bluuebunny/crossref_metadata_2025_split huggingface dataset:
Managing gender diversity in healthcare: getting it right
Authors: Vanderbroeck Paul , Wasserfallen Jean-Blaise 
Published: January 2017

PurposeDiversity, notably gender diversity, is growing in health care, both at the level of teams and the level of organizations. This paper aims to describe the challenges for team leaders and leaders of organizations to manage this diversity. The authors believe that more could be done to help leaders master these challenges in a way that makes diverse teams and organizations more productive.Design/methodology/approachDrawing on previously published research, using gender diversity as an example, the paper first describes how diversity can both have a positive and a negative influence on team productivity. Next, it describes the challenge of gender diversity at an organizational level, using Switzerland as an example.FindingsThe first part of the paper espouses the causes of gender diversity, undoes some of the myths surrounding diversity and presents a model for effective management of diversity in teams. The second part looks at gender diversity at an organizational level. Drawing from sources inside and outside healthcare, the effects of the “leaking pipeline”, “glass wall” and “glass ceiling” that prevent health-care organizations from leveraging the potential of female talent are discussed.Practical implicationsThe authors propose a model developed for intercultural teamwork as a framework for leveraging gender diversity for better team productivity. Proposals are offered to health-care organizations on how they can tip the gender balance at senior levels into their favor, so as to get the maximum benefit from the available talent.Originality/valueApplying the “how to” ideas and recommendations from this general review will help leaders of health-care organizations gain a better return on investment from their talent development as well as to increase the productivity of their workforce by a better use of diverse talent.
The new frontier of public health education
Authors: Birnbaum David , Gretsinger Kathryn , Ellis Ursula 
Published: January 2017

Purpose
The aim of this paper is to describe the experience and educational benefits of a course that has several unique educational design features.

Design/methodology/approach
This includes narrative description of faculty and student experience from participants in a flipped-instructional-design inter-professional education course.

Findings
“Improving Public Health – An Interprofessional Approach to Designing and Implementing Effective Interventions” is an undergraduate public health course open to students regardless of background. Its student activities mirror the real-life tasks and challenges of working in a public health agency, including team-building and leadership; problem and project definition and prioritization; evidence-finding and critical appraisal; written and oral presentation; and press interviews. Students successfully developed project proposals to address real problems in a wide range of communities and settings and refined those proposals through interaction with professionals from population and public health, journalism and library sciences.

Practical implications
Undergraduate public health education is a relatively new endeavor, and experience with this new approach may be of value to other educators.

Originality/value
Students in this course, journalism graduate students who conducted mock interviews with them and instructors who oversaw the course all describe unique aspects and related personal benefit from this novel approach.
Dual leadership in a hospital practice
Authors: Thude Bettina Ravnborg , Thomsen Svend Erik , Stenager Egon , Hollnagel Erik 
Published: January 2017

PurposeDespite the practice of dual leadership in many organizations, there is relatively little research on the topic. Dual leadership means two leaders share the leadership task and are held jointly accountable for the results of the unit. To better understand how dual leadership works, this study aims to analyse three different dual leadership pairs at a Danish hospital. Furthermore, this study develops a tool to characterize dual leadership teams from each other.Design/methodology/approachThis is a qualitative study using semi-structured interviews. Six leaders were interviewed to clarify how dual leadership works in a hospital context. All interviews were transcribed and coded. During coding, focus was on the nine principles found in the literature and another principle was found by looking at the themes that were generic for all six interviews.FindingsResults indicate that power balance, personal relations and decision processes are important factors for creating efficient dual leaderships. The study develops a categorizing tool to use for further research or for organizations, to describe and analyse dual leaderships.Originality/valueThe study describes dual leadership in the hospital context and develops a categorizing tool for being able to distinguish dual leadership teams from each other. It is important to reveal if there are any indicators that can be used for optimising dual leadership teams in the health-care sector and in other organisations.
Population and evolutionary dynamics of Shiga‐toxin producing Escherichia coli O157 in a beef herd: A longitudinal study
Authors: Jones Meghan , Octavia Sophie , Lammers Geraldine , Heller Jane , Lan Ruiting 
Published: January 2017

