bluuebunny/crossref_metadata_2025_split huggingface dataset:
Using Critical Care Simulations to Prepare Nursing Students for Capstone Clinical Experiences
Authors: Smallheer Benjamin , Hunt Jennifer , Smith Judson 
Published: January 2018

The purpose of this innovative learning strategy was to decrease students' fear and anxiety within the critical care environment before the initiation of a critical care capstone clinical experience by enhancing their familiarity of the critical care environment through deliberate practice and experiential learning. This will in turn increase student knowledge and competence in the critical care setting.
Critical care units are often used during a capstone clinical experience to enhance critical thinking and clinical reasoning. Student preparation for these rotations, however, is varied and often inadequate. The resulting fear and anxiety impair learning and also contribute to an unsafe environment for this at-risk population.
Before the capstone experience, students participated in 3 simulation experiences, each addressing a core concept of critical care nursing. Faculty engaged students during the simulations, while modeling the confidence and critical thinking of a critical care nurse.
After both the critical care simulation and the capstone rotation, students stated that the simulation allowed them the time in a safe environment to critically think through the steps to care for critical patients before the capstone rotation. The experience provided them with increased confidence necessary to discharge the responsibilities of a critical care nurse—attention to critical thinking and reasoning.
Mindfully constructed simulations with clear objectives help to inoculate the student against fears associated with high-risk patients. This decrease in fear and anxiety before a hands-on clinical experience may improve patient safety. More confident students are also better able to engage in both experiential and deliberate learning, resulting in a more enhanced and meaningful clinical experience.
Evaluating Sleep in a Surgical Trauma Burn Intensive Care Unit
Authors: Longley Laura , Simons Theresa , Glanzer Luella , Du Claire , Trinks Heather , Letzkus Lisa , Quatrara Beth 
Published: January 2018

Background
Evidence points to the adverse effects of sleep deprivation on a person’s health. Despite decades of attention to the issue, patients, particularly those in the intensive care unit (ICU), continue to suffer.

Objective
The purpose of this pilot study was to examine patients’ perceptions of their sleep experience in the surgical trauma burn ICU and identify contributing factors.

Methodology
Patients were administered the 6-question Richards-Campbell Sleep Questionnaire (RCSQ) consisting of a 0- to 100-mm scale, with a low score indicating poor sleep quality. They were also asked an additional open-ended question.

Results
Sixty patients participated. Data revealed a low overall RCSQ score of 43.6 of 100. Of the 5 validated questions on the RCSQ, the question with the lowest mean (35.6) targeted depth of sleep. The question pertaining to falling asleep immediately scored the highest at 52.2. The open-ended question revealed that 37% reported “interruptions” as the reason for not sleeping. Pain was also cited as a factor by 30%, with 11.7% citing discomfort from the bed as an irritant. An additional 21.6% reported noise as the central reason, with “pumps/monitor” noise as the most frequent culprit at 62%.

Discussion
The pilot study results demonstrate that most participants perceived their sleep as poor in quality. These results direct targeted interventions that can be incorporated to reduce sleep deprivation in ICUs.
Community, Public Policy, and Recovery from Mental Illness: Emerging Research and Initiatives
Authors: Castillo Enrico G. , Chung Bowen , Bromley Elizabeth , Kataoka Sheryl H. , Braslow Joel T. , Essock Susan M. , Young Alexander S. , Greenberg Jared M. , Miranda Jeanne , Dixon Lisa B. , Wells Kenneth B. 
Published: January 2018

AbstractThis commentary examines the roles that communities and public policies play in the definition and processes of recovery for adults with mental illness. Policy, clinical, and consumer definitions of recovery are reviewed, which highlight the importance of communities and policies for recovery. This commentary then presents a framework for the relationships between community-level factors, policies, and downstream mental health outcomes, focusing on macroeconomic, housing, and health care policies; adverse exposures such as crime victimization; and neighborhood characteristics such as social capital. Initiatives that address community contexts to improve mental health outcomes are currently under way. Common characteristics of such initiatives and select examples are discussed. This commentary concludes with a discussion of providers’, consumers’, and other stakeholders’ roles in shaping policy reform and community change to facilitate recovery.
Investigating the Model of Community-Based Case Management in the New South Wales Brain Injury Rehabilitation Program: A Prospective Multicenter Study
Authors: Simpson Grahame , Mitsch Virginia , Doyle Margaret , Forman Marcella , Young Denise , Solomon Vicki , MacPherson Margaret , Gillett Lauren , Strettles Barbara 
Published: January 2018

Objective:
To investigate a model of community-based case management (CM).

