bluuebunny/crossref_metadata_2025_split huggingface dataset:
Harm Prevalence Due to Medication Errors Involving High-Alert Medications: A Systematic Review
Authors: Sodré Alves Bárbara Manuella Cardoso , de Andrade Tâmara Natasha Gonzaga , Cerqueira Santos Sabrina , Goes Aline Santana , Santos Adriano da Silva , Lyra Júnior Divaldo Pereira de , de Oliveira Filho Alfredo Dias 
Published: March 2020

Objective
The aim of the study was to determine the prevalence and main types of harm caused by high-alert medication after medication errors (MEs) in hospitals.

Method
A literature systematic review was conducted on PubMed, Scopus, Web of Science, and Lilacs. Eligible studies published until June 2017 were included.

Result
Of 6244 studies identified through searching four electronic databases, five studies meeting the selection criteria of this study were analyzed. There was wide variation in the overall prevalence of harm due to MEs involving HAM, from 3.8% to 100%, whereas the pooled prevalence was 16.3%. Overall, 0.01% of harm caused by MEs involving HAM resulted in death. The severity of errors ranged from 0.1% to 19.2% for moderate errors, 0.2% to 15.4% for serious errors, and 1.9% lethal to the patients. The highest prevalences of harm occurred after errors involving potassium chloride 15%, insulin, and epoprostenol. The lowest prevalence of harm was related to errors of anticoagulants administration. The methodological heterogeneity limited direct comparisons among the studies.

Conclusions
Of the 15 drugs on the list of Institute for Safe Medication Practices HAMs in the United States and Brazil, nine did not present scientific evidence of the potential for harm. In general, few studies, characterized by methodological and conceptual heterogeneity, were performed to determine the harm prevalence resulting from errors involving these drugs.
Prospective, Blinded Evaluation of Template-Based Cesarean Documentation Error in an Obstetric Training Program
Authors: Perez William M. , Babbar Shilpa , Vricella Laura K. 
Published: March 2020

Objective
Cesarean operative report accuracy impacts postoperative care and future obstetric decision-making. The impact of electronic health record template use on cesarean documentation error remains unknown. The aim of the study was to describe the incidence of resident physician documentation error in cesarean operative reports using electronic health record templates.

Methods
Attending physicians completed a standardized audit form after cesarean deliveries, which was compared with the resident operative report. Resident physicians were blinded to the auditing process. Errors were classified as none, major, or minor using predefined definitions. Author and operative characteristics were collected for comparative and predictive analyses. Data were analyzed by presence or absence of error.

Results
We reviewed 100 cesarean operative reports. Major and minor errors were encountered in 33% and 53% of operative notes, respectively. Advancing training level was associated with lower incidence of major error (50%, for postgraduate year [PGY] 1, 33% for PGY 2, and 0% for PGY 3/4, P = 0.02), but minor errors were similar among training level, P = 0.48. Operative duration, documentation interval, and shift characteristics were similar in cases with and without documentation errors. In multiple logistic regression, PGY was predictive of major documentation error (adjusted odds ratio = 0.39, 95% confidence interval = 0.17–0.92).

Conclusions
A high incidence of clinically significant documentation error was observed in a residency training program using standardized templates for cesarean operative reports. Incidence of major error decreased with increasing training, but minor error was similar across levels of training. These data suggest that measures should be taken to improve documentation accuracy in medical training to provide optimal obstetric care.
The Impact of Resident Holdover Admissions on Length of Hospital Stay and Risk of Transfer to an Intensive Care Unit
Authors: Ashana Deepshikha Charan , Chan Vincent K. , Vangala Sitaram , Bell Douglas S. 
Published: March 2020

Objective
Implementation of residency duty hour standards has led to adoption of different staffing models, such as the “holdover” model, whereby nighttime teams admit patients and transfer their care to daytime teams who provide ongoing care. In contrast, nonholdover teams at our institution are responsible for both admitting patients and providing ongoing care. We sought to determine whether patients admitted by holdover teams experience worse outcomes than those admitted by nonholdover teams.

Methods
This is a retrospective cohort study of patients admitted to the internal medicine hospital service at a quaternary care hospital from July 2013 to June 2015. Primary outcomes included hospital length of stay (LOS) and transfer to an intensive care unit within 72 hours of admission. Secondary outcomes were any transfer to an intensive care unit, in-hospital mortality, discharge to home (versus discharge to postacute care facility), and readmission to the health system within 30 days of discharge.

