bluuebunny/crossref_metadata_2025_split huggingface dataset:
Expanding Pharmacy Services With an Intern Program at an Academic Medical Center
Authors: Li Hanlin , Powell Vickie , Tsapepas Demetra 
Published: August 2020

Background: Organizations that implement pharmacy services to provide patient education have reduced hospital readmissions and improved the patient experience. The term “pharmacy extender” has been used to describe pharmacy technicians and pharmacy students who alleviate the workload of a pharmacist, enhance pharmacy visibility throughout an organization, and foster professional development for the individual. Objective: The objective of this pharmacy intern-driven program is to increase pharmacy reach for medication teaching. Methods: This is a single-center, IRB-approved retrospective cohort analysis. Pharmacist-led medication teaching is currently available to select high-risk populations including solid organ transplant and bone marrow transplant recipients at our organization. Clinicians working in the pharmacy satellites have structured operational and distributional workflow responsibilities, which precludes them from directly engaging with patients. Pharmacy interns can serve as extenders that can participate in medication teaching. An internally created digital medication teaching tool will be employed to expand the pharmacy reach for medication education. Results: During the period of study, the pharmacy interns screened 3,993 patients and educated 2,868 patients. Two-thirds of the pharmacy interns that participated in the program pursued post-graduate residency or fellowship training, while the rest assumed hospital pharmacist positions. Conclusion: Deploying pharmacy interns as extenders for distribution of an internally created digital tool that provides general medication teaching has shown positive outcomes including greater pharmacy presence and visibility, better patient experience, and higher patient satisfaction. Continuous data collection and monitoring are warranted to demonstrate the benefits of the program once sustained and potentially justify more resources for further expansion.
Effectiveness of dry needling for upper extremity spasticity, quality of life and function in subacute phase stroke patients
Authors: Cuenca Zaldívar Juan Nicolás , Calvo Sandra , Bravo-Esteban Elisabeth , Oliva Ruiz Petronila , Santi-Cano Maria José , Herrero Pablo 
Published: August 2020

Background: Stroke is the fourth leading cause of death in Europe, represents one of the most common causes of disability in adult patients, and involves considerable short- and long-term social and healthcare costs. The effectiveness of deep dry needling (DDN) on affected arm functionality was assessed throughout 8 weeks of treatment in patients with stroke in the subacute phase. Methods: Eighty patients were included in this two-group non-randomised study after a propensity score analysis was carried out. Both groups received standard physiotherapy treatment on the affected arm. The needling group also received six sessions of DDN during the 8-week period. Patients were evaluated before and after each session using the Fugl-Meyer upper extremity (FM UE) scale, the modified modified Ashworth scale (MMAS), the resistance to passive movement scale (REPAS) and a 10-point numeric pain rating scale (NPRS 10). The Brunnstrom recovery stage was recorded at the beginning and at the end of the study, and the EuroQoL quality of life survey was completed at the beginning of the study, after the first month of treatment and at the end of the study. Results: Patients treated with DDN showed a reduction in spasticity measured using the REPAS (p < 0.001) and the MMAS (p < 0.05). There was also an improvement in the Brunnstrom recovery stages (p < 0.05). Conclusion: The addition of a specific DDN treatment to a standard physiotherapy treatment appeared to lead to a higher reduction in spasticity in the affected arm; however, it did not provide additional changes in functionality, pain and quality of life. Further studies with a randomised controlled trial design are required to confirm our findings.
Operation Outbreak: A Periop 101 Exam Review Escape Room
Authors: Frederick Ashley N. , Reed Jessica A. 
Published: August 2020