Setting:
New South Wales (NSW) Brain Injury Rehabilitation Program (BIRP).

Participants:
All clinicians (N = 72) providing CM within 14 BIRP community rehabilitation teams.

Design:
A prospective, multicenter study.

Main Measures:
A purpose-designed survey.

Methods:
Participants from the 12 adult and 2 pediatric services (8 located in metropolitan areas, 6 in rural areas) completed a 3-part survey investigating their organizational context, clinical approach, and CM interventions. Between-groups analyses explored differences among individual services, as well as differences based on age (adult vs pediatric) and location (metropolitan vs rural).

Results:
All services provided a direct service model of CM. The underlying principles were uniform across services (more direct than indirect service provision; with more client-related than administrative-related tasks; more holistic than service-led in defining client needs; with decision making equally directed by staff and clients; and undertaking a more comprehensive than minimalist range of tasks). CM interventions included the provision of individual support, family support, advocacy, and community development alongside assessment, monitoring, referral, and liaison tasks. There were little differences in practice based on age or location.

Conclusion:
The NSW BIRP has drawn upon the results to produce a model of service for CM.
Quantitative Volumetric Imaging and Clinical Outcome Characterization of Symptomatic Concussion in 10- to 14-Year-Old Adolescent Athletes
Authors: Mac Donald Christine L. , Barber Jason , Wright Jason , Coppel David , De Lacy Nina , Ottinger Steve , Peck Suzanne , Panks Chris , Zalewski Kody , Sun Samantha , Temkin Nancy 
Published: January 2018

Objective:
Prior work suggests that younger athletes may be more vulnerable to postconcussive syndrome. We investigated measures of clinical outcome and quantitative volumetric imaging in 10- to 14-year-old adolescent athletes to better understand the impact of concussion on this younger population.

Setting:
Outpatient clinics.

Participants:
Ten- to 14-year-old symptomatic pediatric sports concussion patients and typically developing active controls.

Design:
Prospective, observational multiclinic study.

Main Measures:
Demographics, magnetic resonance imaging, clinical assessments (neurocognitive function, postconcussive symptoms, mental health symptoms, quality of life).

Results:
Neuropsychological performance was comparable between groups while symptoms of mental health were discriminating and comprised the top regression model describing factors related to overall health behavior impairment. Concussion patients had smaller total brain volume as well as total intracranial volume in comparison with controls even though there was no difference on measures of natural development (age, height, weight, education, gender, and handedness).

Conclusions:
Findings indicate that 10- to 14-year-old concussion patients symptomatic at 1 month more likely exhibit mental health symptoms impairing health behavior than cognitive dysfunction. There may be a vulnerability for those with smaller brain volumes at the time of the exposure. The study provides new data to support further investigation into risk factors for prolonged symptoms in this younger athlete population.
Open Globe Injury: Demographic and Clinical Features
Authors: Sahin Atik Sevinc , Ugurlu Seyda , Egrilmez Emine Deniz 
Published: January 2018

Background:
Open globe injuries (OGIs) are the main cause of visual impairment worldwide. The aim of this study was to evaluate the clinical features and the visual outcome of OGIs presented to the largest Teaching Hospital in Western part of Turkey.

Methods:
The study included patients presented with OGI between Jan 2009 and Dec 2013. Data including patient demographics, causes of injury, visual acuity (VA) at presentation, and final VA were collected. Ocular Trauma Scores (OTS) were calculated. Statistical analyses were performed to identify prognostic factors.

