bluuebunny/crossref_metadata_2025_split huggingface dataset:
Knowledge, attitudes, and Expectations of Medical Staff Toward Medical Error Management Policies in Humanitarian Medicine: A Qualitative Study
Authors: Biquet Jean-Marc , Schopper Doris , Sprumont Dominique , Michel Philippe 
Published: November 2020

Background
Patient safety, a major component of quality of care, is now an attribute of health care systems in developed countries at least. Although there is ever more research on this subject in developed countries, humanitarian medicine, mainly implemented in resource-poor countries, has yet to structure its own set of policies and strategies on patient safety and the management of medical errors.

Objectives
We assessed the knowledge, attitudes, and expectations of medical humanitarian staff regarding the development of policies and strategies related to patient safety and medical error management in medical humanitarian action.

Methods
We conducted 36 semistructured interviews with international medical and paramedical staff active in 6 medical humanitarian organizations after having interviewed the medical directors or the person in charge of quality of care and the legal advisors. Interviews were transcribed verbatim and subjected to a thematic analysis.

Results
The interviews confirmed the current absence of clear investments in dealing with safety risks in the selected medical humanitarian organizations. The difficulties experienced by medical staff in reporting medical errors such as blame culture, lack of training, and absence of leadership committed on patient safety are nonspecific. Other arguments are related to the specific conditions of humanitarian settings: coexistence of different medical culture, absence of international or local regulations or external pressures, and great diversity of activities and contexts.

Conclusions
Interviewed staff expressed high expectations of receiving guidance from their organizations and support to adopt clear patient safety and medical error management policies adapted to their complex operational and clinical realities.
Implementing Patient and Family Involvement Interventions for Promoting Patient Safety: A Systematic Review and Meta-Analysis
Authors: Giap Thi-Thanh-Tinh , Park Myonghwa 
Published: November 2020

Objective
The aims of the study were to evaluate and to quantify the effects of patient and family involvement (PFI) interventions on patient safety by synthesizing the available global data.

Methods
Four databases were searched to identify relevant studies that have assessed the impact of PFI on patient safety up to March 2019. Reference lists of potential selected articles were also used to identify additional relevant studies. Effect sizes (ESs) were calculated using random and fixed effects models. Statistical heterogeneity was measured using the I
2 test.

Results
Twenty-two studies met the review criteria. The meta-analysis showed that PFI were beneficial in significantly reducing adverse events (ES = −0.240, P < 0.001), decreasing the length of hospital stay (ES = −0.122, P < 0.001), increasing patient safety experiences (ES = 0.630, P = 0.007), and improving patient satisfaction (ES = 0.268, P = 0.004). However, the PFI interventions did not significantly enhance the perception of patient safety (ES = 0.205, P = 0.09) or the quality of life (ES = 0.057, P = 0.61). Moreover, moderate-to-high heterogeneity was found for all impacts except adverse events (I
2 = 0%) and length of hospital stay (I
2 = 35%). A funnel plot indicated a low degree of publication bias for the adverse event outcome.

Conclusions
The synthesized evidence in this review demonstrates the benefits of PFI for promoting patient safety. However, further studies should extend the research scope to fill the existing gaps for both the type of PFI interventions and the patient safety outcomes.
Catastrophic Human Error in Assisted Reproductive Technologies: A Systematic Review
Authors: Nesbit Carleigh , Blanchette Porter Misty , Esfandiari Navid 
Published: November 2020

Objective
Assisted reproductive technologies (ARTs) are complex processes with multiple and diverse opportunities for human error. Errors in ART are thought to be rare, but can have devastating consequences for patients and their offspring. The objectives of this article are to review known cases of human error in the ART laboratory and suggest preventative strategies.

Methods
We performed a systematic review of the literature in accordance with Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines using PubMed and Google Scholar databases. Studies were eligible for inclusion if they involved known cases of unintentional human error in the ART laboratory. Only full-text articles in English were included. References of the resulted studies were considered for inclusion.

Results
A total of 420 articles were screened and 37 articles were selected for inclusion. These largely included case reports and reviews in the medical and legal literature. Twenty-two adverse events due to human error in the ART laboratory were identified. Eight of these adverse events were the result of the insemination with the wrong sperm, 6 errors lead to the transfer of the wrong embryo, 3 lead to an error in preimplantation genetic testing, and 5 adverse events lead to the failure of gamete and embryo cryostorage.

