bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predicting mortality in patients with sepsis in the emergency department by using combinations of biomarkers and clinical scoring systems: a systematic review.
Authors: Tong-Minh Kirby , Welten Iris , Endeman Henrik , Hagenaars Tjebbe , Ramakers Christian , Gommers Diederik , Gorp Eric van , Does Yuri van der 
Published: October 2020

Abstract
Introduction Sepsis can be detected in an early stage in the emergency department (ED) by biomarkers and clinical scoring systems. A combination of multiple biomarkers or biomarker with clinical scoring system might result in a higher predictive value on mortality. The goal of this systematic review is to evaluate the available literature on combinations of biomarkers and clinical scoring systems on 1-month mortality in patients with sepsis in the ED.Methods We performed a systematic search using MEDLINE, PubMed, EMBASE and Google Scholar. Articles were included if they evaluated at least one biomarker combined with another biomarker or clinical scoring system and reported the diagnostic accuracy on 28 or 30 day mortality by area under the curve (AUC) in patients with sepsis. Results We found 18 articles in this systematic review. In these 18 articles, a total of 35 combinations of biomarkers and clinical scoring systems were studied of which 33 unique combinations. In total, seven different clinical scoring systems and 21 different biomarkers were investigated. The combination of procalcitonin (PCT), lactate, interleukin-6 (IL-6) and Simplified Acute Physiology Score-2 (SAPS-2) resulted in the highest AUC on 1-month mortality. Conclusion In this systematic review, the combination of PCT, IL-6, lactate and the SAPS-2 score had the highest AUC on 1-month mortality in patients with sepsis in the ED. The studies we found in this review were too heterogeneous to conclude that a certain combination it should be used in the ED to predict 1-month mortality in patients with sepsis.
Orally delivered MK-4482 inhibits SARS-CoV-2 replication in the Syrian hamster model
Authors: Rosenke Kyle , Hansen Frederick , Schwarz Benjamin , Feldmann Friederike , Haddock Elaine , Rosenke Rebecca , Meade-White Kimberly , Okumura Atsushi , Leventhal Shanna , Hawman David , Ricotta Emily , Bosio Catharine , Saturday Greg , Feldmann Heinz , Jarvis Michael 
Published: October 2020

Abstract
The COVID-19 pandemic progresses unabated in many regions of the world. An effective antiviral against SARS-CoV-2 that could be administered orally for use following high-risk exposure would be of substantial benefit in controlling the COVID-19 pandemic. Herein, we show that MK-4482, an orally administered nucleoside analog, inhibits SARS-CoV-2 replication in the Syrian hamster model. The inhibitory effect of MK-4482 on SARS-CoV-2 replication was observed in animals when the drug was administered either beginning 12 hours before or 12 hours following infection in a high-risk exposure model. These data support the potential utility of MK-4482 to control SARS-CoV-2 infection in humans following high-risk exposure as well as for treatment of COVID-19 patients.
Microstructure and properties of nano-laminated Y3Si2C2 ceramics fabricated via in situ reaction by spark plasma sintering
Authors: Shi Lin-Kun , Zhou Xiaobing , Dai Jian-Qing , Chen Ke , Huang Zhengren , Huang Qing 
Published: October 2020

Abstract
A new nano-laminated Y3Si2C2 ceramic material, for the first time, was successfully synthesized via in situ reaction between YH2 and SiC by spark plasma sintering. A MAX phase-like ternary layered structure of Y3Si2C2 was observed at the atomic-scale by high resolution transmission electron microscopy. The lattice parameters calculated from both X-ray diffraction and selected area electron diffraction patterns are in good agreement with the reported theoretical results. The nano-laminated fracture of kink boundaries, delamination, and slipping was observed at the tip of the Vickers indent. The values of elastic modulus and Vickers hardness of the Y3Si2C2 ceramics sintered at 1500 °C were 156 and 6.4 GPa, respectively. The corresponding values of thermal and electrical conductivity were 13.7 W m-1 k-1 and 6.3 × 105 S m-1, respectively.
A Dissemination Strategy to Promote Relational Coordination in the Veterans Health Administration: A Case Study
Authors: Connelly Brigid , Battaglia Catherine , Gilmartin Heather M. 
Published: October 2020

