bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hospital accreditation impact on healthcare quality dimensions: a systematic review
Authors: Araujo Claudia A S , Siqueira Marina Martins , Malik Ana Maria 
Published: August 2020

Abstract

Purpose
To systematically review the impact of hospital accreditation on healthcare quality indicators, as classified into seven healthcare quality dimensions.

Data source
We searched eight databases in June 2020: EBSCO, PubMed, Web of Science, Emerald, ProQuest, Science Direct, Scopus and Virtual Health Library. Search terms were conceptualized into three groups: hospitals, accreditation and terms relating to healthcare quality. The eligibility criteria included academic articles that applied quantitative methods to examine the impact of hospital accreditation on healthcare quality indicators.

Study selection
We applied the PICO framework to select the articles according to the following criteria: Population—all types of hospitals; Intervention—hospital accreditation; Comparison—quantitative method applied to compare accredited vs. nonaccredited hospitals, or hospitals before vs. after accreditation; Outcomes—regarding the seven healthcare quality dimensions. After a critical appraisal of the 943 citations initially retrieved, 36 studies were included in this review.

Results of data synthesis
Overall results suggest that accreditation may have a positive impact on efficiency, safety, effectiveness, timeliness and patient-centeredness. In turn, only one study analyzes the impact on access, and no study has investigated the impact on equity dimension yet.

Conclusion
Mainly due to the methodological shortcomings, the positive impact of accreditation on healthcare dimensions should be interpreted with caution. This study provides an up-to-date overview of the main themes examined in the literature, highlighting critical knowledge-gaps and methodological flaws. The findings may provide value to healthcare stakeholders in terms of improving their ability to assess the relevance of accreditation processes.
Clinical impact of a Clostridioides (Clostridium) difficile bedside infectious disease stewardship intervention
Authors: Olmedo María , Valerio Maricela , Reigadas Elena , Marín Mercedes , Alcalá Luis , Muñoz Patricia , Bouza Emilio 
Published: August 2020

Abstract

Objectives
To evaluate the clinical impact of a bedside visit to patients with a positive Clostridioides difficile test on the antimicrobial stewardship of C. difficile infection (CDI) and non-C. difficile infections.

Methods
All patients ≥18 years old with positive CDI laboratory tests hospitalized between January 2017 and August 2017 received an immediate bedside intervention that consisted mainly of checking protective measures and providing recommendations on infection control and the management of CDI and other infections.

Results
A total of 214 patients were evaluated. The infectious disease (ID) physician was the first to establish protective measures in 25.2% of the cases. In 22/29 (75.9%) cases, physicians in charge accepted ID consultant recommendations to stop CDI treatment in asymptomatic patients. Unnecessary non-CDI antibiotics were discontinued in 19.1% of the cases. ID recommendations were not accepted by physicians in charge in only 12.6% of the cases.

Conclusions
A bedside rapid intervention for patients with a CDI-positive faecal sample was effective in avoiding overdiagnosis and unnecessary antibiotic treatment, optimizing anti-CDI drugs, increasing compliance with infection control measures and providing educational advice.
On the Basis of Race: The Utility of a Race Factor in Estimating Glomerular Filtration
Authors: Franks Caroline E , Scott Mitchell G 
Published: August 2020

AbstractBackgroundGlomerular filtration rate (GFR) is a measure of the combined rate of filtration of all functional nephrons in the kidney. Measurement of GFR is used in the clinic to detect, stratify, and monitor progression of kidney dysfunction, and also serves as a prognostic tool for staging chronic kidney disease (CKD). The gold standard method for measuring GFR is by plasma or urine clearance of exogenous filtration markers, but this is not feasible in routine clinical practice. The most commonly used method to assess GFR is using equations for estimated GFR (eGFR).ContentAddition of a race factor to eGFR equations has been recommended to optimize performance for Black individuals. Here, we review the basis of the race-based equation and assess its utility and widespread applicability.SummaryAlthough evidence supporting the performance of a race factor exists in the unique populations in which these estimation equations were derived, more studies are needed to assess the need, or lack thereof, for race factors for all ethnicities. Furthermore, ethnicity is complex and likely cannot be qualified with a 2-level descriptor.
Endogenous GHB in Segmented Hair Part II: Intra-individual Variation for Exogenous Discrimination
Authors: Strickland Erin C , Thomas Jennifer L , Lloyd Erin W , Smith Michael A , LeBeau Marc A , Montgomery Madeline A , Karas Roman P , Peters Eugene M , Miller Mark L 
Published: August 2020