Results
We analyzed 5518 encounters, 64% of which were admitted by a holdover team. Outcomes were similar between study groups, except the LOS, which was 5.5 hours longer for holdover encounters in unadjusted analyses (5.18 versus 4.95 days, P = 0.04) but not significantly different in adjusted analyses. The mean discharge time was 4:00 p.m. for both groups, whereas the mean admission times were 12:00 a.m. and 4:00 p.m. for holdover and nonholdover encounters, respectively.

Conclusions
Holdover encounters at our institution were not associated with worse patient safety outcomes. A small increase in LOS may have been attributable to holdover patients having earlier admission and identical discharge times.
Self-Reported Neurotoxic Symptoms in Hip Arthroplasty Patients With Highly Elevated Blood Cobalt: A Case-Control Study
Authors: Swiatkowska Ilona , Henckel Johann , Sabah Shiraz A. , Hart Alister J. 
Published: March 2020

Objectives
This study aimed to investigate the prevalence of self-reported neurotoxicity and cognitive defects in hip replacement patients with markedly raised blood cobalt.

Methods
Case group comprised 53 patients with metal-on-metal (MoM) implants and a history of blood Co ≥20 μg/L for a median of 3 years (interquartile range, 2–5 years). The control group comprised 53 patients with ceramic-on-ceramic prostheses and blood Co <1 μg/L. Median age was 67 years (interquartile range, 60–74 years). The participants completed the Neurotoxic Symptom Checklist-60, Diabetic Neuropathy Score, Douleur Neuropathique-10, and Systemic Symptom Checklist, and underwent the Mini-Mental State Examination.

Results
The MoM and ceramic-on-ceramic groups were compared, the results were as follows: Neurotoxic Symptom Checklist-60 (median): cognitive defects (2.0 versus 1.9; P = 0.002), chest complaints (1.3 versus 1.3; P = 0.042), balance disturbances (1.3 versus 1.0; P < 0.001), sleep disturbances (2.7 versus 2.0; P = 0.004), mood disorders (2.0 versus 1.5; P = 0.001), sensorimotor disorders (1.6 versus 1.2; P < 0.001), physical complaints (2.0 versus 1.4; P = 0.009), fatigue (2.0 versus 1.6; P = 0.001), and total score (108 versus 90; P < 0.001); abnormal Diabetic Neuropathy Score/Douleur Neuropathique-10 (%): 60.3/13.2 versus 24.5/1.9 (P < 0.001/P = 0.028). Systemic Symptom Checklist (in percent): feeling cold (37.7 versus 17; P = 0.01), weight gain (18.9 versus 1.9; P = 0.008), metallic taste (26.4 versus 3.8; P = 0.002), worsening eyesight (37.7 versus 15.1; P = 0.008) and hearing (24.5 versus 7.5; 0.032), ankle swelling (32.1 versus 7.5; P = 0.002), shortness of breath on exertion (9.4 versus 5.7; P = 0.015), and generalized rash (28.3 versus 7.5; P = 0.01); and Mini-Mental State Examination (median): 29 versus 30 (P = 0.017). Patients in the MoM group were aware of their high cobalt levels and displayed a higher tendency to overreport symptoms (P < 0.001), which could have contributed to the higher scores.

Conclusions
Frequency of reporting a number of symptoms was markedly higher in MoM patients, but clinically significant neurotoxicity was not observed (possibly due to the short exposure to elevated cobalt). Patients with repeated blood Co ≥20 μg/L measurements should be questioned about possible systemic health complaints at follow-up.
Hospital Adverse Event Reporting Systems: A Systematic Scoping Review of Qualitative and Quantitative Evidence
Authors: Estrada-Orozco Kelly , Cantor Cruz Francy , Benavides Cruz Johana , Ruiz-Cardozo Miguel Angel , Suárez-Chacón Andrea Marcela , Cortés Tribaldos Jhon Alexánder , Chaparro Rojas Miguel Alejandro , Rojas Contreras Ricardo Andrés , González-Camargo Juan Esteban , González Berdugo Juan Camilo , Villate-Soto Steffany Lorena , Moreno-Chaparro Jaime , García López Andrea , Aristizábal Robayo María Fernanda , Bonilla Regalado Iván Andrés , Castro Barreto Nathaly Liliana , Ceballos-Inga Leydi , Gaitán-Duarte Hernando 
Published: March 2020

Introduction
Reducing the incidence of reportable events with undesirable effects (REUE) is a priority in the hospital environment, which is why reporting systems have been implemented to identify and manage them. Information is required regarding the performance of reporting systems, barriers, or facilitators for reporting and strategies that improve passive reporting.