Abstract
BackgroundImplementing new healthcare practices across large organizations can be difficult due to inefficient diffusion of information. Using social marketing theory and additional evidence-based dissemination strategies, we spread relational coordination, an empirically supported theory of organizational performance, throughout the large Veterans Health Administration (VA). Relational Coordination drives performance outcomes including quality, efficiency, client satisfaction, and worker well-being and engagement and proposes interdependent work is most effectively coordinated by workers with each other, their customers, and their leaders. We aimed to develop a best-practice dissemination plan to educate and motivate researchers and operational staff in the VA to study and implement relational coordination within their programs of research or areas of operation.MethodsIn this observational case study, we followed the four Ps of social marketing theory to develop a strategy to disseminate relational coordination across the VA in two phases. In phase one, we created and distributed relational coordination information and invited VA staff to join the Relational Coordination Research Collaborative. In phase two dissemination efforts targeted researchers who were ready to study and implement relational coordination within existing programs of research. Primarily observational data were collected through both stages of the project and a final, post-project survey was administered after the second phase. The quantitative results were calculated using descriptive statistics and text responses in the survey were analyzed using deductive content analysis. A structured categorization matrix was developed to code the responses based on the survey questions. ResultsThe first phase saw instances of social media dissemination, presentations, as well as phone or email communication between project staff and the target audience. 47 members of VA staff joined the Relational Coordination Research Collaborative and 50% participated in online research seminars. 13 research projects applied for the second stage and 5 projects were ultimately chosen to access the Relational Coordination survey. Relational coordination-related trainings, presentations, and publications also occurred.ConclusionsDissemination approaches that involved personalized, one-on-one efforts seemed to be more effective at spreading relational coordination compared to social media or other online presentations. Participants in the second phase overwhelmingly agreed to that relational coordination should be adopted in the VA but indicated the cost of the program would have been a barrier. Results reiterate the importance of an intentional dissemination plan, including addressing the costs and benefits of programs
Radiographic Analysis in Reduction Loss After Distal Radius Fracture Fixation with Variable Angle Volar Locking Plate
Authors: Fang Pin-Chieh , Lo Tak-Yu-Yubie , Cheng Chun-Ying , Chou Ying-Chao , Chen Alvin Chao-Yu 
Published: October 2020

Abstract
Background Reduction loss is commonly seen even in the newly designed locking plate fixation for distal radius fractures. Our study purpose is to investigate the efficacy of the variable angle volar locking plate (VAVLP) in maintenance of fracture fixation. Methods A total of 37 patients of unilateral distal radius fractures receiving VAVLP fixation were enrolled. Forearm radiographs immediately after surgery and those at 3 months were retrospectively reviewed by orthopedist, radiologist and medical students for analysis of radiographic parameter including radial height (RH), ulnar variance (UV), radial inclination (RI), volar tilt (VT), tear drop angle (TDA), distal dorsal cortical distance (DDD) and Soong classification (SC). Results By comparing the 3-month measurement and normal data, the difference of RH / UV / TDA was significant (p-value of 0.000) while the difference of RI / VT was insignificant. However, there was no significant difference regarding those five parameters between postoperative and 3-month measurement. Linear regression on DDD exhibited positive dependence with p-value of 0.002 between postoperative and 3-month changes; predictability after modification was 21.3%. Postoperative SC was grade 0 in 13 patients, grade 1 in 21, and grade 2, in 3. There were 7 of Gr 0 and 2 of Gr 1 became one grade up.Conclusion VAVLP fixation in distal radius fracture can maintain radiographic alignment without significant reduction loss for at least 3 months. Realignment within normal range was in RI and VT, but not in RH / UV / TDA.
Percutaneous Repair Method and Achilles Tendon Rupture Rehabilitation
Authors: Ficek Krzysztof , Gwiazdoń Paweł , Rajca Jolanta , Hajduk Grzegorz 
Published: October 2020

Abstract
Background: Subcutaneous, spontaneous, complete ruptures of the Achilles tendon are usually caused indirectly by trauma associated with rapid movement. When minimally invasive Achilles tendon repair is performed, an active rehabilitation protocol can be implemented that allows for fast, measurable progress, reduced tissue atrophy, and an improved range of motion, thereby reducing pain and increasing patients’ overall physical well-being. However, overestimating the effectiveness of rehabilitative interventions can lead to arbitrary advancements in rehabilitation that significantly exceed the permitted levels of daily or professional activity. This issue can lead to various side effects and slow rehabilitation. The aim of the study was to evaluate the influence of adverse effects on objective outcomes after minimally invasive Achilles tendon repair.Methods: The study included 36 individuals with complete Achilles tendon rupture who underwent the percutaneous Ma-Griffith technique. The same rehabilitation protocol was used.Results: Five side effects were identified during rehabilitation: deformation of the repair construct (DRC), irritation of the sural nerve (SNI), morning ankle stiffness (MAS), edema of the soft tissue around the tendon (OST) and suture knots. DRC and MAS were associated with a longer time being required to achieve full ankle range of motion. SNI and OST were associated with a longer time being required to meet the criteria for dynamic training. None of the side effects were related to the isokinetic strength of the ankle plantar and dorsiflexors.Conclusions: The incidence of the assessed side effects in the postoperative period is not related to the type of activity, whether it is professional or amateur. Among the identified side effects, deformation of the regenerated shape of the heel tendon and MAS cause a delay in the recovery of full ankle range of motion. Calf nerve irritation and soft tissue swelling increase the time it takes to meet the criteria for starting dynamic training.Trial registration:The study was approved by the ethics committee of the Academy of Physical Education in Katowice (no. 13/2007)
“We Need to Be Told What to Do and What to Eat”: A Qualitative Study Exploring Perioperative Patient Desires, Suggestions and Reflections on Using Digital Health Technology Before and After Bariatric Surgery.&nbsp;
Authors: Robinson Anna , Husband Andy K , Slight Robert D , Slight Sarah P 
Published: October 2020

