bluuebunny/crossref_metadata_2025_split huggingface dataset:
Variation in printed handoff documents: Results and recommendations from a multicenter needs assessment
Authors: Rosenbluth Glenn , Bale James F. , Starmer Amy J. , Spector Nancy D. , Srivastava Rajendu , West Daniel C. , Sectish Theodore C. , Landrigan Christopher P. ,   I‐PASS Study Education Executive Committee
Published: May 2015

BACKGROUNDHandoffs of patient care are a leading root cause of medical errors. Standardized techniques exist to minimize miscommunications during verbal handoffs, but studies to guide standardization of printed handoff documents are lacking.OBJECTIVETo determine whether variability exists in the content of printed handoff documents and to identify key data elements that should be uniformly included in these documents.SETTINGPediatric hospitalist services at 9 institutions in the United States and Canada.METHODSSample handoff documents from each institution were reviewed, and structured group interviews were conducted to understand each institution's priorities for written handoffs. An expert panel reviewed all handoff documents and structured group‐interview findings, and subsequently made consensus‐based recommendations for data elements that were either essential or recommended, including best overall printed handoff practices.RESULTSNine sites completed structured group interviews and submitted data. We identified substantial variation in both the structure and content of printed handoff documents. Only 4 of 23 possible data elements (17%) were uniformly present in all sites' handoff documents. The expert panel recommended the following as essential for all printed handoffs: assessment of illness severity, patient summary, action items, situation awareness and contingency plans, allergies, medications, age, weight, date of admission, and patient and hospital service identifiers. Code status and several other elements were also recommended.CONCLUSIONSWide variation exists in the content of printed handoff documents. Standardizing printed handoff documents has the potential to decrease omissions of key data during patient care transitions, which may decrease the risk of downstream medical errors. Journal of Hospital Medicine 2015;10:517–524. © 2015 Society of Hospital Medicine
Associations between teaching effectiveness scores and characteristics of presentations in hospital medicine continuing education
Authors: Ratelle John T. , Wittich Christopher M. , Yu Roger C. , Newman James S. , Jenkins Sarah M. , Beckman Thomas J. 
Published: May 2015

BACKGROUNDThere is little research regarding characteristics of effective continuing medical education (CME) presentations in hospital medicine (HM). Therefore, we sought to identify associations between validated CME teaching effectiveness scores and characteristics of CME presentations in the field of HM.DESIGN/SETTINGThis was a cross‐sectional study of participants and didactic presentations from a national HM CME course in 2014.MEASUREMENTSParticipants provided CME teaching effectiveness (CMETE) ratings using an instrument with known validity evidence. Overall CMETE scores (5‐point scale: 1 = strongly disagree; 5 = strongly agree) were averaged for each presentation, and associations between scores and presentation characteristics were determined using the Kruskal‐Wallis test. The threshold for statistical significance was set at P < 0.05.RESULTSA total of 277 out of 368 participants (75.3%) completed evaluations for the 32 presentations. CMETE scores (mean [standard deviation]) were significantly associated with the use of audience response (4.64 [0.16]) versus no audience response (4.49 [0.16]; P = 0.01), longer presentations (≥30 minutes: 4.67 [0.13] vs <30 minutes: 4.51 [0.18]; P = 0.02), and larger number of slides (≥50: 4.66 [0.17] vs <50: 4.55 [0.17]; P = 0.04). There were no significant associations between CMETE scores and use of clinical cases, defined goals, or summary slides.CONCLUSIONSTo our knowledge, this is the first study regarding associations between validated teaching effectiveness scores and characteristics of effective CME presentations in HM. Our findings, which support previous research in other fields, indicate that CME presentations may be improved by increasing interactivity through the use of audience response systems and allowing longer presentations. Journal of Hospital Medicine 2015;10:569–573. © 2015 Society of Hospital Medicine
Regional anisotropy of airspace orientation in the lung as assessed with hyperpolarized helium‐3 diffusion MRI
Authors: Komlosi Peter , Altes Talissa A. , Qing Kun , Mooney Karen E. , Miller G. Wilson , Mata Jaime F. , de Lange Eduard E. , Tobias William A. , Cates Gordon D. , Brookeman James R. , Mugler John P. 
Published: May 2015

