bluuebunny/crossref_metadata_2025_split huggingface dataset:
Older Persons’ and Their Caregivers’ Perspectives and Experiences of Research Participation With Impaired Decision-Making Capacity: A Scoping Review
Authors: Hosie Annmarie , Kochovska Slavica , Ries Nola , Gilmore Imelda , Parker Deborah , Sinclair Craig , Sheehan Caitlin , Collier Aileen , Caplan Gideon A , Visser Mandy , Xu Xiaoyue , Lobb Elizabeth , Sheahan Linda , Brown Linda , Lee Wei , Sanderson Christine R , Amgarth-Duff Ingrid , Green Anna , Edwards Layla , Agar Meera R 
Published: August 2020

Abstract

Background and Objectives
Human research ethics statements support the equitable inclusion of diverse groups. Yet older people are underrepresented in clinical research, especially those with impaired decision-making capacity. The aim of this study was to identify the perspectives and experiences of older persons and their caregivers of research participation with impaired decision-making capacity.

Research Design and Methods
Scoping review of the literature and online sources in January–February 2019 (updated June 2020) according to Joanna Briggs Institute methodology and PRISMA Extension for Scoping Reviews. English-language peer-reviewed research articles and Australian online narratives were included. Data were tabulated and narratively synthesized.

Results
From 4,171 database records and 93 online resources, 22 articles (2000–2019, 82% United States, 16 first authors) and one YouTube webinar (2018) were initially included; updated searches yielded an additional article (2020) and YouTube webinar (2020). Studies were heterogeneous in terminology, methods, and foci, with hypothetical scenarios, quantitative analyses, and examination of proxy consent predominating. Participants (N = 7,331) were older persons (71%), caregivers of older persons with dementia/cognitive impairment (23%), and older persons with dementia/cognitive impairment (6%). Synthesis identified 2 themes: willingness to participate and decision-making approaches.

Discussion and Implications
Research participation by older persons with dementia may be optimized through reducing risks and burdens and increasing benefits for participants, greater consumer input into study development, and shared and supported decision-making. Older persons’ and caregivers’ perspectives and experiences of research participation with impaired decision-making capacity require investigation in a greater range of countries and conditions other than dementia, and dissemination through more varied media.
Modelling high-frequency seismograms at ocean bottom seismometers: effects of heterogeneous structures on source parameter estimation for small offshore earthquakes and shallow low-frequency tremors
Authors: Takemura Shunsuke , Yabe Suguru , Emoto Kentaro 
Published: August 2020

SUMMARY
The source characteristics of offshore seismic events, especially regular (or fast) and slow earthquakes, can provide key information on their source physics and frictional conditions at the plate boundary. Due to strong 3-D heterogeneities in offshore regions, such as those relating to sea water, accretionary prism and small-scale velocity heterogeneity, conventional methods using a 1-D earth model may mis-estimate source parameters such as the duration and radiation energy. Estimations could become severe inaccuracies for small offshore seismic events because high-frequency (&gt;1 Hz) seismograms, which are strongly affected by 3-D heterogeneities, are only available for analysis because of their signal-to-noise ratio. To investigate the effects of offshore heterogeneities on source parameter estimation for small seismic events, we analysed both observed and simulated high-frequency seismograms southeast off the Kii Peninsula, Japan, in the Nankai subduction zone. Numerical simulations of seismic wave propagation using a 3-D velocity structure model clarified the effects of each heterogeneity. Comparisons between observations and model simulations demonstrated that the thick low-velocity accretionary prism has significant effects on high-frequency seismic wave propagation. Especially for shallow low-frequency tremors occurring at depths just below the accretionary prism toe, seismogram durations are significantly broader than an assumed source duration, even for stations with epicentral distances of approximately 10 km. Spindle-shape seismogram envelopes were observed even at such close stations. Our results suggest that incorporating 3-D heterogeneities is necessary for practical estimation of source parameters for small offshore events.
Perspectives and practices of healthcare providers and caregivers on healthcare-associated infections in the neonatal intensive care units of two hospitals in Ghana
Authors: Sunkwa-Mills Gifty , Rawal Lal , Enweronu-Laryea Christabel , Aberese-Ako Matilda , Senah Kodjo , Tersbøl Britt Pinkowski 
Published: August 2020

