bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nonalcoholic fatty liver disease: biomarkers as diagnostic tools for liver damage assessment in adult patients from Argentina
Authors: Valva Pamela , Rios Daniela , Casciato Paola , Gadano Adrián , Galdame Omar , Mullen Eduardo , Bertot Gustavo , de Matteo Elena , Preciado María V. 
Published: January 2018

BackgroundNonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease whose prevalence has been increasing constantly and linked to the global obesity epidemic. The NAFLD histologic spectrum ranges from simple steatosis to nonalcoholic steatohepatitis (NASH), which can progress to cirrhosis and hepatocellular carcinoma. Liver biopsy is the only reliable means to diagnose and stage NASH, but its invasive nature limits its use. Therefore, the prediction of hepatic injury by means of the development of new noninvasive tests represents a growing medical need. Our aim was to evaluate matrix deposition and cell-death markers, which correlate with liver injury in an NAFLD patient cohort.Patients and methodsLiver biopsies and serum from 34 NAFLD adult patients were analyzed. Histological parameters were evaluated. Matrix deposition [hyaluronic acid (HA) and tissue inhibitor of matrix metalloproteinase inhibitor-1 (TIMP-1)] and cell-death markers [cytokeratin-18 (M65) and caspase-cleaved cytokeratin-18 (M30)] were measured in serum samples.ResultsHA showed an association with fibrosis severity (P=0.03) and M30 with steatosis (P=0.013), inflammation (P=0.004), and fibrosis severity (P=0.04). In contrast, TIMP-1 and M65 showed no association with any histological parameter of liver injury. The evaluation of diagnostic accuracy showed good performance as less invasive markers of significant fibrosis of both HA (area under the receiver operating characteristic curve: 0.928) and M30 (area under the receiver operating characteristic curve: 0.848).ConclusionBiomarkers are essential tools that may provide a quick and accurate diagnosis for patients with life-threatening NAFLD and NASH. HA and M30, together or determined sequentially, have been found to be straightforward tests that may be sufficient to predict significant fibrosis even in a primary care center of an underdeveloped country.
‘Knocking-fingers’ chest compression technique in infant cardiac arrest: single-rescuer manikin study
Authors: Jung Woo Jin , Hwang Sung Oh , Kim Hyung Il , Cha Yong Sung , Kim Oh Hyun , Kim Hyun , Lee Kang Hyun , Cha Kyoung-Chul 
Published: January 2018

Objective
We designed a new chest compression technique, the ‘knocking-fingers’ chest compression (KF) technique, for a single rescuer in infant cardiac arrest. We compared the effectiveness and feasibility between the KF technique and the two-finger (TF) and two-thumb encircling hands (TT) techniques.

Participants and methods
A prospective, randomized, crossover study was carried out to compare the quality of chest compression and ventilation between the KF, TF, and TT techniques using a 30: 2 compression-to-ventilation ratio and mouth-to-mouth ventilation. The area of chest compression, finger(s) pain, and fatigability were measured to compare safety and feasibility.

Results
The total frequency of chest compression for 5 min was the highest with the KF technique, followed by the TF and TT techniques. The total frequency of ventilation for 5 min was higher with the KF and TF techniques compared with the TT technique. The total hands-off time was the shortest with the KF technique, followed by the TF and TT techniques. The area of chest compression was the smallest in KF technique. Participants complained of severe finger pain and high fatigability in TF technique.

Conclusion
The single-rescuer KF chest compression technique is an effective alternative to the TF or TT techniques for infant cardiac arrest.
A Transactional “Second-Victim” Model—Experiences of Affected Healthcare Professionals in Acute-Somatic Inpatient Settings: A Qualitative Metasynthesis
Authors: Schiess Cornel , Schwappach David , Schwendimann René , Vanhaecht Kris , Burgstaller Melanie , Senn Beate 
Published: January 2018

Background
“Second victims” are healthcare professionals traumatized by involvement in significant adverse events. Associated burdens, e.g., guilt, can impair professional performance, thereby endangering patient safety. To date, however, a model of second victims’ experiences toward a deeper understanding of qualitative studies is missing. Therefore, we aimed to identify, describe, and interpret these experiences in acute-somatic inpatient settings.