Results:
One hundred fifty-nine eyes of 156 patients with OGIs were included. The mean age was 36.89 ± 20.07 years. Significant male predominance was noted (77.6%). Domestic (28.3%) and work-related (22%) accidents were the most common causes of all OGIs. While some improvement in best corrected visual acuity (BCVA) after treatment has been noted in 68 eyes (55.7%), the final BCVA was equal to or worse than the initial BCVA in 54 eyes (44.3%). According to the OTS and final BCVA associations in our study, while the eyes with OGI included in OTS category 1 and 2 (n = 84) consist of 68.8% of all the OGI cases, 48.8% (n = 41) of them were classified as having a poor visual outcome. All of the eyes in OTS category 3 and 4 cases (n = 38) (31.2% of all the OGI cases) showed good visual outcome.

Conclusion:
Some clinical features may have a potential to correctly predict final visual outcomes. Although the OTS has not been fully validated yet, it could potentially be one of the best indicators available for the prognosis in OGI.
Decannulation and Airway Outcomes With Maxillomandibular Distraction in Treacher Collins and Nager Syndrome
Authors: Biskup Nataliya I. , Pan Brian S. , Elhadi-Babiker Haithem , Hathaway Ronald R. , van Aalst John , Gordon Christopher B. 
Published: January 2018

Background:
Treacher Collins syndrome is a rare disorder (1/50,000 live births) with features that include hypoplastic orbitozygomatic complex with downward slanting eyes, and maxillary/mandibular retrusion. Obstructive sleep apnea and tracheostomy-dependence are common. This study presents the outcomes of skeletal distraction on avoidance of tracheostomy and decannulation in this patient population.

Methods:
The authors reviewed charts of all patients with Treacher Collins syndrome who underwent craniofacial reconstruction from 2003 to 2016. Primary outcome measures included decannulation of tracheostomy dependent patients and avoidance of tracheostomy. Secondary outcome measures included cephalometric parameters, polysomnography scores, and airway exposure scores on direct laryngoscopy.

Results:
Twenty-five patients underwent mandibular and maxillary advancement to resolve upper airway obstruction. Mandibular distraction was performed in 24 of 25 patients, and maxillary distraction in 14 of 25 patients. Maxillary distraction was combined with mandibular distraction in 13 of 17 to accomplish greater advancement and counter-clockwise rotation of the entire maxillary-mandibular complex. Six of 7 patients, 85.7%, avoided a tracheostomy and 39% (7 of 18) were decannulated. Cephalometric changes in sella-nasion-A point, sella-nasion-B , occlusal plane angle, and posterior airway space were equivalent between the groups who were able to clear their obstruction and those who were not.

Conclusions:
Treacher Collins is a very challenging disease in which to resolve airway obstruction. Thus, thorough evaluation of the entire airway for all levels of obstruction is critical to successful outcomes. Future collaborative efforts between multiple institutions can help to increase our understanding and effective management of this rare disease.
A Practical Suggestion for Prepare Dorsal Onlay Graft
Authors: Arslan Fatih , Yildiz Cemile Açikgoz 
Published: January 2018

Abstract
Nowadays, rhinoplasty is one of the most popular surgical procedures. Dorsal contour irregularities caused by various maneuvers, such as hump resection, are a major concern in patients who have undergone rhinoplasty. The most common graft used in this case is dorsal onlay graft which is made from sliced and crushed cartilage. Ear, nose and throat specialists usually use Swester table (mayo desk) for preparing the graft, if there is no other steril metal instrument. Crushed cartilage is done on a sterile gauze or on the tables’ cover, as a result cartilage may be contaminated with particules from the tables’ cover and sterile gauze.
The authors recommend using the steril pack of a new sterilized surgical instrument opened on the table for the slicing or crushing process. In this way, the cartilage can be spared from contamination and the loss of some cartilage to the table during slicing or crushing can be prevented.
Exploring Faculty Approaches to Feedback in the Simulated Setting
Authors: Roze des Ordons Amanda Lee , Cheng Adam , Gaudet Jonathan E. , Downar James , Lockyer Jocelyn M. 
Published: January 2018

Introduction
Feedback in clinical education and after simulated experiences facilitates learning. Although evidence-based guidelines for feedback exist, faculty experience challenges in applying the guidelines. We set out to explore how faculty approach feedback and how these approaches align with current recommendations.

