bluuebunny/crossref_metadata_2025_split huggingface dataset:
Beyond Borders: Global Nursing Education for the Future
Authors: Ortega Johis , Mitchell Emma McKim , Peragallo Nilda 
Published: August 2015

Abstract
Most articles on nursing student study abroad experiences are one-sided case studies focusing on students and faculty from developed countries who travel to less developed countries. This article presents the perspectives of students from theUnited States, Chile, Mexico, and Taiwan, both sides of the international exchange experience. Students described the real-world, hands-on experience of immersion in a different health system and professional culture as transformational and having a significant impact on their nursing career goals. In an era of increasing globalization, cross-cultural experiences have great potential for nursing students on both sides of the exchange.
Female Adolescent With Quadricuspid Aortic Valve
Authors: Choji Cam Long , Selvaraj Nemalan , Prather John 
Published: August 2015

Abstract
Quadricuspid aortic valve is a rare congenital heart defect. The authors present a case of this anomaly in a young, asymptomatic adolescent who presented to the echocardiography laboratory for further evaluation of a cardiac murmur detected on routine physical examination. Imaging revealed a quadricuspid aortic valve with aortic regurgitation. This case highlights the importance of auscultation in detecting cardiac abnormalities.
A Bedside Risk Calculator to Preoperatively Distinguish Follicular Thyroid Carcinoma from Follicular Variant of Papillary Thyroid Carcinoma
Authors: Englum Brian R. , Pura John , Reed Shelby D. , Roman Sanziana A. , Sosa Julie A. , Scheri Randall P. 
Published: August 2015

AbstractBackgroundFollicular thyroid carcinoma (FTC) and follicular variant of papillary thyroid carcinoma (FV‐PTC) are difficult entities to distinguish based on cytology prior to pathologic evaluation of surgical specimens but may have different treatment algorithms. The current study describes trends in rates of FTC versus FV‐PTC in the U.S. and develops a risk assessment tool to aid clinicians in predicting final diagnosis and shaping treatment plans.MethodsRelative rates of FTC and FV‐PTC in the surveillance, epidemiology, and end results (SEER) database were evaluated for temporal trends from 1988 to 2011. Using multivariable logistic regression, a simplified scoring system was developed to estimate the risk of FTC versus FV‐PTC using patient and tumor characteristics. The National Cancer Data Base was used for model validation.Results and DiscussionOf 115,091 thyroid cancer cases in the SEER database from 1988 to 2011, 23,980 involved FTC (n = 5056; 21 %) or FV‐PTC (n = 18,924; 79 %). In 1988, half of follicular cases were FV‐PTC; however, FV‐PTC accounted for over 85 % of these lesions by 2010. Increasing age >45 years, male gender, black race, increasing tumor size, and distant metastases were strongly associated with increased risk of FTC, while lymph node disease and extrathyroidal extension were associated with FV‐PTC. A bedside risk assessment nomogram using these preoperative variables classified patient risk of FTC from 2 to 70 %. FV‐PTC has become the dominant malignancy with follicular cytology, accounting for >85 % of these cases. A simple bedside risk assessment tool can risk stratify patients with follicular lesions and inform patient and clinician discussions and decision making.
A Comparative Validation of Primary Surgical Versus Post‐neo‐adjuvant Chemotherapy Sentinel Lymph Node Biopsy for Stage III Breast Cancers
Authors: Agarwal Gaurav , Rajan Sendhil , Gambhir Sanjay , Lal Punita , Krishnani Narendra , Kheruka Subhash 
Published: August 2015