Methodology
Systematic scoping review of the literature that included studies performed in the population exposed to the occurrence of REUE in the health system (teams, patients, and family). A search was performed in Cochrane Database of Systematic Reviews, Epistemonikos, MEDLINE (PubMed), MEDLINE In-Process and MEDLINE Daily Update, EMBASE, LILACS, and databases of the World Health Organization and Pan-American Health Organization.

Results
Fifteen studies were found, 1 systematic review, 2 clinical trials, 8 observational studies, 3 qualitative studies, and 1 mixed study. In 4 of them, the effectiveness of active versus passive reporting systems was compared. The measures to improve the passive systems were education about REUE, simplification of the reporting format, activities focused on increasing the motivation for self-report, adoption of self-report as an obligatory institutional policy, and using specific report formats for each service.

Conclusions
There is information that allows to find differences between the performance of the active and passive reporting systems. The reviewed research articles found that passive techniques significantly underreported adverse events. It is recommended that institutions adopt both active and passive techniques in adverse event surveillance. New studies should be directed to answer the comparative efficiency of the reporting systems.
Do Patients and Relatives Have Different Dispositions When Challenging Healthcare Professionals About Patient Safety? Results Before and After an Educational Program
Authors: Rodrigo‐Rincon Isabel , Irigoyen-Aristorena Isabel , Tirapu-Leon Belen , Zaballos-Barcala Nicolás , Sarobe-Carricas Maite , Antelo-Caamaño May , Lobo-Palanco Joaquín , Martin-Vizcaino Marta 
Published: March 2020

Background
There is a universal interest in evaluating the new roles of patients to improve patient safety. However, relatively little is known about the contribution of family caregivers. The purposes of this study was to determine whether patients and relatives (P&Rs) have different dispositions when challenging healthcare professionals about patient safety and to measure the influence of an educational program.

Methods
An interventional before-and-after design was used to determine the P&Rs’ basal level of willingness and the influence of a training program. One hundred thirty-six participants were recruited, 90 patients and 46 relatives, from the Day Hospital of a Tertiary Hospital in Spain, in 2018.
The safe practices selected were as follows: patient identification, hand hygiene, blood or chemotherapy identification, and secondary effects of treatment. The educational materials comprised brochures and story-type videos. A questionnaire measured participants’ willingness to speak up before and after the training.

Results
One hundred thirty-six P&Rs (63% response rate) agreed to participate. The hypothesis that relatives are more willing to challenge healthcare professionals could not be proven. Their willingness to speak up depended on the type of safe practice both before and after training, ranging from 42% to 87%. The percentage of items that P&Rs were willing to challenge increased after the training among both the patients and the relatives, but statically significant differences were only seen among patients.

Conclusions
After the training, participants’ willingness to challenge healthcare workers was high for all safe practices analyzed but hand hygiene. Patients and relatives had very similar willingness. After the training, participants felt confident with their knowledge about safe practices, thereby increasing their challenging attitude.
The Effect of Clinical Volume on Annual and Per-Patient Encounter Medical Malpractice Claims Risk
Authors: Schaffer Adam C. , Babayan Astrid , Yu-Moe Chihwen Winnie , Sato Luke , Einbinder Jonathan S. 
Published: March 2020

Objectives
The relationship between medical malpractice risk and one of the fundamental characteristics of physician practice, clinical volume, remains undefined. This study examined how the annual and per-patient encounter medical malpractice claims risk varies with clinical volume.

Methods
Clinical volume was determined using health insurance charges and was linked at the physician level to malpractice claims data from a malpractice insurer. The annual medical malpractice claims risk was expressed as the percent of physicians with a malpractice claim, and the per-encounter medical malpractice claims risk was expressed as malpractice claims per 1000 patient encounters. Both of these malpractice claims risk metrics were analyzed as a function of clinical volume, using linear and spline regression.

