bluuebunny/crossref_metadata_2025_split huggingface dataset:
Drivers of predatory behavior and extreme size in house mice
Mus musculus
on Gough Island
Authors: Cuthbert Richard J. , Wanless Ross M. , Angel Andrea , Burle Marie-Helene , Hilton Geoff M. , Louw Henk , Visser Paul , Wilson John W. , Ryan Peter G. 
Published: March 2016

Abstract
In comparison to the mainland, populations of rodents on islands are often characterized by a suite of life history characteristics termed the “island syndrome.” Populations of rodents introduced to islands are also well known for their impacts on native species that have evolved in the absence of mammalian predators. We studied the ecology and behavior of introduced house mice Mus musculus on Gough Island where they are the only terrestrial mammal and where their predatory behavior is having a devastating impact on the island’s burrowing petrel (order Procellariiformes ) population and the Critically Endangered Tristan albatross Diomedea dabbenena . Mice on Gough exhibit extreme features of the island syndrome, including: a body mass 50–60% greater than any other island mouse population, peak densities among the highest recorded for island populations, and low seasonal variation in numbers compared to other studied islands. Seasonal patterns of breeding and survival were linked to body condition and mass, and mice in areas with high chick predation rates were able to maintain higher mass and condition during the winter when mouse mortality rates peak. Within-site patterns of chick predation indicate that proximity to neighboring predated nests and nesting densities are important factors in determining the likelihood of predation. We conclude that selection for extreme body mass and predatory behavior of mice result from enhanced overwinter survival. Small mammal populations at temperate and high latitudes are normally limited by high mortality during the winter, but on Gough Island mice avoid that by exploiting the island’s abundant seabird chicks.
Clumpy tori around type II active galactic nuclei as revealed by X-ray fluorescent lines
Authors: Liu Jiren , Liu Yuan , Li Xiaobo , Xu Weiwei , Gou Lijun , Cheng Cheng 
Published: March 2016

Abstract
The reflection spectrum of a torus around an active galactic nucleus (AGN) is characterized by X-ray fluorescent lines, which are most prominent for type II AGNs. A clumpy torus allows photons reflected from the back-side of the torus to leak through the front regions that are free of obscuration. The observed X-ray fluorescent lines are therefore sensitive to the clumpiness of the torus. We analysed a sample of type II AGNs observed with the Chandra High Energy Transmission Grating Spectrometer (HETGS), and measured the fluxes for the Si Kα and Fe Kα lines. The measured Fe Kα/Si Kα ratios, spanning a range between 5 and 60, are far smaller than the ratios predicted from simulations of smooth tori, indicating that the tori of the studied sources have clumpy distributions rather than smooth ones. We compared the measured Fe Kα/Si Kα ratios with simulation results of clumpy tori. The Circinus galaxy has a Fe Kα/Si Kα ratio of ∼60, which is close to the simulation results for N = 5, where N is the average number of clumps along the line of sight. The Fe Kα/Si Kα ratios of the other sources are all below the simulation results for N = 2. Overall, this shows that the non-Fe fluorescent lines in the soft X-ray band are a potentially powerful probe of the clumpiness of tori around AGNs.
MEGA7: Molecular Evolutionary Genetics Analysis Version 7.0 for Bigger Datasets
Authors: Kumar Sudhir , Stecher Glen , Tamura Koichiro 
Published: March 2016

Abstract
We present the latest version of the Molecular Evolutionary Genetics Analysis (M ega ) software, which contains many sophisticated methods and tools for phylogenomics and phylomedicine. In this major upgrade, M ega has been optimized for use on 64-bit computing systems for analyzing larger datasets. Researchers can now explore and analyze tens of thousands of sequences in M ega . The new version also provides an advanced wizard for building timetrees and includes a new functionality to automatically predict gene duplication events in gene family trees. The 64-bit M ega is made available in two interfaces: graphical and command line. The graphical user interface (GUI) is a native Microsoft Windows application that can also be used on Mac OS X. The command line M ega is available as native applications for Windows, Linux, and Mac OS X. They are intended for use in high-throughput and scripted analysis. Both versions are available from www.megasoftware.net free of charge.
Interprofessional Care Conferences for High-Risk Primary Care Patients
Authors: Weppner William G. , Davis Kyle , Sordahl Jeffrey , Willis Janet , Fisher Amber , Brotman Adam , Tivis Rick , Gordon Tim , Smith C. Scott 
Published: March 2016

Problem
As health care systems convert to team-based care, the need to improve interprofessional education is tremendous. In addition to formal instruction, trainees need authentic team-based workplace learning experiences.