Abstract
Healthcare-associated infections (HAIs) remain a serious threat to patient safety worldwide, particularly in low- and middle-income countries. Reducing the burden of HAIs through the observation and enforcement of infection prevention and control (IPC) practices remains a priority. Despite growing emphasis on HAI prevention in low- and middle-income countries, limited evidence is available to improve IPC practices to reduce HAIs. This study examined the perspectives of healthcare providers (HPs) and mothers in the neonatal intensive care unit on HAIs and determined the major barriers and facilitators to promoting standard IPC practices. This study draws on data from an ethnographic study using 38 in-depth interviews, four focus group discussions and participant observation conducted among HPs and mothers in neonatal intensive care units of a secondary- and tertiary-level hospital in Ghana. The qualitative data were analysed using a grounded theory approach, and NVivo 12 to facilitate coding. HPs and mothers demonstrated a modest level of understanding about HAIs. Personal, interpersonal, community, organizational and policy-level factors interacted in complex ways to influence IPC practices. HPs sometimes considered HAI concerns to be secondary in the face of a heavy clinical workload, a lack of structured systems and the quest to protect professional authority. The positive attitudes of some HPs, and peer interactions promoted standard IPC practices. Mothers expressed interest in participation in IPC activities. It however requires systematic efforts by HPs to partner with mothers in IPC. Training and capacity building of HPs, provision of adequate resources and improving communication between HPs and mothers were recommended to improve standard IPC practices. We conclude that there is a need for institutionalizing IPC policies and strengthening strategies that acknowledge and value mothers’ roles as caregivers and partners in IPC. To ensure this, HPs should be better equipped to prioritize communication and collaboration with mothers to reduce the burden of HAIs.
A social network analysis approach to group and individual perceptions of child physical activity
Authors: Prochnow Tyler , Patterson Megan S , Umstattd Meyer M Renee 
Published: August 2020

Abstract
Child physical activity (PA) is influenced by social environment. Self-perception and perception of others’ behaviors may impact health behaviors such as PA. This study examines associations between child networks, perception of their own PA and the network’s perception of their PA. Children (n = 89, M age = 10.00, SD = 1.34) at a summer care program reported demographics (54% female; 46% Black), PA, and physical skill competency. Children indicated up to five people they interacted with the most while at the program and how active they perceived each person to be. Multilevel modeling was used to determine significant associations between skill competency, network measures, and child’s perception of their own PA, the network’s perception of their PA, and the absolute difference between the two. Children perceived themselves to be more physically active if they perceived their friends were more physically active. Children who were central in the network and more physically competent were perceived as more active by their peers. Absolute differences between self-reported and network perceived PA were significantly larger for females. This work builds on understanding of how network position may impact child PA perceptions at summer care programs. Implications of these perceptions for PA promotion programs are discussed.
Biomarkers of Crohn’s Disease to Support the Development of New Therapeutic Interventions
Authors: Porter Amy C , Aubrecht Jiri , Birch Chandler , Braun Jonathan , Cuff Carolyn , Dasgupta Suryasarathi , Gale Jeremy D , Hinton Robert , Hoffmann Steven C , Honig Gerard , Linggi Bryan , Schito Marco , Casteele Niels Vande , Sauer John-Michael 
Published: August 2020

Abstract

Background
Currently, 2 coprimary end points are used by health authorities to determine the effectiveness of therapeutic interventions in patients with Crohn’s disease (CD): symptomatic remission (patient-reported outcome assessment) and endoscopic remission (ileocolonoscopy). However, there is lack of accepted biomarkers to facilitate regulatory decision-making in the development of novel therapeutics for the treatment of CD.

Methods
With support from the Helmsley Charitable Trust, Critical Path Institute formed the Crohn’s Disease Biomarkers preconsortium (CDBpC) with members from the pharmaceutical industry, academia, and nonprofit organizations to evaluate the CD biomarker landscape. Biomarkers were evaluated based on biological relevance, availability of biomarker assays, and clinical validation data.

