bluuebunny/crossref_metadata_2025_split huggingface dataset:
Improving Care for Critical Care Patients by Strategic Alignment of Quality Goals With a Physician Financial Incentive Model
Authors: Shittu Atinuke , Hannon Emily , Kyriacou Jonathan , Arnold Desiree , Kitz Michael , Zhang Ziya , Chan Christy , Kohli-Seth Roopa 
Published: December 2020

Background and Objectives:
The passage of the Affordable Care Act has ignited a shift from the pay-for-performance model to value-based care with a particular relevance in critical care settings. Provider incentive programs are widely considered as a means to reward providers based on the achievement of preset quality metrics. This article aims to demonstrate the effects of a provider incentive program in the critical care delivery system in a large academic center in the Northeastern United States.

Methods:
This article describes the results of a retrospective analysis of a performance-driven quality improvement initiative at a critical care facility of an academic medical center using a quasi-experimental pre-/posttest design. A set of quality measures was selected as outcome metrics. Selection criteria for the process measures are as follows: (i) the metric goals should be influenced by the physician's input to a large degree; (ii) the measure must be transparent and accessible within the hospital-wide data reporting system; (iii) the metric that required group effort and interdisciplinary collaboration to achieve; and (iv) the measure must directly affect patient outcome. The outcome metrics are central line–associated bloodstream infections (CLABSIs) and catheter-associated urinary tract infections (CAUTIs), standardized infection ratio (SIR), Foley catheter and central line utilization standardized utilization ratio (SUR), hand hygiene compliance, and adherence to respiratory recovery pathway goals. These metrics were tracked from for 3 years with success defined as achieving set benchmarks for each metric.

Results:
The average CLABSI SIR and CAUTI SIR across all intensive care units (ICUs) decreased by 44% (P = .05) and 87% (P = .02) over 3 years as well as the central line and Foley catheter utilization falling by 41% and 30%, respectively. Hand hygiene compliance in the ICUs improved for the same period by 27 percentage points, as did compliance with the respiratory recovery pathway program by 4 percentage points.

Conclusion:
The use of a physician-driven financial incentive model in a critical care setting measured by outcome metrics dependent on physician input is successful with rigorous implementation and careful evaluation.
Effective Organizational Justice and Organizational Citizenship Behavior Using Fuzzy Logic to Obtain the Optimal Relationship
Authors: Ajlouni Wajdee Mohammadkair Ebrheem , Kaur Gurvinder , Alomari Saleh Ali 
Published: December 2020

Background:
Organizational justice (OJ) is important for organizational success; it reflects employee perceptions of fair treatment. OJ promotes employee retention and work engagement toward high performance. Organizational citizenship behavior (OCB) is a discretionary behavior, describing how employees contribute to a smoother organizational performance. OCB enhances employee satisfaction, quality of care, patients' satisfaction with hospital performance, and the use of best hospital practices. Moreover, OJ increases employee satisfaction and is perceived as a factor that encourages workers to go “above and beyond” their responsibilities, while avoiding OCB in the workplace may reduce awareness of justice. Previous efforts have shown that perceptions of a just workplace promoted OCB at different industrial companies. Still, few studies have investigated this relationship in hospitals.

Objectives:
This study addressed this gap by investigating the significant relationships of OJ and OCB in a large Jordanian hospital.

Methods:
A fuzzy approach to Pearson's correlation was applied to test the formulated hypothesis, with an aim to better understand causal correlation of vague data.

Results:
A statistically significant, positive correlation existed between OJ and OCB. Maximum correlations existed between distributive justice and altruism, procedural justice, courtesy, and interactional or interpersonal justice and conscientiousness. This study showed that procedural justice was the best predictor of OCB.