AbstractIntroductionSentinel lymph node biopsy (SLNB) is the standard of care for staging N0 primary early breast cancers (EBC). Patients in developing countries mostly present with large (LOBC) or locally advanced cancers (LABC) and are treated with neo‐adjuvant chemotherapy (NACT). Accuracy of SLNB in staging stage III N0 and post‐NACT N0 patients is uncertain. This prospective validation study on LOBC/LABC patients compared the accuracy of SLNB between primary versus post‐NACT surgery.Materials and methodsFifty T3/T4, N0 patients undergoing primary surgery (Group I) and 70 LOBC/LABC (index stage) treated with NACT and N0 at the time of surgery (Group II) were inducted. Validation SLNB was performed using low‐cost methylene‐blue and 99mTc‐Antimony colloid. SLN identification (IR) and false‐negative (FNR) rates were compared between the groups. Sub‐group analysis was done in Group II per index tumor and nodal stage to identify factors predicting SLN IR and FNR in post‐NACT patients. SLN IR and FNR in both groups were compared with those in previously published SLN validation study and meta‐analysis in EBC.ResultsUsing combination of blue‐dye and radio‐colloid, post‐NACT SLN IR and FNR (82.9, 13.5 %) were far inferior to T3/T4 primary surgery group (94, 7.7 %; p values 0.034, 0.041) and in EBC. SLN IR using blue‐dye alone was dismally low in post‐NACT LABCs. Factors predicting unidentified post‐NACT SLN and false‐negative SLNB included young age, LVI, skin infiltration, extra‐nodal spread or N2a stage, and UOQ tumors.ConclusionsAccuracy of SLNB in T3, N0 tumors undergoing primary surgery is comparable to that of SLNB for N0 EBC. In post‐NACT patients, SLNB IR are lower and FNR are higher. Factors predictive of non‐identification and false‐negative SLNB include pre‐NACT skin involvement (T4b), N2a stage or extra‐nodal invasion and LVI, and to a lesser extent, young age and UOQ location of the tumor.
Clinical Issues‐September 2015
Authors: Van Wicklin Sharon A. , Brubaker Scott A. 
Published: August 2015

This MonthSurgical wound classificationKey words: wound classification, documentation, surgical site infection.Storing and using small, prefilled containers of formalin in the ORKey words: formalin, formaldehyde, eyewash stations, Occupational Safety and Health Administration.Latex‐free environments for tissue recovery and organ procurement proceduresKey words: allografts, organ donation, tissue recovery, latex sensitivity, latex‐free environment.Covering facial hair in semirestricted and restricted areasKey words: facial hair, beards, surgical masks.Covering ears in semirestricted and restricted areasKey words: ears, pierced earrings, surgical head coverings.
Back to Basics: The Perioperative Surgical Home
Authors: Spruce Lisa 
Published: August 2015

AbstractThe Patient Centered Medical Home (PCMH) is designed to improve care for patients, decrease health care costs, and transform the way in which clinicians deliver primary care. The PCMH is a model for primary care delivery that encompasses comprehensive patient‐centered care that is coordinated across all settings and provides accessible services and community support as needed with shorter wait times, enhanced hours, and around‐the‐clock telephone or electronic access for patient needs. In addition, providers use evidence‐based practice and clinical decision support tools to provide the best possible care to patients. This article discusses how the model originated and provides a how‐to guide and strategies for success in implementing this model of care.
Implementing a Perioperative RN Training Program for Recent Graduates
Authors: Byrd Debra , Mullen Linda , Renfro David , Harris Theodore A. 
Published: August 2015

AbstractIn 2010, nurse educators at one health care facility implemented a new program that emphasized placing new graduates in specialty areas, including the hemodialysis unit, the gastroenterology unit, and the OR. Managers in the OR faced staffing challenges because of the difficulty in recruiting and retaining experienced perioperative nurses and the expected retirement of a significant number of staff members. Surgical services managers agreed to participate in the new graduate program and decided to use AORN's Periop 101™ course and a series of monthly simulation training sessions to supplement the program and provide recently graduated nurses with a strong perioperative nursing foundation. In three years, a total of nine newly graduated RNs successfully completed the program. The three‐year retention rate was 78%.
Survey Analysis of an Ambulatory Surgical Checklist for Patient Use
Authors: Fernando Rohesh J. , Shapiro Fred E. , Urman Richard D. 
Published: August 2015