Approach
The authors designed the PACT-ICU (Patient-Aligned Care Team Interprofessional Care Update) conference to provide team-based care to high-risk patients while teaching trainees principles of interprofessionalism and modeling relevant behaviors. Trainees, supervisors, and affiliated support staff from the fields of internal medicine, nurse practitioner, pharmacy, psychology, and nursing all participate in this conference. During the conference, each participant focuses on the narrative of the patient’s illness from his/her own professional perspective. A multifaceted care plan with specific action items is the product of the conference. To evaluate this workplace learning opportunity, the authors recorded patient characteristics, plus trainees’ participation and satisfaction.

Outcomes
Over the first 16 months (2013–2014) of the PACT-ICU, 33 trainees presented 79 patients. Each trainee presented two or three times each academic year. Patients were 90% male; their mean age was 64.5 years (SD 9.3, range 28–92), and their mean calculated 90-day risk of death or hospitalization was 22% (SD 14%, range 1%–45%).
Overall, all surveyed trainees (n = 32; 97% response rate) expressed satisfaction, reporting that the conference was “helpful” or “very helpful” in developing treatment plans.

Next Steps
Further assessment of change in trainee behavior related to interprofessional team care, patient-level outcomes (e.g., quality of care and utilization), and factors facilitating dissemination of the model to other academic clinic settings is necessary.
Where Do Soldiers Really Come From? A Faculty Development Workshop on Veteran-Centered Care
Authors: Lypson Monica L. , Ross Paula T. , Zimmerman Natalie , Goldrath Kathryn E. , Ravindranath Divy 
Published: March 2016

Problem
Addressing the medical concerns of veterans in both civilian health care systems and the Veterans Affairs (VA) health care system, where staff are familiar with issues of military reintegration, remains difficult but is increasingly important.

Approach
In 2013, the authors developed and implemented a faculty development workshop for practicing clinicians using the documentary Where Soldiers Come From. The workshop included topics on unconscious bias, the service member trajectory, health care disparities, and strategies for overcoming barriers to treating veterans with posttraumatic stress disorder and traumatic brain injury. The workshop engaged faculty in the following active-learning techniques: images in education; trigger video; critical thinking and reflective writing; think–pair–share; and large-group discussion. The workshop has been conducted at three locations with 46 health care professionals.

Outcomes
Thirty-one of 37 (84%) participants who completed the workshop evaluation were VA employees. The evaluation results show 25/32 (78.1%) participants indicated the workshop activities changed their knowledge, attitudes, and/or skills; 22/34 (64.7%) stated they had a better understanding of how to develop a care plan for veterans; and 27/34 (79.4%) stated they gained a better understanding of how to prepare for issues around returning veterans.

Next Steps
To address the issue of veteran-centered care education more broadly, the authors have developed a massive open online course for health professionals, using most of the content from this workshop, which will be offered in spring 2016. Another important next step will be to deliver this workshop to and collect evaluation data from non-VA providers.
Changing Physician Behavior With Implementation Intentions: Closing the Gap Between Intentions and Actions
Authors: Saddawi-Konefka Daniel , Schumacher Daniel J. , Baker Keith H. , Charnin Jonathan E. , Gollwitzer Peter M. 
Published: March 2016

In medical education, even well-intentioned learners struggle to change their practice. This intention–action gap is a well-described phenomenon. Strong commitment to changing behaviors is important, but by itself it is only a modest predictor of goal attainment.
Implementation intentions are an extensively studied strategy from cognitive psychology that have been shown to close the intention–action gap and increase goal attainment across myriad domains. Implementation intentions are “if–then” plans that specify an anticipated future situation and a planned response—“If I encounter situation X, then I will respond with action Y.” They differ from simple goals, which specify only a desired behavior or outcome—“I intend to perform action Z.” Despite this subtle difference, they have shown substantial effectiveness over goals alone in increasing goal attainment.
In this article, the authors first describe implementation intentions, review the substantial body of evidence demonstrating their effectiveness, and explain the underlying psychological mechanisms. They then illustrate the connections between implementation intentions and established learning theory. The final section focuses on forming effective implementation intentions in medical education. The authors provide concrete examples across the continuum of learners (from medical students to attending physicians) and competencies, and make recommendations for when and how to employ implementation intentions.
A Simple Dual-Planar Osteotomy to Correct Cubitus Varus Deformity in Children
Authors: Liddell Travis R. , Hennrikus William L. , Bresnahan James J. 
Published: March 2016