Conclusion:
This study revealed a correlation between OJ and OCB, reflecting the diversity of these correlation relationships, which can help decision makers to form their strategic plans.
Expert Consensus Guidelines on Minimally Invasive Donor Hepatectomy for Living Donor Liver Transplantation From Innovation to Implementation
Authors: Cherqui Daniel , Ciria Ruben , Kwon Choon Hyuck David , Kim Ki-Hun , Broering Dieter , Wakabayashi Go , Samstein Benjamin , Troisi Roberto I. , Han Ho Seong , Rotellar Fernando , Soubrane Olivier , Briceño Javier , Alconchel Felipe , Ayllón María Dolores , Berardi Giammauro , Cauchy Francois , Luque Irene Gómez , Hong Suk Kyun , Yoon Young-Yin , Egawa Hiroto , Lerut Jan , Lo Chung-Mau , Rela Mohamed , Sapisochin Gonzalo , Suh Kyung-Suk 
Published: December 2020

Objective:
The Expert Consensus Guidelines initiative on MIDH for LDLT was organized with the goal of safe implementation and development of these complex techniques with donor safety as the main priority.

Background:
Following the development of minimally invasive liver surgery, techniques of MIDH were developed with the aim of reducing the short- and long-term consequences of the procedure on liver donors. These techniques, although increasingly performed, lack clinical guidelines.

Methods:
A group of 12 international MIDH experts, 1 research coordinator, and 8 junior faculty was assembled. Comprehensive literature search was made and studies classified using the SIGN method. Based on literature review and experts opinions, tentative recommendations were made by experts subgroups and submitted to the whole experts group using on-line Delphi Rounds with the goal of obtaining >90% Consensus. Pre-conference meeting formulated final recommendations that were presented during the plenary conference held in Seoul on September 7, 2019 in front of a Validation Committee composed of LDLT experts not practicing MIDH and an international audience.

Results:
Eighteen Clinical Questions were addressed resulting in 44 recommendations. All recommendations reached at least a 90% consensus among experts and were afterward endorsed by the validation committee.

Conclusions:
The Expert Consensus on MIDH has produced a set of clinical guidelines based on available evidence and clinical expertise. These guidelines are presented for a safe implementation and development of MIDH in LDLT Centers with the goal of optimizing donor safety, donor care, and recipient outcomes.
Bayesian back-calculation and nowcasting for line list data during the COVID-19 pandemic
Authors: Li Tenglong , White Laura F. 
Published: December 2020

AbstractSurveillance is the key of controling the COVID-19 pandemic, and it typically suffers from reporting delays and thus can be misleading. Previous methods for adjusting reporting delays are not particularly appropriate for line list data, which usually have lots of missing values that are non-ignorable for modeling reporting delays. In this paper, we develop a Bayesian approach that dynamically integrates imputation and estimation for line list data. We show this Bayesian approach lead to accurate estimates of the epidemic curve and time-varying reproductive numbers and is robust to deviations from model assumptions. We apply the Bayesian approach to a COVID-19 line list data in Massachusetts and find the reproductive number estimates correspond more closely to the control measures than the ones based on the reported curve.
A multi-omics study of circulating phospholipid markers of blood pressure
Authors: Liu Jun , de Vries Paul S. , Greco M. Fabiola Del , Johansson Åsa , Schraut Katharina E. , Hayward Caroline , van Dijk Ko Willems , Franco Oscar. H. , Hicks Andrew A. , Vitart Veronique , Rudan Igor , Campbell Harry , Polašek Ozren , Pramstaller Peter P. , Wilson James F. , Gyllensten Ulf , van Duijn Cornelia M. , Dehghan Abbas , Demirkan Ayşe 
Published: December 2020

