bluuebunny/crossref_metadata_2025_split huggingface dataset:
Characteristics of the Nursing Practice Environment Associated With Lower Unit-Level RN Turnover
Authors: Nelson-Brantley Heather V. , Park Shin Hye , Bergquist-Beringer Sandra 
Published: December 2017

OBJECTIVE
The aim of this study is to examine characteristics of the nursing practice environment associated with lower RN turnover.

BACKGROUND
Identifying characteristics of the practice environment that contribute to lower RN turnover is important for meeting the national quality strategy priority of reducing healthcare costs.

METHODS
Data from 1002 adult care units in 162 National Database of Nursing Quality Indicators participating hospitals were analyzed using multivariate linear regression. The Practice Environment Scale of the Nursing Work Index was used to measure practice environment characteristics. RN turnover was measured at the unit level.

RESULTS
Nursing units with higher overall ratings of the nursing practice environment had lower rates of RN turnover. Units with higher RN perceived staffing and resource adequacy experienced significantly lower RN turnover.

CONCLUSIONS
Unit managers and hospital administrators should consider RN perception of staffing and resource adequacy and the overall practice environment when developing targeted strategies for decreasing RN turnover.
A Thematic Analysis of Self-described Authentic Leadership Behaviors Among Experienced Nurse Executives
Authors: Alexander Catherine , Lopez Ruth Palan 
Published: December 2017

OBJECTIVE
The aim of this study is to understand the behaviors experienced nurse executives use to create healthy work environments (HWEs). The constructs of authentic leadership formed the conceptual framework for the study.

BACKGROUND
The American Association of Critical-Care Nurses recommends authentic leadership as the preferred style of leadership for creating and sustaining HWEs. Behaviors associated with authentic leadership in nursing are not well understood.

METHODS
A purposive sample of 17 experienced nurse executives were recruited from across the United States for this qualitative study. Thematic analysis was used to analyze the in-depth, semistructured interviews.

RESULTS
Four constructs of authentic leaders were supported and suggest unique applications of each including self-awareness (a private and professional self), balanced processing (open hearted), transparency (limiting exposure), and moral leadership (nursing compass).

CONCLUSIONS
Authentic leadership may provide a sound foundation to support nursing leadership practices; however, its application to the discipline requires additional investigation.
The Effect of Acetaminophen on Temperature in Critically Ill Children: A Retrospective Analysis of Over 50,000 Doses
Authors: Ray Samiran , Rogers Libby , Brown Katherine L. , Peters Mark J. 
Published: December 2017

Objectives:
Acetaminophen is widely used in PICUs. Although randomized controlled trials suggest that acetaminophen significantly reduces body temperature in adults, the effect of acetaminophen on temperature in critically ill children has not been previously quantified.

Design:
Retrospective observational cohort study.

Setting:
Single-center general and cardiac PICU in a specialist children’s hospital.

Patients:
All children who received acetaminophen or had a fever (temperature ≥ 38°C) while on the ICU over a 40-month period (September 2012 to December 2015).

Interventions:
None.

Measurements and Main Results:
In total, 58,177 doses of acetaminophen were administered, with temperature data available for analysis for 54,084 doses. Temperature decreased by 0.11°C (95% CI, 0.09–0.14°C) 4 hours post acetaminophen dose, after adjustment for weight and illness severity. In children who had a fever and were given acetaminophen, temperature decreased by 0.78°C (95% CI, 0.74–0.82°C). Temperature decreased by 0.88°C (95% CI, 0.85–0.92°C) in children who had fever but did not receive acetaminophen. The change in temperature associated with fever was significantly different between those who did and did not receive acetaminophen (likelihood ratio statistic 246.06; p < 2.2 × 10–16).

