bluuebunny/crossref_metadata_2025_split huggingface dataset:
Failure to Rescue Deteriorating Patients: A Systematic Review of Root Causes and Improvement Strategies
Authors: Burke Joshua R. , Downey Candice , Almoudaris Alex M. 
Published: May 2020

Objectives
“Failure to rescue” (FTR) is the failure to prevent a death resulting from a complication of medical care or from a complication of underlying illness or surgery. There is a growing body of evidence that identifies causes and interventions that may improve institutional FTR rates. Why do patients “fail to rescue” after complications in hospital? What clinically relevant interventions have been shown to improve organizational fail to rescue rates? Can successful rescue methods be classified into a simple strategy?

Methods
A systematic review was performed and the following electronic databases searched between January 1, 2006, to February 12, 2018: MEDLINE, PsycINFO, Cochrane Library, CINAHL, and BNI databases. All studies that explored an intervention to improve failure to rescue in the adult population were considered.

Results
The search returned 1486 articles. Eight hundred forty-two abstracts were reviewed leaving 52 articles for full assessment. Articles were classified into 3 strategic arms (recognize, relay, and react) incorporating 6 areas of intervention with specific recommendations.

Conclusions
Complications occur consistently within healthcare organizations. They represent a huge burden on patients, clinicians, and healthcare systems. Organizations vary in their ability to manage such events. Failure to rescue is a measure of institutional competence in this context. We propose “The 3 Rs of Failure to Rescue” of recognize, relay, and react and hope that this serves as a valuable framework for understanding the phases where failure of patient salvage may occur. Future efforts at mitigating the differences in outcome from complication management between units may benefit from incorporating this proposed framework into institutional quality improvement.
Performance and Acceptability of the FC2 Female Condom When Used With and Without a Silicone Placebo Vaginal Ring—A Randomized, Crossover Trial
Authors: Nel Annalene , Malherbe Mariëtte , van Niekerk Neliëtte , Beksinska Mags , Greener Ross , Smit Jennifer , Frezieres Ron , Walsh Terri 
Published: May 2020

Background:
The silicone Dapivirine Vaginal Ring 25 mg, has been developed to provide an additional HIV prevention option for women. If approved for use, women will always be counselled to use condoms when using the vaginal ring for maximum protection. This paper evaluates the compatibility of female condoms with the ring.

Methods:
This was a 2-period crossover, randomized noninferiority trial. Couples in 2 sites in the United States of America were randomized to FC2 Female Condom (FC2) with and without a placebo silicone ring and asked to use 4 female condoms in each period. The primary noninferiority endpoint was the clinical failure rate during intercourse or withdrawal (self-reported clinical breakage, slippage, misdirection, and invagination). Frequencies and percentages were calculated for each failure mode and differences in performance of the 2 periods, using the female condom without the ring as reference. Noninferiority was defined using an 8% margin at the 5% significance level. Safety and tolerability were also assessed.

Results:
Eighty-one couples were enrolled and 79 completed the trial using a total of 596 female condoms (297 and 299 with/without a ring inserted, respectively). Total female condom clinical failure was 14.1% and 15.7% in the presence and absence of a ring, respectively, with a difference of −2.1% (95% confidence interval: −7.8% to 3.6%), thereby demonstrating noninferiority when used with the ring. There were no differences in safety and tolerability between the 2 periods.

Discussion:
Concurrent use of the placebo silicone vaginal ring had no significant effect on female condom functionality or safety outcomes.
Associations Between Widespread Pain and Sleep Quality in People With HIV
Authors: Sabin Caroline A. , Harding Richard , Doyle Nicki , Redline Susan , de Francesco Davide , Mallon Patrick W. G. , Post Frank A. , Boffito Marta , Sachikonye Memory , Geressu Adam , Winston Alan , Kunisaki Ken M. 
Published: May 2020

Background:
We investigate the association of widespread pain with sleep quality among people with HIV and HIV-negative controls.

Setting:
UK-based cohort.

Methods:
Pain information was collected through a pain mannikin identifying affected body sites; pain was classified as widespread if pain was reported in ≥4 of 5 body regions and in ≥7 of 15 body sites, and as regional otherwise. Sleep was assessed a median of 3.2 years later through 7-night actigraphy and through self-reported assessments of sleep quality. Chi-squared tests, Kruskal–Wallis tests, and linear/logistic regression considered associations between pain extent and sleep quality.