Results
As clinical volume increased, the percent of physicians with a malpractice claim increased linearly. Among all physicians studied, for each decile increase in clinical volume, there was a 0.373% increase in physicians with a malpractice claim (95% confidence interval, 0.301%–0.446%; P < 0.0001). As clinical volume increased, the rate of malpractice claims per 1000 patient encounters decreased. This relationship between clinical volume and per-encounter claims risk was nonlinear. There was a clinical volume threshold, below which decreasing clinical volume was associated with increasing per-encounter claims risk, and above which claims risk no longer significantly varied with increases in clinical volume.

Conclusions
Clinical volume is a crucial determinant of physician malpractice risk, with higher-volume physicians having higher annual risk but lower per-encounter risk. Clinical volume data should be incorporated into analyses of malpractice risk.
Impact of marijuana on venous thromboembolic events: Cannabinoids cause clots in trauma patients
Authors: Stupinski Jack , Bible Letitia , Asmar Samer , Chehab Mohamad , Douglas Molly , Ditillo Michael , Gries Lynn , Khurrum Muhammad , Joseph Bellal 
Published: March 2020

BACKGROUNDTetrahydrocannabinoids (THC) can modulate the coagulation cascade resulting in hypercoagulability. However, the clinical relevance of these findings has not been investigated. The aim of our study was to evaluate the impact of preinjury marijuana exposure on thromboembolic complications (TEC) in trauma patients.METHODSWe performed a 2-year (2015–2016) analysis of American College of Surgeons Trauma Quality and Improvement Program database and included all adult (≥18 year) trauma patients. Patients were stratified based on preinjury exposure to Marijuana: THC + ve and THC −ve groups. We performed propensity score matching to control for confounding variables: demographics, comorbidities, injury parameters, hospital course, and thromboprophylaxis use. Outcomes were TEC (deep venous thrombosis, pulmonary embolism, stroke, myocardial infarction) and mortality.RESULTSOf 593,818 trauma patients, 678 patients were matched (THC + ve: 226 vs. THC −ve: 452). Mean age was 34 ± 15 years, Injury Severity Score was 14 (10–21). There was no difference between the two groups regarding age (p =0.75), sex (p =0.99), Injury Severity Score (p =0.54), spine Abbreviated Injury Scale (AIS) (p =0.61), head AIS (p = 0.32), extremities AIS (p =0.38), use of unfractionated heparin (p =0.54), use of low molecular weight heparin (p = 0.54), and hospital length of stay (p =0.87). Overall, the rate of TEC was 4.3% and mortality was 4%. Patients in THC + ve group had higher rates of TEC compared with those in THC −ve group (3.5% vs. 1.1%,p =0.03). The rate of deep venous thrombosis (6.6% vs. 1.8%,p= 0.02) and PE (2.2% vs. 0.2%,p =0.04) was higher in THC + ve group. However, there was no difference regarding the rate of stroke (p =0.24), myocardial infarction (p= 0.35) and mortality (p =0.28).CONCLUSIONTHC exposure increases the risk of TEC in patients with trauma. Early identification and treatment for TEC is required to improve outcomes in this high-risk subset of trauma patients.LEVEL OF EVIDENCEPrognostic study, level III.
Transmission and reflection at the boundary of a random two-component composite
Authors: Willis J. R. 
Published: March 2020

A half-space
x
2
> 0 is occupied by a two-component statistically uniform random composite with specified volume fractions and two-point correlation. It is bonded to a uniform half-space
x
2
< 0 from which a plane wave is incident. The transmitted and reflected mean waves are calculated via a variational formulation that makes optimal use of the given statistical information. The problem requires the specification of the properties of three media: those of the two constituents of the composite and those of the homogeneous half-space. The complexity of the problem is minimized by considering a model acoustic-wave problem in which the three media have the same modulus but different densities. It is formulated as a problem of Wiener–Hopf type which is solved explicitly in the particular case of an exponentially decaying correlation function. Possible generalizations are discussed in a brief concluding section.
Nanopore-based long-read transcriptome data ofNosema ceranae-infected and un-infected western honeybee workers’ midguts
Authors: Chen Huazhi , Fan Xiaoxue , Du Yu , Fan Yuanchan , Wang Jie , Jiang Haibin , Xiong Cuiling , Zheng Yanzhen , Chen Dafu , Guo Rui 
Published: March 2020