Results
The CDBpC identified the most critical need as pharmacodynamic/response biomarkers to monitor disease activity in response to therapeutic intervention. Fecal calprotectin (FC) and serum C-reactive protein (CRP) were identified as biomarkers ready for the regulatory qualification process. A number of exploratory biomarkers and potential panels of these biomarkers was also identified for additional development. Given the different factors involved in CD and disease progression, a combination of biomarkers, including inflammatory, tissue injury, genetic, and microbiome-associated biomarkers, will likely have the most utility.

Conclusions
The primary focus of the Inflammatory Bowel Disease Regulatory Science Consortium will be development of exploratory biomarkers and the qualification of FC and CRP for IBD. The Inflammatory Bowel Disease Regulatory Science Consortium, focused on tools to support IBD drug development, will operate in the precompetitive space to share data, biological samples for biomarker testing, and assay information for novel biomarkers.
De-escalation of antimicrobial therapy in ICU settings with high prevalence of multidrug-resistant bacteria: a multicentre prospective observational cohort study in patients with sepsis or septic shock
Authors: Routsi Christina , Gkoufa Aikaterini , Arvaniti Kostoula , Kokkoris Stelios , Tourtoglou Alexandros , Theodorou Vassiliki , Vemvetsou Anna , Kassianidis Georgios , Amerikanou Athena , Paramythiotou Elisabeth , Potamianou Efstathia , Ntorlis Kyriakos , Kanavou Angeliki , Nakos Georgios , Hassou Eleftheria , Antoniadou Helen , Karaiskos Ilias , Prekates Athanasios , Armaganidis Apostolos , Pnevmatikos Ioannis , Kyprianou Miltiades , Zakynthinos Spyros , Poulakou Garyfallia , Giamarellou Helen 
Published: August 2020

Abstract

Background
De-escalation of empirical antimicrobial therapy, a key component of antibiotic stewardship, is considered difficult in ICUs with high rates of antimicrobial resistance.

Objectives
To assess the feasibility and the impact of antimicrobial de-escalation in ICUs with high rates of antimicrobial resistance.

Methods
Multicentre, prospective, observational study in septic patients with documented infections. Patients in whom de-escalation was applied were compared with patients without de-escalation by the use of a propensity score matching by SOFA score on the day of de-escalation initiation.

Results
A total of 262 patients (mean age 62.2 ± 15.1 years) were included. Antibiotic-resistant pathogens comprised 62.9%, classified as MDR (12.5%), extensively drug-resistant (49%) and pandrug-resistant (1.2%). In 97 (37%) patients de-escalation was judged not feasible in view of the antibiotic susceptibility results. Of the remaining 165 patients, judged as patients with de-escalation possibility, de-escalation was applied in 60 (22.9%). These were matched to an equal number of patients without de-escalation. In this subset of 120 patients, de-escalation compared with no de-escalation was associated with lower all-cause 28 day mortality (13.3% versus 36.7%, OR 0.27, 95% CI 0.11–0.66, P = 0.006); ICU and hospital mortality were also lower. De-escalation was associated with a subsequent collateral decrease in the SOFA score. Cox multivariate regression analysis revealed de-escalation as a significant factor for 28 day survival (HR 0.31, 95% CI 0.14–0.70, P = 0.005).

Conclusions
In ICUs with high levels of antimicrobial resistance, feasibility of antimicrobial de-escalation was limited because of the multi-resistant pathogens isolated. However, when de-escalation was feasible and applied, it was associated with lower mortality.
Development of a predictive model for retention in HIV care using natural language processing of clinical notes
Authors: Oliwa Tomasz , Furner Brian , Schmitt Jessica , Schneider John , Ridgway Jessica P 
Published: August 2020

Abstract

Objective
Adherence to a treatment plan from HIV-positive patients is necessary to decrease their mortality and improve their quality of life, however some patients display poor appointment adherence and become lost to follow-up (LTFU). We applied natural language processing (NLP) to analyze indications towards or against LTFU in HIV-positive patients’ notes.