Background: Perioperative nursing is expected to see a 20% reduction in the workforce due to retirement within five (5) years. To recruit and retain nurses within this specialty, the Association of Operating Room Nurses (AORN) Periop 101: Core Curriculum™ OR was added to an existing nurse residency program. Periop 101 is an online learning program providing evidence-based guidelines for practice and requires the learner to pass a final exam with a score of 80% or higher. Following a didactic final exam review session, most nurse residents at a midwestern community hospital failed to pass the final exam on their first attempt. Aim: To address this knowledge gap, the clinical educators decided to create a more interactive review session by creating an escape room. Current literature supports the use of escape rooms to increase knowledge and learner engagement. Method: Nurse residents participate in Operation Outbreak during the exam review session. A convenience sample of twenty-two (22) registered nurses were included in the quality improvement project. Group one consisted of 18 participants who received only the didactic review session. Group two had four participants who participated in the didactic review session as well as the Operation Outbreak escape room. Results/Conclusion: Overall, there was improvement in the average final exam scores and average percentage of residents to pass the exam on the first attempt after the addition of the escape room. Statistical analysis was not performed due to sample limitations.
Early home-based pulmonary rehabilitation following acute exacerbation of COPD: A feasibility study using an action research approach
Authors: Wageck Bruna , Cox Narelle S , Bondarenko Janet , Corbett Monique , Nichols Amanda , Moore Rosemary , Holland Anne E 
Published: August 2020

Objective: Pulmonary rehabilitation (PR) improves function, reduces symptoms and decreases healthcare usage in people with chronic obstructive pulmonary disease (COPD) following an acute exacerbation (AECOPD). However, rehabilitation uptake rates are low. This study aimed to address barriers to uptake and completion of PR following AECOPD. Methods: An action research approach was used to reflect on study feasibility, and to plan and implement an improved protocol. Phase I tested the feasibility of home-based PR started early after AECOPD. Phase II used qualitative interviews to identified potential barriers to program uptake. Phase III re-tested the program with changes to recruitment and assessment strategies. Results: Phase I: From 97 screened patients, 26 were eligible and 10 (38%) started home-based PR. Eight participants undertook ≥70% of PR sessions, achieving clinically meaningful improvement in 6-minute walk distance (mean (SD) change 76 (60) m) and chronic respiratory disease questionnaire total score (15 (21) units). Phase II: Potential barriers to uptake of home-based PR included access issues, confidence to exercise, and lack of information about PR benefits. Phase III: From 77 screened patients, 23 were eligible and 5 (22%) started the program. Discussion: Home-based PR improved clinical outcomes, but program eligibility and uptake remain challenging. Efforts should be made to ensure PR program eligibility criteria are broad enough to accommodate patient needs, and new ways of engaging patients are needed to improve PR uptake after AECOPD.
Decreased Preoperative Estimated Glomerular Filtration Rate Was Related With Poor Prognosis of NSCLC Patients
Authors: Jia Wenqiao , Wang Cong , Cheng Yufeng 
Published: August 2020

(1) Background: The coexistence of chronic kidney disease (CKD) and cancer is common due to the increased incidence of cancer in patients with CKD. Glomerular filtration rate is the optimal way to measure kidney function. To date, little is known about the role preoperative renal function plays in the prognosis of NSCLC patients. (2) Methods: The study enrolled 140 patients who had been newly diagnosed NSCLC and received potential radical surgery for treatment from 2009 January to 2012 December. The detailed characteristics were collected including gender, age, smoking and drinking habits, KPS score, hemoglobin levels, tumor size, pathology type, differentiation, pTNM stage and serum creatinine before surgery. Univariate and multivariate analyses of overall survival (OS) and disease-free survival (DFS) were performed using Kaplan-Meier method and Cox model. (3) Results: The univariate analysis identified that the pTNM stage ( p < 0.001), eGFR level ( p = 0.006), and adjuvant treatment ( p = 0.007) were prognostic factors for OS, while drinking habit ( p = 0.032), pTNM stage ( p = 0.002) and eGFR level ( p = 0.006) were the prognostic factors for DFS. Further multivariate analysis found that pTNM stage (HR = 2.091, 95% CI 1.424-3.071; p < 0.001) and eGFR level (HR = 1.890, 95% CI 1.424-3.071; p = 0.004) were independent factors associated with OS. The pTNM stage (HR = 1.735, CI 1.215-2.479; p = 0.002) and eGFR (HR = 1.793, CI 1.193-2.696; p = 0.005) were independent factors associated with DFS. Further subgroup analyses found that in female patients/ no smoking patients/ patients younger than 60 years, better eGFR level was significantly associated with better OS and DFS. (4) Conclusions: Decreased preoperative eGFR was associated with poor clinical outcome of NSCLC patients.
A potential prognostic marker in primitive lung neuroendocrine tumor: A case report
Authors: Russo Luigi , Grilli Bruna , Minopoli Anita , Capozzi Monica , Tafuto Salvatore , Correra Marco , Trillò Giusy , Isgrò Maria Antonietta , Cavalcanti Ernesta 
Published: August 2020