SummaryShiga toxin producing Escherichia coli O157:H7 (STEC O157) is naturally found in the gastrointestinal tract of cattle and can cause severe disease in humans. There is limited understanding of the population dynamics and microevolution of STEC O157 at herd level. In this study, isolates from a closed beef herd of 23 cows were used to examine the population turnover in the herd. Of the nine STEC O157 clades previously described, clade 7 was found in 162 of the 169 isolates typed. Multiple locus variable number tandem repeat analysis (MLVA) differentiated 169 isolates into 33 unique MLVA types. Five predominant MLVA types were evident with most of the remaining types containing only a single isolate. MLVA data suggest that over time clonal replacement occurred within the herd. Genome sequencing of 18 selected isolates found that the isolates were divided into four lineages, representing four different ‘clones’ in the herd. Genome data confirmed clonal replacement over time and provided evidence of cross transmission of strains between cows. The findings enhanced our understanding of the population dynamics of STEC O157 in its natural host that will help developing effective control measures to prevent the spread of the pathogen to the human population.
Melanin is effective in protecting fast and slow growing fungi from various types of ionizing radiation
Authors: Pacelli Claudia , Bryan Ruth A. , Onofri Silvano , Selbmann Laura , Shuryak Igor , Dadachova Ekaterina 
Published: January 2017

SummaryMelanin is a ubiquitous pigment with unique physicochemical properties. The resistance of melanized fungi to cosmic and terrestrial ionizing radiation suggests that melanin also plays a pivotal role in radioprotection. In this study, we compared the effects of densely‐ionizing deuterons and sparsely‐ionizing X‐rays on two microscopic fungi capable of melanogenesis. We utilized the fast‐growing pathogenic basiodiomycete forming an induced DOPA‐melanin, Cryptococcus neoformans (CN); and the slow‐growing environmental rock‐inhabiting ascomycete synthesizing a constitutive DHN‐melanin, Cryomyces antarcticus (CA); melanized and non‐melanized counterparts were compared. CA was more resistant to deuterons than CN, and similar resistance was observed for X‐rays. Melanin afforded protection against high‐dose (1.5 kGy) deuterons for both CN and CA (p‐values < 10−4). For X‐rays (0.3 kGy), melanin protected CA (p‐values < 10−4) and probably CN. Deuterons increased XTT activity in melanized strains of both species, while the activity in non‐melanized cells remained stable or decreased. For ATP levels the reverse occurred: it decreased in melanized strains, but not in non‐melanized ones, after deuteron exposure. For both XTT and ATP, which reflect the metabolic activity of the cells, larger and more statistically‐significant differences as a function of melanization status occurred in CN. Our data show, for the first time, that melanin protected both fast‐growing and slow‐growing fungi from high doses of deuterons under physiological conditions. These observations may give clues for creating melanin‐based radioprotectors.
Maternal and neonatal outcomes in women with severe early onset pre‐eclampsia before 26 weeks of gestation, a case series
Authors: van Oostwaard MF , van Eerden L , de Laat MW , Duvekot JJ , Erwich JJHM , Bloemenkamp KWM , Bolte AC , Bosma JPF , Koenen SV , Kornelisse RF , Rethans B , van Runnard Heimel P , Scheepers HCJ , Ganzevoort W , Mol BWJ , de Groot CJ , Gaugler‐Senden IPM 
Published: January 2017