Methods
This qualitative metasynthesis reflects a systematic literature search of PubMed, CINAHL, and PsycINFO, extended by hand searches and expert consultations. Two researchers independently evaluated qualitative studies in German and English, assessing study quality via internationally approved criteria. Results were analyzed inductively and aggregated quantitatively.

Results
Based on 19 qualitative studies (explorative-descriptive: n = 13; grounded theory: n = 3; phenomenology: n = 3), a model of second-victim experience was drafted. This depicts a multistage developmental process: in appraising their situation, second victims focus on their involvement in an adverse event, and they become traumatized. To restore their integrity, they attempt to understand the event and to act accordingly; however, their reactions are commonly emotional and issue focused. Outcomes include leaving the profession, surviving, or thriving. This development process is alternately modulated by safety culture and healthcare professionals.

Conclusions
For the first time, this model works systematically from the second-victim perspective based on qualitative studies. Based on our findings, we recommend integrating second victims’ experiences into safety culture and root-cause analyses. Our transactional model of second-victim experience provides a foundation for strategies to maintain and improve patient safety.
Volume at First Leak Is Associated With Sling Failure Among Women With Stress Urinary Incontinence
Authors: Hill Bryan , Fletcher Sarah , Blume Jeffrey , Adam Rony , Ward Renée 
Published: January 2018

Introduction
Stress urinary incontinence at a low bladder volume is a clinically observed phenomenon that is not well studied with regard to treatment outcomes. The primary aim of our study was to determine if the volume at first leak is associated with sling outcome.

Methods
This is a retrospective cohort study evaluating whether urodynamic stress urinary incontinence observed at low volumes is associated with sling failure using the Synthetic Derivative database. Sling failure was defined as (1) undergoing a subsequent surgery for stress incontinence (eg, urethral bulking agent, repeat sling) or (2) leakage that was subjectively worse or unchanged from baseline. Sling success was defined as subjective improvement in incontinence or being dry. Intrinsic sphincter deficiency was defined as maximum urethral closure pressure 20 cm H20 or less or abdominal leak point pressure less than 60 cm H20.

Results
Outcome data were available for 168 of 206 women who underwent a sling after urodynamic testing from 2006 to 2014. Of the 168 women, 80 were transobturator, 79 were retropubic, 8 lacked data regarding the approach to the midurethral sling, and 1 was an autologous pubovaginal sling. Similar failure rates were seen for transobturator (10%) and retropubic slings (7.6%). Preoperative urodynamic parameters, such as cystometric capacity and intrinsic sphincter deficiency, were similar among failed and successful slings. For every additional 50 mL in bladder volume at first leak (SUIvol), there was a 1.6 increased odds of having a successful sling (odds ratio, 1.576; 95% confidence interval, 1.014–2.450; P = 0.04). There was no statistically significant association between maximum urethral closure pressure, abdominal leak point pressure, body mass index, age, sling type, or whether a prior anti-incontinence procedure had been performed and sling success.

Conclusions
Bladder volume at first leak is a strong predictor of sling failure.
Impact of a statewide trauma system on the triage, transfer, and inpatient mortality of injured patients
Authors: Porter Austin , Karim Saleema , Bowman Stephen M. , Recicar John , Bledsoe Gregory H. , Maxson Robert T. 
Published: January 2018

BACKGROUND
In 2009, Arkansas implemented a statewide trauma system to address the high rates of mortality and morbidity due to trauma. The principal objective of the Arkansas Trauma System is to transport patients to the appropriate facility based on the injuries of the patients. This study evaluated four metrics that were crucial to system health. These measures included: treatment location, scene triage, admission to nondesignated facilities, and inpatient mortality. Furthermore, the authors sought to quantify how the system is selective toward the severely injured regarding triage and treatment location. The authors hypothesized that system implementation should increase the proportion of patients, particularly the severely injured, treated at Level I/II facilities. The system should increase the proportion of patients, especially the severely injured, admitted to Level I/II facilities directly from the scene. The system should result in fewer patients admitted to nondesignated facilities. Lastly, system implementation should result in fewer inpatient deaths.