Abstract
The endogenous presence of gamma-hydroxybutyric acid (GHB) complicates the interpretation of results in cases where an exogenous dosing is suspected. Due to GHB’s rapid metabolism and clearance following exogenous doses, hair has become a preferential matrix for confirmation of GHB exposure in drug-facilitated crimes. However, unlike blood and urine where an agreed-upon cut-off concentration for differentiation between endogenous and exogenous GHB has been made, there has been no consensus on a cut-off concentration for hair. This is due in part to the wide inter- and intra-individual variation that has been observed in endogenous GHB hair studies. A large (&gt;50) population study of 214 donors was conducted to better understand these variations and to evaluate whether a cut-off concentration could be established for endogenous GHB in human hair. As seen in our previous study, the inter-individual variation was large, with concentrations ranging from &lt;0.40 to 5.47 ng/mg. This range made an absolute cut-off concentration recommendation inappropriate, so an alternative approach for GHB discrimination was investigated utilizing the intra-individual variation. Male donors appeared to have greater intra-individual variation than female donors, yet it was noted that segment-to-segment variation along the length of hair had minimal change between individual donor’s adjacent segments. Overall, 97.1% of the adjacent segment differences were within ±0.5 ng/mg. Therefore, instead of a recommended cut-off concentration, it appears that using adjacent segment concentration differences could be a strategy to assist in differentiating endogenous from single exogenous GHB exposure. In the absence of controlled dosing data, previously published segmented results from controlled and suspected dosing donors are examined using the adjacent segmental difference approach and the results compared to currently used ratio-based calculations.
Challenging the Hegemony of the Symptom: Reclaiming Context in PTSD and Moral Injury
Authors: Kinghorn Warren 
Published: August 2020

Abstract
Although post-traumatic stress disorder (PTSD) is now constituted by a set of characteristic symptoms, its roots lie in Post-Vietnam Syndrome, a label generated by a Vietnam-era advocacy movement that focused not on symptoms but on war’s traumatic context. When Post-Vietnam Syndrome was subsumed into the abstract, individualistic, symptom-centered language of DSM-III and rendered as PTSD, it not only lost this focus on context but also neglected the experiences of veterans who suffer from things done or witnessed, not primarily from what was done to them, in war. This agent-related trauma has been rediscovered in contemporary work on moral injury, but moral injury too is increasingly subjected to the hegemony of the symptom. Focusing on symptoms, however, unhelpfully pathologizes and individualizes trauma, neglects traumatic context, and legitimates problematic therapeutic approaches. Trauma researchers and clinicians should decenter the language of symptoms and focus instead on context and on alternative accounts of trauma.
Ectopic maxillary tooth as a cause of recurrent maxillary sinusitis: a case report and review of the literature
Authors: Almomen Ali , Alkhudair B , Alkhatib A , Alazzah G , Ali Zainab , Al Yaeesh Ibrahim , AlOmairin Ahmed , Alshuaibi Abdullah , AlBahr Abdulelah 
Published: August 2020

Abstract
This article presents a rare case report of an ectopic third molar tooth located in the medial wall of maxillary sinus in a young male manifesting as recurrent sinusitis along with upper jaw pain and postnasal discharge diagnosed with an ectopic tooth and bilateral dentigerous cysts. This article aims to discuss this rare presentation of an ectopic tooth as a cause of recurrent maxillary sinusitis and the endonasal endoscopic management of the case.
The basic helix-loop-helix transcription factor bHLH95 affects fruit ripening and multiple metabolisms in tomato
Authors: Zhang Lincheng , Kang Jing , Xie Qiaoli , Gong Jun , Shen Hui , Chen Yanan , Chen Guoping , Hu Zongli 
Published: August 2020