ObjectiveTo describe the maternal and neonatal outcomes and prolongation of pregnancies with severe early onset pre‐eclampsia before 26 weeks of gestation.DesignNationwide case series.SettingAll Dutch tertiary perinatal care centres.PopulationAll women diagnosed with severe pre‐eclampsia who delivered between 22 and 26 weeks of gestation in a tertiary perinatal care centre in the Netherlands, between 2008 and 2014.MethodsWomen were identified through computerised hospital databases. Data were collected from medical records.Main outcome measuresMaternal complications [HELLP (haemolysis, elevated liver enzyme levels, and low platelet levels) syndrome, eclampsia, pulmonary oedema, cerebrovascular incidents, hepatic capsular rupture, placenta abruption, renal failure, and maternal death], neonatal survival and complications (intraventricular haemorrhage, retinopathy of prematurity, necrotising enterocolitis, bronchopulmonary dysplasia, and sepsis), and outcome of subsequent pregnancies (recurrent pre‐eclampsia, premature delivery, and neonatal survival).ResultsWe studied 133 women, delivering 140 children. Maternal complications occurred frequently (54%). Deterioration of HELLP syndrome during expectant care occurred in 48%, after 4 days. Median prolongation was 5 days (range: 0–25 days). Neonatal survival was poor (19%), and was worse (6.6%) if the mother was admitted before 24 weeks of gestation. Complications occurred frequently among survivors (84%). After active support, neonatal survival was comparable with the survival of spontaneous premature neonates (54%). Pre‐eclampsia recurred in 31%, at a mean gestational age of 32 weeks and 6 days.ConclusionsConsidering the limits of prolongation, women need to be counselled carefully, weighing the high risk for maternal complications versus limited neonatal survival and/or extreme prematurity and its sequelae. The positive prospects regarding maternal and neonatal outcome in future pregnancies can supplement counselling.Tweetable abstractSevere early onset pre‐eclampsia comes with high maternal complication rates and poor neonatal survival.
Uterine leiomyosarcoma: a review of recent advances in molecular biology, clinical management and outcome
Authors: Cui RR , Wright JD , Hou JY 
Published: January 2017

Uterine leiomyosarcoma (LMS) are rare but aggressive tumours with poor clinical outcomes regardless of stage. Most tumours are identified by histopathology at time of surgery, and pre‐operative diagnosis remains a clinical challenge. Management of early‐stage LMS relies on surgical resection. Cytotoxic chemotherapy remains the mainstay of therapy for advanced‐stage, recurrent or metastatic LMS, and includes single or combination doxorubicin‐, ifosfamide‐ or gemcitabine‐based regimens. Recent interest in genetic biomarkers led to developments of targeted therapies for LMS, although more research is needed to understand the molecular complexities underlying LMS to guide the development of novel treatment strategies.Tweetable abstractThe diagnosis and treatment of uterine LMS is challenging. Novel biomarkers offer hope for future therapies.
Malpractice Claim Fears and the Costs of Treating Medicare Patients: A New Approach to Estimating the Costs of Defensive Medicine
Authors: Reschovsky James D. , Saiontz‐Martinez Cynthia B. 
Published: January 2017

ObjectiveTo estimate the cost of defensive medicine among elderly Medicare patients.Data SourcesWe use a 2008 national physician survey linked to respondents’ elderly Medicare patients’ claims data.Study DesignUsing a sample of survey respondent/beneficiary dyads stratified by physician specialty, we estimated cross‐sectional regressions of annual costs on patient covariates and a medical malpractice fear index formed from five validated physician survey questions. Defensive medicine costs were calculated as the difference between observed patient costs and those under hypothetical alternative levels of malpractice concern, and then aggregated to estimate average defensive medicine costs per beneficiary.Data Collection MethodsThe physician survey was conducted by mail. Patient claims were linked to survey respondents and reweighted to approximate the elderly Medicare beneficiary population.Principal FindingsHigher levels of the malpractice fear index were associated with higher patient spending. Based on the measured associations, we estimated that defensive medicine accounted for 8 to 20 percent of total costs under alternative scenarios. The highest estimate is associated with a counterfactual of no malpractice concerns, which is unlikely to be socially optimal as some extrinsic incentives to avoid medical errors are desirable. Among specialty groups, primary care physicians contributed the most to defensive medicine spending. Higher costs resulted mostly from more hospital admissions and greater postacute care.ConclusionsAlthough results are based on measured associations between malpractice fears and spending, and may not reflect the true causal effects, they suggest defensive medicine likely contributes substantial additional costs to Medicare.
Perspectives: Using Results from HRSA's Health Workforce Simulation Model to Examine the Geography of Primary Care
Authors: Streeter Robin A. , Zangaro George A. , Chattopadhyay Arpita 
Published: January 2017