METHODS
A pre-post study design was used for this evaluation. Data from the Arkansas Hospital Discharge data set (2007 through 2012) identified patients who were admitted as a result of their injuries. The ICD-MAP software was used to categorize those with and without severe injuries based on an Injury Severity Score of 16 or greater or head Abbreviated Injury Scale score of 3 or greater.

RESULTS
The results indicate that while there was an overall increase in odds of patients being admitted to Level I/II facilities, those with severe injuries were associated with an even greater odds of admission to Level I/II facilities (p < 0.0001). System implementation was also associated with more severely injured patients admitted to Level I/II facilities from the scene. There were also fewer patients admitted to nondesignated hospitals after system implementation (p < 0.0001). System implementation was associated with fewer inpatient deaths (p = 0.02).

CONCLUSION
Two years after implementation, the trauma system showed significant progress. The measures evaluated in this study are believed to support the effectiveness of the trauma system.

LEVEL OF EVIDENCE
Therapeutic study, level IV.
Neurostimulation for drug-resistant epilepsy: a systematic review of clinical evidence for efficacy, safety, contraindications and predictors for response
Authors: Boon Paul , De Cock Elien , Mertens Ann , Trinka Eugen 
Published: January 2018

Purpose of reviewNeurostimulation is becoming an increasingly accepted treatment alternative for patients with drug-resistant epilepsy (DRE) who are unsuitable surgery candidates. Standardized guidelines on when or how to use the various neurostimulation modalities are lacking. We conducted a systematic review on the currently available neurostimulation modalities primarily with regard to effectiveness and safety.Recent findingsFor vagus nerve stimulation (VNS), there is moderate-quality evidence for its effectiveness in adults with drug-resistant partial epilepsies. Moderate-to-low-quality evidence supports the efficacy and safety of deep brain stimulation (DBS) and responsive neurostimulation (RNS) in patients with DRE. There is moderate-to-very low-quality evidence that transcranial direct current stimulation (tDCS) is effective or well tolerated. For transcutaneous vagus nerve stimulation (tVNS), transcranial magnetic stimulation (TMS) and trigeminal nerve stimulation (TNS), there are insufficient data to support the efficacy of any of these modalities for DRE. These treatment modalities, nevertheless, appear well tolerated, with no severe adverse events reported.SummaryHead-to-head comparison of treatment modalities such as VNS, DBS and RNS across different epileptic syndromes are required to decide which treatment modality is the most effective for a given patient scenario. Such studies are challenging and it is unlikely that data will be available in the near future. Additional data collection on potentially promising noninvasive neurostimulation modalities like tVNS, TMS, TNS and tDCS is warranted to get a more precise estimate of their therapeutic benefit and long-term safety.
LFMM 2.0: Latent factor models for confounder adjustment in genome and epigenome-wide association studies
Authors: Caye Kevin , Jumentier Basile , François Olivier 
Published: January 2018

AbstractMotivationGenome-wide, epigenome-wide and gene-environment association studies are plagued with the problems of confounding and causality. Although those problems have received considerable attention in each application field, no consensus have emerged on which approaches are the most appropriate to solve this problem. Current methods use approximate heuristics for estimating confounders, and often ignore correlation between confounders and primary variables, resulting in suboptimal power and precision.ResultsIn this study, we developed a least-squares estimation theory of confounder estimation using latent factor models, providing a unique framework for several categories of genomic data. Based on statistical learning methods, the proposed algorithms are fast and efficient, and can be proven to provide optimal solutions mathematically. In simulations, the algorithms outperformed commonly used methods based on principal components and surrogate variable analysis. In analysis of methylation profiles and genotypic data, they provided new insights on the molecular basis of diseases and adaptation of humans to their environment.Availability and implementationSoftware is available in the R package lfmm athttps://bcm-uga.github.io/lfmm/.
Analog Signalling with ‘Digital’ Molecular Switches
Authors: Clarke Stephen E 
Published: January 2018