Abstract
BackgroundA patient’s capability, motivation, and opportunity to change their lifestyle are significant determinants of successful outcomes following bariatric surgery. Healthier lifestyle changes before and after surgery, including improved dietary intake and physical activity levels, have been shown to contribute to greater post-surgical weight loss and improved long-term health. Integrating patient-centred digital technologies within the bariatric surgical pathway could form part of an innovative strategy to promote and sustain healthier behaviours and provide holistic patient support, to improve surgical success. This study explores the desires, suggestions, and reflections of perioperative patients in the context of integrating digital technologies within the surgical pathway. MethodsPatients attending bariatric surgery clinics within one hospital in the North of England were invited to take part in the study. Semi-structured interviews were conducted with pre- and post-operative patients to discuss lifestyle behaviour change and perspectives of using digital technologies to complement current care. Interviews were audio-recorded and transcribed verbatim. Thematic analysis enabled the development of themes from the data. Ethical approval was obtained from the NHS Health Research Authority.ResultsEighteen patients were interviewed. Four overarching themes were identified relating to patient perspectives of optimised technology functionality to: 1) provide tailored content and support, 2) facilitate self-monitoring and goal-setting, 3) deliver information in an accessible, trusted, and usable manner, and 4) meet patient information-seeking and engagement needs. ConclusionsWe make recommendations to address the unmet needs of this patient cohort. These findings have the potential to influence the design of person-centred, perioperative technologies.
Barriers and Facilitators of Following Perioperative Internal Medicine Recommendations by Surgical Teams: A Sequential, Explanatory Mixed-methods Study
Authors: Flemons Kristin , Bosch Michael , Coakeley Sarah , Muzammal Bushra , Kachra Rahim , Ruzycki Shannon M. 
Published: October 2020

Abstract
Background: Preoperative medical consultations add expense and burden for patients and the impact of these consults on patient outcomes is conflicting. Previous work suggests that 10-40% of preoperative medical consult recommendations are not followed. This limits measurement of the effect of perioperative medical consultation on patient outcomes and represents a quality gap, given the patient time and healthcare cost associated with consultation. We aimed to measure, characterize, and understand reasons for missed recommendations from preoperative medical consultation.Methods: This explanatory, sequential mixed methods study used chart audits followed by semi-structured interviews. Chart audit of consecutive patients seen in preoperative medical clinic were reviewed to measure the proportion and characterize the type of recommendations that were not completed (‘missed’). This phase informed the interview participants and questions. The interview guide was developed using the Consolidated Framework for Implementation Research and the Theoretical Domains Framework. Template analysis was used to understand drivers and barriers of missed recommendationsResults: Chart audit included 295 patients (n=188, 63.7% female) seen in preadmission clinic between April 1 and April 30th, 2019. 51.8% of patients all recommendations followed (n=142). Postoperative anticoagulation management and postoperative cardiac biomarker surveillance recommendations were least commonly followed (45.2%; n=28, and 64.1%; n=84, respectively). Eighteen surgical team members were interviewed. Missed recommendations were both unintentional and intentional, and the key drivers differed by these categories. Unintentionally missed recommendations occurred due to individual-level factors (drivers: knowledge of the consultation note, lack of routine for reviewing the consultation note, and competing demands on time) and systems-level factors (drivers: lack of role clarity). Intentionally missed recommendations occurred due to user error due (drivers: lack of knowledge of guidelines or evidence) and appropriate modifications (drivers: need to adapt a preoperative plan for a complicated postoperative course).Conclusions: Only 51.8% of consult notes had all recommendations followed, suggesting a quality gap in perioperative medical care. Qualitative data suggests multiple drivers of missed recommendations that should be targeted to improve the efficiency of care for these patients.
Dengue Outbreak Prediction Based on Artificial Neural Networking Model Using Climatic Parameters
Authors: Ghosh Biplab , Soni Monika 
Published: October 2020