Methods
There is strong evidence for the following four components of feedback: feedback as a social interaction, tailoring content, providing specific descriptions of performance, and identifying actionable items. Faculty preceptors participated in feedback simulations followed by debriefing. The simulations were video recorded, transcribed, and analyzed qualitatively using template analysis to examine faculty approaches to feedback relative to evidence-informed recommendations.

Results
Recorded encounters involving 18 faculty and 11 facilitators yielded 111 videos. There was variability in the extent to which feedback approaches aligned with recommended practices. Faculty behaviors aligned with recommendations included a conversational approach, flexibly adapting feedback techniques to resident context, offering rich descriptions of observations with specific examples and concrete suggestions, achieving a shared understanding of strengths and gaps early on to allow sufficient time for problem-solving, and establishing a plan for ongoing development. Behaviors misaligned with guidelines included prioritizing the task of feedback over the relationship, lack of flexibility in techniques applied, using generic questions that did not explore residents' experiences, and ending with a vague plan for improvement.

Conclusions
Faculty demonstrate variability in feedback skills in relation to recommended practices. Simulated feedback experiences may offer a safe environment for faculty to further develop the skills needed to help residents progress within competency-based medical education.
Visual and auditory brain areas share a representational structure that supports emotion perception
Authors: Sievers Beau , Parkinson Carolyn , Kohler Peter J. , Hughes James M. , Fogelson Sergey V. , Wheatley Thalia 
Published: January 2018

SummaryEmotionally expressive music and dance occur together across the world. This may be because features shared across the senses are represented the same way even in different sensory brain areas, putting music and movement in directly comparable terms. These shared representations may arise from a general need to identify environmentally relevant combinations of sensory features, particularly those that communicate emotion. To test the hypothesis that visual and auditory brain areas share a representational structure, we created music and animation stimuli with crossmodally matched features expressing a range of emotions. Participants confirmed that each emotion corresponded to a set of features shared across music and movement. A subset of participants viewed both music and animation during brain scanning, revealing that representations in auditory and visual brain areas were similar to one another. This shared representation captured not only simple stimulus features, but also combinations of features associated with emotion judgments. The posterior superior temporal cortex represented both music and movement using this same structure, suggesting supramodal abstraction of sensory content. Further exploratory analysis revealed that early visual cortex used this shared representational structure even when stimuli were presented auditorily. We propose that crossmodally shared representations support mutually reinforcing dynamics across auditory and visual brain areas, facilitating crossmodal comparison. These shared representations may help explain why emotions are so readily perceived and why some dynamic emotional expressions can generalize across cultural contexts.
Causal explanation of individual differences in human sensorimotor memory formation
Authors: Petitet Pierre , O’Reilly Jill X. , Gonçalves Ana M. , Salvan Piergiorgio , Kitazawa Shigeru , Johansen-Berg Heidi , O’Shea Jacinta 
Published: January 2018

AbstractSensorimotor cortex mediates the formation of adaptation memory. Individuals differ in the rate at which they acquire, retain, and generalize adaptation. We present a mechanistic explanation of the neurochemical and computational causes of this variation in humans. Neuroimaging identified structural, functional and neurochemical covariates of a computational parameter that determines memory persistence. To establish causality, we increased sensorimotor cortex excitability during adaptation, using transcranial direct current stimulation. As predicted, this increased retention. Inter-individual variance in the stimulation-induced E:I increase predicted the computational change, which predicted the memory gain. These relations did not hold, and memory was unchanged, with stimulation applied before adaptation. This cognitive state dependent effect was modulated by the BDNF val66met genetic polymorphism. Memory was enhanced by stimulation in Val/Val carriers only, implicating a mechanistic role for activity-dependent BDNF secretion. Sensorimotor cortex E:I causally determines the time constant of memory persistence, explaining phenotypic variation in adaptation decay.
COSSMO: Predicting Competitive Alternative Splice Site Selection using Deep Learning
Authors: Bretschneider Hannes , Gandhi Shreshth , Deshwar Amit G , Zuberi Khalid , Frey Brendan J 
Published: January 2018