AbstractAlthough checklists are used as tools for providers, they have not been adequately explored as tools for patients. The purpose of this study was to survey the stakeholders on the usefulness of an ambulatory surgical checklist for patients. We performed a cross‐sectional study through a survey designed to include both patients and providers. Descriptive analysis of the data was performed based on responses from 35 patients and 52 providers. Overall, 94% of patients and 83% of providers thought the checklist would be beneficial for patients. In addition, 37% of providers indicated potential barriers to checklist implementation, including fear of confusing the patient, making patients doubt the care they were receiving, taking too much time, and lack of resources. Based on survey responses, the study suggests that the ambulatory surgical checklist can potentially facilitate patient education, enable more active patient participation, increase patient satisfaction, and decrease patient anxiety.
Oogenesis and Fecundity Type of Gray Triggerfish in the Gulf of Mexico
Authors: Lang Erik T. , Fitzhugh Gary R. 
Published: August 2015

Abstract
The fecundity of Gray Triggerfish Balistes capriscus has been difficult to estimate, as few imminently spawning or recently spawned females have been detected. Our study focused on verifying the pattern of oogenesis and fecundity type in Gray Triggerfish. During 1999–2012, females (n = 1,092) were collected from the eastern Gulf of Mexico, and subsets of these fish were used to calculate condition indices and assess ovarian histology. The gonadosomatic index, hepatosomatic index, and Fulton's condition factor indicated that liver and somatic energy stores increased prior to spawning and were depleted throughout the spawning period, characteristic of a capital pattern of energy storage and allocation to reproduction. Typical of a capital breeding pattern, we also observed (1) a hiatus in oocyte size distribution and (2) group-synchronous oogenesis, which are both traits of a determinate fecundity type. However, evidence that fecundity was not set prior to spawning included the observation of “de novo” vitellogenesis during the spawning season; secondary oocytes increased in number and failed to increase in mean size over time. Thus, Gray Triggerfish exhibit an indeterminate fecundity type with mixed reproductive traits that may characterize species exhibiting female parental care in warmwater environments. Further, we estimated the secondary oocyte growth rate (37 m/d) based upon the time lag of postovulatory follicle (POF) degeneration. Using oocyte growth rate and the proportion of females bearing POFs, the interspawning interval was estimated to range from 8 to 11 d, indicating that 8–11 batches/female could be produced during the estimated 86-d reproductive period. The hiatus in oocyte size distribution was used to define a minimum size (250 m) from which to distinguish an advancing batch of secondary growth oocytes. Batch fecundity (BF) ranged from 0.34 to 1.99 million eggs and was significantly related to FL (mm): BF = 8,703.69·FL – 1,776,483 (r2 = 0.56).
Received October 10, 2014; accepted June 27, 2015
Multi-modality management of craniopharyngioma: a review of various treatments and their outcomes
Authors: Varlotto John , DiMaio Christopher , Grassberger Clemens , Tangel Matthew , Mackley Heath , Pavelic Matt , Specht Charles , Sogge Steven , Nguyen Dan , Glantz Michael , Saw Cheng , Upadhyay Urvashi , Moser Richard , Yunus Shakeeb , Rava Paul , Fitzgerald Thomas , Glanzman Jonathan , Sheehan Jonas 
Published: August 2015

Abstract
Craniopharyngioma is a rare tumor that is expected to occur in ∼400 patients/year in the United States. While surgical resection is considered to be the primary treatment when a patient presents with a craniopharyngioma, only 30% of such tumors present in locations that permit complete resection. Radiotherapy has been used as both primary and adjuvant therapy in the treatment of craniopharyngiomas for over 50 years. Modern radiotherapeutic techniques, via the use of CT-based treatment planning and MRI fusion, have permitted tighter treatment volumes that allow for better tumor control while limiting complications. Modern radiotherapeutic series have shown high control rates with lower doses than traditionally used in the two-dimensional treatment era. Intracavitary radiotherapy with radio-isotopes and stereotactic radiosurgery may have a role in the treatment of recurrent cystic and solid recurrences, respectively. Recently, due to the exclusive expression of the Beta-catenin clonal mutations and the exclusive expression of BRAF V600E clonal mutations in the overwhelming majority of adamantinomatous and papillary tumors respectively, it is felt that inhibitors of each pathway may play a role in the future treatment of these rare tumors.
Adeno-Associated Virus Type 2 Rep68 Can Bind to Consensus Rep-Binding Sites on the Herpes Simplex Virus 1 Genome
Authors: Seyffert Michael , Glauser Daniel L. , Tobler Kurt , Georgiev Oleg , Vogel Rebecca , Vogt Bernd , Agúndez Leticia , Linden Michael , Büning Hildegard , Ackermann Mathias , Fraefel Cornel 
Published: August 2015

