bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reflections on implementing a hospital-wide provider-based electronic inpatient mortality review system: lessons learnt
Authors: Mendu Mallika L , Lu Yi , Petersen Alec , Tellez Melinda Gomez , Beloff Jennifer , Fiumara Karen , Kachalia Allen 
Published: October 2019

ImportanceDeath due to preventable medical error is a leading cause of death, with varying estimates of preventable death rates (14%–56% of total deaths based on national extrapolated estimates, 3%–11% based on single-centre estimates). Yet, how best to reduce preventable mortality in hospitals remains unknown.ObjectiveIn this article, we detail lessons learnt from implementing a hospital-wide, automated, real-time, electronic mortality reporting system that relies on the opinions of front-line clinicians to identify opportunities for improvement. We also summarise data obtained regarding possible preventability, systems issues identified and addressed, and challenges with implementation. We outline our process of survey, evaluation, escalation and tracking of opportunities identified through the review process.MethodsWe aggregated and analysed 7 years of review data regarding deaths, review responses categorised by ratings of possible preventability and inter-rater reliability of possible preventability. A qualitative analysis of reviews was performed to identify care delivery opportunities and institutional response.ResultsOver the course of 7 years, 7856 inpatient deaths occurred, and 91% had at least one review completed. 5.2% were rated by front-line clinicians as potentially being preventable (likely or possibly), and this rate was consistent over time. However, there was only slight inter-rater agreement regarding potential preventability (Cohen’s kappa=0.185). Nevertheless, several major systems-level opportunities were identified that facilitated care delivery improvements, such as communication challenges, need for improved end-of-life care and interhospital transfer safety.ConclusionsThrough implementation, we found that a hospital-wide mortality review process that elicits feedback from front-line providers is feasible, and provides valuable insights regarding potential preventable mortality and prioritising actionable opportunities for care delivery improvements.
Bayesian approach to quantify morphological impact on performance in international elite freestyle swimming
Authors: Pla Robin , Leroy Arthur , Massal Romain , Bellami Maxime , Kaillani Fatima , Hellard Philippe , Toussaint Jean-François , Sedeaud Adrien 
Published: October 2019

ObjectivesThe purpose of this study was to quantify the impact of morphological characteristics on freestyle swimming performance by event and gender.DesignHeight, mass, body mass index (BMI) and speed data were collected for the top 100 international male and female swimmers from 50 to 1500 m freestyle events for the 2000–2014 seasons.MethodsSeveral Bayesian hierarchical regressions were performed on race speed with height, mass and BMI as predictors. Posterior probability distributions were computed using Markov chain Monte Carlo algorithms.ResultsRegression results exhibited relationships between morphology and performance for both genders and all race distances. Height was always positively correlated with speed with a 95% probability. Conversely, mass plays a different role according to the context. Heavier profiles seem favourable on sprint distances, whereas mass becomes a handicap as distance increases. Male and female swimmers present several differences on the influence of morphology on speed, particularly about the mass. Best morphological profiles are associated with a gain of speed of 0.7%–3.0% for men and 1%–6% for women, depending on race distance. BMI has been investigated as a predictor of race speed but appears as weakly informative in this context.ConclusionMorphological indicators such as height and mass strongly contribute to swimming performance from sprint to distance events, and this contribution is quantified for each race distance. These profiles may help swimming federations to detect athletes and drive them to compete in specific distances according to their morphology.
Echocardiography during submaximal isometric exercise in children with repaired coarctation of the aorta compared with controls
Authors: Panzer Joseph , Dequeker Laure , Coomans Ilse , Vandekerckhove Kristof , Bove Thierry , De Wolf Daniël , Rietzschel Ernst 
Published: October 2019