Background: The diagnosis and monitoring of primitive lung neuroendocrine tumors (lung pNETs) are usually performed by the measurement of serum chromogranin A (CgA) and urinary 5-hydroxyindolacetic acid (5-HIAA) levels. However, imaging techniques are necessary due to the poor diagnostic efficiency of the laboratory tests. Methods: A total-body computed tomography and bone scintigraphy scans showed multiple hepatic and bone metastases of a 55-year-old man affected by well-differentiated lung pNETs without severe initial symptoms. After diagnosis, he started therapy and was monitored with serum, urinary markers, and imaging techniques. Results: During follow-up, the urinary 5-HIAA levels did not significantly increase, while serum CgA and urinary para-hydroxyphenylacetic acid (pHPAA) levels (urinary organic acid physiologically present in the urines of healthy subjects) showed significant increases related to worsening clinical condition. Conclusions: The early increase in urinary pHPAA levels—usually not dosed in pNET patient monitoring—could be a promising prognostic marker.
Inequality, Familial Aggregation, and Risk Prediction of Caries in Siblings
Authors: Sengupta K. , Ersbøll A.K. , Christensen L.B. , Mortensen L.H. , Andersen I. 
Published: August 2020

Introduction: Social and family conditions are likely of great importance to dental health; however, limited evidence of familial aggregation of caries among adolescent siblings exists. Moreover, social and family-level factors have never been evaluated as isolated caries predictors at the individual level. Objectives: The objectives were to evaluate socioeconomic patterning of caries among siblings, assess sibling-specific aggregation of caries within families, and examine if such aggregation differed by parental socioeconomic position (SEP). We also evaluated the discriminant ability of sibling caries, SEP, and other social and familial factors in predicting caries in cosiblings. Methods: This nationwide register-based study included all 15-y-olds in Denmark in 2003 (index siblings) and their biological siblings born within ±3 y (cosiblings). Clinical and sociodemographic data for each subject were compiled from Danish national dental, social, and population registers. Caries was measured by the decayed, missing, and filled tooth surfaces (DMFS) index. Predictors included SEP (parental education, income, and occupational social class), gender, birth order, immigration status, and household type. Adjusted SEP-caries associations were estimated using negative binomial regression. Familial aggregation was evaluated using adjusted pairwise odds ratios from alternating logistic regressions. Caries prediction was based on classification and regression tree (CART) analyses. Results: The study included 23,847 sibling pairs (n = 47,694). Socioeconomic patterning of caries was similar among the index and cosiblings with significant graded SEP-caries associations. Significant sibling-specific aggregation of caries was observed; cosiblings of caries-affected index siblings had odds of having caries 3.9 times (95% confidence interval: 3.65–4.18) as high as that of cosiblings with caries-free index siblings. This sibling similarity was stronger in socioeconomically disadvantaged families (adjusted pairwise odds ratios: 3.08–5.47). CART revealed index sibling caries as the single most important caries predictor, with caries predicted in ≥84% of cosiblings of adolescents with ≥3 carious tooth surfaces. Conclusions: Caries in a sibling should prompt preventive family-based approaches targeting cosiblings. Knowledge Transfer Statement: This study revealed significant socioeconomic patterning of caries in adolescent siblings. Prediction modeling indicated that the single most important caries predictor among cosiblings was index sibling caries. Information on sibling caries level should be routinely combined with clinical evaluation to identify children at risk. Moreover, information on social and family conditions should be used to target prevention and health promotion at the school or municipal level. These approaches could possibly contribute to reducing the existing caries inequalities.
Light Trapping Induced High Short-Circuit Current Density in III-Nitride Nanorods/Si (111) Heterojunction Solar Cells
Authors: Chang Ching-Wen , Wadekar Paritosh V. , Huang Hui-Chun , Chen Quark Yung-Sung , Wu Yuh-Renn , Chen Ray T. , Tu Li-Wei 
Published: August 2020

