bluuebunny/crossref_metadata_2025_split huggingface dataset:
Is it time to rethink how we page physicians? Understanding paging patterns in a tertiary care hospital
Authors: Witherspoon Luke , Nham Emily , Abdi Hamidreza , Dergham Ali , Skinner Thomas , Oake J. Stuart , Watterson James , Lavallée Luke T. 
Published: December 2019

Abstract
Background
Frequent pages can disrupt workflow, interrupt patient care, and may contribute to physician burnout. We hypothesized that paging volumes followed consistent temporal trends, regardless of the medical or surgical service, reflecting systems based issues present in our hospitals.

Methods
A retrospective review of the hospital paging systems for 4 services at The Ottawa Hospital was performed. Resident paging data from April 1 to July 31, 2018 were collected for services with a single primary pager number including orthopaedic surgery, general surgery, neurology, and neurosurgery. Trends in paging volume during the 4-month period were examined. Variables examined included the location of origin of the page (emergency room vs. inpatient unit), and day/time of the page.

Results
During the study period, 25,797 pages were received by the 4 services, averaging 211 (± Standard Deviation (SD) 12) pages per day. 19,371 (75%) pages were from in-patient hospital units, while 6426 (24%) were pages from the emergency room. The median interval between pages across all specialties was 22:30 min. Emergency room pages peaked between 16:30 and 20:00, while in-patient units peaked between 17:30 and 18:30.

Conclusions
Each service experienced frequent paging with similar patterns of marked increases at specific times. This study identifies areas for future study about what the factors are that contribute to the paging patterns observed.
TBX2-positive cells represent a multi-potent mesenchymal progenitor pool in the developing lung
Authors: Wojahn Irina , Lüdtke Timo H. , Christoffels Vincent M. , Trowe Mark-Oliver , Kispert Andreas 
Published: December 2019

AbstractBackgroundIn the embryonic mammalian lung, mesenchymal cells act both as a signaling center for epithelial proliferation, differentiation and morphogenesis as well as a source for a multitude of differentiated cell types that support the structure of the developing and mature organ. Whether the embryonic pulmonary mesenchyme is a homogenous precursor pool and how it diversifies into different cell lineages is poorly understood. We have previously shown that the T-box transcription factor geneTbx2is expressed in the pulmonary mesenchyme of the developing murine lung and is required therein to maintain branching morphogenesis.MethodsWe determined Tbx2/TBX2 expression in the developing murine lung by in situ hybridization and immunofluorescence analyses. We used a genetic lineage tracing approach with aCreline under the control of endogenousTbx2control elements (Tbx2cre), and theR26mTmGreporter line to trace TBX2-positive cells in the murine lung. We determined the fate of the TBX2 lineage by co-immunofluorescence analysis of the GFP reporter and differentiation markers in normal murine lungs and in lungs lacking or overexpressing TBX2 in the pulmonary mesenchyme.ResultsWe show that TBX2 is strongly expressed in mesenchymal progenitors in the developing murine lung. In differentiated smooth muscle cells and in fibroblasts, expression of TBX2 is still widespread but strongly reduced. In mesothelial and endothelial cells expression is more variable and scattered. All fetal smooth muscle cells, endothelial cells and fibroblasts derive from TBX2+progenitors, whereas half of the mesothelial cells have a different descent. The fate of TBX2-expressing cells is not changed inTbx2-deficient and inTBX2-constitutively overexpressing mice but the distribution and abundance of endothelial and smooth muscle cells is changed in the overexpression condition.ConclusionThe fate of pulmonary mesenchymal progenitors is largely independent of TBX2. Nevertheless, a successive and precisely timed downregulation of TBX2 is necessary to allow proper differentiation and functionality of bronchial smooth muscle cells and to limit endothelial differentiation. Our work suggests expression of TBX2 in an early pulmonary mesenchymal progenitor and supports a role of TBX2 in maintaining the precursor state of these cells.
When and how do individuals transition from regular drug use to injection drug use in Uganda? Findings from a rapid assessment
Authors: Baluku Matayo , Wamala Twaibu 
Published: December 2019

Abstract
Background
In Uganda, injection drug use is a growing but less studied problem. Preventing the transition to injection drug use may help prevent blood-borne viral transmission, but little is known about when and how people transition to injection drug use. A greater understanding of this transition process may aid in the country’s efforts to prevent the continued growth of injection drug use, HIV, and hepatitis C Virus (HCV) infection among people who inject drugs (PWID).

Methods
Using a rapid situation assessment framework, we conducted semi-structured interviews among 125 PWID (102 males and 23 females)—recruited through outreach and snow-ball sampling. Participants were interviewed about their experiences on when and how they transitioned into injection drug use and these issues were also discussed in 12 focus groups held with the participants.