Abstract
Ethylene signaling pathways regulate several physiological alterations that occur during tomato fruit ripening, such as changes in colour and flavour. The mechanisms underlying the transcriptional regulation of genes in these pathways remain unclear, although the role of the MADS-box transcription factor RIN has been widely reported. Here, we describe a bHLH transcription factor, SlbHLH95, whose transcripts accumulated abundantly in breaker+4 and breaker+7 fruits compared with rin (ripening inhibitor) and Nr (never ripe) mutants. Moreover, the promoter activity of SlbHLH95 was regulated by RIN in vivo. Suppression of SlbHLH95 resulted in reduced sensitivity to ethylene, decreased accumulation of total carotenoids, and lowered glutathione content, and inhibited the expression of fruit ripening- and glutathione metabolism-related genes. Conversely, up-regulation of SlbHLH95 in wild-type tomato resulted in higher sensitivity to ethylene, increased accumulation of total carotenoids, slightly premature ripening, and elevated accumulation of glutathione, soluble sugar, and starch. Notably, overexpression of SlbHLH95 in rin led to the up-regulated expression of fruit ripening-related genes (FUL1, FUL2, SAUR69, ERF4, and CNR) and multiple glutathione metabolism-related genes (GSH1, GSH2, GSTF1, and GSTF5). These results clarified that SlbHLH95 participates in the regulation of fruit ripening and affects ethylene sensitivity and multiple metabolisms targeted by RIN in tomato.
An analysis of radial pulse strength to recorded blood pressure in the Department of Defense Trauma Registry
Authors: Naylor Jason F , Fisher Andrew D , April Michael D , Schauer Steven G 
Published: August 2020

Abstract

Introduction
Hemorrhage is the leading cause of potentially preventable death on the battlefield. The tactical combat casualty care guidelines recommend the use of the radial pulse strength to guide the administration of blood products or intravenous fluids when equipment for blood pressure monitoring is not available. Data supporting this measurement tool are limited. We sought to validate this method in a deployed trauma population.

Materials and Methods
This is a secondary analysis of a previously published dataset from the Department of Defense Trauma Registry. In this subanalysis, we focused on emergency department radial pulse strength documented in conjunction with systolic blood pressure readings.

Results
Our predefined search codes captured 28,222 Department of Defense Trauma Registry casualties. Of those, 22,192 casualties had at least 1 radial pulse strength documented, with a total of 27,366 documented measurements total among the 22,192. The median age of casualties was 25 years, most were male (96.8%), U.S. military made up the largest proportion (44.2%), most were injured by explosive (55.8%), and most were in Afghanistan (67.0%) with a median injury severity score of 9. Mean systolic blood pressures were significantly different based on radial pulse strength: strong (129.6), weak (107.5), and absent (85.1). However, when using a binary threshold of 80 mmHg, there were 615 documented instances of hypotension. Within that 615, 55.6% had a strong radial pulse, 29.3% had a weak radial pulse, and 15.1% had an absent radial pulse (P &lt; .001).

Conclusions
Although mean systolic blood pressure was associated with radial pulse quality, when using a binary measurement of hypotension (systolic &lt; 80 mmHg) characterization of the radial pulse was not a reliable indicator of hypotension. Better methods for casualty monitoring must be employed to avoid missing opportunities for intervention.
Peptidorhamanomannan: A surface fungal glycoconjugate from Scedosporium aurantiacum and Scedosporium minutisporum and its recognition by macrophages
Authors: de Meirelles Jardel Vieira , Xisto Mariana Ingrid Dutra da Silva , Rollin-Pinheiro Rodrigo , Serrato Rodrigo Vassoler , Haido Rosa Maria Tavares , Barreto-Bergter Eliana 
Published: August 2020