Objectives:
To report the outcomes when performing a dual-planar osteotomy of the distal humerus via a posterior approach for gunstock deformity in children.

Design:
A retrospective review.

Setting:
Penn State Hershey Pediatric Bone and Joint Institute.

Patients/Participants:
Sixteen patients were reviewed. The average patient age was 8 years (range, 5–13 years).

Intervention:
A complete dual-planar closing wedge osteotomy was performed with the patient in the prone position via a posterior triceps-splitting approach. Fixation with buried smooth K wires was utilized.

Main Outcome Measurements:
Valgus correction obtained, final elbow range of motion, radiographic and clinical correction of the deformity, the patient's satisfaction, and elbow function were evaluated.

Results:
Preoperative radiographs showed the average humeral-ulnar angle (HUA) was 17 degrees of varus (range, 10–26 degrees varus). The average wedge removed wallow-up clinical exam demonstrated that the carrying angle was in valgus in 15 cases and neutral in 1 case. The average carrying angle was 5 degrees of valgus (range, 0–11 degrees valgus). The average hyperextenss 25 degrees (range, 20–40 degrees). Duration of follow-up averaged 51 months (range, 12–126 months). Final foion deformity improved from 9 degrees preoperatively to 1 degree postoperatively. Outcomes were classified by the grading scale described by Oppenheim: 14 cases had excellent results and 2 cases had good results.

Conclusions:
This method provides clear visualization and excellent correction of the deformities. The posterior scar is cosmetically acceptable. We recommend this technique for the treatment of gunstock deformity in children.

Level of Evidence:
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Economic Benefit of Calcium and Vitamin D Supplementation: Does It Outweigh the Cost of Nonunions?
Authors: Childs Benjamin R. , Andres Brendan A. , Vallier Heather A. 
Published: March 2016

Objectives:
The purpose was to evaluate economic benefit of calcium and vitamin D supplementation in orthopaedic trauma patients. We hypothesized that reduced nonunion rates could justify the cost of supplementing every orthopaedic trauma patient.

Design:
Retrospective, economic model.

Setting:
Level 1 trauma center.

Patients/Participants:
Adult patients over 3 consecutive years presenting with acute fracture.

Intervention:
Operative or nonoperative fracture management.

Main Outcome Measurements:
Electronic medical records were queried for ICD-9 code for diagnosis of nonunion and for treatment records of nonunion for fractures initially treated within our institution.

Results:
In our hospital, a mean of 92 (3.9%) fractures develop nonunion annually. A 5% reduction in nonunion risk from 8 weeks of vitamin D supplementation would result in 4.6 fewer nonunions per year. The mean estimate of cost for nonunion care is $16,941. Thus, the projected reduction in nonunions after supplementation with vitamin D and calcium would save $78,030 in treatment costs per year. The resulting savings outweigh the $12,164 cost of supplementing all fracture patients during the first 8 weeks of fracture healing resulting in a net savings of $65,866 per year.

Conclusions:
Vitamin D and calcium supplementation of orthopaedic trauma patients for 8 weeks after fracture seems to be cost effective. Supplementation may also reduce the number of subsequent fractures, enhance muscular strength, improve balance in the elderly, elevate mood leading to higher functional outcome scores, and diminish hospital tort liability by reducing the number of nonunions.

Level of Evidence:
Economic Level V. See Instructions for Authors for a complete description of levels of evidence.
Treatment Efficacy of Combined Sertraline and Guanfacine in Comorbid Obsessive–Compulsive Disorder and Attention Deficit/Hyperactivity Disorder: Two Case Studies
Authors: Taormina Shibany P. , Galloway Matthew P. , Rosenberg David R. 
Published: March 2016

ABSTRACT:

Objective:
Treatment of obsessive–compulsive disorder (OCD) is complicated by comorbid psychiatric disorders. Successful treatment of 2 pediatric patients with severe OCD and comorbid attention deficit/hyperactivity disorder (ADHD) is described.