Results:
Of the 414 participants, 74 (17.9%) reported widespread and 189 (45.7%) regional pain. Although there were few clear associations between actigraphy outcomes and pain extent, those with widespread and regional pain consistently reported poorer sleep quality on all self-reported measures than those with no pain. Median (interquartile range) insomnia severity index and Patient-reported Outcomes Measurement Information System (PROMIS) for sleep disturbance and sleep-related impairment scores were 12 (7–16), 55.3 (48.0–58.9), and 57.2 (48.9–61.3), respectively, for those with widespread pain, 8 (4–13), 51.2 (45.5–58.3), and 50.3 (43.6–56.1) for those with regional pain, and 5 (2–9), 47.9 (42.9–54.3), and 45.5 (41.4–50.3) for those with no pain (all P values 0.0001). Associations remained strong after adjustment for HIV status and other confounders, and were reduced but remained significant, after adjustment for depressive symptoms.

Conclusions:
Widespread pain was not associated with objective measures of sleep but was strongly associated with self-reported assessments of sleep quality in people with HIV.
Spectrum of Frontotemporal Lobar Degeneration on 18F-FDG PET/CT Scan
Authors: Seniaray Nikhil , Verma Ritu , Ranjan Rajeev , Belho Ethel , Gupta Vanshika , Mahajan Harsh 
Published: May 2020

Abstract
FTLD (Frontotemporal lobar degeneration) is a clinically and pathologically heterogeneous group of degenerative disorders, characterized by predominantly asymmetric degeneration of frontal and temporal lobes with selective neuronal loss and gliosis. The disease presents with variable degrees of impairment in behavior, language, executive control, and motor symptoms with progressive loss of cognition. On the basis of presenting clinical symptoms, FTLD is further divided into behavioral variant, nonfluent/agrammatic variant primary progressive aphasia (PPA), semantic variant PPA, logopenic variant PPA, progressive supranuclear palsy, and corticobasal ganglionic degeneration. Here we illustrate the utility of FDG PET with statistical parametric analysis for evaluation of these patients.
Detection of Insulinomas Using Dual-Time-Point 68Ga-DOTA-Exendin 4 PET/CT
Authors: Michalski Kerstin , Laubner Katharina , Stoykow Christian , Omrane Mohamed Aymen , Maecke Helmut R. , Seufert Jochen , Goetz Christian , Meyer Philipp T. , Ruf Juri 
Published: May 2020

Purpose
Insulinomas are predominantly benign neuroendocrine tumors originating from beta cells within the islets of Langerhans of the endocrine pancreas. Because surgical resection represents the only curative therapy option, exact tumor localization and discrimination of insulinomas from focal or diffuse manifestations of congenital hyperinsulinism are crucial for optimal treatment strategies. We investigated the diagnostic value of glucagon-like peptide 1 receptor PET/CT using 68Ga-DOTA-exendin 4 for detecting insulinomas and compared the diagnostic value of PET scans performed at 2 time points.

Methods
In 10 patients with clinically and biochemically suspected insulinoma, PET/CT was performed at 1 hour (PET1) and 2 hours (PET2) after injection of 68Ga-DOTA-exendin 4. In this retrospective analysis, tracer uptake was visually assessed in both scans by 2 independent readers. SUVmax and tumor-to-background ratio (TBR) of focal lesions were assessed. Imaging results were compared with histopathologic findings, if patients underwent resection.

Results
Increased focal 68Ga-DOTA-exendin 4 uptake was observed in 8 of 10 patients concordantly by both readers. Seven patients with focal uptake underwent surgery with tumor enucleation and histopathologic proof of insulinoma (7/8). Two of 10 patients without focal uptake were considered to suffer from diffuse form of congenital hyperinsulinism and consequently received medical treatment. A significant increase of tumoral SUVmax on PET2 (PET1: SUVmax 20.2 ± 8.2 g/mL; PET2: SUVmax 24.7 ± 7.9 g/mL; P = 0.0018) did not result in a significant improvement in TBR (PET1: TBR 4.9 ± 1.7; PET2: TBR 4.3 ± 1.2; P = 0.2892).