Abstract
The genus Scedosporium is composed of clinically relevant fungal species, such as Scedosporium aurantiacum, Scedosporium apiospermum, and Scedosporium boydii. Surface molecules have been described that play crucial roles in fungi-macrophage interaction, and many of them are pathogen-associated molecular patterns (PAMPs). The present study aims to characterize peptidoglycans obtained from Scedosporium aurantiacum and Scedosporium minutisporum, a clinical and an environmental isolate, respectively, and compare their roles in pathogen-host interaction. Both molecules were characterized as peptidorhamnomannans (PRMs), similar to what has been already described for other Scedosporium species. Rabbit immune sera obtained by injecting whole cells from each species recognized both fungal cells and purified PRMs, suggesting that a cross-reaction occur between both fungi. Immunofluorescent microscopy revealed that PRMs are exposed on fungal surface. Prior incubation of purified molecules with immune sera before adding to cells led to loss of fluorescent, indicating that PRM is a major molecule recognized by immune sera. Fungi-macrophage interaction revealed that S. aurantiacum is able to survive more inside phagocytic cells than S. minutisporum, and PRM from both fungi plays a role in phagocytosis when the purified molecule is pre-incubated with macrophage. In addition, PRM induce nitric oxide release by macrophages. Our data indicate that PRM is an important PAMP exposed on fungal surface with the potential of immune modulation.
The stellar mass assembly of low-redshift, massive, central galaxies in SDSS and the TNG300 simulation
Authors: Jackson Thomas M , Pasquali A , Pacifici C , Engler C , Pillepich A , Grebel E K 
Published: August 2020

ABSTRACT
The stellar mass assembly of galaxies can be affected by both secular and environmental processes. In this study, for the first time, we investigate the stellar mass assembly of $\sim 90\, 000$ low-redshift, central galaxies selected from SDSS group catalogues ($M_{\rm Stellar}\gtrsim 10^{9.5}\, \mathrm{M}_{\odot }$, $M_{\rm Halo}\gtrsim 10^{12}\, \mathrm{M}_{\odot }$) as a function of both stellar mass and halo mass. We use estimates of the times at which 10, 50, and 90 per cent of the stellar mass were assembled from photometric spectral energy distribution fitting, allowing a more complete investigation than single stellar ages alone. We consider trends in both stellar mass and halo mass simultaneously, finding dependences of all assembly times on both. We find that galaxies with higher stellar masses (at constant halo mass) have on average older lookback times, similar to previous studies of galaxy assembly. We also find that galaxies at higher halo mass (at constant stellar mass) have younger lookback times, possibly due to a larger reservoir of gas for star formation. An exception to this is a subsample with high stellar-to-halo mass ratios, which are likely massive, field spirals. We compare these observed trends to those predicted by the TNG300 simulation, finding good agreement overall as a function of either stellar mass or halo mass. However, some differences in the assembly times (of up to ∼3 Gyr) appear when considering both stellar mass and halo mass simultaneously, noticeably at intermediate stellar masses (MStellar ∼ 1011 M⊙). These discrepancies are possibly linked to the quenched fraction of galaxies and the kinetic mode active galactic nucleus feedback implemented in TNG300.
Extracellular vesicles engineered with valency-controlled DNA nanostructures deliver CRISPR/Cas9 system for gene therapy
Authors: Zhuang Jialang , Tan Jizhou , Wu Chenglin , Zhang Jie , Liu Ting , Fan Chunhai , Li Jiaping , Zhang Yuanqing 
Published: August 2020

Abstract
Extracellular vesicles (EVs) hold great promise for transporting CRISPR–Cas9 RNA-guided endonucleases (RNP) throughout the body. However, the cell-selective delivery of EVs is still a challenge. Here, we designed valency-controlled tetrahedral DNA nanostructures (TDNs) conjugated with DNA aptamer, and loaded the valency-controlled TDNs on EV surface via cholesterol anchoring for specific cell targeting. The targeting efficacy of different ratios of aptamer/cholesterol from 1:3 to 3:1 in TDNs on decorating EVs was investigated. TDNs with one aptamer and three cholesterol anchors (TDN1) efficiently facilitated the tumor-specific accumulation of the EVs in cultured HepG2 cells and human primary liver cancer-derived organoids, as well as xenograft tumor models. The intracellular delivery of RNP by TDN1-EVs successfully realized its subsequent genome editing, leading to the downregulation of GFP or WNT10B in specific cells. This system was ultimately applied to reduce the protein expression of WNT10B, which presented remarkable tumor growth inhibition in vitro, ex vivo and in vivo, and could be extended to other therapeutic targets. The present study provides a platform for the directional display of aptamer on surface labeling and the EVs-based Cas9 delivery, which provides a meaningful idea for future cell-selective gene editing.
39. CHARACTERIZING NOVEL INHIBITORS OF BRAIN METASTASIS-INITIATING CELLS
Authors: Kieliszek Agata , Venugopal Chitra , Bassey-Archibong Blessing , Aghaei Nikoo , Lam Fred , Singh Sheila 
Published: August 2020

