusions: Post-urethroplasty DVIU for isolated, recurrent strictures may be offered as a minimally invasive treatment option. Approximately 40% of patients were spared further intervention.
Effects of a smoking ban on clozapine plasma concentrations in a nonsecure psychiatric unit
Authors: Gee Siobhan H. , Taylor David M. , Shergill Sukhwinder S. , Flanagan Robert , MacCabe James H. 
Published: December 2016

Background: Tobacco smoke is known to affect plasma levels of some drugs, including the antipsychotic clozapine. The effects of suddenly stopping smoking on patients who take clozapine can be severe, as plasma concentrations are expected to rapidly rise, potentially leading to toxicity. A ban on smoking at South London and the Maudsley NHS Foundation Trust (SLaM) was implemented in 2014, and this was expected to affect the plasma concentrations of clozapine for inpatients at the time. This study aimed to determine whether plasma concentrations of clozapine were affected, and additionally, in line with observations from other authors, whether levels of reported violence would also be affected. Methods: The smoking habits of all patients at SLaM who smoked and were prescribed clozapine were recorded both before and after the ban. The Glasgow Antipsychotic Side Effect Scale for Clozapine (GASS-C) scale was used to evaluate side-effect burden. Clozapine doses and plasma concentrations were also collected. Results: In total, 31 patients were included in this study. The mean clozapine dose before the ban was 502 mg/day, and this did not change significantly after the ban. Similarly, there were no significant changes in clozapine or norclozapine plasma concentrations, or in GASS-C scores. There was no change in the amount of tobacco patients reported smoking before or after the ban. A modest but statistically significant reduction in violent incidences was observed. Conclusions: Our data suggest that a ban on smoking for patients taking clozapine on open wards at inpatient hospital sites had little impact on clozapine plasma concentrations, because patients continued to smoke tobacco if allowed to leave. Smoking bans may result in a reduction in violent incidences.
A novel technique of needle setting for curvilinear endobronchial ultrasound: Improved efficiency with no cost
Authors: Meena Nikhil , Innabi Ayoub , Alzghoul Bashar , Bartter Thaddeus 
Published: December 2016

Background: Standard instructions for biopsy using the convex curvilinear endobronchial ultrasound scope include visualization and adjustment of the sheath housing the biopsy needle before every puncture. In our practice, we pre-set this relationship before inserting the endobronchial ultrasound scope and leave it fixed for every puncture. Objective: We postulated that this approach is more efficient than repeated re-adjustment and aimed to show that it would not increase the frequency of endobronchial ultrasound scope damage. Methods: Retrospective review of every biopsy using the endobronchial ultrasound scope over a 6-year period with documentation of damages and costs. Results: There were 15 scope damages out of 1792 procedures (0.8%). Eight damages were determined to be due to needle damage, one due to patient bite, three due to Williams airway abrasions, and three were camera failures. All damages occurred during the first 5 years of the study. Costs totaled US$138,725, for an average of US$23,120 per year. This rate of damages appears to be similar to or lower than that reported when standard instructions are followed. Conclusion: Pre-setting of the biopsy needle when the endobronchial ultrasound scope is used leads to greater efficiency and no increase in scope damages.
Predicting the recurrence of noncoding regulatory mutations in cancer
Authors: Yang Woojin , Bang Hyoeun , Jang Kiwon , Sung Min Kyung , Choi Jung Kyoon 
Published: December 2016

AbstractBackgroundOne of the greatest challenges in cancer genomics is to distinguish driver mutations from passenger mutations. Whereas recurrence is a hallmark of driver mutations, it is difficult to observe recurring noncoding mutations owing to a limited amount of whole-genome sequenced samples. Hence, it is required to develop a method to predict potentially recurrent mutations.ResultsIn this work, we developed a random forest classifier that predicts regulatory mutations that may recur based on the features of the mutations repeatedly appearing in a given cohort. With breast cancer as a model, we profiled 35 quantitative features describing genetic and epigenetic signals at the mutation site, transcription factors whose binding motif was disrupted by the mutation, and genes targeted by long-range chromatin interactions. A true set of mutations for machine learning was generated by interrogating publicly available pan-cancer genomes based on our statistical model of mutation recurrence. The performance of our random forest classifier was evaluated by cross validations. The variable importance of each feature in the classification of mutations was investigated. Our statistical recurrence model for the random forest classifier showed an area under the curve (AUC) of ~0.78 in predicting recurrent mutations. Chromatin accessibility at the mutation sites, the distance from the mutations to known cancer risk loci, and the role of the target genes in the regulatory or protein interaction network were among the most important variables.ConclusionsOur methods enable to characterize recurrent regulatory mutations using a limited number of whole-genome samples, and based on the characterization, to predict potential driver mutations whose recurrence is not found in the given samples but likely to be observed with additional samples.