AbstractMolecular switches, such as the protein kinase CaMKII, play a fundamental role in cell signalling by decoding inputs into either high or low states of activity; because the high activation state can be turned on and persist after the input ceases, these switches have earned a reputation as ‘digital’. Although this on/off, binary perspective has been valuable for understanding long timescale synaptic plasticity, accumulating experimental evidence suggests that the CaMKII switch can also control plasticity on short timescales. To investigate this idea further, a non-autonomous, nonlinear ordinary differential equation, representative of a general bistable molecular switch, is analyzed. The results suggest that switch activity in regions surrounding either the high- or low-stable states of activation could act as a reliable analog signal, whose short timescale fluctuations relative to equilibrium track instantaneous input frequency. The model makes intriguing predictions and is validated against previous work demonstrating its suitability as a minimal representation of switch dynamics; in combination with existing experimental evidence, the theory suggests a multiplexed encoding of instantaneous frequency information over short timescales, with integration of total activity over long timescales.Author SummaryBistable molecular switches can decode cellular inputs into distinct high- or low-states of persistent enzymatic activity. Although this on-off, ‘digital’ perspective is valuable for long timescales, I suggest that short timescale fluctuations of switch activity around either stable state acts as an analog signal that reliably encodes instantaneous input frequency. A minimal model and theory make predictions about the molecular switch CaMKII, synaptic plasticity and burst detection.
Label-free assessment of red blood cell storage lesions by deep learning
Authors: Doan M. , Sebastian J. A. , Pinto R. N. , McQuin C. , Goodman A. , Wolkenhauer O. , Parsons M. J. , Acker J. P. , Rees P. , Hennig H. , Kolios M. C. , Carpenter A. E. 
Published: January 2018

AbstractBlood transfusion is a life-saving clinical procedure. With millions of units needed globally each year, it is a growing concern to improve product quality and recipient outcomes.Stored red blood cells (RBCs) undergo continuous degradation, leading to structural and biochemical changes. To analyze RBC storage lesions, complex biochemical and biophysical assays are often employed.We demonstrate that label-free imaging flow cytometry and deep learning can characterize RBC morphologies during 42-day storage, replacing the current practice of manually quantifying a blood smear from stored blood units. Based only on bright field and dark field images, our model achieved 90% accuracy in classifying six different RBC morphologies associated with storage lesions versus human-curated manual examination. A model fitted to the deep learning-extracted features revealed a pattern of morphological changes within the aging blood unit that allowed predicting the expiration date of stored blood using solely morphological assessment.Deep learning and label-free imaging flow cytometry could therefore be applied to reduce complex laboratory procedures and facilitate robust and objective characterization of blood samples.
DNA methylation mediates genetic liability to non-syndromic cleft lip/palate
Authors: Howe Laurence J , Richardson Tom G , Arathimos Ryan , Alvizi Lucas , Passos-Bueno Maria-Rita , Stanier Philip , Nohr Ellen , Ludwig Kerstin U , Mangold Elisabeth , Knapp Michael , Stergiakouli Evie , St Pourcain Beate , Davey Smith George , Sandy Jonathan , Relton Caroline L , Lewis Sarah J , Hemani Gibran , Sharp Gemma C 
Published: January 2018