Abstract
Background: Dengue fever is a vector-borne tropical disease radically amplified by 30 times in occurrence between 1960 and 2010. The upsurge is considered to be because of urbanization, population growth and climate change. Therefore, Meteorological parameters (temperature, precipitation and relative humidity) have impact on the occurrence and outbreaks of dengue fever. There are not many studies that enumerate the relationship between the dengue cases in a particular locality and the meteorological parameters. This study explores the relationship between the dengue cases and the meteorological parameters. In prevalent localities, it is essential to alleviate the outbreaks using modelling techniques for better disease control.Methods: An artificial neural network (ANN) model was developed for predicting the number of dengue cases by knowing the meteorological parameters. The model was trained with 7 years of dengue fever data of Kamrup and Lakhimpur district of Assam, India. The practicality of the model was corroborated using independent data set with satisfactory outcomes. Findings: It was apparent from the sensitivity analysis that precipitation is more sensitive to the number of dengue cases than other meteorological parameters. Conclusion: This model would assist dengue fever alleviation and control in the long run.
Predictive Value of Tumor Infiltrating Lymphocytes in Neoadjuvant Chemotherapy Treated Breast Cancer: A Meta-Analysis of 8052 Patients
Authors: Li Shiqi , Zhang Ying , Wang Shujun , Yang Rui 
Published: October 2020

Abstract
Background: We conducted a meta-analysis to determine the prognostic value of Tumor infiltrating lymphocytes (TILs) for patients with breast cancer on Neoadjuvant Chemotherapy, to explore the prognostic value of different TILs threshold in terms of pathological complete response (PCR).Methods: A systematic search of PubMed, EMBASE and Web of Science electronic databases was conducted to identify eligible articles published before September 2020. Data from studies were analyzed by using Review Manager 5.3 and Stata 15.0Results: A total of 22 published studies (including 8 052 patients) were eligible. Patients with high TILs level showed a higher rate of PCR to treatment (OR=3.182, 95 %CI, 2.549-3.973) compared to breast cancer patients with low TILs level. Although the association of TILs with response to neoadjuvant chemotherapy was similar across most breast cancer subtypes, there were a few differences ER negative or ER positive breast cancer. In studies (Type of breast cancer not clearly classified in the literature) where the cut-off value for TILs was ≥10 %, higher levels of total TILs predicted a higher PCR rate of Neoadjuvant Chemotherapy. However, for HER2-positive breast cancer patients, when a cut-off valve of TILs ≥ 30 % was used, the OR was 2.631 (95 % CI, 1.739-3.982, P = 0.000). TILs also were related to better DFS (HR=0.95, 95 %CI, 0.92-0.98, P=0.000) and overall survival (OS) (HR=0.90, 95 %CI, 0.85-0.95, P<0.0001) after Neoadjuvant Chemotherapy.Conclusions: TILs can be used as predictors of patients with breast cancer on Neoadjuvant Chemotherapy. TILs threshold with the greatest prognostic significance of PCR is as yet unknown, but a TILs threshold of at least 30 % is associated with the most powerful outcome prognostication of PCR.
Biomechanical evaluation of the primary stability of three different types of femoral stem fixations for canine total hip replacement
Authors: Saban Charles , Viguier Eric , Taroni Mathieu , Baldinger Arnaud , Blondel Margaux , Massenzio Michel , Carozzo Claude , Moissonnier Pierre , Cachon Thibaut 
Published: October 2020

Abstract
Background: Total hip arthroplasty is the main salvage procedure performed for hip osteoarthritis in dogs. Two main types of femoral stems are available: cemented stems, which offer excellent primary stability but are subject to aseptic loosening in the long term, and cementless stems, which have good long-term outcomes but lack primary stability. The adjunction of a neutral rod through the neck of the cementless stem to the lateral cortex of the femur could offer better primary stability before osteointegration. The aim of this study was to compare the primary stability of three different femoral stems, cemented (cFS), press-fit cementless (pfFS), and rod-press-fit cementless stems (r-pfFS), by measuring their transverse displacement on cyclic assays and resistance to subsidence with unidirectional load compression parallel to the longitudinal axis of the femur.Results: The force-displacement and stress-strain curves were assessed. The work necessary for subsidence, strain to failure, and mean strain of the cyclic assays were calculated. No significant differences were observed in transverse displacement (p=0.263) or mean strain (p=0.244) during the cyclic tests or in work necessary for subsidence (p=0.079) or strain to failure (p=0.075). The cFS and r-pfFS were significantly more resistant to subsidence than was the pfFS (p<0,05). No significant differences were observed between the cFS and r-pfFS groups (p=0.48).Conclusions: Cementless femoral stems with transfixing rods offer significantly higher stability to compressive load parallel to the longitudinal axis of the femur than do standard cementless stems and a level of stability comparable to that of cemented stems. r-pfFSs may be valuable in limiting the subsidence and micro-motion of press-fit femoral stems and thus improving the state of osteointegration of the prosthesis during the short-term postoperative period.