Results
All the study participants started their drug use career with non-injecting forms including chewing, smoking, and sniffing before transitioning to injecting. Transitioning was generally described as a peer-driven and socially learnt behavior. The participants’ social networks and accessibility to injectable drugs on the market and among close friends influenced the time lag between first regular drug use and first injecting—which took an average of 4.5 years. By the age of 24, at least 81.6% (95.7% for females and 78.4% for males) had transitioned into injecting. Over 84.8% shared injecting equipment during their first injection, 47.2% started injecting because a close friend was already injecting, 26.4% desired to achieve a greater “high” (26.4%) which could reflect drug-tolerance, and 12% out of curiosity.

Conclusions
Over 81% non-injecting drug users in Kampala and Mbale districts transitioned into injecting by the age of 24; a process that reproduces a population of PWID but also puts them at increased risk of HIV and HCV infection. As Uganda makes efforts to introduce and/or strengthen harm reduction services, interventions targeting non-injecting drug users before they transition into injecting should be considered as a key component for HIV/HCV epidemic control efforts, and their evaluation considered in future researches.
Molecular biomarkers in multiple sclerosis
Authors: Ziemssen Tjalf , Akgün Katja , Brück Wolfgang 
Published: December 2019

AbstractMultiple sclerosis (MS) is an inflammatory-neurodegenerative disease of the central nervous system presenting with significant inter- and intraindividual heterogeneity. However, the application of clinical and imaging biomarkers is currently not able to allow individual characterization and prediction. Complementary, molecular biomarkers which are easily quantifiable come from the areas of immunology and neurobiology due to the causal pathomechanisms and can excellently complement other disease characteristics. Only a few molecular biomarkers have so far been routinely used in clinical practice as their validation and transfer take a long time. This review describes the characteristics that an ideal MS biomarker should have and the challenges of establishing new biomarkers. In addition, clinically relevant and promising biomarkers from the blood and cerebrospinal fluid are presented which are useful for MS diagnosis and prognosis as well as for the assessment of therapy response and side effects.
Life-threatening complications of high doses of intravenous methylprednisolone for treatment of Graves’ orbitopathy
Authors: Walasik-Szemplińska Dorota , Kamiński Grzegorz , Sudoł-Szopińska Iwona 
Published: December 2019

Abstract
Background
Treatment of moderate to severe Graves’ orbitopathy (GO) is based mainly on intravenous pulses of methylprednisolone. High doses of methylprednisolone can exert several adverse effects, some of which might be life-threatening. The objective of this study is to describe the most severe complications associated with intravenous administration of high doses of glucocorticoids, and to develop the patient examination standards prior to their qualification for the therapy.

Main body
In this paper, we describe the most severe, life-threatening complications of intravenous methylprednisolone and address their possible underlying mechanism. We also present recommendations and precautions which should be taken prior to initiation of intravenous pulses of methylprednisolone treatment for GO. To address risk of hepatic complications, we recommend regular monitoring of biochemical parameters of hepatic function. Additionally, assessment of the risk of cardiovascular events should be undertaken based on medical history, estimation of risk factors, and investigations, such as determination of thyroid hormones and thyroid-stimulating hormone levels, electrolyte and glucose concentrations, electrocardiogram examination and measurements of blood pressure.

Conclusions
An individualized safe and effective dose of intravenous methylprednisolone should be established for each patient with GO based on the vascular risk factors, comorbidities, and concomitant drugs. According to the European Group on Graves’ Orbitopathy (EUGOGO) guidelines, cumulative doses of intravenous methylprednisolone should not exceed 8 g.
Impact of gender on post- traumatic intensive care and outcomes
Authors: Larsson Emma , Lindström Ann-Charlotte , Eriksson Mikael , Oldner Anders 
Published: December 2019

AbstractBackgroundSeveral reports indicate gender disparities in health care provision. There is a well-documented male patient dominance in intensive care unit (ICU) admittance. It is not established if this difference reflects medical needs or is influenced by other factors. The aim of the current study was to investigate if patient gender influences the pattern of ICU admittance in a cohort of trauma patients.MethodsData from patients admitted to an urban trauma centre over a 10-year interval were linked to regional and national health registries to obtain data on demographics, co-comorbidities, trauma-related variables, ICU-admittance patterns and mortality. The association between gender and ICU-admission were explored using logistic regression analysis. The association between gender and short- and long-term mortality were explored using Cox regression models.ResultsIn this study cohort of approximately 14,000 trauma patients, men had a higher probability of being admitted to the ICU after initial trauma resuscitation. The difference was limited to patients with less severe injuries (ISS < 15). No differences were noted in short-term survival, whereas men had a higher long-term mortality.ConclusionsIn this retrospective cohort study we found a difference between men and women in post trauma ICU admittance patterns, restricted to less injured patients, where men had a higher probability of ICU admittance. Whether this is a true gender bias or an effect of other factors not analysed in this study remains unknown. This finding warrants further studies.
Feature selection and dimension reduction for single-cell RNA-Seq based on a multinomial model
Authors: Townes F. William , Hicks Stephanie C. , Aryee Martin J. , Irizarry Rafael A. 
Published: December 2019

