bluuebunny/crossref_metadata_2025_split huggingface dataset:
Applying Situational Leadership to Redeployment Duties During COVID-19: Lessons Learned
Authors: Nonaillada Jeannine , Martin Rob Armstrong 
Published: February 2022

Background and Objectives:
In March 2020, the coronavirus disease-2019 (COVID-19) pandemic caused many disruptions to usual operations and demands in excess of normal capacity at NYU Langone Hospital Long Island and NYU Long Island School of Medicine. Significant increases in volume of critically ill patients necessitated hospital administrators to redeploy faculty physicians and other staff to support other areas as a way of exercising option value. This commentary describes our experiences as 2 medical school deans and teaching professors where we recently applied the model of situational leadership during our redeployment as unit clerks on newly-created COVID patient care units at the height of the COVID-19 pandemic in our local area. Our experience yielded personal feelings of accomplishment and allowed us to exercise nonlinear thinking, which we believe contributed to greater staff operational efficiency, using principles of situational leadership during these hospital redeployment initiatives.

Key Takeaways:
Situational leadership is an effective management model for hospital academic leaders who are not routinely in clinical operations to initiate in emergency conditions when unprecedented working scenarios and feelings of staff uncertainty are occurring, while option value is being exercised with faculty/staff redeployment. Our experience led to increased self-actualization. We provide recommendations to health care administrators on how to better prepare for future faculty/staff redeployments in the hospital.
Addressing Maternal Depression Through Home Visiting: One State's Experience With a Breakthrough Series Collaborative
Authors: Fifolt Matthew , Johnson Heather H. , Preskitt Julie , Enlow Margaret , Tullier Dianna , Arbour MaryCatherine 
Published: February 2022

Background and Objectives:
From 2013 to 2017, a national Breakthrough Series (BTS) collaborative in Maternal, Infant, and Early Childhood Home Visiting programs developed a toolkit that led to improvements in maternal depression outcomes. In 2018, Alabama's home visiting program (First Teacher) aimed to reproduce these impacts with a state-led BTS that enrolled 8 local implementing agencies (LIAs) serving more than 500 families.

Methods:
LIAs tested changes in practices using Plan-Do-Study-Act cycles and tracked data regarding depression screening, referrals, service access, and symptom improvement via run charts. First Teacher administered a post-collaborative survey to assess LIA team members' satisfaction with their BTS experience.

Results:
Alabama's BTS resulted in positive shifts in maternal depression referrals, service access, and symptom improvement. Change ideas that supported these shifts included the use of a screening script, motivational interviewing, “Mothers and Babies,” and a registry. LIAs noted that BTS tools and resources helped build capacity to address the difficult and frequently stigmatized topic of maternal depression.

Conclusion:
Findings from this study indicate that evidence- and experience-based practices regarding maternal depression screening, referrals, and service access can lead to symptom improvement among mothers enrolled in a state-based home visiting program. Results of this investigation corroborate findings from previous studies while also incorporating feedback from LIAs about the BTS experience.
Optimizing Aesthetics in Reconstructive Breast Surgery Using Muscle-Sparing Latissimus Dorsi Flap in Radiated and Nonradiated Patients
Authors: Gal Shaili , Movassaghi Kiya 
Published: February 2022

Background
The latissimus dorsi musculocutaneous flap (LDMF) has been a workhorse for breast reconstruction. Its high rate of donor-site morbidity has led to the advent of the muscle-sparing latissimus dorsi flap (MSLDF). However, there are very limited reports using the MSLDF in irradiated patients. Prior studies of MSLDF have either precluded previously radiated patients from receiving MSLDF or have included them as part of their larger MSLSDF cohort without specifically analyzing their outcome as a separate group or comparing them to the traditional LDMF group.

Objective
We describe the technique and outcome of MSLDF in both radiated and nonradiated patients and compare the outcome to our LDMF patients.

Methods
A retrospective chart review of patients undergoing breast reconstruction between 2003 and 2020 using either a pedicled MSLDF or LDMF with a transverse skin paddle was conducted. All patients underwent a 2-stage reconstruction with the flap and tissue expander placement done during the first stage, and replacement with implant and, if needed, fat grafting to enhance soft tissue during the second stage. Complications, subjective functional morbidity, and aesthetic outcomes were reviewed.