Conclusions:
Acetaminophen is associated with a significant decrease in temperature in children with fever. However, temperature may decrease following fever without acetaminophen in the PICU. The threshold to use acetaminophen must be understood to determine the true effect on temperature in any future trials.
Rurality, Quality Improvement Maturity, and Accreditation Readiness: A Comparison Study of Colorado, Kansas, and Nebraska Local Health Departments
Authors: Gregg Abbey , Bekmuratova Sarbinaz , Palm David , VanRaemdonck Lisa , Pezzino Gianfranco , Chen Li-Wu , Manetta Peter 
Published: December 2017

Objective:
To compare local health department (LHD) accreditation readiness (AR) and quality improvement (QI) maturity in 3 states, between LHDs with varying levels of rurality, and across an LHD staffing-level continuum.

Design:
This was a cross-sectional comparative study that included an online survey administered to LHD directors in Colorado, Kansas, and Nebraska. The survey included 10 questions assessed on a 5-point Likert scale covering 3 QI domains and 13 questions covering 5 AR domains. The median score for both QI maturity and AR was calculated by each state, by the number of full-time equivalent staff employed at the LHD, and by a measure of rurality and population density.

Setting and Participants:
A total of 156 LHDs from the states of Colorado, Kansas, and Nebraska.

Main Outcome Measure(s):
QI maturity and AR scores.

Results:
A majority (59%) of the surveyed LHDs plan to apply or have already applied for Public Health Accreditation Board (PHAB) accreditation. The overall QI maturity and AR scores were highest in Nebraska, as was the intent to seek PHAB accreditation and current use of PHAB standards. Across levels of rurality and staffing, LHD QI maturity scores were similar; however, AR scores improved as LHD staffing levels increased and rurality decreased.

Conclusions:
Small LHDs and rural LHDs have QI maturity levels that are comparable to larger, less rural LHDs, but their AR is much lower. As accreditation has been found to have positive benefits, it is important that all LHDs have the capacity and resources to meet the performance standards required of accredited LHDs. Small, rural LHDs may need additional resources and support in order to improve their ability to be accredited and/or certain accreditation requirements may need modification to make accreditation more accessible to small LHDs.
Lessons Learned From the Environmental Public Health Tracking Sub-County Data Pilot Project
Authors: Werner Angela K. , Strosnider Heather , Kassinger Craig , Shin Mikyong 
Published: December 2017

Objective:
Small area data are key to better understanding the complex relationships between environmental health, health outcomes, and risk factors at a local level. In 2014, the Centers for Disease Control and Prevention's National Environmental Public Health Tracking Program (Tracking Program) conducted the Sub-County Data Pilot Project with grantees to consider integration of sub-county data into the National Environmental Public Health Tracking Network (Tracking Network).

Design:
The Tracking Program and grantees developed sub-county-level data for several data sets during this pilot project, working to standardize processes for submitting data and creating required geographies. Grantees documented challenges they encountered during the pilot project and documented decisions.

Results:
This article covers the challenges revealed during the project. It includes insights into geocoding, aggregation, population estimates, and data stability and provides recommendations for moving forward.

Conclusion:
National standards for generating, analyzing, and sharing sub-county data should be established to build a system of sub-county data that allow for comparison of outcomes, geographies, and time. Increasing the availability and accessibility of small area data will not only enhance the Tracking Network's capabilities but also contribute to an improved understanding of environmental health and informed decision making at a local level.
Evaluating the Potential Health and Revenue Outcomes of a 100% Healthy Vending Machine Nutrition Policy at a Large Agency in Los Angeles County, 2013-2015
Authors: Wickramasekaran Ranjana N. , Robles Brenda , Dewey George , Kuo Tony 
Published: December 2017

Context:
Healthy vending machine policies are viewed as a promising strategy for combating the growing obesity epidemic in the United States. Few studies have evaluated the short- and intermediate-term outcomes of healthy vending policies, especially for interventions that require 100% healthy products to be stocked.

Objective:
To evaluate the potential impact of a 100% healthy vending machine nutrition policy.

Design:
The vendor's quarterly revenue, product sales records, and nutritional information data from 359 unique vending machines were used to conduct a baseline and follow-up policy analysis.

Setting:
County of Los Angeles facilities, 2013-2015.

Participants:
Vending machines in facilities located across Los Angeles County.

Intervention:
A healthy vending machine policy executed in 2013 that required 100% of all products sold in contracted machines meet specified nutrition standards.