ObjectiveInform health planning and policy discussions by describing Health Resources and Services Administration's (HRSA's) Health Workforce Simulation Model (HWSM) and examining the HWSM's 2025 supply and demand projections for primary care physicians, nurse practitioners (NPs), and physician assistants (PAs).Data SourcesHRSA's recently published projections for primary care providers derive from an integrated microsimulation model that estimates health workforce supply and demand at national, regional, and state levels.Principal FindingsThirty‐seven states are projected to have shortages of primary care physicians in 2025, and nine states are projected to have shortages of both primary care physicians and PAs. While no state is projected to have a 2025 shortage of primary care NPs, many states are expected to have only a small surplus.ConclusionsPrimary care physician shortages are projected for all parts of the United States, while primary care PA shortages are generally confined to Midwestern and Southern states. No state is projected to have shortages of all three provider types. Projected shortages must be considered in the context of baseline assumptions regarding current supply, demand, provider‐service ratios, and other factors. Still, these findings suggest geographies with possible primary care workforce shortages in 2025 and offer opportunities for targeting efforts to enhance workforce flexibility.
Clinical and pathological evaluation of patients with prostate and colorectal cancer five or more years after curative resection
Authors: Lee Jung Nam , Park Yeon Ho , Han Jung , Baek Jeong‐Heum , Park Sung Won , Lee Won‐Suk 
Published: January 2017

AimThe survival of men diagnosed with colorectal cancer (CRC) has improved over time, and the current 5‐year overall survival rate is 65.1 per cent. The long survival of patients with CRC raises issues regarding risk of a second primary prostate cancer and the need for continued proper surveillance. The aim of the study was to evaluate the incidence of prostate cancer in a uniform CRC population.Patients and MethodsBetween September 2007 and September 2012, 347 patients with curatively‐resected CRC who have had a follow‐up duration of more than 3 years at Gachon Medical Center were included in this study.ResultsThe incidence of synchronous or metachronous prostate cancer in addition to CRC was 4.3 per cent (15 patients). The time interval between CRC to prostate tumour in ranged from 0.1 to 5.5 years. Fourteen patients (93.3 per cent) were greater than 65 years of age. There were only two synchronous prostate cancers (0.6 per cent) among the CRC patients.ConclusionDue to the increased survival of CRC, continued surveillance could be necessary.
Factors affecting outcomes in traumatic liver injury: A retrospective study
Authors: Lee Kit‐Fai , Chong Charing Ching‐Ning , Yeung Janice Hiu‐Hung , Cheung Nai‐Kwong , Siu Eva Yin‐Yu , Cheung Yue‐Sun , Wong John , Lai Paul Bo‐San 
Published: January 2017

AimTo achieve better outcomes, nonoperative management (NOM) and damage control surgery (DCS) are now recommended for traumatic liver injury. The aim of the present study was to review the outcomes of patients suffering from liver trauma and to determine the factors affecting the outcomes, with emphasis on NOM and DCS.Patients and MethodsThis was a retrospective cohort study for liver trauma patients from a single centre. The outcomes were compared between two equal consecutive periods: period A (2001–2007) and period B (2008–2014).ResultsThere were 116 patients, with a mean age of 38.1 years and a male predominance (61.2 per cent). Approximately 57 per cent of patients suffered from grade III or higher liver injury. The mean Injury Severity Score (ISS) was 32.3. The 90‐day mortality was 20.7 per cent. During period B, the 90‐day mortality was significantly lowered (6/56 vs 18/60, P = 0.010) with less liver operations (13/56 vs 26/60, P = 0.022) and more hepatic angiography ± embolization (7/56 vs 0/60, P = 0.005). The proportion of DCS was similar, but more hepatectomies were performed in period B (4/13 vs 0/26, P = 0.009). Multivariate analysis revealed that ISS grade, age and sex were predictors for 90‐day mortality.ConclusionsReduced mortality was seen in traumatic liver injury accomplished by increased NOM, but not DCS.
Diagnostic accuracy of sialendoscopy referenced to current imaging modalities
Authors: Ng Siu‐Kwan , Chan Jason Ying‐Kuen , Wong Eddy Wai‐Yeung , Vlantis Alexander Chris 
Published: January 2017