Method:
A report on 2 pediatric clinical cases (Ages 9 and 10) with comorbid OCD and ADHD was used to describe response to medication management through the serotonin transporter inhibitor, sertraline, and the noradrenergic α2A receptor agonist, guanfacine, along with cognitive behavioral therapy.

Results:
Cognitive behavioral therapy combined with titrated doses of the serotonin transporter inhibitor, sertraline, and the noradrenergic α2A receptor agonist, guanfacine resolved OCD symptoms and the underlying ADHD.

Conclusion:
The novel observations support a focused psychological and pharmacological approach to successful treatment of complex symptoms in patients with comorbid OCD and ADHD. Limitations to generalizability are discussed.
Strengths and weaknesses in team communication processes in a UK emergency department setting: findings using the Communication Assessment Tool-Team
Authors: Graham Blair , Smith Jason E. , Enki Doyo 
Published: March 2016

Introduction
Identifying weaknesses in emergency department (ED) communication may highlight areas where quality improvement may be beneficial. This study explores whether the Communication Assessment Tool-Team (CAT-T) survey can identify communication strengths and weaknesses in a UK setting.

Objectives
This study aimed to determine the frequency of patient responses for each item on the CAT-T survey and to compare the proportion of responses according to patient and operational characteristics.

Methods
Adults presenting to the minors area of a semi-urban ED between April and May 2015 were included. Those lacking capacity or in custody were excluded. Multivariate analysis identified associations between responses and demographic/operational characteristics.

Results
A total of 407/526 eligible patients responded (77.3%). Respondents were mostly White British (93.9%), with a median age of 45 years. Most responses were obtained during daytime hours (84.2% between 08 : 00 and 18 : 00). The median reported times to triage, assessment and disposition were 15, 35 and 90 min, respectively. Items most frequently rated as ‘very good’/‘excellent’ (strengths) were ‘ambulance staff treated me with respect’ (86.7%), ED staff ‘let me talk without interruptions’ (85%) and ‘paid attention to me’ (83.7%). Items most frequently rated as ‘poor’/‘fair’ (weaknesses) were ‘encouraged me to ask questions’, ‘reception treated me with respect’ (10.4%) and ‘staff showed an interest in my health’ (6.8%). Arrival time, analgesia at triage and time to assessment were associated with significantly increased odds of positive perception of team communication for a range of items.

Conclusion
The CAT-T survey may be used within a UK setting to identify discrete strengths and weaknesses in ED team communication.
The Effect of Acute Exercise on Affect and Arousal in Inpatient Mental Health Consumers
Authors: Stanton Robert , Reaburn Peter , Happell Brenda 
Published: March 2016

Abstract
Acute exercise performed at a self-selected intensity improves affect and may improve long-term adherence. Similarly, in people with severe depression, acute aerobic exercise performed at self-selected intensity improves affect and arousal. However, the relationship between changes in affect and arousal and perceived exercise intensity in people with mental illness has not been evaluated. Affect and arousal were assessed immediately prior to, and immediately following, a group exercise program performed at a self-selected intensity in 40 inpatient mental health consumers who received a diagnosis of anxiety or bipolar or depressive disorders. Exercise intensity was assessed immediately after exercise. Postexercise affect was significantly improved for people with bipolar and depressive disorders but not for people with anxiety disorders. For the group as a whole, results showed a significant curvilinear relationship between ratings of perceived exertion and postexercise affect. These data will inform the development and delivery of future exercise interventions for inpatient mental health consumers.
Ankle Movements During Supine Kicking in Infants Born Preterm
Authors: Grant-Beuttler Marybeth , Heriza Carolyn B. , Palisano Robert J. , Wagner Barbara Reddien , Miller Debra P. , Karduna Andrew 
Published: March 2016

Background:
Knowledge of musculoskeletal factors that influence supine kicking of infants born preterm has implications for early intervention.