AbstractMotivationAlternative splice site selection is inherently competitive and the probability of a given splice site to be used also depends strongly on the strength of neighboring sites. Here we present a new model named Competitive Splice Site Model (COSSMO), which explicitly models these competitive effects and predict the PSI distribution over any number of putative splice sites. We model an alternative splicing event as the choice of a 3’ acceptor site conditional on a fixed upstream 5’ donor site, or the choice of a 5’ donor site conditional on a fixed 3’ acceptor site. We build four different architectures that use convolutional layers, communication layers, LSTMS, and residual networks, respectively, to learn relevant motifs from sequence alone. We also construct a new dataset from genome annotations and RNA-Seq read data that we use to train our model.ResultsCOSSMO is able to predict the most frequently used splice site with an accuracy of 70% on unseen test data, and achieve an R2 of 60% in modeling the PSI distribution. We visualize the motifs that COSSMO learns from sequence and show that COSSMO recognizes the consensus splice site sequences as well as many known splicing factors with high specificity.AvailabilityOur dataset is available from http://cossmo.deepgenomics.com.Contactfrey@deepgenomics.comSupplementary informationSupplementary data are available at Bioinformatics online.
A saturation mutagenesis approach to understanding PTEN lipid phosphatase activity and genotype-phenotypes relationships
Authors: Mighell Taylor L. , Evans-Dutson Sara , O’Roak Brian j. 
Published: January 2018

ABSTRACTPhosphatase and tensin homolog (PTEN) is a tumor suppressor frequently mutated in diverse cancers. GermlinePTENmutations are also associated with a range of clinical outcomes, including PTEN hamartoma tumor syndrome (PHTS) and autism spectrum disorder (ASD). To empower new insights into PTEN function and clinically relevant genotype-phenotype relationships, we systematically evaluated the effect ofPTENmutations on lipid phosphatase activityin vivo. Using a massively parallel approach that leverages an artificial humanized yeast model, we derived high-confidence estimates of functional impact for 7,244 single amino acid PTEN variants (86% of possible). These data uncovered novel insights into PTEN protein structure, biochemistry, and mutation tolerance. Variant functional scores can reliably discriminate likely pathogenic from benign alleles. Further, 32% of ClinVar unclassified missense variants are phosphatase deficient in our assay, supporting their reclassification. ASD associated mutations generally had less severe fitness scores relative to PHTS associated mutations (p = 7.16×10-5) and a higher fraction of hypomorphic mutations, arguing for continued genotype-phenotype studies in larger clinical datasets that can further leverage these rich functional data.
Genomic copy-number loss is rescued by self-limiting production of DNA circles
Authors: Mansisidor Andrés , Molinar Temistocles , Srivastava Priyanka , Blitzblau Hannah , Klein Hannah , Hochwagen Andreas 
Published: January 2018

SummaryCopy-number changes generate phenotypic variability in health and disease. Whether organisms protect against copy-number changes is largely unknown. Here, we show that Saccharomyces cerevisiae monitors the copy number of its ribosomal DNA (rDNA) and rapidly responds to copy-number loss with the clonal amplification of extrachromosomal rDNA circles (ERCs) from chromosomal repeats. ERC production is proportional to repeat loss and reaches a dynamic steady state that responds to the addition of exogenous rDNA copies. ERC levels are also modulated by RNAPI activity and diet, suggesting that rDNA copy number is calibrated against the cellular demand for rRNA. Lastly, we show that ERCs reinsert into the genome in a dosage-dependent manner, indicating that they provide a reservoir for ultimately increasing rDNA array length. Our results reveal a DNA-based mechanism for rapidly restoring copy number in response to catastrophic gene loss that shares fundamental features with unscheduled copy-number amplifications in cancer cells.