Conclusions
Focal uptake of 68Ga-DOTA-exendin 4 reliably indicated insulinomas as histopathologically confirmed in all patients undergoing consecutive surgery. The diagnostic value of PET2 was not found to be superior to PET1, indicating that a single 1-hour 68Ga-DOTA-exendin 4 PET/CT scan is a sufficient and convenient approach for patient care.
A data first approach to modelling Covid-19
Authors: Prasad Jayanti 
Published: May 2020

AbstractThe primary data for Covid-19 pandemic is in the form of time series for the number of confirmed, recovered and dead cases. This data is updated every day and is available for most countries from multiple sources such as [Gar20b, iD20]. In this work we present a two step procedure for model fitting to Covid-19 data. In the first step, time dependent transmission coefficients are constructed directly from the data and, in the second step, measures of those (minimum, maximum, mean, median etc.,) are used to set priors for fitting models to data. We call this approach a “data driven approach” or “data first approach”. This scheme is complementary to Bayesian approach and can be used with or without that for parameter estimation. We use the procedure to fit a set of SIR and SIRD models, with time dependent contact rate, to Covid-19 data for a set of most affected countries. We find that SIR and SIRD models with constant transmission coefficients cannot fit Covid-19 data for most countries (mainly because social distancing, lockdown etc., make those time dependent). We find that any time dependent contact rate decaying with time can help to fit SIR and SIRD models for most of the countries. We also present constraints on transmission coefficients and basic reproduction number, as well as effective reproduction number. The main contributions of our work are as follows. (1) presenting a two step procedure for model fitting to Covid-19 data (2) constraining transmission coefficients as well asand, for a set of countries and (3) releasing a python packagePyCov19[Pra20b] that can used to fit a class of compartmental models, with time varying coefficients, to Covid-19 data.
Prevalence and Risk Factors of Diabetes Mellitus in People over 40 Years Old in Rural Areas of Central Hunan Province
Authors: Li Lan , Liao Yuan , Xiao Hao , Wang Tiantian , Liu Jing , Zhou Guijuan , Sun Guanghua , Li Kang , Huang Fujin , Feng Weibin , Zhou Jun 
Published: May 2020

AbstractObjectiveTo explore the prevalence of diabetes mellitus in rural areas of central Hunan province, and to analyze the risk factors related to diabetes mellitus (DM).MethodsA cross-sectional study was conducted by using questionnaires (gender, age, occupation, degree of education, exercise habits, smoke status, alcohol consumption, hypertension, cardiovascular disease, family history of diabetes), anthropometric measurements (height, weight, waist circumference, blood pressure) and biochemical indexes test (fasting blood-glucose, glycosylated hemoglobin, blood lipids). Villagers over 40 years old from a community in rural areas of central Hunan Province were investigated.ResultsA total of 410 clinical data were collected. The prevalence of diabetes mellitus in 410 (177 in male and 233 in female) villagers was 13.41%, including 13 males with a prevalence rate of 7.34% and 42 females with a prevalence rate of 15.16%. The prevalence of impaired fasting glucose (IFG) was 11.95%, 21 males (11.86% of males) and 28 females (10.11% of females). And the results of glycosylated hemoglobin test showed that 64% villagers with diabetes mellitus had hemoglobin A1c(HbA1c) above 6.5%. Univariate analysis suggested that gender, smoke status, alcohol consumption, family history of diabetes mellitus, hypercholesterolemia and hypertension were involved in diabetes mellitus (P<0.05). Multivariate logistic regression analysis showed that family history of diabetes (OR: 1.759; 95% CI: 1.010-3.065), hypercholesterolemia (OR: 3.819; 95% CI: 1.27-11.486) and hypertension (OR: 2.074; 95% CI: 1.130-3.809) were independent risk factors for diabetes mellitus, and the differences were statistically significant (P < 0.05).ConclusionThe prevalence of diabetes mellitus in rural areas of central Hunan Province is higher. Family history of diabetes, hypercholesterolemia and hypertension are major risk factors for diabetes mellitus. The knowledge of diabetes should be strengthened. Related interventions should be given based on the diabetes epidemic status of local.
The transmission of SARS-CoV-2 is likely comodulated by temperature and by relative humidity
Authors: Raines Kevin S. , Doniach Sebastian , Bhanot Gyan 
Published: May 2020