Results
A total of 35 MSLDFs and 40 LDMFs were performed: 24 MSLDFs (69%) and 25 LDMFs (63%) were inset into a previously irradiated field. There were 2 cases of infection requiring explantation in both MSLDF (8.3%) and LDMF (8.0%) radiated cohorts. There were no cases of donor-site seroma in the MSLDF cohorts versus 12 (30%) in the LDMF cohorts. Minor distal tip superficial epidermolysis was seen in 5 MSLDFs (14.3%), 3 of which were in the radiated cohort, and in 1 LDMF (2.5%) radiated cohort with no cases of flap loss. Functional and aesthetic outcomes were satisfactory. Four patients who had a unilateral MSLDF had a completion upper back lift.

Conclusions
This is the largest series to date demonstrating the use of the MSLDF in both nonradiated and radiated patients and comparing it to a standard LDMF for breast reconstruction by the same surgeon. The pedicled MSLDF is a versatile option for breast reconstruction in radiated patients, and radiation should not be considered a contraindication for its use.
A Comparison Between Immediate and Babysitter Deep Inferior Epigastric Perforator Flap Breast Reconstruction in Postoperative Outcomes
Authors: Huang Hao , Chadab Tara M. , Wang Marcos Lu , Norman Sofya , Cohen Leslie E. , Otterburn David M. 
Published: February 2022

Background
Delayed-immediate, or “babysitter,” deep inferior epigastric perforator (DIEP) flap reconstruction, defined as immediate tissue expander or implant placement at the time of mastectomy followed by eventual exchange for DIEP flap, is becoming increasingly popular in breast cancer patients anticipated to receive adjuvant radiotherapy. In this study, we aim to compare delayed-immediate to immediate DIEP flap patients in postoperative outcomes including major complications and surgical site morbidity.

Methods
A retrospective cohort study between immediate and delayed-immediate DIEP flap patients was performed. Patient demographics, comorbidities, and preoperative cancer treatment were compared between the 2 cohorts. Clinical outcomes of interest included dehiscence, necrosis, and infection of the breast, abdomen, and umbilicus in the 90-day postoperative period as well as breast hematoma, anastomotic failure, flap loss, and venous thromboembolism.

Results
Of the 248 patients (443 breasts) included in this study, 193 women (344 breasts) and 55 women (99 breasts) were in the immediate and delayed-immediate cohorts, respectively. The 2 cohorts were comparable in age, body mass index, and comorbidities (P > 0.05). Despite significantly higher rates of preoperative cancer treatment (P < 0.05), delayed-immediate patients were not at an elevated risk for major complications. The 2 cohorts were also comparable in surgical site outcomes, with the exception of breast skin necrosis, which was significantly higher in incidence in the immediate cohort (16.0% vs 2.0%, P < 0.001).

Conclusions
This study is the first to directly compare delayed-immediate to immediate DIEP flap reconstruction in postoperative outcomes. Our findings show that babysitter DIEP flaps are a safe option for patients, even in those expected to undergo breast irradiation preoperatively.
A Critical Assessment of the Transgender Health Care Workforce in the United States and the Capacity to Deliver Gender-Affirming Bottom Surgery
Authors: Kang Christine O. , Kim Erin , Cuccolo Nicholas , Dagi Alexander , Luther Lauren , Veeramani Anamika , Boskey Elizabeth R. , Lee Bernard , Taghinia Amir H. , Ganor Oren 
Published: February 2022

Background
Gender-affirming surgery is a critical component of transgender health care, but access information is limited. The study aim was to assess workforce capacity to perform gender affirming bottom surgeries (GABSs) in the United States.

Methods
A questionnaire was administered via email, phone call, or fax from February to May 2020 to 86 practices identified as performing GABS by searching 10 Web-based databases with standardized keywords. Questions assessed training capacity, surgical capacity, and surgeon experience.

Results
Thirty-two of 86 practices responded, 20 met the inclusion criteria. Practices were identified in 15 states, with an average 2.4 (SD, 1.3) surgeons performing GABS per year. States with the greatest number of total providers offering GABS were Illinois (n = 21), Texas (n = 10), and Massachusetts (n = 13). No significant correlation between number of GABS types offered and geographic population density (r = −0.40, P = 0.08), or between number of providers and geographic population density (r = 0.19, P = 0.44). Vaginoplasty was most frequently performed, with the longest waitlists and highest number of waitlist additions per month. Phalloplasty was the second most common procedure, and waitlist additions per month exceeded provider capacity to perform the procedure. Most surgeons performing GABS were plastic surgeons and urologists, whereas obstetricians/gynecologists performed the majority of hysterectomies.