Outcome Measures:
Policy adherence; average number of calories, sugar, and sodium in food products sold; revenue change.

Results:
Policy adherence increased for snacks and beverages sold by the vending machines by 89% and 98%, respectively. Average snack and beverage revenues decreased by 37% and 34%, respectively, during the sampled period.

Conclusions:
Although a 100% healthy vending policy represents a promising strategy for encouraging purchases of healthier foods, steps should be taken to counteract potential revenue changes when planning its implementation.
US State Public Health Departments Special Pathogen Planning
Authors: Herstein Jocelyn J. , Biddinger Paul D. , Gibbs Shawn G. , Le Aurora B. , Jelden Katelyn C. , Hewlett Angela L. , Lowe John J. 
Published: December 2017

Context:
US state public health departments played key roles in planning for and responding to confirmed and suspected cases of Ebola virus disease (EVD) during the 2014-2016 outbreak, including designating select hospitals as high-level isolation units (HLIUs) for EVD treatment in conjunction with the Centers for Disease Control and Prevention.

Objective:
To identify existing guidelines and perspectives of state health departments pertaining to the management and transport of patients with EVD and other highly hazardous communicable diseases (HHCDs).

Design:
An electronic 8-question survey with subquestions was administered as a fillable PDF.

Setting:
The survey was distributed to publicly accessible e-mails of state health department employees.

Participants:
State epidemiologists, emergency preparedness directors, or chief medical officers from each of the 50 states and the District of Columbia were contacted; a representative from 36 states and the District of Columbia responded (73%).

Main Outcome Measures:
Descriptive statistics were used to identify the proportion of state health departments with various existing protocols.

Results:
A majority of states reported that they would prefer patients confirmed with viral hemorrhagic fevers (eg, EVD, Marburg fever) and smallpox be transported to an HLIU for treatment rather than remain at the initial hospital of diagnosis. While most (89%) states had written guidelines for the safe transportation of patients with HHCDs, only 6 (16%) had written protocols for the management of accidents or other travel disruptions that may occur during HHCD transport within the state. Twenty-two state health departments (59%) had operationally exercised transport of a patient to an HLIU.

Conclusions:
Nearly half of states in the United States lack an HLIU, yet most prefer to have patients with HHCDs treated in high-level isolation. Recent budget cuts and uncertainty of future funding threaten the abilities of health departments to devote the necessary resources and staff to prepare for and deliver the desired care to HHCD cases. The lack of HLIUs in some states may complicate transport to a geographically proximate HLIU. Moreover, limited guidance on diseases that warrant high-level isolation may cause disagreement in HHCD patient placement between health departments, diagnosing facilities, and HLIUs.
Scaling up HIV self-testing in sub-Saharan Africa: a review of technology, policy and evidence
Authors: Indravudh Pitchaya P. , Choko Augustine T. , Corbett Elizabeth L. 
Published: December 2017

Purpose of review
HIV self-testing (HIVST) can provide complementary coverage to existing HIV testing services and improve knowledge of status among HIV-infected individuals. This review summarizes the current technology, policy and evidence landscape in sub-Saharan Africa and priorities within a rapidly evolving field.

Recent findings
HIVST is moving towards scaled implementation, with the release of WHO guidelines, WHO prequalification of the first HIVST product, price reductions of HIVST products and a growing product pipeline. Multicountry evidence from southern and eastern Africa confirms high feasibility, acceptability and accuracy across many delivery models and populations, with minimal harms. Evidence on the effectiveness of HIVST on increased testing coverage is strong, while evidence on demand generation for follow-on HIV prevention and treatment services and cost-effective delivery is emerging. Despite these developments, HIVST delivery remains limited outside of pilot implementation.