PurposeTo evaluate regional anisotropy of lung‐airspace orientation by assessing the dependence of helium‐3 (3He) apparent diffusion coefficient (ADC) values on the direction of diffusion sensitization at two field strengths.Materials and MethodsHyperpolarized 3He diffusion‐weighted magnetic resonance imaging (MRI) of the lung was performed at 0.43T and 1.5T in 12 healthy volunteers. A gradient‐echo pulse sequence was used with a bipolar diffusion‐sensitization gradient applied separately along three orthogonal directions. ADC maps, median ADC values, and signal‐to‐noise ratios were calculated from the diffusion‐weighted images. Two readers scored the ADC maps for increased values at lung margins, major fissures, or within focal central regions.ResultsADC values were found to depend on the direction of diffusion sensitization (P < 0.01, except for craniocaudal vs. anteroposterior directions at 1.5T) and were increased at the lateral and medial surfaces for left‐right diffusion sensitization (12 of 12 subjects); at the apex and base (9 of 12), and along the major fissure (8 of 12), for craniocaudal diffusion sensitization; and at the most anterior and posterior lung (10 of 12) for anteroposterior diffusion sensitization. Median ADC values at 0.43T (0.201 ± 0.017, left‐right; 0.193 ± 0.019, craniocaudal; and 0.187 ± 0.017 cm2/s, anteroposterior) were slightly lower than those at 1.5T (0.205 ± 0.017, 0.197 ± 0.017 and 0.194 ± 0.016 cm2/s, respectively; P < 0.05).ConclusionThese findings indicate that diffusion‐weighted hyperpolarized 3He MRI can detect regional anisotropy of lung‐airspace orientation, including that associated with preferential orientation of terminal airways near pleural surfaces. J. MAGN. RESON. IMAGING 2015;42:1777–1782.
Effect of zoledronic acid on spinal fusion outcomes in an ovariectomized rat model of osteoporosis
Authors: Yasen Miersalijiang , Li Xiangqian , Jiang Libo , Yuan Wei , Che Wu , Dong Jian 
Published: May 2015

ABSTRACTTo evaluate the effect of zoledronic acid (ZA) on spinal fusion in ovariectomized (OVX) rats. Female SD rats (n = 50) were OVX or sham‐operated and randomized into five groups: Sham, OVX control, ZOL‐20 (20 µg/kg), ZOL‐100 (100 µg/kg), and ZOL‐500 (500 µg/kg). Eight weeks after OVX, bilateral lumbar spinal fusion was performed using autologous iliac bone with ZA or saline according to the grouping. The lumbar spines were harvested at 8 weeks and subjected to radiographic, manual palpation, micro‐computed tomographic (micro‐CT), and histological analysis. The manual palpation result differed significantly only between the ZOL‐500 (fused: partially fused: not fused, 9:0:0) and OVX control (4:2:3) (p < 0.05). The radiographic scales were also differed significantly only between these two groups. According to the micro‐CT results, the bone volume fraction (BV/TV) were significantly higher in all ZA‐treated groups (54.2%, 65.9%, and 73.6%) than OVX control (43.7%) (p < 0.01). At clinical dose or lower, ZA didn't alter the spinal fusion, but a higher dose increased the spinal fusion rate significantly. This study suggests ZA may have a positive effect on spinal fusion in the presence of osteoporosis, and spinal fusion surgery outcome is not likely to be altered by ZA at clinical dose. © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 33:1297–1304, 2015.
Surgical margins and primary site resection in achieving local control in oral cancer resections
Authors: Varvares Mark A. , Poti Shannon , Kenyon Bianca , Christopher Kara , Walker Ronald J. 
Published: May 2015