AbstractBackgroundsHigh-throughput techniques allow us to measure a wide-range of phospholipids which can provide insight into the mechanisms of hypertension. We aimed to conduct an in-depth multi-omics study of various phospholipids with systolic blood pressure (SBP) and diastolic blood pressure (DBP).MethodsThe associations of blood pressure and 151 plasma phospholipids measured by electrospray ionization tandem mass spectrometry were performed by linear regression in five European cohorts (n = 2,786 in discovery and n = 1,185 in replication). We further explored the blood pressure-related phospholipids in Erasmus Rucphen Family (ERF) study by associating them with multiple cardiometabolic traits (linear regression) and predicting incident hypertension (Cox regression). Mendelian Randomization (MR) and phenome-wide association study (pheWAS) were also explored to further investigate these association results.ResultsWe identified six phosphatidylethanolamines (PE 38:3, PE 38:4, PE 38:6, PE 40:4, PE 40:5 and PE 40:6) and two phosphatidylcholines (PC 32:1 and PC 40:5) which together predicted incident hypertension with an area under the curve (AUC) of 0.61. The identified eight phospholipids are strongly associated with triglycerides, obesity related traits (e.g. waist, waist-hip ratio, total fat percentage, BMI, lipid-lowering medication, and leptin), diabetes related traits (e.g. glucose, HOMA-IR and insulin) and prevalent type 2 diabetes. The genetic determinants of these phospholipids also associated with many lipoproteins, heart rate, pulse rate and blood cell counts. No significant association was identified by bi-directional MR approach.ConclusionWe identified eight blood pressure-related circulating phospholipids that have a predictive value for incident hypertension. Our cross-omics analyses show that phospholipid metabolites in the circulation may yield insight into blood pressure regulation and raise a number of testable hypothesis for future research.
Follow-up study on serum cholesterol profiles in recovered COVID-19 patients
Authors: Li Guiling , Du Li , Cao Xiaoling , Wei Xiuqi , Jiang Yao , Lin Yuqi , Nguyen Vi , Tan Wenbin , Wang Hui 
Published: December 2020

AbstractCOVID-19 patients develop hypolipidemia. However, it is unknown whether lipid levels have improved in recovered patients. In this study, a 3–6 month follow-up study was performed to examine serum levels of laboratory values in 107 discharged COVID-19 patients (mild = 59; severe/critical = 48; diagnoses on admission). 61 patients had a revisit chest CT scan. A Wilcoxon signed-rank test was used to analyze changes in laboratory values. LDL-c and HDL-c levels were significantly higher at follow-up than at admission in severe/critical cases (p < 0.05). LDL-c levels were significantly higher at follow-up than at admission in mild cases (p < 0.05). With adjustment of the factor of traditional Chinese medicine, LDL-c and HDL-c levels were significantly improved at follow-up than at admission in severe/critical cases (p < 0.05). Increases in HDL-c significantly correlated with increases in numbers of white blood cells (p<0.001) and decreases in levels of C-reactive protein (p < 0.05) during patients’ recovery. Residue lesions were observed in CT images in 69% (42 of 61) of follow-up patients. We concluded that improvements of LDL-c, HDL-c and incomplete absorption of lung lesions were observed at follow-up for recovered patients, indicating that a long-term recovery process could be required.
Quantifying individual nociceptive sensitivity to optimise analgesic trials in infants
Authors: Cobo Maria M. , Hartley Caroline , Gursul Deniz , Andritsou Foteini , van der Vaart Marianne , Mellado Gabriela Schmidt , Baxter Luke , Duff Eugene P. , Buckle Miranda , Fry Ria Evans , Green Gabrielle , Hoskin Amy , Rogers Richard , Adams Eleri , Moultrie Fiona , Slater Rebeccah 
Published: December 2020

AbstractDespite the high burden of pain experienced by hospitalised infants there are few analgesics with proven efficacy. Testing analgesics in infants is experimentally and ethically challenging and minimising the number of infants required to demonstrate efficacy is essential. EEG-derived measures of noxious-evoked brain activity can be used to assess analgesic efficacy, however, as variability exists in infant’s responses to painful procedures, large sample sizes are often required. Here we present a novel experimental paradigm to account for individual differences in baseline nociceptive sensitivity which can be used to improve the design of analgesic trials in infants. The paradigm is developed and tested across four studies using clinical, experimental and simulated data (99 infants). We provide evidence of the efficacy of both gentle brushing and paracetamol, substantiating the need for randomised controlled trials of these interventions. This work provides an important step towards safe, cost-effective clinical trials of analgesics in infants.
Risk factors for retirement home COVID-19 outbreaks in Ontario, Canada: A population-level cohort study
Authors: Costa Andrew P. , Manis Derek R. , Jones Aaron , Stall Nathan M. , Brown Kevin A. , Boscart Veronique , Castellino Adriane , Heckman George A. , Hillmer Michael P. , Ma Chloe , Pham Paul , Rais Saad , Sinha Samir K , Poss Jeffrey W. 
Published: December 2020