Conclusions
Since the advent of ART, there have been reports of catastrophic events occurring secondary to human error in the laboratory to include incidents of unintended parentage, and have resulted in the loss of embryos and gametes through cryostorage failure. Proposed solutions include the stringent implementation and adherence to safety protocols, adequate laboratory staffing and training, and novel methods for specimen labeling and tracking. Of utmost importance is having knowledge of these errors and the ability to determine cause so that future events can be prevented.
Labio-facial Necrotizing Fasciitis in a Young Patient
Authors: Lança Maria Leticia de Almeida , Trento Guilherme dos Santos , Santos José Cleveilton dos , Navarro Claudia Maria , Pereira-Filho Valfrido Antônio 
Published: November 2020

Abstract
Necrotizing fasciitis (NF) is an infection of the deeper tissues that results in progressive destruction of muscle fascia and overlying subcutaneous fat. It has a fast and destructive course. Moreover, it is related to immunosuppression and could be fatal. The aim of this study is to report a clinical case of a young patient, without immunosuppression, who developed NF evolution due to an erroneous diagnosis of abscess at the beginning of the disease. Patient was submitted to broad-spectrum antibiotic therapy and aggressive surgical treatment. Adequate treatment led to a satisfactory evolution in a short period of time. Early recognition and adequate treatment are essential for a favorable prognosis.
Lithium for Carbamazepine-Induced Syndrome of Inappropriate Antidiuretic Hormone
Authors: Pham Vicky M. , White Jennifer M. , Gunther Steven R. , Stewart Jonathan T. 
Published: November 2020

Objectives
To examine the effectiveness of low-dose lithium carbonate for managing carbamazepine-induced hyponatremia.

Methods
Single case study in an 88 year old man with bipolar illness and vascular dementia who had failed to respond to other mood stabilizers.

Results
The patient had developed hyponatremia on two separate occasions when treated with carbamazepine. Introduction of low-dose lithium resulted in prompt normalization of serum sodium levels, which was maintained for the subsequent 8 weeks.

Conclusions
Carbamazepine may sometimes be the best or only viable treatment option for patients with bipolar illness or other conditions. When its use is complicated by syndrome of inappropriate ADH, dose reduction and fluid restriction are the simplest options but, if ineffective, addition of lithium may be a feasible, albeit somewhat complicated, alternative.
The impacts of COVID-19 mitigation on dengue virus transmission: a modelling study
Authors: Cavany Sean M , España Guido , Vazquez-Prokopec Gonzalo M , Scott Thomas W , Perkins T Alex 
Published: November 2020

SummaryBackgroundThe COVID-19 pandemic has induced unprecedented reductions in human mobility and social contacts throughout the world. Because dengue virus (DENV) transmission is strongly driven by human mobility, behavioral changes associated with the pandemic have been hypothesized to impact dengue incidence. By discouraging human contact, COVID-19 control measures have also disrupted dengue vector control interventions, the most effective of which require entry into homes.MethodWe used an agent-based model with a realistic treatment of human mobility and vector control to investigate how and why dengue incidence could differ under a lockdown scenario with a proportion of the population sheltered at home.ResultWe found that a lockdown in which 70% of the population sheltered at home led to a small average increase in cumulative DENV infections of up to 10%, depending on the time of year lockdown occurred. Lockdown had a more pronounced effect on the spatial distribution of DENV infections, with higher incidence under lockdown in regions with high mosquito abundance. Transmission was also more focused in homes following lockdown. The proportion of people infected in their own home rose from 54% under normal conditions to 66% under lockdown, and the household secondary attack rate rose from 0.109 to 0.128, a 17% increase. When we considered that lockdown measures could disrupt regular, city-wide vector control campaigns, the increase in incidence was more pronounced than with lockdown alone, especially if lockdown occurred at the optimal time for vector control.DiscussionOur results indicate that an unintended outcome of COVID-19 control measures may be to adversely alter the epidemiology of dengue. This observation has important implications for an improved understanding of dengue epidemiology and effective application of dengue vector control. When coordinating public health responses during a syndemic, it is important to monitor multiple infections and understand that an intervention against one disease may exacerbate another.
Public perceptions of non-adherence to COVID-19 measures by self and others in the United Kingdom
Authors: Williams Simon N , Armitage Christopher J. , Tampe Tova , Dienes Kimberly 
Published: November 2020

ABSTRACTOBJECTIVETo explore the perceptions of non-adherence to COVID-19 policy measures by self and others in the UK, focusing on perceived reasons for non-adherence.DESIGNQualitative study comprising 12 online focus groups conducted between 25th September and 13th November 2020.SETTINGOnline video-conferencingPARTICIPANTS51 UK residents aged 18 and above, reflecting a range of ages, genders and race/ethnicities.RESULTSParticipants reported seeing an increase in non-adherence in others and identified a number of challenges to their own adherence to measures. Thematic analysis identified six main themes related to participants’ reported reasons for non-adherence in self and others: (1) Alert fatigue (2) Inconsistent rules (3) Lack of trust in government (4) Helplessness (5) Resistance and rebelliousness (6) Reduced perception of risk and the prospect of a vaccine. Participants also raised concerns that adherence would be impacted by a desire to socialise over Christmas. Two forms of non-adherence were observed: overt rule- breaking and subjective rule interpretation.CONCLUSIONSAdherence may be improved by: less frequent and clearer information on COVID-19 to reduce alert fatigue; implementing a more unified set of measures within and across countries in the UK; role modelling good adherence by authority figures; exploring ways to mitigate the impact that events like Christmas vaccine ‘breakthroughs’ may have on reducing adherence.
Fighting COVID-19 with Flexible Testing: Models and Insights
Authors: Yu Jiali , Shen Zuo-Jun (Max) 
Published: November 2020