Materials and Methods
Unstructured lemmatized notes were labeled with an LTFU or Retained status using a 183-day threshold. An NLP and supervised machine learning system with a linear model and elastic net regularization was trained to predict this status. Prevalence of characteristics domains in the learned model weights were evaluated.

Results
We analyzed 838 LTFU vs 2964 Retained notes and obtained a weighted F1 mean of 0.912 via nested cross-validation; another experiment with notes from the same patients in both classes showed substantially lower metrics. “Comorbidities” were associated with LTFU through, for instance, “HCV” (hepatitis C virus) and likewise “Good adherence” with Retained, represented with “Well on ART” (antiretroviral therapy).

Discussion
Mentions of mental health disorders and substance use were associated with disparate retention outcomes, however history vs active use was not investigated. There remains further need to model transitions between LTFU and being retained in care over time.

Conclusion
We provided an important step for the future development of a model that could eventually help to identify patients who are at risk for falling out of care and to analyze which characteristics could be factors for this. Further research is needed to enhance this method with structured electronic medical record fields.
Computed Tomography Measurements of Sarcopenia Predict Length of Stay in Older Burn Patients
Authors: Romanowski Kathleen S , Fuanga Praman , Siddiqui Sheryar , Lenchik Leon , Palmieri Tina L , Boutin Robert D 
Published: August 2020

Abstract
Sarcopenia and frailty are associated with aging. In older burn patients, frailty has been associated with mortality and discharge disposition, but sarcopenia has not been examined. This study aims to investigate the relationship between frailty and computed tomography (CT)-derived sarcopenia with length of stay and mortality in older burn patients. Burn patients ≥60 years old admitted between 2008 and 2017 who had chest or abdomen CT scans within 1 week of admission were evaluated. Frailty was assessed using the Canadian Study of Health and Aging Clinical Frailty Scale (CFS). Sarcopenia was assessed on CT exams by measuring skeletal muscle index (SMI) of paraspinal muscles at T12 and all skeletal muscles at L3. The relationship between frailty scores and SMI with length of stay (LOS) and mortality was determined using logistic regression. Eighty-three patients (59 men; mean age 70.2 ± 8.5 years) had chest (n = 50) or abdomen (n = 60) CT scans. Mean TBSA = 14.3 ± 14.0%, LOS = 25.8 ± 21.3 days, CFS = 4.36 ± 0.99. Sixteen patients (19.3%) died while in the hospital. CT-derived measurement of SMI at T12 was significantly associated with LOS (P &lt; .05), but not with mortality (P = .561). CT-derived metrics at L3 were not significantly associated with outcomes. CFS was not associated with LOS (P = .836) or mortality (P = .554). In older burn patients, low SMI of the paraspinal muscles at T12 was associated with longer LOS.
Transient Improvement in Erythropoiesis Is Achieved Via the Chaperone AHSP With Early Administration of Propranolol in Burn Patients
Authors: Walczak Julia , Bunn Corinne , Saini Pravesh , Liu Yuk Ming , Baldea Anthony J , Muthumalaiappan Kuzhali 
Published: August 2020

Abstract
Burn patients experience erythropoietin resistant anemia in which early commitment and late maturation of erythroblasts are defective. The authors previously showed that propranolol (Prop) treatment restores erythroid committed progenitors, but terminal maturation remains impaired. Hemoglobinization and maturation occur during terminal erythropoiesis and these processes are aided by an erythroblast intrinsic functional protein called alpha-hemoglobin stabilizing protein (AHSP). The authors evaluated the role of AHSP in PBMC- (peripheral blood mono nuclear cell) derived erythroblasts and the implications of Prop in burn patients. Blood samples were collected at three time points from 17 patients receiving standard burn care (SBC) or Prop. Five healthy volunteers provided control plasma (CP). PBMCs were placed in biphasic cultures with 5% autologous plasma (BP) or CP. Erythroblasts were harvested during mid and late maturation stages; the percentage of AHSP+ erythroblasts, AHSP expression, and relative distribution of reticulocytes and polychromatophilic erythroblasts (PolyE) were determined by cytometry. During the second time point (7–10 days postburn), Prop cohort required 35% less transfusions. At mid maturation, PBMCs from Prop-treated patients cultured in BP had 33% more AHSP+ erythroblasts and 40% more AHSP expression compared with SBC. Furthermore, at late maturation, Prop had 50% more reticulocytes and 30% less PolyEs in CP vs BP compared with SBC (11% and 6%, respectively). AHSP is positively associated with late-stage maturation of PBMC-derived erythroblasts in the presence of CP. Albeit transiently, this is more pronounced in Prop than SBC. Early administration of propranolol in burn patients supports erythropoiesis via the chaperone AHSP.
Myoelectric prosthesis: a potential emerging therapeutic in restoring function post-arm amputation complicated by necrotizing fasciitis
Authors: Adams D’Shaun D , Schwartz-Fernandes Francisco A 
Published: August 2020