AbstractBackgroundThe epidemiology of COVID-19 in retirement homes (also known as assisted living facilities) is largely unknown. We examined the association between retirement home and community level characteristics and the risk of COVID-19 outbreaks in retirement homes during the first wave of the COVID-19 epidemic.MethodsWe conducted a population-based retrospective cohort study of licensed retirement homes in Ontario, Canada, from March 1st - September 24th, 2020. Our primary outcome was a COVID-19 outbreak (≥1 resident or staff confirmed case by validated nucleic acid amplification assay). We used time-dependent proportional hazards methods to model the associations between retirement home and community level characteristics and COVID-19 outbreaks.ResultsOur cohort included all 770 licensed retirement homes in Ontario, which housed 56,491 residents. There were 172 (22.3%) COVID-19 retirement home outbreaks involving 1,045 (1.9%) residents and 548 staff (1.5%). COVID-19 cases were distributed unevenly across retirement homes, with 1,593 (92.2%) resident and staff cases occurring in 77 (10%) of homes. The adjusted hazard of a COVID-19 outbreak in a retirement home was positively associated with homes that had a large resident capacity, homes that were co-located with a long-term care facility, large corporate owned chains, homes that offered many services onsite, increases in regional COVID-19 incidence, and a higher community-level ethnic concentration.InterpretationReadily identifiable retirement home-level characteristics are independently associated with COVID-19 outbreaks and may support risk identification. A higher ethnic concentration of the community surrounding a retirement home is associated COVID-19 outbreaks, with an uncertain mechanism.
How detection ranges and usage stops impact digital contact tracing effectiveness for COVID-19
Authors: Pandl Konstantin D. , Thiebes Scott , Schmidt-Kraepelin Manuel , Sunyaev Ali 
Published: December 2020

AbstractTo combat the COVID-19 pandemic, many countries have adopted digital contact tracing apps. Various technologies exist to trace contacts that are potentially prone to different types of tracing errors. Here, we study the impact of different proximity detection ranges on the effectiveness and efficiency of digital contact tracing apps. Furthermore, we study a usage stop effect induced by a false positive quarantine. Our results reveal that policy makers should adjust digital contact tracing apps to the behavioral characteristics of a society. Based on this, the proximity detection range should at least cover the range of a disease spread, and be much wider in certain cases. The widely used Bluetooth Low Energy protocol may not necessarily be the most effective option in its current setting.
Genome-wide survey of parent-of-origin specific associations across clinical traits derived from electronic health records
Authors: Kim Hye In , Ye Bin , Staples Jeffrey , Marcketta Anthony , Gao Chuan ,   Regeneron Genetics Center,   Geisinger Regeneron DiscovEHR Collaboration, Shuldiner Alan R. , Van Hout Cristopher V. 
Published: December 2020

AbstractParent-of-origin (PoO) effects refer to the differential phenotypic impact of genetic variants dependent on their parental inheritance. Genetic variants in imprinted genes can have PoO specific effects on complex traits, but these effects may be poorly captured by models that do not differentiate the parental origin of the variant. The aim of this study was to screen genome-wide imputed sequence for PoO effects on electronic health records (EHR) derived clinical traits in 134,049 individuals of European ancestry from the DiscovEHR study.Using pairwise kinship estimates from genetic data and demographic data, we identified 22,051 offspring with at least one parent present in the DiscovEHR study. We then assigned the PoO of ∼9 million variants in the heterozygous offspring using two methods. First, when one of the parental genotypes was homozygous, we determined PoO based on apparent Mendelian segregation. Second, we estimated PoO by comparing parental and offspring haplotypes around the variant allele. Using these PoO assignments, we performed genome-wide PoO association analyses across 154 quantitative traits including lab test results and biometric measures and 612 binary traits of ICD10 3-digit codes extracted from EHR in the DiscovEHR study. Out of 732 PoO associations meeting a significance threshold of P <5×10−8, we attempted to replicate 274 PoO associations in the UK Biobank study, consisting of 462,453 individuals and including 5,015 offspring with at least one parent, and replicated 9 PoO associations with nominal significance threshold P <0.05.In summary, the current study characterizes PoO effects of genetic variants genome-wide on a broad range of clinical traits derived from EHR in a large population study enriched for familial relationships. Our results suggest that 1) PoO specific effects are frequently captured by a standard additive model and that 2) statistical power to detect PoO specific effects remains modest even in large studies. Nonetheless, accurately modeling PoO effects of genetic variants has the potential to improve our understanding of the mechanism of the association and finding new associations that are not captured by the additive model.
Can Severity of a Humanitarian Crisis be Quantified? Assessment of the INFORM Severity Index
Authors: Lopez Velma K , Nika Angeliki , Blanton Curtis , Talley Leisel , Garfield Richard 
Published: December 2020