Conclusions
This study demonstrated a shortage of providers with requisite training and experience to provide GABS. Although more robust studies are needed to better characterize the relationship between the number of patients seeking GABS and available providers, these findings indicate a need for improved training.
Professionalism of Admitting and Consulting Services and Trauma Patient Outcomes
Authors: Cooper William O. , Hickson Gerald B. , Guillamondegui Oscar D. , Cannon Jeremy W , Charles Anthony G. , Hoth J. Jason , Alam Hasan B. , Tillou Areti , Luchette Frederick A. , Skeete Dionne A. , Domenico Henry J. , Meredith J. Wayne , Brennan Theresa M. H. , Smith Brian P , Kelz Rachel R. , Biesterveld Ben E. , Busuttil Ashley , Jopling Jeffrey K. , Hopkins Joseph R. , Emory Cynthia L. , Sullivan Patricia G. , Martin R. Shayn , Howerton Russell M. , Cryer Henry M. , Davidson Heather A. , Gonzalez Richard P. , Spain David A. 
Published: February 2022

Objective:
To determine whether trauma patients managed by an admitting or consulting service with a high proportion of physicians exhibiting patterns of unprofessional behaviors are at greater risk of complications or death.

Summary Background Data:
Trauma care requires high-functioning interdisciplinary teams where professionalism, particularly modeling respect and communicating effectively, is essential.

Methods:
This retrospective cohort study used data from 9 level I trauma centers that participated in a national trauma registry linked with data from a national database of unsolicited patient complaints. The cohort included trauma patients admitted January 1, 2012 through December 31, 2017. The exposure of interest was care by 1 or more high-risk services, defined as teams with a greater proportion of physicians with high numbers of patient complaints. The study outcome was death or complications within 30 days.

Results:
Among the 71,046 patients in the cohort, 9553 (13.4%) experienced the primary outcome of complications or death, including 1875 of 16,107 patients (11.6%) with 0 high-risk services, 3788 of 28,085 patients (13.5%) with 1 high-risk service, and 3890 of 26,854 patients (14.5%) with 2+ highrisk services (P < 0.001). In logistic regression models adjusting for relevant patient, injury, and site characteristics, patients who received care from 1 or more high-risk services were at 24.1% (95% confidence interval 17.2% to 31.3%; P < 0.001) greater risk of experiencing the primary study outcome.

Conclusions:
Trauma patients who received care from at least 1 service with a high proportion of physicians modeling unprofessional behavior were at an increased risk of death or complications.
Comparative genomic analysis of Staphylococcus aureus isolates associated with either bovine intramammary infections or human infections demonstrates the importance of restriction-modification systems in host adaptation
Authors: Park Soyoun , Jung Dongyun , O’Brien Bridget , Ruffini Janina , Dussault Forest , Dube-Duquette Alexis , Demontier Élodie , Lucier Jean-François , Malouin François , Dufour Simon , Ronholm Jennifer 
Published: February 2022

Staphylococcus aureus

is a major etiological agent of clinical and subclinical bovine mastitis. The versatile and adaptative evolutionary strategies of this bacterium have challenged mastitis control and prevention globally, and the high incidence of

S. aureus

mastitis increases concerns about antimicrobial resistance (AMR) and zoonosis. This study aims to describe the evolutionary relationship between bovine intramammary infection (IMI)-associated

S. aureus

and human pathogenic

S. aureus

and further elucidate the specific genetic composition that leads to the emergence of successful bovine IMI-associated

S. aureus

lineages. We performed a phylogenomic analysis of 187

S

.

aureus

isolates that originated from either dairy cattle or humans. Our results revealed that bovine IMI-associated

S. aureus

isolates showed distinct clades compared to human-originated

S. aureus

isolates. From a pan-genome analysis, 2070 core genes were identified. Host-specific genes and clonal complex (CC)-specific genes were also identified in bovine

S. aureus

isolates, mostly located in mobile genetic elements (MGEs). Additionally, the genome sequences of three apparent human-adapted isolates (two from CC97 and one from CC8), isolated from bovine mastitis samples, may provide an snapshot of the genomic characteristics in early host spillover events. Virulence and AMR genes were not conserved among bovine IMI-associated