ABSTRACTApis mellifera ligusticais a subspecies of western honeybee,Apis mellifera. Nosema ceranaeis known to cause bee microspodiosis, which seriously affects bee survival and colony productivity. In this article, Nanopore long-read sequencing was used to sequenceN. ceranae-infected and un-infected midguts ofA. m. ligusticaworkers at 7 d and 10 d post inoculation (dpi). In total, 5942745, 6664923, 7100161 and 6506665 raw reads were respectively yielded from AmT1, AmT2, AmCK1 and AmCK2, with average lengths of 1148, 1196, 1178 and 1201 bp, and N50 of 1328, 1394, 1347 and 1388 bp. The length distribution of raw reads from AmT1, AmT2, AmCK1 and AmCK2 was ranged from 1 kb to more than 10 kb. Additionally, the distribution of quality score of raw reads from AmT1 and AmT2 was among Q6∼Q12, while that from AmCK1 and AmCK2 was among Q6∼Q16. Further, 5745048, 6416987, 6928170, 6353066 clean reads were respectively gained from AmT1, AmT2, AmCK1 and AmCK2, and among them 4172542, 4638289, 5068270 and 4857960 were identified as being full-length. After removing redundant reads, the length distribution of remaining full-length transcripts was among 1 kb∼8 kb, with the most abundant length of 2 kb. The long-read transcriptome data reported here contributes to a deeper understanding of the molecular regulatingN. ceranae-response ofA. m. ligusticaand host-fungal parasite interaction during microsporidiosis.
Potent human neutralizing antibodies elicited by SARS-CoV-2 infection
Authors: Ju Bin , Zhang Qi , Ge Xiangyang , Wang Ruoke , Yu Jiazhen , Shan Sisi , Zhou Bing , Song Shuo , Tang Xian , Yu Jinfang , Ge Jiwan , Lan Jun , Yuan Jing , Wang Haiyan , Zhao Juanjuan , Zhang Shuye , Wang Youchun , Shi Xuanling , Liu Lei , Wang Xinquan , Zhang Zheng , Zhang Linqi 
Published: March 2020

AbstractThe pandemic caused by emerging coronavirus SARS-CoV-2 presents a serious global public health emergency in urgent need of prophylactic and therapeutic interventions. SARS-CoV-2 cellular entry depends on binding between the viral Spike protein receptor-binding domain (RBD) and the angiotensin converting enzyme 2 (ACE2) target cell receptor. Here, we report on the isolation and characterization of 206 RBD-specific monoclonal antibodies (mAbs) derived from single B cells of eight SARS-CoV-2 infected individuals. These mAbs come from diverse families of antibody heavy and light chains without apparent enrichment for particular families in the repertoire. In samples from one patient selected for further analyses, we found coexistence of germline and germline divergent clones. Both clone types demonstrated impressive binding and neutralizing activity against pseudovirus and live SARS-CoV-2. However, the antibody neutralizing potency is determined by competition with ACE2 receptor for RBD binding. Surprisingly, none of the SARS-CoV-2 antibodies nor the infected plasma cross-reacted with RBDs from either SARS-CoV or MERS-CoV although substantial plasma cross-reactivity to the trimeric Spike proteins from SARS-CoV and MERS-CoV was found. These results suggest that antibody response to RBDs is viral species-specific while that cross-recognition target regions outside the RBD. The specificity and neutralizing characteristics of this plasma cross-reactivity requires further investigation. Nevertheless, the diverse and potent neutralizing antibodies identified here are promising candidates for prophylactic and therapeutic SARS-CoV-2 interventions.
Characterization Of Hydrocarbon Utilizing Bacteria In Waste Engine Oil-Impacted Sites
Authors: Jones A. M. , James I. I. , Akpan P. S. , Eka I.I. , Oruk A. E. , Ibuot A. A. 
Published: March 2020

ABSTRACTThe present work was aimed at isolating and identifying hydrocarbon utilizing bacteria from waste engine oil polluted soil, and assessing their hydrocarbon-utilizing ability. Materials and method: Eight bacterial species;Corynebacterium kutscheri, Pseudomonas aeruginosa, Flavobacterium aquatile, Serratia odorifera, Micrococcus agilis, Staphylococcus aureus, Micrococcus luteusandBacillus substiliswere isolated by selective enrichment technique and screened for hydrocarbon utilization capability in mineral salt media with waste engine oil as a sole carbon and energy source. Bacterial species showed varied hydrocarbon utilization during the 15 days of incubation. All isolates also showed variable emulsification ability. These results demonstrate the presence of indigenous bacteria in hydrocarbon polluted soils and the potential towards remediation of hydrocarbons.