ObjectivePatients with repaired coarctation (RCoA) remain at higher risk of cardiac dysfunction, initially often only detected during exercise. In this study, haemodynamics of isometric handgrip (HG) and bicycle ergometry (BE) were compared in patients with RCoA and matched controls (MCs).MethodsCase–control study of 19 children with RCoA (mean age 12.9±2.3 years; mean age of repair 7 months) compared with 20 MC. HG with echocardiography followed by BE was performed in both groups.ResultsDuring HG (blood pressure) BP increased from 114±11/64±4 mm Hg to 132±14/79±7 mm Hg, without significant differences. During HG as well as BE, HR increased less in patients with RCoA. There were no significant differences in (left ventricle) LV dimensions or LV mass.The RCoA group had diastolic dysfunction: both at rest and during HG they had significantly higher transmitral E and A velocities and lower tissue Doppler E′ and A′ velocities. E/E′ was higher, reaching statistical significance during HG (p<0001).Conventional parameters of systolic function (FS and EF) were similar at rest and HG. More sensitive tissue Doppler S′ was significantly lower at rest in CoA subjects (5.1±1.5 cm/s vs 6.5±1±1 cm/s; p<0.01), decreasing further during HG by 5% in the CoA group (NS) while unchanged in controls.ConclusionsWe provide first evidence that HG with echocardiography is feasible, easy and patient-friendly. A decreased systolic (tissue Doppler) and impaired diastolic LV function was measured in the RCoA group, a difference that tended to increase during HG.
Transition phase towards psoriatic arthritis: clinical and ultrasonographic characterisation of psoriatic arthralgia
Authors: Zabotti Alen , McGonagle Dennis G , Giovannini Ivan , Errichetti Enzo , Zuliani Francesca , Zanetti Anna , Tinazzi Ilaria , De Lucia Orazio , Batticciotto Alberto , Idolazzi Luca , Sakellariou Garifallia , Zandonella Callegher Sara , Sacco Stefania , Quartuccio Luca , Iagnocco Annamaria , De Vita Salvatore 
Published: October 2019

ObjectiveNon-specific musculoskeletal pain is common in subjects destined to develop psoriatic arthritis (PsA). We evaluated psoriatic patients with arthralgia (PsOAr) compared with psoriasis alone (PsO) and healthy controls (HCs) using ultrasonography (US) to investigate the anatomical basis for joint symptoms in PsOAr and the link between these imaging findings and subsequent PsA transition.MethodsA cross-sectional prevalence analysis of clinical and US abnormalities (including inflammatory and structural lesions) in PsOAr (n=61), PsO (n=57) and HCs (n=57) was performed, with subsequent prospective follow-up for PsA development.ResultsTenosynovitis was the only significant sonographic feature that differed between PsOAr and PsO (29.5% vs 5.3%, p<0.001), although synovitis and enthesitis were numerically more frequent in PsOAr. Five patients in PsOAr and one in PsO group developed PsA, with an incidence rate of 109.2/1000 person-years in PsOAr vs 13.4/1000 person-years in PsO (p=0.03). Visual Analogue Scale pain, Health Assessment Questionnaire, joint tenderness and US active enthesitis were baseline variables associated with PsA development.ConclusionTenosynovitis was associated with arthralgia in subjects with psoriasis. Baseline US evidence of enthesitis was associated with clinical PsA development in the longitudinal analysis. These findings are relevant for enriching for subjects at risk of imminent PsA development.
Formation of 1 × 3 splitting by embedded double-layer reflective grating under second Bragg illumination
Authors: Gao Chenhao , Wang Bo , Wen Kunhua , Meng Ziming , Nie Zhaogang , Xing Xiangjun , Chen Li , Lei Liang , Zhou Jinyun 
Published: October 2019

In order to obtain a [Formula: see text] grating with high performance, we designed a double-layer reflective grating beam splitter with a covering layer at a wavelength of 1550 nm. We obtain a better grating structure by modal analysis and rigorous coupled-wave method. The reflectivity of the three diffraction orders for the grating is close to 33.3%. The optimized data show that the grating beam splitter has a large period process tolerance for TE polarization. The grating performance has high incident performance and uniform splitting effect.
Cost Effectiveness of Assessing Ultrasound Plaque Characteristics to Risk Stratify Asymptomatic Patients With Carotid Stenosis
Authors: Baradaran Hediyeh , Gupta Ajay , Anzai Yoshimi , Mushlin Alvin I. , Kamel Hooman , Pandya Ankur 
Published: October 2019

Background
Imaging may play an important role in identifying high‐risk plaques in patients who have carotid disease and who could benefit from surgical revascularization. We sought to evaluate the cost effectiveness of a decision‐making rule based on the ultrasound imaging assessment of plaque echolucency in patients with asymptomatic carotid stenosis.