AbstractIncreasing testing capacities plays a substantial role in safely reopening the economy and avoiding a new wave of COVID-19. Pooled testing can expand testing capabilities by pooling multiple individual samples, but it also raises accuracy concerns. In this study, we propose a flexible testing strategy that adopts pooled testing or individual testing according to epidemic dynamics. We identify the prevalence threshold between individual and pooled testing by modeling the expected number of tests per confirmed case. Incorporating an epidemic model, we show pooled testing is more effective in containing epidemic outbreaks and can generate more reliable test results than individual testing because the reliability of test results is relevant to both testing methods and prevalence. Our study is the first to evaluate the interplay between pooled testing and a rapidly evolving outbreak to the best of our knowledge. Our results allay accuracy concerns about pooled testing and provide theoretical supports to empirical studies.
Estimating COVID-19 Virus Prevalence from Records of Testing Rate and Test Positivity
Authors: Everts Arnout JW 
Published: November 2020

ABSTRACTIntroductionPCR testing for COVID-19 is not done at random but selectively on suspected cases. This paper presents a method to estimate a “genuine Virus Prevalence” by quantifying and removing the bias related to selective testing.MethodsData used are from nine (9) neighbouring countries in Western Europe that record similar epidemic trends despite differences in Testing Rate. Regression analysis is used to establish a relationship of declining Test Positivity with increased Testing Rate. By extrapolating this trend to an “infinitely complete” Testing Rate, an unbiased Test Positivity or “genuine Virus Prevalence” is computed. Via pairing of “genuine Virus Prevalence” with Excess-Deaths, a “genuine Infection Fatality Rate (IFR) is also derived.ResultsPeak levels of “genuine Virus Prevalence” were around 0.5 to 2% during the 1st epidemic “wave” (week 10 to week 20) and are approaching similar levels in the ongoing 2nd “wave” (week 34 onward). “Genuine Virus Prevalence” estimates are close to reported Seroprevalence in the studied countries with a correlation coefficient of 0.58. “Genuine” IFR is found comparable to closed-community model IFR. Finally, results of community mass-testing in Slovakia are within the estimated range of “genuine Virus Prevalence”.ConclusionsEstimates of “genuine Virus Prevalence” benchmark favourably to other indications of virus prevalence suggesting the estimation method is robust and potentially deployable beyond this initial dataset of countries. “Genuine Virus Prevalence” curves suggest that during the 1st epidemic “wave”, curve flattening and waning happened at very modest levels of infection spread, either naturally or facilitated by government measures.
Sustained expression of inflammatory monocytes and activated T cells in COVID-19 patients and recovered convalescent plasma donors
Authors: Singh Ravinder , Bajpai Meenu , Yadav Pushpa , Maheshwari Ashish Kumar , Kumar Suresh , Agrawal Sonal , Kumar Jayesh , Md Islam , Mars Jaswinder Singh , Ramakrishna Gayatri , Sarin Shiv K , Trehanpati Nirupma 
Published: November 2020

ABSTRACTIntense monocyte activation and infiltration into the target tissues is the main mechanism of lung injury in SARS CoV2 infection. A reduction in the degree and nature of such cellular responses is expected following recovery. We aimed to investigate the immune responses in severe Covid-19 patients and recovered patients.MethodsSevere COVID-19 patients (n=34) at Lok Nayak Hospital, New Delhi and COVID-19 recovered patients (n=15) from mild disease and considered for convalescent plasma (COPLA) donation at Institute of Liver and Biliary Sciences (ILBS), New Delhi were recruited. We performed a multiplex cytokine bead assay in plasma and detailed multicolour flow cytometric analysis in peripheral blood of both groups and outcomes were compared in both groups and with healthy controls (n=10).ResultsA significant increase in inflammatory markers [MIP1-a, MIP3a, MCP1, MIF, MMP12, ITAC, VEGF-A, and leptin] was observed in severe patients. Non-survivors additionally showed increased IL-6 levels. Despite the sustained expression of MIPs, the recovered patients showed a surge in MCSF and IL-18 levels. Both the groups had increased CCR2, CX3CR1 positive monocytes, low CD8 T cells, APRIL and BAFFR+ve B cells compared with healthy subjects. In conclusion, patients who have recovered and considered for COPLA donations still have compromised immunity with sustained expression of inflammatory monocytes and activated T cells.
Structural requirements for dihydrobenzoxazepinone anthelmintics: actions against medically important and model parasites -Trichuris muris,Brugia malayi,Heligmosomoides polygyrusandSchistosoma mansoni
Authors: Partridge Frederick A , Bataille Carole JR , Forman Ruth , Marriott Amy E , Forde-Thomas Josephine , Häberli Cécile , Dinsdale Ria L , O’Sullivan James DB , Willis Nicky J , Wynne Graham M , Whiteland Helen , Archer John , Steven Andrew , Keiser Jennifer , Turner Joseph D , Hoffmann Karl F , Taylor Mark J , Else Kathryn J , Russell Angela J , Sattelle David B 
Published: November 2020