AbstractSingle-cell RNA-Seq (scRNA-Seq) profiles gene expression of individual cells. Recent scRNA-Seq datasets have incorporated unique molecular identifiers (UMIs). Using negative controls, we show UMI counts follow multinomial sampling with no zero inflation. Current normalization procedures such as log of counts per million and feature selection by highly variable genes produce false variability in dimension reduction. We propose simple multinomial methods, including generalized principal component analysis (GLM-PCA) for non-normal distributions, and feature selection using deviance. These methods outperform the current practice in a downstream clustering assessment using ground truth datasets.
What and how should we measure in paediatric oncology FDG-PET/CT? Comparison of commonly used SUV metrics for differentiation between paediatric tumours
Authors: Blautzik Janusch , Grelich Leonie , Schramm Nicolai , Henkel Rebecca , Bartenstein Peter , Pfluger Thomas 
Published: December 2019

AbstractBackgroundIn clinical routine, SUVmaxand SUVpeakare most often used to determine the glucose metabolism in tumours by18F-FDG PET/CT. Both metrics can be further normalised to SUVs in reference regions resulting in a SUV ratio (SUVratio). The aim of the study was to directly compare several widely used SUVs/SUVratioswith regard to differentiation between common tumours in paediatric patients; a special focus was put on characteristics of reference region SUVs.MethodsThe final study population consisted of 61 children and adolescents with diagnoses of non-Hodgkin lymphoma (NHL,n= 25), Hodgkin lymphoma (HL,n= 14), and sarcoma (n= 22). SUV metrics included SUVmaxand SUVpeakas well as both parameters normalised to liver and mediastinal blood pool, respectively, yielding the SUVratiosSUVmax/liver, SUVmax/mediastinum, SUVpeak/liver, and SUVpeak/mediastinum.ResultsThe metrics SUVmax, SUVpeak, SUVmax/liver, and SUVpeak/liverall proved to be sensitive for tumour differentiation (p≤ 0.008); in contrast, SUVmax/mediastinumand SUVpeak/mediastinumrevealed to be non-sensitive approaches. Correlation analyses showed inverse associations between reference region SUVs and SUVratios(p< 0.05). Multiple regression analyses demonstrated significant effects of factors as bodyweight and uptake time on reference region SUVs (p< 0.01), and thus indirectly on the corresponding SUVratios.ConclusionsIn the paediatric population, the ability to differentiate between common tumours remarkably varies between SUV metrics. When using SUVratios, the choice of reference region is crucial. Factors potentially influencing reference region SUVs (and thus SUVratios) should be taken into account in order to avoid erroneous conclusions. When not possible, SUVmaxand SUVpeakrepresent less complex, more robust alternatives.
Online/offline score informed music signal decomposition: application to minus one
Authors: Munoz-Montoro Antonio Jesús , Carabias-Orti Julio José , Vera-Candeas Pedro , Canadas-Quesada Francisco Jesús , Ruiz-Reyes Nicolás 
Published: December 2019

AbstractIn this paper, we propose a score-informed source separation framework based on non-negative matrix factorization (NMF) and dynamic time warping (DTW) that suits for both offline and online systems. The proposed framework is composed of three stages: training, alignment, and separation. In the training stage, the score is encoded as a sequence of individual occurrences and unique combinations of notes denoted as score units. Then, we proposed a NMF-based signal model where the basis functions for each score unit are represented as a weighted combination of spectral patterns for each note and instrument in the score obtained from a trained a priori over-completed dictionary. In the alignment stage, the time-varying gains are estimated at frame level by computing the projection of each score unit basis function over the captured audio signal. Then, under the assumption that only a score unit is active at a time, we propose an online DTW scheme to synchronize the score information with the performance. Finally, in the separation stage, the obtained gains are refined using local low-rank NMF and the separated sources are obtained using a soft-filter strategy. The framework has been evaluated and compared with other state-of-the-art methods for single channel source separation of small ensembles and large orchestra ensembles obtaining reliable results in terms of SDR and SIR. Finally, our method has been evaluated in the specific task of acoustic minus one, and some demos are presented.
Preferred Reporting Items for Overviews of Reviews (PRIOR): a protocol for development of a reporting guideline for overviews of reviews of healthcare interventions
Authors: Pollock Michelle , Fernandes Ricardo M. , Pieper Dawid , Tricco Andrea C. , Gates Michelle , Gates Allison , Hartling Lisa 
Published: December 2019