Methods and Results

We used a decision‐analytic model to project lifetime quality‐adjusted life years and costs for 5 stroke prevention strategies: (1) medical therapy only; (2) revascularization if
both
plaque echolucency and stenosis progression to >90% are present; (3) revascularization only if plaque echolucency is present; (4) revascularization only if stenosis progression >90% is present; or (5) either plaque echolucency or stenosis progression is present. Risks of clinical events, costs, and quality‐of‐life values were estimated based on published sources and the analysis was conducted from a healthcare system perspective for asymptomatic patients with 70% to 89% carotid stenosis at presentation. Patients who did not undergo revascularization had the highest stroke events (17.6%) and lowest life‐years (8.45), while those who underwent revascularization on the basis of either presence of plaque echolucency on ultrasound or progression of carotid stenosis had the lowest stroke events (12.0%) and longest life‐years (14.41). The
either
plaque echolucency or progression‐based revascularization group had an incremental cost‐effectiveness ratio of $110 000/quality‐adjusted life years compared with the plaque echolucency‐based strategy, which had an incremental cost‐effectiveness ratio of $29 000/quality‐adjusted life years compared with the joint echolucency and progression‐based strategy.

Conclusions
Plaque echolucency on ultrasound can be a cost‐effective tool to identify patients with asymptomatic carotid artery stenosis most likely to benefit from carotid endarterectomy.
Diagnostic Accuracy of Positive Airway Pressure Device for Sleep Apnea Detection in Acute Stroke Patients
Authors: Camilo Millene Rodrigues , Machado Luís Artur , Castilho Cristiane Menezes , Sander Heidi Haueisen , Eckeli Alan Luiz , Fernandes Regina França , Leite Joao Pereira , Pontes-Neto Octavio Marques 
Published: October 2019

Background and Purpose—
Sleep apnea has been associated with a poor outcome in acute stroke patients. Polysomnography is the gold standard diagnostic method for sleep apnea, but it is not feasible as a routine in the acute stroke setting. The current generation of positive airway pressure (PAP) devices can detect the different types of respiratory events. This study aimed to compare the algorithms used in PAP device to manually scored events on polysomnography in patients with acute stroke.

Methods—
A sleep study was performed with standard polysomnography and PAP device, simultaneously, within the first 48 hours after acute stroke onset.

Results—

We prospectively evaluated 29 patients with acute stroke (59.5±12.1 years). The area under the receiver operating characteristic curve for each apnea-hypopnea index value was above 0.90 by PAP device. There was a good correlation of apnea-hypopnea index (
r
s
=0.92;
P
<0.001), hypopnea index (
r
s
=0.89;
P
<0.001), and apnea index (
r
s
=0.70;
P
<0.001) between device-detected events and manually scored polysomnography.

Conclusions—
Given the high frequency of sleep apnea during the acute phase of stroke and the complexity of a full polysomnography study in this setting, PAP device on diagnostic mode can be used as an alternative tool for sleep apnea detection in acute stroke patients.
The Study of Emotions in Early Jewish Texts: Review and Perspectives
Authors: Mirguet Françoise 
Published: October 2019

AbstractThis article reviews recent research on emotions in the field of early Judaism, mostly in literature. The article starts with an example from the biblical story of Joseph, to illustrate the need for a culturally sensitive understanding of emotions. Various approaches to emotions are then examined: philology and the history of the self, the construction of identity, structures of power (including gender), experiences with the divine, and emotions as adaptive practices. Each section starts with a brief outline of the scholarship conducted in other fields and serving as a background for research on early Judaism. The conclusion considers several facets of emotions, as they are highlighted by various disciplines; cultural manipulations of emotions often harness the tensions that may result from these multiple facets. The article closes with a brief assessment of the contribution of emotion research to the broader study of early Judaism and with perspectives for further research.
Polarimetric Radar Observations of Simultaneous Tornadoes on 10 May 2010 near Norman, Oklahoma
Authors: Griffin Casey B. , Bodine David J. , Palmer Robert 
Published: October 2019