AbstractNine hundred million people are infected with the soil-transmitted helminthsAscaris lumbricoides(roundworm), hookworm, andTrichuris trichiura(whipworm). However, low single-dose cure rates of the benzimidazole drugs, the mainstay of preventative chemotherapy for whipworm, together with parasite drug resistance, mean that current approaches may not be able to eliminate morbidity from Trichuriasis. We are seeking to develop new anthelmintic drugs specifically with activity against whipworm as a priority, and previously identified a hit series of dihydrobenzoxazepinone (DHB) compounds that block motility ofex vivo Trichuris muris.Here we report a systematic investigation of the structure-activity relationship of the anthelmintic activity of DHB compounds. We synthesised 47 analogues, which allowed us to define features of the molecules essential for anthelmintic action, as well as broadening the chemotype by identification of dihydrobenzoquinolinones (DBQ) with anthelmintic activity. We investigated the activity of these compounds against other parasitic nematodes, identifying DHB compounds with activity againstBrugia malayiandHeligmosomoides polygyrus. We also demonstrated activity of DHB compounds against the trematodeSchistosoma mansoni,a parasite that causes schistosomiasis. These results demonstrate the potential of DHB and DBQ compounds for further development as broad-spectrum anthelmintics.Author summaryAround a billion people are infected by the soil transmitted helminthsAscaris,hookworm and whipworm. In the case of whipworm, the benzimidazole drugs, which are distributed to school children in affected areas, have low cure rates. This means that finding an improved treatment for whipworm is a priority. We previously identified five DHB compounds in a screen for new compounds active against whipworm. Here we systematically dissect these molecules, making 47 modified versions of the compounds. This allowed us to define the features of these compounds that are important for activity against whipworm. We also demonstrate activity of DHB compounds against other parasitic nematodes, and againstSchistosoma mansoni,a trematode parasite. These results show the potential for further development of DHB compounds as broad-spectrum anthelmintics.
SEMITONES: Single-cEll Marker IdentificaTiON by Enrichment Scoring
Authors: Vlot Anna Hendrika Cornelia , Maghsudi Setareh , Ohler Uwe 
Published: November 2020

AbstractIdentification of markers is an essential step in single-cell analytic. Current marker identification strategies typically rely on cluster assignments of cells. Cluster assignment, in particular of development data, is non-trivial, potentially arbitrary and commonly relies on prior knowledge. Yet, cluster uncertainty is not commonly taken into account. In response, we present SEMITONES, a principled method for cluster-free marker identification. We showcase its application on healthy haematopoiesis data as 1) a robust alternative to highly variable gene selection, 2) for marker gene and regulatory region identification, and 3) for the construction of co-enrichment networks that reveal regulators of cell identity.
A Hybrid Cellular-Heterogeneous Catalyst Strategy for the Production of Olefins from Glucose
Authors: Wang Zhen Q. , Song Heng , Hara Noritaka , Park Dae Sung , Kumar Gaurav , Min Yejin , Dauenhauer Paul J. , Chang Michelle C. Y. 
Published: November 2020

AbstractLiving systems provide a promising approach to chemical synthesis, having been optimized by evolution to convert renewable carbon sources such as glucose to an enormous range of small molecules. However, a large number of synthetic structures can still be difficult to obtain solely from cells, such as unsubstituted hydrocarbons. In this work, we demonstrate the use of a hybrid cellular-heterogeneous catalytic strategy to produce olefins from glucose, using a selective hydrolase to generate an activated intermediate that is readily deoxygenated. Using a new family of iterative thiolase enzymes, we have genetically engineered a microbial strain that produces 4.3 ± 0.4 g L−1of fatty acid from glucose with 86% captured as 3-hydroxyoctanoic and 3-hydroxydecanoic acids. This 3-hydroxy substituent serves as a leaving group enabling heterogeneous tandem decarboxylation-dehydration routes to olefinic products on Lewis acidic catalysts without the additional redox input required for enzymatic or chemical deoxygenation of simple fatty acids.