AbstractBackgroundOverviews of reviews (i.e., overviews) compile information from multiple systematic reviews to provide a single synthesis of relevant evidence for healthcare decision-making. Despite their increasing popularity, there are currently no systematically developed reporting guidelines for overviews. This is problematic because the reporting of published overviews varies considerably and is often substandard. Our objective is to use explicit, systematic, and transparent methods to develop an evidence-based and agreement-based reporting guideline for overviews of reviews of healthcare interventions (PRIOR, Preferred Reporting Items for Overviews of Reviews).MethodsWe will develop the PRIOR reporting guideline in four stages, using established methods for developing reporting guidelines in health research. First, we will establish an international and multidisciplinary expert advisory board that will oversee the conduct of the project and provide methodological support. Second, we will use the results of comprehensive literature reviews to develop a list of prospective checklist items for the reporting guideline. Third, we will use a modified Delphi exercise to achieve a high level of expert agreement on the list of items to be included in the PRIOR reporting guideline. We will identify and recruit a group of up to 100 international experts who will provide input into the guideline in three Delphi rounds: the first two rounds will occur via online survey, and the third round will occur during a smaller (8 to 10 participants) in-person meeting that will use a nominal group technique. Fourth, we will produce and publish the PRIOR reporting guideline.DiscussionA systematically developed reporting guideline for overviews could help to improve the accuracy, completeness, and transparency of overviews. This, in turn, could help maximize the value and impact of overviews by allowing more efficient interpretation and use of their research findings.
Using simulation-based learning to provide interprofessional education in diabetes to nutrition and dietetics and exercise physiology students through telehealth
Authors: O’Shea Marie-Claire , Reeves Nathan E. , Bialocerkowski Andrea , Cardell Elizabeth 
Published: December 2019

AbstractBackgroundCurrent workforce demands require new graduates to competently work within health care teams and often in remote settings. To better prepare students for this work, universities have spent much time developing interprofessional education (IPE) activities. The body of literature supporting IPE of allied health students is growing. Simulation-based learning with simulated patients is one platform through which IPE can be implemented in a dedicated, supported environment and potentially at scale. This study describes an interprofessional simulation-based learning experience with nutrition and dietetics and exercise physiology students. The common practice area of interacting with patients who have type 2 diabetes was targeted, and the simulation was delivered in partnership with simulated patients via a telehealth platform to allow interprofessional teams to work collaboratively in remote locations.MethodsTen nutrition and dietetics and 13 exercise physiology students participated in a simulation module in which students observed and collaborated in the development and delivery of an interprofessional treatment plan for patients with diabetes. Learning outcomes were measured according to the first two levels of Kirkpatrick’s (1994) model for training evaluation (i.e. reaction and learning), as well as the perceived impact on behaviour.ResultsThe students’ confidence in communication, assessment, management and ability to work with another health professional significantly increased (p< 0.05) post-activity. Students perceived that the simulation-based learning would have a positive impact on their clinical skills and ability to work with other health professionals. Students reported that the most effective aspects of the simulation module were learning from and about each other, the opportunity for experiential learning and the supportive learning environment. However, the telehealth platform audio clarity and delay had negative impact on the learning experiences for students.ConclusionThe overall positive results demonstrate the potential of simulation-based learning activities for preparing allied health students for working in interprofessional teams. Although remote access was possible, the telehealth platform was identified as a limiting factor to this simulation-based learning experience. However, videoconferencing technology has advanced considerably since this study. Hence, there is an opportunity to employ more reliable technology for future simulations.
Role of magnetic resonance imaging in pregnancy-associated obstetric and gynecological complications
Authors: Nagenthran Gayathri , Rangasami Rajeshwaran , Chandrasekharan Anupama , Soundararajan Poovini , Godla Usha Rani 
Published: December 2019

Abstract
Background
To study the role of MRI in diagnosing pregnancy-associated obstetric and gynecological complications. We prospectively studied 48 pregnant and postpartum women, aged between 20 and 45 years, who were referred for MRI between August 2016 and April 2018 with suspected pregnancy-associated obstetric and gynecological complication. MRI findings were confirmed by intra-operative or histological findings.

Results
Out of the 48 patients, there were 32 women with suspected placenta accreta, 5 pregnant women with 6 ectopic pregnancies (1 patient had two gestational sacs), 3 with ovarian pathologies, 3 with uterine pathologies, 3 with abruptio placenta, and 2 with miscellaneous pathologies. In our study, there was an accuracy of 81.6% with sensitivity of 100% and specificity of 50%. There was 100% accuracy in predicting abruptio placenta, ovarian, uterine, and miscellaneous pathologies by MRI. There was 83.4% and 75% accuracy in predicting ectopic pregnancy and placenta accreta, respectively, by MRI.

Conclusion
MRI is very useful to diagnose pregnancy-associated obstetric and gynecological complications. It will be an important complementary tool to sonography and thereby facilitate better patient management.