S. aureus

isolates. Restriction-modification (R-M) genes in bovine IMI-associated

S. aureus

demonstrated that the Type I R-M system was lineage-specific and Type II R-M system was sequence type (ST)-specific. The distribution of exclusive, virulence, and AMR genes were closely correlated with the presence of R-M systems in

S. aureus

, suggesting that R-M systems may contribute to shaping clonal diversification by providing a genetic barrier to the horizontal gene transfer (HGT). Our findings indicate that the CC or ST lineage-specific R-M systems may limit genetic exchange between bovine-adapted

S. aureus

isolates from different lineages.
Clinical and Non-clinical Proof of Concept Supporting the Development of RJX As an Adjunct to Standard of Care Against Severe COVID-19
Authors: Uckun Fatih M. , Saeed Muhammad , Awili Mustafa , Ozercan Ibrahim H. , Qazi Sanjive , Lee Cynthia , Shibli Adeel , Skolnick Alan W. , Prusmack Alonso , Varon Joseph , Barrera Cesar I.P. , Orhan Cemal , Volk Michael , Sahin Kazim 
Published: February 2022

ABSTRACTBackgroundThe identification of effective strategies capable of reducing the case mortality rate of high-risk COVID-19 is an urgent and unmet medical need. We recently reported the clinical safety profile of RJX, a well-defined intravenous GMP-grade pharmaceutical formulation of anti-oxidant and anti-inflammatory vitamins as active ingredients, in a Phase 1 study in healthy volunteers (ClinicalTrials.govIdentifier:NCT03680105) (Uckun et al., Front. Pharmacol. 11, 594321. 10.3389/fphar.2020.594321). Here we report data from a pilot clinical study (RPI-015) which examined the safety, tolerability, and feasibility of using RJX in combination with clinical standard of care (SOC) in hospitalized COVID-19 patients with pneumonia (ClinicalTrials.govIdentifier:NCT04708340). In addition to our early clinical proof of concept (POC) data, we also present non-clinical POC from a mouse model of CRS and ARDS that informed the design of the reported clinical study.Methods13 patients, who were hospitalized with COVID-19 pneumonia and abnormally elevated serum inflammatory biomarkers markers ≥3 months prior to the identification of the first confirmed U.S case of the Omicron variant, were treated with IV RJX (daily x 7 days) plus SOC. Non-clinical POC study examined the ability of RJX plus dexamethasone (DEX) to improve the survival outcome in the lipopolysaccharide (LPS)-Galactosamine (GalN) mouse model of fatal cytokine release syndrome (CRS), sepsis and acute respiratory distress syndrome (ARDS).FindingsIn the Phase 1 clinical study, none of the 13 patients developed a treatment-related DLT, SAE, or Grade 3-5 AEs. Nine (9) of the 12 evaluable patients, including 3 patients with hypoxemic respiratory failure, showed rapid clinical recovery. In the non-clinical POC study in LPS-GalN challenged mice, the combination of RJX plus DEX was more effective than RJX alone or DEX alone, reversed the CRS as well as inflammatory tissue damage in the lungs and liver, and improved the survival outcome. Taken together, these findings provide the early clinical and non-clinical POC for the development of RJX as an adjunct to the SOC in the multi-modality management of high-risk COVID-19.
TheAmidellaclade in Europe (AmanitaPers.,Basidiomycota:Amanitaceae): clarification of the contentiousAmanita valensand the importance of taxon-specific PCR primers for identification
Authors: Arraiano-Castilho Ricardo , Silva Ana Cristina , Vila-Viçosa Carlos , Castro Mário Rui , Morgado Luís Neves , Oliveira Paulo 
Published: February 2022