Abstract
This study utilizes data collected by the University of Oklahoma Advanced Radar Research Center’s Polarimetric Radar for Innovations in Meteorology and Engineering (OU-PRIME) C-band radar as well as the federal KTLX and KOUN WSR-88D S-band radars to study a supercell that simultaneously produced a long-track EF-4 tornado and an EF-2 landspout tornado (EF indicates the enhanced Fujita scale) near Norman, Oklahoma, on 10 May 2010. Contrasting polarimetric characteristics of two tornadoes over similar land cover but with different intensities are documented. Also, the storm-scale sedimentation of debris within the supercell is investigated, which includes observations of rotation and elongation of a tornadic debris signature with height. A dual-wavelength comparison of debris at S and C bands is performed. These analyses indicate that lofted debris within the tornado was larger than debris located outside the damage path of the tornado and that debris size outside the tornado increased with height, likely as the result of centrifuging. Profiles of polarimetric variables were observed to become more vertically homogeneous with time.
Suicide and sudden death bereavement in Australia: A longitudinal study of family members over 2 years after death
Authors: Kõlves Kairi , Zhao Qing , Ross Victoria , Hawgood Jacinta , Spence Susan H , de Leo Diego 
Published: October 2019

Objective: Grief reactions change over time. However, only a limited number of studies, and none in Australia, have analysed changes in individual grief reactions longitudinally. The aim is to examine changes in grief reactions, mental health and suicidality of close family members bereaved by suicide, 6, 12 and 24 months after their loss compared with those bereaved by other forms of sudden death, adjusting for confounding factors. Method: Participants were 142 adult family members bereaved by suicide and 63 by other sudden death, followed up at 6, 12 and 24 months in Queensland, Australia. The Grief Experience Questionnaire, Depression Anxiety Stress Scale and Beck Scale for Suicide Ideation were used as main outcomes. Mixed-effects linear and logistic regressions were utilized for statistical analyses. Results: There were significant differences in rejection, stigmatization, shame and responsibility between the suicide and sudden death bereaved over the 2-year period, after adjusting for potential confounding factors. Rejection, stigmatization, search for explanation, somatic reactions and symptoms of depression and anxiety (Depression Anxiety Stress Scale) declined significantly over time in both groups. Rejection and somatic reactions showed group-by-time interaction effects, with a decrease in the suicide bereaved and no change in the sudden death bereaved. Loss of social support and suicidal ideation did not show a group or time effect. Conclusion: Although our findings confirm that there are several common dimensions to experiencing a sudden death of a family member, several differences were found between the suicide and non-suicide sudden death bereaved including significantly higher levels of rejection, stigmatization, shame and responsibility remaining in the suicide compared to sudden death bereaved 2 years after their loss. These findings should be considered in clinical practice and when designing postvention services in Australia.
Outcomes After Latarjet Procedure: Patients With First-Time Versus Recurrent Dislocations
Authors: Hardy Alexandre , Sabatier Vincent , Laboudie Pierre , Schoch Bradley , Nourissat Geoffroy , Valenti Philippe , Kany Jean , Deranlot Julien , Solignac Nicolas , Hardy Philippe , Vigan Marie , Werthel Jean-David 
Published: October 2019

Background: The preoperative number of dislocations has been previously proved to be a major factor influencing the results after Bankart repair with more preoperative dislocations correlated with higher recurrence rates and more reoperations. This could possibly be because of the lower quality of the tissue repaired during the procedure after multiple dislocations. On the other hand, the Latarjet procedure does not “repair” but rather reconstructs and augments the anterior glenoid. Purpose/Hypothesis: The main objective was to report the clinical outcomes of patients undergoing a Latarjet procedure after 1 dislocation versus multiple (≥2) dislocations. The hypothesis was that the preoperative number of dislocations would not influence clinical results. Study Design: Cohort study; Level of evidence, 3. Methods: Patients older than 18 years who had undergone a primary Latarjet procedure for shoulder instability with at least 2 years of follow-up were included. Three different techniques were used: a mini-open technique using 2 screws, an arthroscopic technique using 2 screws, and an arthroscopic technique using 2 cortical buttons. Patients were evaluated and answered a questionnaire to assess the number of episodes of dislocation before surgery, the time between the first dislocation and surgery, recurrence of the dislocation, revision surgery, the Walch-Duplay score, the Simple Shoulder Test score, and the visual analog scale (VAS) score for pain. Results: A total of 308 patients were included for analysis with a mean follow-up of 3.4 ± 0.8 years. Of that, 83 patients were included in the first-time dislocation group and 225 in the recurrent dislocation group. At last follow-up, the rates of recurrence and reoperation were not significantly different between groups: 4.8% in the first-time dislocation group versus 3.65% in the recurrent dislocation group and 6.1% versus 4.0%, respectively. The overall Walch-Duplay scores at last follow-up were also comparable between the 2 groups, 67.3 ± 24.85 and 71.8 ± 25.1, even though the first-time dislocation group showed a lower pain subscore (15.0 ± 8.6 vs 18.0 ± 7.5; P = .003). The VAS for pain was also significantly higher in the first-time dislocation group compared with the recurrent dislocation group (1.8 ± 2.3 vs 1.2 ± 1.7; P = .03). Conclusion: The number of episodes of dislocation before surgery does not affect postoperative instability rates and reoperation rates after the Latarjet procedure. However, patients with first-time dislocations had more postoperative pain compared with patients with recurrent dislocations before surgery.
Tracking Changes in US Organizations’ Workplace Health Promotion Initiatives: A Longitudinal Analysis of Performance Against Quality Benchmarks
Authors: Weaver GracieLee M. , Bibeau Daniel L. , Rulison Kelly , Bray Jeremy , Dudley William N. , Unsal Nilay 
Published: October 2019