AbstractBackgroundNon-syndromic cleft lip/palate (nsCL/P) is a complex trait with genetic and environmental risk factors. Around 40 distinct genetic risk loci have been identified for nsCL/P, but many reside in non-protein-coding regions with an unclear function. We hypothesised that one possibility is that the genetic risk variants influence susceptibility to nsCL/P through gene regulation pathways, such as those involving DNA methylation.MethodsUsing nsCL/P Genome-wide association study summary data and methylation data from four studies, we used Mendelian randomization and joint likelihood mapping to identify putative loci where genetic liability to nsCL/P may be mediated by variation in DNA methylation in blood.ResultsThere was evidence at three independent loci, VAX1 (10q25.3), LOC146880 (17q23.3) and NTN1 (17p13.1), that liability to nsCL/P and variation in DNA methylation might be driven by the same genetic variant. Follow up analyses using DNA methylation data, derived from lip and palate tissue, and gene expression catalogues provided further insight into possible biological mechanisms.ConclusionsGenetic variation may increase liability to nsCL/P by influencing DNA methylation and gene expression at VAX1, LOC146880 and NTN1.
Unsupervised embedding of single-cell Hi-C data
Authors: Liu Jie , Yardımcı Galip Gürkan , Lin Dejun , Noble William Stafford 
Published: January 2018

AbstractSingle-cell Hi-C (scHi-C) data promises to enable scientists to interrogate the 3D architecture of DNA in the nucleus of the cell, studying how this structure varies stochastically or along developmental or cell cycle axes. However, Hi-C data analysis requires methods that take into account the unique characteristics of this type of data. In this work, we explore whether methods that have been developed previously for the analysis of bulk Hi-C data can be applied to scHi-C data. In this work, we apply methods designed for analysis of bulk Hi-C data to scHi-C data in conjunction with unsupervised embedding. We find that one of these methods, HiCRep, when used in conjunction with multidimensional scaling (MDS), strongly outperforms three other methods, including a technique that has been used previously for scHi-C analysis. We also provide evidence that the HiCRep/MDS method is robust to extremely low per-cell sequencing depth, that this robustness is improved even further when high-coverage and low-coverage cells are projected together, and that the method can be used to jointly embed cells from multiple published datasets.
Brownies & Downies: coffee, culture and community: a social innovation that supports the intellectually disabled
Authors: Marks Jonathan , Hidden Karen 
Published: January 2018

Subject area
Entrepreneurship; Social entrepreneurship.

Study level/applicability
Graduate level.

Case overview
This paper, The Brownies & Downies case study, aims to examine a social enterprise that provides employment, training and job placements for people with intellectual disability within a trendy artisanal coffee shop in Cape Town, South Africa. The business is based on a similar establishment (same name) in The Netherlands and was brought to Cape Town by Wendy Vermeulen, a Dutch national who completed a social development internship in Cape Town. The case is located within the field of social enterprise with a particular focus on the tension between purpose and profit and the pressure and challenges of replication, growth and scale/expansion. The protagonist in the case is Wade Schultz, Wendy’s business partner, who is grappling with how to not only remain true to the social purpose of the business but also turn a profit in the pressured and competitive coffee industry. He is further challenged by deciding whether to expand the existing training business into other sectors or seek a replication model in other South African cities as a means of growing revenue and increasing the social impact.

Expected learning outcomes
The key learning from this case study are as follows: First, intellectual disability is a hidden form of disability, often misunderstood and subject to prejudice and discriminatory hiring practices. Intellectual disability exists on a scale – some individuals are able to work outside of pretexted or sheltered workspaces. Greater effort is required within open workplaces to sensitive staff to working with/alongside intellectually disabled people. This case illustrates a social enterprise model that seeks to bridge the gap between sheltered workspaces and open workspaces. Second, most social enterprises grapple with the tension between profit and purpose; this case presents a company that is living this dilemma. The importance of remaining true to purpose needs to be balanced carefully against becoming economically self-sufficient; however, the pursuit of profits should not happen at the cost of social mission. Alternate business models are a mechanism to building revenue to support the social objective.

Supplementary materials
Teaching Notes are available for educators only. Please contact your library to gain login details or email support@emeraldinsight.com to request teaching notes.

Subject code
CSS: 3: Entrepreneurship.