ABSTRACT
Adeno-associated virus type 2 is known to inhibit replication of herpes simplex virus 1 (HSV-1). This activity has been linked to the helicase- and DNA-binding domains of the Rep68/Rep78 proteins. Here, we show that Rep68 can bind to consensus Rep-binding sites on the HSV-1 genome and that the Rep helicase activity can inhibit replication of any DNA if binding is facilitated. Therefore, we hypothesize that inhibition of HSV-1 replication involves direct binding of Rep68/Rep78 to the HSV-1 genome.
Intracellular Signaling and Desmoglein 2 Shedding Triggered by Human Adenoviruses Ad3, Ad14, and Ad14P1
Authors: Wang Hongjie , Ducournau Corinne , Saydaminova Kamola , Richter Maximilian , Yumul Roma , Ho Martin , Carter Darrick , Zubieta Chloé , Fender Pascal , Lieber André 
Published: August 2015

ABSTRACTWe recently discovered that desmoglein 2 (DSG2) is a receptor for human adenovirus species B serotypes Ad3, Ad7, Ad11, and Ad14. Ad3 is considered to be a widely distributed human pathogen. Ad3 binding to DSG2 triggers the transient opening of epithelial junctions. Here, we further delineate the mechanism that leads to DSG2-mediated epithelial junction opening in cells exposed to Ad3 and recombinant Ad3 fiber proteins. We identified an Ad3 fiber knob-dependent pathway that involves the phosphorylation of mitogen-activated protein (MAP) kinases triggering the activation of the matrix-metalloproteinase ADAM17. ADAM17, in turn, cleaves the extracellular domain of DSG2 that links epithelial cells together. The shed DSG2 domain can be detected in cell culture supernatant and also in serum of mice with established human xenograft tumors. We then extended our studies to Ad14 and Ad14P1. Ad14 is an important research and clinical object because of the recent appearance of a new, more pathogenic strain (Ad14P1). In a human epithelial cancer xenograft model, Ad14P1 showed more efficient viral spread and oncolysis than Ad14. Here, we tested the hypothesis that a mutation in the Ad14P1 fiber knob could account for the differences between the two strains. While our X-ray crystallography studies suggested an altered three-dimensional (3D) structure of the Ad14P1 fiber knob in the F-G loop region, this did not significantly change the fiber knob affinity to DSG2 or the intracellular signaling and DSG2 shedding in epithelial cancer cells.IMPORTANCEA number of widely distributed adenoviruses use the epithelial junction protein DSG2 as a receptor for infection and lateral spread. Interaction with DSG2 allows the virus not only to enter cells but also to open epithelial junctions which form a physical barrier to virus spread. Our study elucidates the mechanism beyond virus-triggered junction opening with a focus on adenovirus serotype 3. Ad3 binds to DSG2 with its fiber knob domain and triggers intracellular signaling that culminates in the cleavage of the extracellular domain of DSG2, thereby disrupting DSG2 homodimers between epithelial cells. We confirmed this pathway with a second DSG2-interacting serotype, Ad14, and its recently emerged strain Ad14P1. These new insights in basic adenovirus biology can be employed to develop novel drugs to treat adenovirus infection as well as be used as tools for gene delivery into epithelial tissues or epithelial tumors.
Unique Determinants of Neuraminidase Inhibitor Resistance among N3, N7, and N9 Avian Influenza Viruses
Authors: Song Min-Suk , Marathe Bindumadhav M. , Kumar Gyanendra , Wong Sook-San , Rubrum Adam , Zanin Mark , Choi Young-Ki , Webster Robert G. , Govorkova Elena A. , Webby Richard J. 
Published: August 2015