AimThe aim of the present study was to determine the accuracy of diagnostic sialendoscopy in patients with suspected obstructive salivary duct disease referenced to current imaging modalities.Patients and MethodsA retrospective study of patients with symptoms suggestive of obstructive salivary duct disease who underwent one or more imaging modalities, and then sialendoscopy at an academic hospital, were reviewed. The radiological and sialendoscopic findings were compared, and the diagnostic accuracy of various imaging modalities was determined using sialendoscopy as a reference.ResultsSeventy‐five sialendoscopies were performed in 68 patients (39 females, 29 males). Obstructive lesions were identified in 71 of the 75 sialendoscopies; 18 stones and 53 nonstone obstructive lesions were identified. Imaging consisting of plain X‐ray (n = 4), radiosialography (n = 18), ultrasonography (n = 58), computed tomography (n = 13) and magnetic resonance imaging (n = 10) detected disease in 25, 70.6, 69.1, 69.2 and 100 per cent of diseased ducts, respectively.ConclusionSialendoscopy is more sensitive, and thus more useful, in diagnosing obstructive salivary duct disease in symptomatic patients than current imaging modalities. Symptomatic patients with negative imaging should be considered for sialendoscopy when therapy, such as stone retrieval or stricture dilation, can instituted at the time of diagnosis.
Abiotic effects on the distributions of major insect species in agricultural fields
Authors: Eo Jinu , Kim Myung‐Hyun , Na Young‐Eun , Oh Young‐Ju , Park Sangkyu 
Published: January 2017

AbstractWe compared how abiotic factors affect the regional distributions of four insect groups (Dermaptera, Formicidae, Orthoptera and Diptera). Insects were collected using a pitfall trap from 36 agricultural field sites, and 31 933 individuals encompassing 139 species were observed. The distribution pattern of dominant species was not obviously different among the four groups. Species richness (H′) of Orthoptera showed a negative and positive correlation with precipitation and sunlight duration, respectively. Longitudinal zonation was the main distribution pattern of many dominant species. Overall, canonical correspondence analysis showed that temperature and precipitation were closely associated with the distribution of Orthoptera, but not that of Formicidae, implying that Formicidae may be affected less by abiotic factors compared to other taxonomic groups. Some orthopteran species such as Dianemobius nigrofasciatus and Polionemobius mikado showed a negative correlation with temperature. We suggest that these species can be categorized as susceptible to climate change. Our results also implied that the association between climate variables and distribution of insects should be evaluated at a species level.
MicroRNA profile analysis in the liver fibrotic tissues of chronic hepatitis B patients
Authors: Chen Rong , Wu Jun Cheng , Liu Ting , Qu Ying , Lu Lun Gen , Xu Ming Yi 
Published: January 2017

OBJECTIVE
We aimed to identify the features of microRNA (miRNA) at different fibrotic stages in patients with hepatitis B virus (HBV)‐related liver fibrosis.
METHODS
Liver tissues were collected from 40 chronic hepatitis B (CHB) patients at fibrotic stages S0–4. Microarrays of miRNAs and genomic informatics analysis were performed.
RESULTS
In total, 105 miRNAs were differentially expressed in fibrotic tissues (S1–4 groups) compared with no fibrotic tissues (S0 group; P < 0.05). Combined with three classifications, 17 differential miRNAs were found to be closely related to fibrotic stages (over twofold change and P < 0.05). Five miRNAs had a signature that correlated with serum biochemical parameters and liver inflammatory grades. The receiver operating characteristic (ROC) curve showed that six miRNAs performed excellently in the diagnosis of liver fibrosis, with the area under the ROC curve (AUROC) over 0.8; among them hsa‐miR‐214‐3p had the highest AUROC (0.867). Gene ontology functions of differential miRNAs mainly involved in the cellular and developmental processes, localization, biological regulation, binding, transcriptional regulator and organelle. We also found that 23 novel signaling pathways were dysregulated in the liver fibrosis.
CONCLUSIONS
MiRNA profile signature, including 17 differential miRNAs and 23 dysregulated signaling pathways, was associated with liver fibrosis. Hepatic inflammatory grades were correlated with the differential miRNA. Some miRNAs can be used for the diagnosis of liver fibrosis.