AbstractThe species in genusAmanitasectionAmidellaform a well-defined clade, but some taxa remain difficult to discriminate. In particular, the concept ofAmanita valens(E.-J. Gilbert) Bertault remains controversial. To understand the phylogenetic placement of a set of collections from South Portugal with a novel nrDNA barcode, we have obtained nrDNA sequences for previously unassessed type collections. The taxon formerly described asAmanita curtipesf.pseudovalensNeville & Poumarat is interpreted as a separate species,Amanita pseudovalens(Neville & Poumarat) Arraiano-Castilhoet al. comb. et stat. nov., and is genetically indistinct from the Portuguese collections, thus clarifying their taxonomic context. However, our collections are morphologically and ecologically distinct (respectively, ellipsoid to oblong basidiospores and association withCistuson acidic schist soils), and are proposed as a new variety,Amanita pseudovalensvar.tartessianaArraiano-Castilhoet al.. These developments also enable a better diagnosis ofAmidellataxa in Europe, a progress that is most decisive for the late Winter to Spring season collections, and identification keys are proposed. However, the co-occurrence and morphological similarity of the new variety, in comparison with the prized edibleAmanita ponderosaMalençon & Heim, could leave some collections of either taxa unresolved. Thus, a molecular marker approach was developed, to provide a clear and cost-effective identification aid to complement the keys. The proposed diagnostic tools can be applied toward a review of EuropeanAmidellataxa chorology from existing records, conserved materials, and future collections. Evolutionary convergence may contribute to the determination difficulties in theAmidellaclade.
Rock inhibitors target SRSF2 leukemia by disrupting cell mitosis and nuclear morphology
Authors: Su M , Fleisher T , Grosheva I , Bokstad Horev M , Olszewska M , Barr H , Plotnikov A , Carvalho S , Moskovich Y , Minden MD , Chapal-Ilani N , Papapetrou EP , Dezorella N , Cheng T , Kaushansky N , Geiger B , Shlush LI 
Published: February 2022

AbstractSpliceosome machinery mutations are common early mutations in myeloid malignancies, however effective targeted therapies against them are still lacking. In the current study, we used an in vitro high-throughput drug screen among four different isogenic cell lines and identified ROCK inhibitors (ROCKi) as selective inhibitors of SRSF2 mutants. ROCKi targeted SRSF2 Mut primary human samples in a xenografts model and were not toxic to mice nor human cells. ROCKi induced mitotic catastrophe through their apparent effects on microtubules and nuclear organization. Transmission electron microscopy revealed that SRSF2 mutations induce deep nuclear indentation and segmentation, driven by microtubule-rich cytoplasmic intrusions, which were exacerbated by ROCKi. The severe nuclear deformation driven by the combination of SRSF2 Mut and ROCKi prevent cells from completing mitosis. These findings shed light on new ways to target SRSF2 and on the role of the microtubule system in SRSF2 Mut cells.
Spatial patterns of biomass change across Finland in 2009–2015
Authors: Haakana Markus , Tuominen Sakari , Heikkinen Juha , Peltoniemi Mikko , Lehtonen Aleksi 
Published: February 2022

ABSTRACTForest characteristics vary largely at the regional level and in smaller geographic areas in Finland. The amount of greenhouse gas emissions is related to changes in biomass and the soil type (e.g. upland soils vs. peatlands). Spatially accurate map data of forests and biomass changes could improve the ability to suggest optimal management alternatives for any patch of land, e.g. in terms of climate change mitigation. In our study, estimating and explaining spatial patterns of biomass change across Finland was the main interest. We analysed biomass changes on different soil and site types on forested land using the Finnish Multi-Source National Forest Inventory (MS-NFI) map layers of the 2009 and 2015 datasets. Silvicultural management and treatment units larger than individual pixels were created by automatic segmentation of the thematic maps. The segmented MS-NFI biomass maps of growing stocks, including above and below ground biomass resulted an average estimate of 77.7 tons ha-1 compared to the national forest inventory estimate of 76.5 tons ha-1 in 2015 for Finland. Forest soil type had a similar effect on average biomass in segmented MS-NFI and NFI data. Despite good regional and country-level results, at the segment level the biomass distributions were narrowed and averaging of biomass estimates was observed. Hence, biomass changes on segments can be considered only approximate values; also, those small differences in average biomass may accumulate when map layers from more than one time point are compared. MS-NFI classification results depend on the satellite images and field data used, causing variation in successive inventories. In addition, to avoid false biomass change observations due to the low growth rate of boreal forests, a six-year study period was set. A kappa of 0.44 was achieved for precision when comparing undisturbed and disturbed forest stands in the Global Forest Cover layer and MS-NFI segmented map, indicating the low ability of the global forest map to identify land cover changes for Finland. The segmented biomass maps provide a useful tool for forest owners to analyse carbon stock changes in their forests and how to affect the amount of carbon by forest management.