ABSTRACTHuman infections with avian influenza viruses are a serious public health concern. The neuraminidase (NA) inhibitors (NAIs) are the frontline anti-influenza drugs and are the major option for treatment of newly emerging influenza. Therefore, it is essential to identify the molecular markers of NAI resistance among specific NA subtypes of avian influenza viruses to help guide clinical management. NAI-resistant substitutions in NA subtypes other than N1 and N2 have been poorly studied. Here, we identified NA amino acid substitutions associated with NAI resistance among influenza viruses of N3, N7, and N9 subtypes which have been associated with zoonotic transmission. We applied random mutagenesis and generated recombinant influenza viruses carrying single or double NA substitution(s) with seven internal genes from A/Puerto Rico/8/1934 (H1N1) virus. In a fluorescence-based NA inhibition assay, we identified three categories of NA substitutions associated with reduced inhibition by NAIs (oseltamivir, zanamivir, and peramivir): (i) novel subtype-specific substitutions in or near the enzyme catalytic site (R152W, A246T, and D293N, N2 numbering), (ii) subtype-independent substitutions (E119G/V and/or D and R292K), and (iii) substitutions previously reported in other subtypes (Q136K, I222M, and E276D). Our data show that although some markers of resistance are present across NA subtypes, other subtype-specific markers can only be determined empirically.IMPORTANCEThe number of humans infected with avian influenza viruses is increasing, raising concerns of the emergence of avian influenza viruses resistant to neuraminidase (NA) inhibitors (NAIs). Since most studies have focused on NAI-resistance in human influenza viruses, we investigated the molecular changes in NA that could confer NAI resistance in avian viruses grown in immortalized monolayer cells, especially those of the N3, N7, and N9 subtypes, which have caused human infections. We identified not only numerous NAI-resistant substitutions previously reported in other NA subtypes but also several novel changes conferring reduced susceptibility to NAIs, which are subtype specific. The findings indicate that some resistance markers are common across NA subtypes, but other markers need to be determined empirically for each subtype. The study also implies that antiviral surveillance monitoring could play a critical role in the clinical management of influenza virus infection and an essential component of pandemic preparedness.
Type I Interferons Triggered through the Toll-Like Receptor 3–TRIF Pathway Control Coxsackievirus A16 Infection in Young Mice
Authors: Yang Juhao , Yang Chunfu , Guo Nining , Zhu Kai , Luo Kaiming , Zhang Na , Zhao Hui , Cui Ying , Chen Lei , Wang Hongyang , Gu Jun , Ge Baoxue , Qin Cheng-Feng , Leng Qibin 
Published: August 2015

ABSTRACTCoxsackievirus A16 (CVA16) is one of the major etiological agents of hand, foot, and mouth disease (HFMD) in children. The host defense mechanisms against CVA16 infection remain almost entirely unknown. Unlike previous observations with enterovirus 71 (EV71) infection, here we show that gamma interferon (IFN-γ) or invariant NK T cell deficiency does not affect disease development or the survival of CVA16-infected mice. In contrast, type I interferon receptor deficiency resulted in the development of more severe disease in mice, and the mice had a lower survival rate than wild-type mice. Similarly, a deficiency of Toll-like receptor 3 (TLR3) and TRIF, but not other pattern recognition receptors, led to the decreased survival of CVA16-infected mice. TLR3-TRIF signaling was indispensable for the induction of type I interferons during CVA16 infection in mice and protected young mice from disease caused by the infection. In particular, TRIF-mediated immunity was critical for preventing CVA16 replication in the neuronal system before disease occurred. IFN-β treatment was also found to compensate for TRIF deficiency in mice and decreased the disease severity in and mortality of CVA16-infected mice. Altogether, type I interferons induced by TLR3-TRIF signaling mediate protective immunity against CVA16 infection. These findings may shed light on therapeutic strategies to combat HFMD caused by CVA16 infection.IMPORTANCEHand, foot, and mouth disease (HFMD) is a major threat to public health in the Asia-Pacific region. Both CVA16 and EV71 are major pathogens that are responsible for HFMD. The majority of research efforts have focused on the more virulent EV71, but little has been done with CVA16. Thus far, host immune responses to CVA16 infection have not yet been elucidated. The present study discovered an initial molecular mechanism underlying host protective immunity against CVA16 infection, providing the first explanation for why CVA16 and EV71 cause different clinical outcomes upon infection of humans. Therefore, different therapeutic strategies should be developed to treat HFMD cases caused by these two viruses.