Hypotheses:
Differences exist between infants born preterm and full-term in ankle kinematics during supine kicking, which are attributable to passive measures of the gastrocnemius/soleus (g/s) muscle tendon unit (MTU).

Subjects:
Twenty infants born full-term and 22 born preterm were measured at term, 6 weeks, and 12 weeks of age.

Outcome Measures:
Ankle kinematics during supine kicking and g/s MTU length.

Results:
Infants born preterm demonstrated less dorsiflexion, more plantar flexion, and more total ankle range during supine kicking. Gestational age explained 69% to 85% of the variability in MTU length from term to 12 weeks of age. MTU lengths explained 0% to 42% of the variance in ankle kinematics.

Conclusions:
Passive measures of the g/s MTU may inform clinicians about ankle kinematics in newborns to 12-week infants during supine kicking.
Differences Between Methods of Detecting Medication Errors: A Secondary Analysis of Medication Administration Errors Using Incident Reports, the Global Trigger Tool Method, and Observations
Authors: Härkänen Marja , Turunen Hannele , Vehviläinen-Julkunen Katri 
Published: March 2016

Objectives
This study aimed to compare medication administration errors detected by 3 different methods in terms of severity, type, and contributing factors.

Methods
The study was performed in one university hospital in Finland. A convenience sample of medication administration errors (n = 451) reported on incident reports or detected by reviewing randomly selected patient records via the Global Trigger Tool method and direct observations of patient record reviews were collected for reanalysis. The severity of the medication administration errors, the types thereof, and factors contributing to such errors were reclassified using the National Coordinating Council for Medication Error Reporting and Prevention’s taxonomy of medication errors.

Results
The observational method revealed fewer medication errors that were more likely to cause harm to patients than did the incident reports or the Global Trigger Tool method. The incident reports and the Global Trigger Tool method mainly revealed wrong doses, whereas most medication administration errors in the observational data were errors involving the use of the incorrect technique. In addition, each method produced different information regarding the factors contributing to medication administration errors.

Conclusions
Based on the study’s findings and the limitations of each method, a combination of different methods should be used to discover representative information concerning medication administration errors. To increase medication administration safety, advanced multiprofessional collaboration, effective communication, adequate skills, more systematic medication processes, and distraction-free work environments are needed.
Evaluation of High-Pitch Ungated Pediatric Cardiovascular Computed Tomography for the Assessment of Cardiac Structures in Neonates
Authors: Sriharan Mona , Lazoura Olga , Pavitt Christopher W. , Castellano Isabel , Owens Catherine M. , Rubens Michael B. , Padley Simon P.G. , Nicol Edward D. 
Published: March 2016

Purpose:
We evaluated a high-pitch, non–electrocardiogram-gated cardiac computed tomographic protocol, designed to image both cardiac and extracardiac structures, including coronary arteries, in a neonatal population (less than 1 year old) that was referred for congenital heart disease assessment and compared it with an optimized standard-pitch protocol in an equivalent cohort.

Materials and Methods:
Twenty-nine high-pitch scans were compared with 31 age-matched, sex-matched, and weight-matched standard-pitch, dosimetrically equivalent scans. The visualization and subjective quality of both cardiac and extracardiac structures were scored by consensus between 2 trained blinded observers. Image noise, signal-to-noise and contrast-to-noise ratios, and radiation doses were also compared.

Results:
The high-pitch protocol better demonstrated the pulmonary veins (P=0.03) and all coronary segments (all P<0.05), except the distal right coronary artery (P=0.10), with no significant difference in the visualization of the remaining cardiac or extracardiac structures. Both contrast-to-noise and signal-to-noise ratios improved due to greater vessel opacity, with significantly fewer streak (P<0.01) and motion (P<0.01) artifacts. Image noise and computed tomographic dose index were comparable across the 2 techniques; however, the high-pitch acquisition resulted in a small, but statistically significant, increase in dose-length product [13.0 mGy.cm (9.0 to 17.3) vs. 11.0 mGy.cm (9.0 to 13.0), P=0.05] due to greater z-overscanning.

Conclusions:
In neonates, a high-pitch protocol improves coronary artery and pulmonary vein delineation compared with the standard-pitch protocol, allowing a more comprehensive assessment of cardiovascular anatomy while obviating the need for either patient sedation or heart rate control.