AbstractAn effective-area photovoltaic efficiency of 1.27% in power conversion, excluding the grid metal contact area and under 1 sun, AM 1.5G conditions, has been obtained for the p-GaN/i-InGaN/n-GaN diode arrays epitaxially grown on (111)-Si. The short-circuit current density is 14.96 mA/cm2 and the open-circuit voltage is 0.28 V. Enhanced light trapping acquired via multiple reflections within the strain and defect free III-nitride nanorod array structures and the short-wavelength responses boosted by the wide bandgap III-nitride constituents are believed to contribute to the observed enhancements in device performance.
A fatal fecaloma
Authors: Logre Elsa , Degravi Lauriane , Plantefève Gaëtan , Contou Damien 
Published: August 2020

Abstract
Background
Fecal impaction may complicate chronic constipation. We report a fatal case of fecal impaction in a patient treated with long-term neuroleptic treatment.

Case presentation
A 70-year-old man with a history of severe chronic psychosis treated with olanzapine was admitted to the emergency department for acute abdominal pain and increased abdominal perimeter. Abdominal computed tomography revealed a severe fecal impaction with no sign of peritonitis or acute mesenteric ischemia. The patient eventually died from multi-organ failure 2 days after his admission to the intensive care unit.

Conclusions
Chronic constipation with fecal impaction is a well-known complication of long-term neuroleptic treatment. Severe forms may be life-threatening. Prevention with systematic administration of laxatives appears of paramount importance.
Theoretical and empirical comparisons of expected and realized relationships for the X-chromosome
Authors: Druet Tom , Legarra Andres 
Published: August 2020

Abstract
Background
X-chromosomal loci present different inheritance patterns compared to autosomal loci and must be modeled accordingly. Sexual chromosomes are not systematically considered in whole-genome relationship matrices although rules based on genealogical or marker information have been derived. Loci on the X-chromosome could have a significant contribution to the additive genetic variance, in particular for some traits such as those related to reproduction. Thus, accounting for the X-chromosome relationship matrix might be informative to better understand the architecture of complex traits (e.g., by estimating the variance associated to this chromosome) and to improve their genomic prediction. For such applications, previous studies have shown the benefits of combining information from genotyped and ungenotyped individuals.

Results
In this paper, we start by presenting rules to compute a genomic relationship matrix (GRM) for the X-chromosome (GX) without making any assumption on dosage compensation, and based on coding of gene content with 0/1 for males and 0/1/2 for females. This coding adjusts naturally to previously derived pedigree-based relationships (S) for the X-chromosome. When needed, we propose to accommodate and estimate dosage compensation and genetic heterogeneity across sexes via multiple trait models. Using a Holstein dairy cattle dataset, including males and females, we then empirically illustrate that realized relationships (GX) matches expectations (S). However, GX presents high deviations from S. GX has also a lower dimensionality compared to the autosomal GRM. In particular, individuals are frequently identical along the entire chromosome. Finally, we confirm that the heritability of gene content for markers on the X-chromosome that are estimated by using S is 1, further demonstrating that S and GX can be combined. For the pseudo-autosomal region, we demonstrate that the expected relationships vary according to position because of the sex-gradient. We end by presenting the rules to construct the 'H matrix’ by combining both relationship matrices.