AbstractInferring the impact of climate upon the transmission of SARS-CoV-2 has been confounded by variability in testing, unknown disease introduction rates, and changing weather. Here we present a data model that accounts for dynamic testing rates and variations in disease introduction rates. We apply this model to data from Colombia, whose varied and seasonless climate, central port of entry, and swift, centralized response to the Covid-19 pandemic present an opportune environment for assessing the impact of climate factors on the spread of Covid-19. We observe strong attenuation of transmission in climates with sustained daily temperatures above 30 degrees Celsius and simultaneous mean relative humidity below 78%, with outbreaks occurring at high humidity even where the temperature is high. We hypothesize that temperature and relative humidity comodulate the infectivity of SARS-CoV-2 within respiratory droplets.
Impaired T cell functions along with elevated activated Tregs at the early stage of asymptomatic SARS-CoV-2 infection
Authors: Yang Jingyi , Zhang Ejuan , Zhong Maohua , Yang Qingyu , Hong Ke , Shu Ting , Zhou Dihan , Xiang Jie , Xia Jianbo , Zhou Xi , Zhang Dingyu , Huang Chaolin , Shang You , Yan Huimin 
Published: May 2020

SummaryBackgroundLimited data are available on the T cell responses for the asymptomatic SARS-CoV-2 infection case.MethodsAn imported SARS-CoV-2 infection case in Wuhan was admitted in hospital for quarantine and observation. The T cell responses were followed up by flow cytometry analysis of the peripheral blood nonnuclear cells (PBMCs) at days 7, 13, 22, and 28 after admission.FindingsWe found the imported SARS-CoV-2 infection in Wuhan is an asymptomatic case. His T cell differentiation, proliferation and activation matched the classical kinetics of T cell responses induced by viral infection, but the activation maintained at a relatively low level. Function analysis indicated frequencies of IFN-γ producing CD4+ and CD8+ T cells were notably lower than that of the healthy controls (HC) at day 7, and then rebound gradually. But IFN-γ+CD8+ T cells were detained at a significant lower level even at day 28, when the SARS-CoV-2 virus had already become undetectable for 3 weeks. Moreover, percentage of IL-17 producing CD4+ T cells was also detained constantly at a much lower level compared to HC. At day 7, although percentage of Tregs was in normal range, the frequency of activated Treg (aTreg) was remarkably as high as 4·4-fold of that in HC.InterpretationThe T cell activation in the asymptomatic SARS-CoV-2 infection experienced a significant suppression and presented impairment of Th1/Th17 and CD8+ T cell functions. Early elevation of the aTregs might play role in the activation and function of T cells in the asymptomatic SARS-CoV-2 infection.
Prediction of mechanical properties and optimization of process parameters in friction-stir-welded dissimilar aluminium alloys
Authors: T. Senthilnathan , B. Sujay Aadithya , K. Balachandar 
Published: May 2020

Purpose
This study aims to predict the mechanical properties such as equivalent tensile strength and micro-hardness of friction-stir-welded dissimilar aluminium alloy plates AA 6063-O and AA 2014-T6, using artificial neural network (ANN).

Design/methodology/approach
The ANN model used for the experiment was developed through back propagation algorithm. The input parameter of the model consisted of tool rotational speed and weld-traverse speed whereas the output of the model consisted of mechanical properties (tensile strength and hardness) of the joint formed by friction-stir welding (FSW) process. The ANN was trained for 60% of the experimental data. In addition, the impact of the process parameters (tool rotational speed and weld-traverse speed) on the mechanical properties of the joint was determined by Taguchi Grey relational analysis.

Findings
Subsequently, testing and validation of the ANN were done using experimental data, which were not used for training the network. From the experiment, it was inferred that the outcomes of the ANN are in good agreement with the experimental data. The result of the analyses showed that the tool rotational speed has more impact than the weld-traverse speed.