Purpose: To examine changes in organizations’ workplace health promotion (WHP) initiatives over time associated with repeated self-assessment using the Well Workplace Checklist (WWC). Design: Well Workplace Checklist data include a convenience sample of US organizations that selected to assess their performance against quality WHP benchmarks. Setting: Workplaces. Subjects: In total, 577 US organizations completed the WWC in 2 or more years from 2008 to 2015. Measures: The WWC is a 100-item organizational assessment that measures performance against the original set of quality benchmarks that were established by the Wellness Council of America (WELCOA). Analysis: This study examined changes in overall WWC scores as well as 7 separate benchmark scores. Multilevel modeling was used to examine changes in scores associated with repeated assessments, controlling for the year of assessment and organizational characteristics. Results: There were significant increases in overall WWC scores (β = 2.93, P < .001) associated with the repeated WWC assessments, after controlling for organizational characteristics. All 7 benchmark scores had significant increases associated with reassessment. Compared to other benchmarks, operating plan (β = 6.18, P < .001) and evaluation (β = 4.91, P < .001) scores increased more with each reassessment. Conclusion: Continued reassessment may represent more commitment to and investment in WHP initiatives which could lead to improved quality. Other factors that may positively influence changes in performance against benchmarks include company size, access to outside resources for WHP, and a history with implementing WHP.
Argatroban Versus Bivalirudin in the Treatment of Suspected or Confirmed Heparin-Induced Thrombocytopenia
Authors: Duewell Brittney E. , Briski Matthew J. , Feih Joel T. , Rinka Joseph R. G. , Tawil Justin N. 
Published: October 2019

Background: Argatroban and bivalirudin are direct thrombin inhibitors (DTIs) used for the treatment of heparin-induced thrombocytopenia (HIT). The purpose of this study was to determine whether either agent offered an advantage in efficacy and ability to remain within the targeted therapeutic anticoagulation range. Methods: This was a single-center, retrospective, observational cohort study at a large academic medical center. The primary efficacy outcome was time to therapeutic anticoagulation, defined as total number of hours to achieve 2 consecutive activated partial thromboplastin time (aPTT) values in goal range. Results: A total of 91 patients were included in the analysis. Average time to initial therapeutic anticoagulation was 4.71 hours and 9.8 hours for the argatroban and bivalirudin groups, respectively ( P < .01). Conclusions: Argatroban may be advantageous compared to bivalirudin in achieving initial therapeutic anticoagulation goals among patients with suspected or confirmed HIT.
Sub-syndromal PTSD: what is important to know in military personnel and veterans?
Authors: Wallace Duncan , Moss Andrew S , Hodges Samantha 
Published: October 2019

Objective: To assist healthcare professionals in their management of military personnel and veterans by providing information on the importance of sub-syndromal PTSD. Conclusion: Sub-syndromal PTSD occurs when persons experience many of the symptoms of PTSD, with some impairment, but do not meet full diagnostic criteria. Found to be associated with a range of mental health conditions including alcohol abuse, higher rates of suicidal ideas and delayed-onset PTSD, it should be seen as ‘symptoms that are predictive of later disorder’. Patients with this condition need accurate assessment, trauma-focused therapy and follow-up to address the symptoms and, potentially, prevent development of PTSD.