AbstractA literature search confirmed no previous cases of an arm amputation secondary to necrotizing fasciitis (NF) being successfully treated with a myoelectric prosthesis. This report explores a case of a 55-year-old right-handed male with flexor tenosynovitis infection of the hand after a small laceration. Following infectious disease consult of the infection, a diagnosis of NF was made. Broad-spectrum antibiotics were initiated but the infection worsened after 12 hours. Two debridements with wound vacuum were undertaken in the next 48 hours. After further patient deterioration, a distal left forearm amputation was undertaken. The patient fully recovered and then underwent occupational therapy training with a myoelectric prosthesis to restore hand function. The patient was seen for follow-up 3, 6, 12 and 24 months after amputation. At 2-year follow-up, the patient was continuing rehabilitation with an occupational therapist to acclimate to the prosthesis with some gain of function in gross movement.
Three-stage approach to resection of left pancoast tumour with spinal and major vessel involvement
Authors: Wallace Alison M , Oreopoulos George D , Rampersaud Yoga R , Waddell Thomas K 
Published: August 2020

Abstract
Here we describe the successful outcome of a complex and challenging resection of a left-sided pancoast tumour involving the left subclavian artery and vertebral bodies. The resection was performed following neoadjuvant chemoradiotherapy in a multi-staged fashion involving multiple teams including thoracic surgery, plastic surgery, neurosurgery and vascular surgery. Each operation was less than 6 h, without complication, and the patient was discharged within 1 week of each procedure. This case report highlights the importance of multidisciplinary team collaboration and planning in order to achieve a successful oncologic outcome and a good quality of life following treatment of these challenging tumours. The patient had a good functional outcome and no evidence of recurrence 1.5 years later.
Reconceptualising the Interest in Knowing One’s Origins: A Case for Mandatory Disclosure
Authors: Wade Katherine 
Published: August 2020

Abstract
The aim of this article is to make a case for mandatory disclosure in assisted reproduction. This refers to a system whereby those who are born through gamete donation and/or surrogacy would be notified about the manner of their birth and the availability of information about their genetic and/or gestational origins. The article argues that, to date, the law has interpreted an individual’s interest in knowing their origins as being predominately about identity. However, the central importance of the principle of autonomy in the conceptualisation of this interest has been overlooked. A reconceptualisation of the interest in knowing one’s origins as being concerned predominantly with autonomy provides a justification for mandatory disclosure. It is argued that the interest of individuals born through assisted reproduction in having autonomous choice regarding the significance of information about their origins should be prioritised over the autonomous choices of parents not to disclose to their offspring the manner of their birth.
An improved parametric method for evaluating radiative accelerations in stellar interiors
Authors: Alecian G , LeBlanc F 
Published: August 2020

ABSTRACT
The single-valued parameter (SVP) method is a parametric method that offers the possibility of computing radiative accelerations in stellar interiors much faster than other methods. It has been implemented in a few stellar evolution numerical codes for about a decade. In this paper, we describe improvements we have recently brought in the process of preparing, from atomic/opacity data bases, the SVP tables that are needed to use the method, and their extension to a larger stellar mass domain (from 1 to 10 solar mass) on the main sequence. We discuss the validity domain of the method. We also present the website from where new tables and codes can be freely accessed and implemented in stellar evolution codes.