Abstract

BACKGROUND
The incidence of brain metastases (BM) is tenfold higher than primary brain tumors. BM commonly originate from primary lung, breast, and melanoma tumors with a 90% mortality rate within one year of diagnosis. Current standard of care for BM includes surgical resection with concurrent chemoradiation, but does not extend median survival past 16 months, posing a large unmet need to identify novel therapies against BM.

METHODS
From a large in-house biobank of patient-derived BM cell lines, the Singh Lab has generated murine orthotopic patient-derived xenograft (PDX) models of lung, breast, and melanoma BM that recapitulate the stages of BM progression as seen in human patients. Using these three PDX models, we identified a population of “pre-metastatic” brain metastasis-initiating cells (BMICs) that are newly arrived in the brain but have yet to form detectable tumors. Pre-metastatic BMICs are not detectable in human patients but are important therapeutic targets with the potential to prevent BM in at-risk patients.

RESULTS
RNA sequencing of pre-metastatic BMICs from all three PDX primary tumor models with subsequent Connectivity Map analysis identified novel compounds that have the potential of killing all three types of BMICs. In particular, we identified two compounds that have selective killing of BMICs in vitro from all three primary tumor cohorts while sparing non-cancerous cells. We further characterized their ability to inhibit the self-renewal and proliferative properties of BMICs. Ongoing in vivo work will investigate the compounds’ preclinical utilities in preventing BM.

CONCLUSION
Identification of novel small molecules that target BMICs could prevent the formation of BM completely and dramatically improve the prognosis of at-risk cancer patients.
47. UNCOVERING A NOVEL ROLE FOR HLA-G IN BRAIN METASTASES
Authors: Bassey-Archibong Blessing , Aghaei Nikoo , Chokshi Chirayu , Kieliszek Agata , Tatari Nazanin , Mckenna Dillon , Singh Mohini , Subapanditha Minomi , Tokar Tomas , Jurisica Igor , Lam Fred , Lu Yu , Venugopal Chitra , Singh Sheila 
Published: August 2020

Abstract
Brain metastases (BM) are the most common brain tumour in adults and are ten times more likely to develop than primary brain tumours. More than 20% of patients with cancer will develop BM with the three most common sources being primary cancers of the lung, breast, and melanoma. Unfortunately, current treatment options for BM do not effectively eradicate BM, with a mere median overall survival time of 12 months in treated patients. This indicates the need for better and more effective therapies against BM. Using patient-derived cell lines established from surgically removed brain metastatic tumours of lung-, breast- and melanoma-BM patients, we generated patient-derived orthotopic murine xenograft (PDX) models of lung-, breast-, and melanoma-BM. From these PDX models, we isolated a rare population of stem-like brain metastasis initiating cells (BMICs) we termed “pre-metastatic”, that had traveled from their primary/orthotopic tumours and lodged in the brain but had not yet developed into mature BM. Transcriptomic analyses performed on pre-metastatic and non-pre-metastatic BMICs from lung, breast and melanoma PDX models of BM, identified a set of deregulated genes exclusive only to pre-metastatic BMICs. Further analysis revealed HLA-G as being commonly up-regulated only during the pre-metastatic stage of the lung-, breast-, and melanoma-BM cascade. In vitro and in vivo analyses demonstrated that HLA-G knock-down reduced the proliferation and survival of BMICs from all BM cohorts, and attenuated the establishment of mature brain metastatic tumours, implying a crucial role for HLA-G in the formation of BM. Developing a therapeutic strategy that targets HLA-G in BM may prove effective at completely eliminating brain metastatic cells at an early stage of the BM cascade, thereby turning a fatal disease into an eminently more treatable one.