Originality/value
The developed neural network can be used to predict the mechanical properties of the weld. Results indicate that the network prediction is similar to the experiment results. Overall regression value computed for training, validation and testing is greater than 0.9900 for both tensile strength and microhardness. In addition, the percentage error between experimental and predicted values was found to be minimal for the mechanical properties of the weldments. Therefore, it can be concluded that ANN is a potential tool for predicting the mechanical properties of the weld formed by FSW process. Similarly, the results of Taguchi Grey relational analysis can be used to optimize the process parameters of the weld process and it can be applied extensively to ascertain the most prominent factor. The results of which indicates that rotational speed of 1,270 rpm and traverse speed of 30 mm/min are to be the optimized process parameters. The result also shows that tool rotational speed has more impact on the mechanical properties of the weld than that of traverse speed.
Comparative transcriptomic analyses of Chromera and Symbiodiniaceae
Authors: Mohamed Amin R. , Chan Cheong Xin , Ragan Mark A. , Zhang Jia , Cooke Ira , Ball Eldon E. , Miller David J. 
Published: May 2020

SummaryReef‐building corals live in a mutualistic relationship with photosynthetic algae (family Symbiodiniaceae) that usually provide most of the energy required by the coral host. This relationship is sensitive to temperature stress; as little as a 1°C increase often leads to the collapse of the association. This sensitivity has led to an interest in the potential of more stress‐tolerant algae to supplement or substitute for the normal Symbiodiniaceae mutualists. In this respect, the apicomplexan‐like microalga Chromera is of particular interest due to its greater temperature tolerance. We generated a de novo transcriptome for a Chromera strain isolated from a GBR coral (‘GBR Chromera’) and compared with those of the reference strain of Chromera (‘Sydney Chromera’), and to those of Symbiodiniaceae (Fugacium kawagutii, Cladocopium goreaui and Breviolum minutum), as well as the apicomplexan parasite, Plasmodium falciparum. In contrast to the high sequence divergence amongst representatives of different genera within the family Symbiodiniaceae, the two Chromera strains featured low sequence divergence at orthologous genes, implying that they are likely to be conspecifics. Although KEGG categories provide few criteria by which true coral mutualists might be identified, they do supply a molecular rationalization that explains the ecological dominance of Cladocopium spp. amongst Indo‐Pacific reef corals. The presence of HSP20 genes may contribute to the high thermal tolerance of Chromera.
Is radical resection of hilar cholangiocarcinoma plus partial resection of pancreatic head justified for advanced hilar cholangiocarcinoma?
Authors: Liu Fei , Hu Hai‐Jie , Ma Wen‐Jie , Wang Jun‐Ke , Ran Cong‐Dun , Regmi Parbatraj , Li Fu‐Yu 
Published: May 2020

AbstractBackgroundTo outline our experience with the radical resection of hilar cholangiocarcinoma (HCCA) combined with the partial resection of the pancreatic head (RRHCCAPRPH) as a treatment for HCCA with distal bile duct involvement and to appraise the feasibility of this challenging procedure.MethodsBetween 2007 and 2017, 205 patients with HCCA who underwent curative surgery at our hospital were included. Among the patients, extrahepatic bile duct resection combined with hepatectomy (EBDRH), RRHCCAPRPH and hepatopancreaticoduodenectomy (HPD) was performed in 168, 21 and 16 patients, respectively. Clinical pathological factors, post‐operative complications and survival were compared between the three groups.ResultsThere was a significant difference in operative blood loss, operative time, post‐operative hospital stay and tumour size between EBDRH group, RRHCCAPRPH group and HPD group (P < 0.05). In terms of post‐operative complications, there was no statistical difference between the three groups (P = 0.177). Further analysis showed that the incidence of pancreatic fistula (43.8%) and delayed gastric emptying (25%) after HPD were significantly higher than the other two groups. The median survival time and overall survival rate for 172 patients with R0 resection were 33 months and 85.5% at 1 year, 47.7% at 3 years, 28.4% at 5 years. Furthermore, the 1‐, 3‐ and 5‐year survival rates of patients with EBDRH, RRHCCAPRPH and HPD after R0 resection were 86.2%, 48.7%, 29.2%; 85.0%, 44.0%, 24.7% and 78.6%, 42.9%, 22.9%, respectively (P = 0.948).ConclusionThe RRHCCAPRPH in some selected patients can actually replace HPD as a surgical treatment for HCCA with distal bile duct involvement.