AbstractBackgroundThose responding to humanitarian crises have an ethical imperative to respond most where the need is greatest. Metrics are used to estimate the severity of a given crisis. The INFORM Severity Index, one such metric, has become widely used to guide policy makers in humanitarian response decision making. The index, however, has not undergone critical statistical review. If imprecise or incorrect, the quality of decision making for humanitarian response will be affected. This analysis asks, how precise and how well does this index reflect the severity of conditions for people affected by disaster or war?ResultsThe INFORM Severity Index is calculated from 35 publicly available indicators, which conceptually reflect the severity of each crisis. We used 172 unique global crises from the INFORM Severity Index database that occurred January 1 to November 30, 2019 or were ongoing by this date. We applied exploratory factor analysis (EFA) to determine common factors within the dataset. We then applied a second-order confirmatory factor analysis (CFA) to predict crisis severity as a latent construct. Model fit was assessed via chi-square goodness-of-fit statistic, Comparative Fit Index (CFI), Tucker-Lewis Index (TLI), and Root Mean Square Error of Approximation (RMSEA). The EFA models suggested a 3- or 4-factor solution, with 46% and 53% variance explained in each model, respectively. The final CFA was parsimonious, containing three factors comprised of 11 indicators, with reasonable model fit (Chi-squared=107, with 40 degrees of freedom, CFI=0.94, TLI=0.92, RMSEA=0.10). In the second-order CFA, the magnitude of standardized factor-loading on the ‘societal governance’ latent construct had the strongest association with the latent construct of ‘crisis severity’ (0.73), followed by the ‘humanitarian access/safety’ construct (0.56).ConclusionsA metric of crisis-severity is a critical step towards improving humanitarian response, but only when it reflects real life conditions. Our work is a first step in refining an existing framework to better quantify crisis severity.
Association of circulating Fibroblast Growth Factor-2 with progression of HIV-chronic kidney diseases in children
Authors: Ray Patricio E , Li Jinliang , Das Jharna , Yu Jing 
Published: December 2020

ABSTRACTIntroductionPeople living with HIV frequently show high plasma levels of Fibroblast Growth Factor-2 (FGF-2/bFGF). Previous studies reported that FGF-2 can accelerate the progression of experimental kidney diseases. However, how circulating FGF-2 affects the progression of HIV-chronic kidney diseases (HIV-CKDs) in children is unknown.MethodsTo address this question we measured the plasma and urine levels of FGF-2 in 84 children (< 12 years of age) living with HIV, and determine their association with a high viral load (HVL) and HIV-CKDs. Kidney sections from children with HIV-CKD were used to assess the localization and expression levels of the FGF-2 binding sites. The fate of circulating FGF-2 was determined in young wild type and HIV-transgenic (HIV-Tg26) mice injected with human recombinant FGF-2. Cells cultured from children with HIV-CKDs where used to define how FGF-2 affected their infection, survival, and expression of APOL1.ResultsHigh plasma FGF-2 levels were associated with a HVL and HIV-CKDs. High urine FGF-2 levels were found in almost all children with HIV-CKDs. A large reservoir of renal FGF-2 low affinity binding sites in children and HIV-Tg26mice with HIV-CKDs facilitated the recruitment of circulating FGF-2. FGF-2 slightly decreased the expression of APOL1 mRNA in cultured podocytes, but increased the survival of HIV infected inflammatory cells or podocytes, and precipitated HIV-nephropathy in HIV-Tg26mice.ConclusionChildren with high plasma and urine FGF-2 levels were more likely to develop HIV-CKDs. Persistently high plasma FGF-2 levels appear to be an independent risk factor for developing progressive childhood HIV-CKDs.