Objectives/HypothesisEvaluate effectiveness of resection of oral cavity cancer with a standardized approach for margin evaluation. Primary end points were local control and survival.Study DesignRetrospective, nonrandomized, single institution.MethodsOne hundred eight patients who underwent surgery for oral cancer were evaluated using specific anatomical pathology criteria. Frozen section was performed with the surgeon and pathologist agreeing where on the specimen the frozen sections should be taken in most cases.ResultsNinety‐one patients (84.3%) had frozen sections taken from the specimen, eight from the tumor bed, and nine had none taken at the time of surgery. Overall local recurrence rate was 18.5%, 25% in patients who had margins taken from the tumor bed and 17.6% when taken from the specimen. Twenty‐nine patients had margins ≥5 mm, 53 <5 mm and clear, and 14 positive re‐resected to negative with local recurrence rates of 3.4%, 26.4%, and 28.6%, respectively. The radial distance of the resection margin was shown to have an impact on overall survival (hazard ratio [HR] = 3.59, 95% confidence interval [CI] = 1.12‐11.57), disease‐free survival (HR = 7.00, 95% CI = 1.89‐25.95), and local recurrence‐free survival (HR = 28.80, 95% CI = 3.00–276.82).ConclusionsAssessing margins from the resection specimen rather than the tumor bed consistently predicts local control. There is a statistical improvement in local control, disease‐free, and overall survival with increasing radial margin distance from the tumor, and 5 mm should be agreed upon as the definition of a clear resection margin. Frozen sections can be used to revise positive or close resection margins intraoperatively with improved outcomes.Level of Evidence4. Laryngoscope, 125:2298–2307, 2015
Monomers for Adhesive Polymers, 16 Synthesis of Acidic Dimethacrylates Starting from Thioglycerol
Authors: Catel Yohann , Schörpf Sebastian , Moszner Norbert 
Published: May 2015

AbstractSix novel acidic monomers were synthesized in three to six steps, starting from thioglycerol. Four phosphonic acids, a dihydrogen phosphate, and a bisphosphonic acid were prepared. They were characterized by 1H‐NMR, 13C‐NMR, 31P‐NMR spectroscopy, and by HRMS. Their free radical polymerization was carried out in a water/ethanol solution, using 2,2′‐azobis(2‐methylpropionamidine) dihydrochloride as an initiator. Photopolymerization of these acidic monomers as well as of their corresponding diethyl phosphonates and phosphates was investigated using photo‐DSC. Self‐etch adhesives were formulated and used to mediate a bond between the dental hard tissues and a composite. Dentin and enamel shear bond strength tests showed that each acidic monomer was able to provide a good adhesion. The adhesive based on the bisphosphonic acid monomer led to the best adherence.
Guidelines for the Synthesis of Block Copolymer Particles of Various Morphologies by RAFT Dispersion Polymerization
Authors: Rieger Jutta 
Published: May 2015

This article presents the recent developments of radical dispersion polymerizaton controlled by reversible addition fragmentation chain transfer (RAFT) for the production of block copoly­mer particles of various morphologies, such as core‐shell spheres, worms, or vesicles. It is not meant to be an exhaustive review but it rather provides guidelines for non‐specialists. The article is subdivided into eight sections. After a general introduction, the mechanism of polymerization‐induced self‐assembly (PISA) through RAFT‐mediated dispersion polymerization is presented and the different parameters that control the morphology produced are discussed. The next two sections are devoted to the choice of the monomer/solvent pair and the macroRAFT agent. Afterwards, post‐polymerization morphological order‐to‐order transitions (i.e. morphological transitions triggered by extrinsic stimuli) or order‐to‐disorder transitions (i.e. disassembly of chains) are discussed. Assemblies based on more complex polymer architectures, such as triblock copolymers, are presented next, and finally the possibility to stabilize these structures by crosslinking is reported. The manuscript ends with a short conclusion and an outlook.
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Up to 100% Improvement in Dynamic Nuclear Polarization Solid‐State NMR Sensitivity Enhancement of Polymers by Removing Oxygen
Authors: Le Dao , Ziarelli Fabio , Phan Trang N. T. , Mollica Giulia , Thureau Pierre , Aussenac Fabien , Ouari Olivier , Gigmes Didier , Tordo Paul , Viel Stéphane 
Published: May 2015

High‐field dynamic nuclear polarization (DNP) has emerged as a powerful technique for improving the sensitivity of solid‐state NMR (SSNMR), yielding significant sensitivity enhancements for a variety of samples, including polymers. Overall, depending upon the type of polymer, the molecular weight, and the DNP sample preparation method, sensitivity enhancements between 5 and 40 have been reported. These promising enhancements remain, however, far from the theoretical maximum (>1000). Crucial to the success of DNP SSNMR is the DNP signal enhancement (εDNP), which is the ratio of the NMR signal intensities with and without DNP. It is shown here that, for polymers exhibiting high affinity toward molecular oxygen (e.g., polystyrene), removing part of the absorbed (paramagnetic) oxygen from the solid‐state samples available as powders (instead of dissolved or dispersed in a solvent) increases proton nuclear relaxation times and εDNP, hereby providing up to a two‐fold sensitivity increase (i.e., a four‐fold reduction in experimental time).
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Generalized finite element approaches for analysis of localized thermo‐structural effects
Authors: Plews J.A. , Duarte C.A. 
Published: May 2015