Conclusions
This work shows theoretically and empirically that a pedigree-based relationship matrix built with rules specifically developed for the X-chromosome (S) matches the realized GRM for the X-chromosome. Therefore, applications that combine expected relationships and genotypes for markers on the X-chromosome should use S and GX.
Response of the gut microbiota during the Clostridioides difficile infection in tree shrews mimics those in humans
Authors: Gu Wenpeng , Li Wenge , Wang Wenguang , Kuang Dexuan , Zhang Wenzhu , Lu Caixia , Li Na , Tong Pinfen , Han Yuanyuan , Sun Xiaomei , Lu Jinxing , Wu Yuan , Dai Jiejie 
Published: August 2020

Abstract
Background
Clostridioides difficile is a major cause of antibiotic associated diarrhea. Several animal models are used to study C. difficile infection (CDI). The tree shrew has recently been developed as a model of primate processes. C. difficile infection has not been examined in tree shrews. We infected tree shrews with hyper-virulent C. difficile strains and examined the alterations in gut microbiota using 16S rRNA gene sequencing.

Results
C. difficile colonized the gastrointestinal tract of tree shrew and caused diarrhea and weight loss. Histopathologic examination indicated structures and mucosal cell destruction in ileal and colonic tissues. The gut microbial community was highly diversity before infection and was dominated by Firmicutes, Fusobacteria, Bacteroidetes, and Proteobacteria. Antibiotic administration decreased the diversity of the gut microbiota and led to an outgrowth of Lactobacillus. The relative abundance of Proteobacteria, Gammaproteobacteria, Enterobacteriales, Lachnospiraceae, Enterobacteriaceae, Escherichia, Blautia, and Tyzzerella increased following C. difficile infection. These taxa could be biomarkers for C. difficile colonization.

Conclusions
In general, the disease symptoms, histopathology, and gut microbiota changes following C. difficile infection in tree shrews were similar to those observed in humans.
Case report: the first case of unilateral retinal pigment epithelium dysgenesis in China
Authors: Ding Yuhua , Yao Bangtao , Xie Keren , Ye Hui , Yu Yan 
Published: August 2020

Abstract
Background
Unilateral retinal pigment epithelium dysgenesis (URPED) is a rare condition and is characterized by a unilateral and solitary lesion in the peripapillary region. The lesion presents with central atrophy, peripheral fibrosis, and hyperplastic changes in the retinal pigment epithelium (RPE). Herein, we report the first case of URPED in a Chinese individual using multimodal imaging techniques such as en-face optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA).

Case presentation
A 10-year-old girl presented with 20/40 vision in her left eye. Presented as a solitary, unilateral, large and yellowish-white lesion, with fringe-like margins was observed in the posterior pole and lower middle periphery of the left eye continuous with the optic nerve, indicated URPED. Infrared fundal (IR) images showed that the fringe-like contour of the lesion was visible, with diffuse hyperreflective signals specifically in the fovea, while with peripheral dark spots, having a typical leopard-spot like appearance. Fundus autofluorescence (FAF) revealed a markedly scalloped lesion containing a hypoautofluorescence area mixed with an isoautofluorescence area. Spectral-domain optical coherence tomography (SD-OCT) revealed the outer segments of photoreceptors presented with an inhomogeneous signal in the fovea, with a weak local signal. The ellipsoid and interdigitation zones were thinner than normal, while the RPE/Bruch’s complex was not flat, with locally visible protrusions. En-face OCT image at the level of the RPE zone showed a mottled hyperreflective signal with peripheral hyporeflective spots, fringe-like margin lesions. OCTA of the avascular area of the fovea in the superficial, deep, and outer retinal layers appeared to be oval in shape, the choroid capillary layer revealed an increase in the density of the choroidal vasculature in the fovea.

Conclusions
This is the first report on URPED in China. Both en-face OCT and OCTA were essential in observing and studying the disease. Further investigation is required to better define the en-face OCT and OCTA features of URPED and clarify the disease characteristics and prognosis.