Summary
Important technology gaps include increasing availability of more sensitive HIVST products in low and middle-income countries. Regulatory and postmarket surveillance systems for HIVST also require further development. Randomized trials evaluating the effectiveness and cost-effectiveness under multiple distribution models, including unrestricted delivery and with a focus on linkage to HIV prevention and treatment, remain priorities. Diversification of studies from west and central Africa and around blood-based products should be addressed.
Generative adversarial networks for reconstructing natural images from brain activity
Authors: Seeliger K. , Güçlü U. , Ambrogioni L. , Güçlütürk Y. , van Gerven M. A. J. 
Published: December 2017

AbstractWe explore a method for reconstructing visual stimuli from brain activity. Using large databases of natural images we trained a deep convolutional generative adversarial network capable of generating gray scale photos, similar to stimUli presented during two functional magnetic resonance imaging experiments. Using a linear model we learned to predict the generative model’s latent space from measured brain activity. The objective was to create an image similar to the presented stimulus image through the previously trained generator. Using this approach we were able to reconstruct structural and some semantic features of a proportion of the natural images sets. A behavioral test showed that subjects were capable of identifying a reconstruction of the original stimuhis in 67.2% and 66.4% of the cases in a pairwise comparison for the two natural image datasets respectively. our approach does not require end-to-end training of a large generative model on limited neuroimaging data. Rapid advances in generative modeling promise further improvements in reconstruction performance.
Earthquake-induced habitat migration in a riparian spawning fish: implications for conservation management
Authors: Orchard Shane , Hickford Michael J. H. , Schiel David R. 
Published: December 2017

AbstractGalaxias maculatus is a riparian spawning fish that supports an important recreational fishery in New Zealand with spawning habitat requirements strongly structured by salinity gradients at rivermouths. This study reports changes to the spawning habitat following a series of large earthquakes that resulted in widespread deformation of ground surfaces in the vicinity of waterways. Assessments of habitat recovery focussed on two rivers systems, the Avon and Heathcote, with pre-disturbance data available over a 20 year period. Recovery dynamics were assessed by field survey and mapping of spawning habitat prior to and on seven occasions after the disturbance event. Riparian land-use and management patterns were mapped and analysed using overlay methods in GIS. Habitat migration of up to 2 km occurred in comparison to all previous records and several anthropogenic land uses have become threats due to changed patterns of co-occurrence. Incompatible activities now affect more than half of the spawning habitat in both rivers, particularly in areas managed for flood control purposes and recreational use. The results are an example of landscape scale responses to salinity and water level changes driven by tectonic dynamics. These dynamics are not the source of the stress per se, rather, they have increased exposure to pre-existing stressors. The case illustrates important principles for managing subtle, yet widespread, change. Adaptive conservation methods and investments in information are priorities for avoiding management failure following environmental change.
ProGeM: A framework for the prioritisation of candidate causal genes at molecular quantitative trait loci
Authors: Stacey David , Fauman Eric B. , Ziemek Daniel , Sun Benjamin B. , Harshfield Eric L. , Wood Angela M. , Butterworth Adam S. , Suhre Karsten , Paul Dirk S. 
Published: December 2017

ABSTRACTQuantitative trait locus (QTL) mapping of molecular phenotypes such as metabolites, lipids, and proteins through genome-wide association studies (GWAS) represents a powerful means of highlighting molecular mechanisms relevant to human diseases. However, a major challenge of this approach is to identify the causal gene(s) at the observed QTLs. Here we present a framework for the “Prioritisation of candidate causal Genes at Molecular QTLs” (ProGeM), which incorporates biological domain-specific annotation data alongside genome annotation data from multiple repositories. We assessed the performance of ProGeM using a reference set of 227 previously reported and extensively curated metabolite QTLs. For 98% of these loci, the expert-curated gene was one of the candidate causal genes prioritised by ProGeM. Benchmarking analyses revealed that 69% of the causal candidates were nearest to the sentinel variant at the investigated molecular QTLs, indicating that genomic proximity is the most reliable indicator of “true positive” causal genes. In contrast, cis-gene expression QTL data led to three false positive candidate causal gene assignments for every one true positive assignment. We provide evidence that these conclusions also apply to other molecular phenotypes, suggesting that ProGeM is a powerful and versatile tool for annotating molecular QTLs. ProGeM is freely available via GitHub.
Effort distribution changes effector choice, behaviour and performance: A visuomotor tracking study using finger forces
Authors: Salam Satishchandra , Varadhan SKM 
Published: December 2017