SummaryThis work addresses computational modeling challenges associated with structures subjected to sharp, local heating, where complex temperature gradients in the materials cause three‐dimensional, localized, intense stress and strain variation. Because of the nature of the applied loadings, multiphysics analysis is necessary to accurately predict thermal and mechanical responses. Moreover, bridging spatial scales between localized heating and global responses of the structure is nontrivial. A large global structural model may be necessary to represent detailed geometry alone, and to capture local effects, the traditional approach of pre‐designing a mesh requires careful manual effort. These issues often lead to cumbersome and expensive global models for this class of problems. To address them, the authors introduce a generalized FEM (GFEM) approach for analyzing three‐dimensional solid, coupled physics problems exhibiting localized heating and corresponding thermomechanical effects. The capabilities of traditional hp‐adaptive FEM or GFEM as well as the GFEM with global–local enrichment functions are extended to one‐way coupled thermo‐structural problems, providing meshing flexibility at local and global scales while remaining competitive with traditional approaches. The methods are demonstrated on several example problems with localized thermal and mechanical solution features, and accuracy and (parallel) computational efficiency relative to traditional direct modeling approaches are discussed. Copyright © 2015 John Wiley & Sons, Ltd.
An efficient binning scheme with application to statistical crack mechanics
Authors: Huq F. , Brannon R. , Graham‐Brady L. 
Published: May 2015

SummaryA computational scheme is developed for sampling‐based evaluation of a function whose inputs are statistically variable. After a general abstract framework is developed, it is applied to initialize and evolve the size and orientation of cracks within a finite domain, such as a finite element or similar subdomain. The finite element is presumed to be too large to explicitly track each of the potentially thousands (or even millions) of individual cracks in the domain. Accordingly, a novel binning scheme is developed that maps the crack data to nodes on a reference grid in probability space. The scheme, which is clearly generalizable to applications involving arbitrary numbers of random variables, is illustrated in the scope of planar deformations of a brittle material containing straight cracks. Assuming two random variables describe each crack, the cracks are assigned uniformly random orientations and non‐uniformly random sizes. Their data are mapped to a computationally tractable number of nodes on a grid laid out in the unit square of probability space so that Gauss points on the grid may be used to define an equivalent subpopulation of the cracks. This significantly reduces the computational cost of evaluating ensemble effects of large evolving populations of random variables. Copyright © 2015 John Wiley & Sons, Ltd.
Propensity score matching and persistence correction to reduce bias in comparative effectiveness: the effect of cinacalcet use on all‐cause mortality
Authors: Gillespie Iain A. , Floege Jürgen , Gioni Ioanna , Drüeke Tilman B. , de Francisco Angel L. , Anker Stefan D. , Kubo Yumi , Wheeler David C. , Froissart Marc ,   on behalf the ARO Steering Committee collaborators
Published: May 2015