AbstractHuman movement and its associated performance are bounded by a hierarchy of constraints operating over certain control variables. One such variable of both physiological and behavioural importance is the mechanical effort exerted by the participating elements. Here, we explored how motor performance is affected by the distribution of work, and consequently the effort.Using human hand as a model, we employed a visuomotor tracking task to study the associated motor performance when mechanical effort exerted by the fingers are modulated. The subject has to trace a set of ideal paths provided on visual feedback screen to reach a target through a cursor controlled by index and little finger forces. Modulation of these forces allows us to see how the perceived effort requirement affects the tracking performance. In this task demanding two-element coordination, we represent index finger as the independent/dominant element against little finger as the dependent/subjugate counterpart. We study how increasing mechanical effort contribution from the independent element leads to changes in both behaviour and performance.We found that despite higher mechanical requirements of employing index finger to produce larger absolute force, the movement control system continues to prefer it as against little finger which could have produced smaller absolute force. Moreover, the observation of better tracking performance under larger contributions from the independent component reflects to a plausible hierarchy of constraints employed in the motor control system that operates with more than one objective, energy minimisation per se. At least for the behaviour in study, the improved motor performance suggests that the control system prefers higher independence of the participating elements.
Long Read Annotation (LoReAn): automated eukaryotic genome annotation based on long-read cDNA sequencing
Authors: Cook David E. , Espejo Valle-Inclan Jose , Pajoro Alije , Rovenich Hanna , Thomma Bart PHJ , Faino Luigi 
Published: December 2017

AbstractSingle-molecule full-length cDNA sequencing can aid genome annotation by revealing transcript structure and alternative splice-forms, yet current annotation pipelines do not incorporate such information. Here we present LoReAn (LongReadAnnotation) software, an automated annotation pipeline utilizing short- and long-read cDNA sequencing, protein evidence, andab initioprediction to generate accurate genome annotations. Based on annotations of two fungal and two plant genomes, we show that LoReAn outperforms popular annotation pipelines by integrating single-molecule cDNA sequencing data generated from either the PacBio or MinION sequencing platforms, and correctly predicting gene structure and capturing genes missed by other annotation pipelines.
Repertoire analysis of antibody CDR-H3 loops suggests affinity maturation does not typically result in rigidification
Authors: Jeliazkov Jeliazko R. , Sljoka Adnan , Kuroda Daisuke , Tsuchimura Nobuyuki , Katoh Naoki , Tsumoto Kouhei , Gray Jeffrey J. 
Published: December 2017

AbstractAntibodies can rapidly evolve in specific response to antigens. Affinity maturation drives this evolution through cycles of mutation and selection leading to enhanced antibody specificity and affinity. Elucidating the biophysical mechanisms that underlie affinity maturation is fundamental to understanding B-cell immunity. An emergent hypothesis is that affinity maturation reduces the conformational flexibility of the antibody’s antigen-binding paratope to minimize entropic losses incurred upon binding. In recent years, computational and experimental approaches have tested this hypothesis on a small number of antibodies, often observing a decrease in the flexibility of the Complementarity Determining Region (CDR) loops that typically comprise the paratope and in particular the CDR-H3 loop, which contributes a plurality of antigen contacts. However, there were a few exceptions, and previous studies were limited to a small handful of cases. Here, we determined the structural flexibility of the CDR-H3 loop for thousands of recently-determined homology models of the human peripheral blood cell antibody repertoire using rigidity theory. We found no clear delineation in the flexibility of naïve and antigen-experienced antibodies. To account for possible sources of error, we additionally analyzed hundreds of human and mouse antibodies in the Protein Data Bank through both rigidity theory and B-factor analysis. By both metrics, we observed only a slight decrease in the CDR-H3 loop flexibility when comparing affinity-matured antibodies to naïve antibodies, and the decrease was not as drastic as previously reported. Further analysis, incorporating molecular dynamics (MD) simulations, revealed a spectrum of changes in flexibility. Our results suggest that rigidification may be just one of many biophysical mechanisms for increasing affinity.