AbstractPurposeThe generalisability of randomised controlled trials (RCTs) may be limited by restrictive entry criteria or by their experimental nature. Observational research can provide complementary findings but is prone to bias. Employing propensity score matching, to reduce such bias, we compared the real‐life effect of cinacalcet use on all‐cause mortality (ACM) with findings from the Evaluation of Cinacalcet Therapy to Lower Cardiovascular Events (EVOLVE) RCT in chronic haemodialysis patients.MethodsIncident adult haemodialysis patients receiving cinacalcet, recruited in a prospective observational cohort from 2007–2009 (AROii; n = 10,488), were matched to non‐exposed patients regardless of future exposure status. The effect of treatment crossover was investigated with inverse probability of censoring weighted and lag‐censored analyses. EVOLVE ACM data were analysed largely as described for the primary composite endpoint.ResultsAROii patients receiving cinacalcet (n = 532) were matched to 1790 non‐exposed patients. The treatment effect of cinacalcet on ACM in the main AROii analysis (hazard ratio 1.03 [95% confidence interval (CI) 0.78–1.35]) was closer to the null than for the Intention to Treat (ITT) analysis of EVOLVE (0.94 [95%CI 0.85–1.04]). Adjusting for non‐persistence by 0‐ and 6‐month lag‐censoring and by inverse probability of censoring weight, the hazard ratios in AROii (0.76 [95%CI 0.51–1.15], 0.84 [95%CI 0.60–1.18] and 0.79 [95%CI 0.56–1.11], respectively) were comparable with those of EVOLVE (0.82 [95%CI 0.67–1.01], 0.83 [95%CI 0.73–0.96] and 0.87 [95%CI 0.71–1.06], respectively).ConclusionsCorrecting for treatment crossover, we observed results in the ‘real‐life’ setting of the AROii observational cohort that closely mirrored the results of the EVOLVE RCT. Persistence‐corrected analyses revealed a trend towards reduced ACM in haemodialysis patients receiving cinacalcet therapy. © 2015 The Authors. Pharmacoepidemiology and Drug Safety Published by John Wiley & Sons Ltd.
An integrative approach combining ion mobility mass spectrometry, X‐ray crystallography, and nuclear magnetic resonance spectroscopy to study the conformational dynamics of α1‐antitrypsin upon ligand binding
Authors: Nyon Mun Peak , Prentice Tanya , Day Jemma , Kirkpatrick John , Sivalingam Ganesh N. , Levy Geraldine , Haq Imran , Irving James A. , Lomas David A. , Christodoulou John , Gooptu Bibek , Thalassinos Konstantinos 
Published: May 2015

AbstractNative mass spectrometry (MS) methods permit the study of multiple protein species within solution equilibria, whereas ion mobility (IM)‐MS can report on conformational behavior of specific states. We used IM‐MS to study a conformationally labile protein (α1‐antitrypsin) that undergoes pathological polymerization in the context of point mutations. The folded, native state of the Z‐variant remains highly polymerogenic in physiological conditions despite only minor thermodynamic destabilization relative to the wild‐type variant. Various data implicate kinetic instability (conformational lability within a native state ensemble) as the basis of Z α1‐antitrypsin polymerogenicity. We show the ability of IM‐MS to track such disease‐relevant conformational behavior in detail by studying the effects of peptide binding on α1‐antitrypsin conformation and dynamics. IM‐MS is, therefore, an ideal platform for the screening of compounds that result in therapeutically beneficial kinetic stabilization of native α1‐antitrypsin. Our findings are confirmed with high‐resolution X‐ray crystallographic and nuclear magnetic resonance spectroscopic studies of the same event, which together dissect structural changes from dynamic effects caused by peptide binding at a residue‐specific level. IM‐MS methods, therefore, have great potential for further study of biologically relevant thermodynamic and kinetic instability of proteins and provide rapid and multidimensional characterization of ligand interactions of therapeutic interest.
Protonation states and catalysis: Molecular dynamics studies of intermediates in tryptophan synthase
Authors: Huang Yu‐ming M. , You Wanli , Caulkins Bethany G. , Dunn Michael F. , Mueller Leonard J. , Chang Chia‐en A. 
Published: May 2015

AbstractThe importance of protonation states and proton transfer in pyridoxal 5’‐phosphate (PLP)‐chemistry can hardly be overstated. Although experimental approaches to investigate pKa values can provide general guidance for assigning proton locations, only static pictures of the chemical species are available. To obtain the overall protein dynamics for the interpretation of detailed enzyme catalysis in this study, guided by information from solid‐state NMR, we performed molecular dynamics (MD) simulations for the PLP‐dependent enzyme tryptophan synthase (TRPS), whose catalytic mechanism features multiple quasi‐stable intermediates. The primary objective of this work is to elucidate how the position of a single proton on the reacting substrate affects local and global protein dynamics during the catalytic cycle. In general, proteins create a chemical environment and an ensemble of conformational motions to recognize different substrates with different protonations. The study of these interactions in TRPS shows that functional groups on the reacting substrate, such as the phosphoryl group, pyridine nitrogen, phenolic oxygen and carboxyl group, of each PLP‐bound intermediate play a crucial role in constructing an appropriate molecular interface with TRPS. In particular, the protonation states of the ionizable groups on the PLP cofactor may enhance or weaken the attractions between the enzyme and substrate. In addition, remodulation of the charge distribution for the intermediates may help generate a suitable environment for chemical reactions. The results of our study enhance knowledge of protonation states for several PLP intermediates and help to elucidate their effects on protein dynamics in the function of TRPS and other PLP‐dependent enzymes.