bluuebunny/crossref_metadata_2025_split huggingface dataset:
How, in what contexts, and why do quality dashboards lead to improvements in care quality in acute hospitals? Protocol for a realist feasibility evaluation
Authors: Randell Rebecca , Alvarado Natasha , McVey Lynn , Greenhalgh Joanne , West Robert M , Farrin Amanda , Gale Chris , Parslow Roger , Keen Justin , Elshehaly Mai , Ruddle Roy A , Lake Julia , Mamas Mamas , Feltbower Richard , Dowding Dawn 
Published: February 2020

IntroductionNational audits are used to monitor care quality and safety and are anticipated to reduce unexplained variations in quality by stimulating quality improvement (QI). However, variation within and between providers in the extent of engagement with national audits means that the potential for national audit data to inform QI is not being realised. This study will undertake a feasibility evaluation of QualDash, a quality dashboard designed to support clinical teams and managers to explore data from two national audits, the Myocardial Ischaemia National Audit Project (MINAP) and the Paediatric Intensive Care Audit Network (PICANet).Methods and analysisRealist evaluation, which involves building, testing and refining theories of how an intervention works, provides an overall framework for this feasibility study. Realist hypotheses that describe how, in what contexts, and why QualDash is expected to provide benefit will be tested across five hospitals. A controlled interrupted time series analysis, using key MINAP and PICANet measures, will provide preliminary evidence of the impact of QualDash, while ethnographic observations and interviews over 12 months will provide initial insight into contexts and mechanisms that lead to those impacts. Feasibility outcomes include the extent to which MINAP and PICANet data are used, data completeness in the audits, and the extent to which participants perceive QualDash to be useful and express the intention to continue using it after the study period.Ethics and disseminationThe study has been approved by the University of Leeds School of Healthcare Research Ethics Committee. Study results will provide an initial understanding of how, in what contexts, and why quality dashboards lead to improvements in care quality. These will be disseminated to academic audiences, study participants, hospital IT departments and national audits. If the results show a trial is feasible, we will disseminate the QualDash software through a stepped wedge cluster randomised trial.
Using a machine learning approach to predict mortality in critically ill influenza patients: a cross-sectional retrospective multicentre study in Taiwan
Authors: Hu Chien-An , Chen Chia-Ming , Fang Yen-Chun , Liang Shinn-Jye , Wang Hao-Chien , Fang Wen-Feng , Sheu Chau-Chyun , Perng Wann-Cherng , Yang Kuang-Yao , Kao Kuo-Chin , Wu Chieh-Liang , Tsai Chwei-Shyong , Lin Ming-Yen , Chao Wen-Cheng 
Published: February 2020

ObjectivesCurrent mortality prediction models used in the intensive care unit (ICU) have a limited role for specific diseases such as influenza, and we aimed to establish an explainable machine learning (ML) model for predicting mortality in critically ill influenza patients using a real-world severe influenza data set.Study designA cross-sectional retrospective multicentre study in TaiwanSettingEight medical centres in Taiwan.ParticipantsA total of 336 patients requiring ICU-admission for virology-proven influenza at eight hospitals during an influenza epidemic between October 2015 and March 2016.Primary and secondary outcome measuresWe employed extreme gradient boosting (XGBoost) to establish the prediction model, compared the performance with logistic regression (LR) and random forest (RF), demonstrated the feature importance categorised by clinical domains, and used SHapley Additive exPlanations (SHAP) for visualised interpretation.ResultsThe data set contained 76 features of the 336 patients with severe influenza. The severity was apparently high, as shown by the high Acute Physiology and Chronic Health Evaluation II score (22, 17 to 29) and pneumonia severity index score (118, 88 to 151). XGBoost model (area under the curve (AUC): 0.842; 95% CI 0.749 to 0.928) outperformed RF (AUC: 0.809; 95% CI 0.629 to 0.891) and LR (AUC: 0.701; 95% CI 0.573 to 0.825) for predicting 30-day mortality. To give clinicians an intuitive understanding of feature exploitation, we stratified features by the clinical domain. The cumulative feature importance in the fluid balance domain, ventilation domain, laboratory data domain, demographic and symptom domain, management domain and severity score domain was 0.253, 0.113, 0.177, 0.140, 0.152 and 0.165, respectively. We further used SHAP plots to illustrate associations between features and 30-day mortality in critically ill influenza patients.ConclusionsWe used a real-world data set and applied an ML approach, mainly XGBoost, to establish a practical and explainable mortality prediction model in critically ill influenza patients.
Prevalence of and mothers’ knowledge, attitude and practice towards glucose-6-phosphate dehydrogenase deficiency among neonates with jaundice: a cross-sectional study
Authors: Kasemy Zeinab A , Bahbah Wael A , El Hefnawy Sally M , Alkalash Safa H 
Published: February 2020

BackgroundNeonatal jaundice (NNJ) is a frequent complication of glucose-6-phosphate dehydrogenase (G6PD) deficiency.ObjectivesTo estimate the prevalence of G6PD deficiency among neonates with jaundice and to assess mothers’ perception towards G6PD and NNJ.MethodsA cross-sectional study was carried out on 487 ethnic Egyptian neonates with indirect hyperbilirubinaemia from June 2018 to July 2019. The collected data included maternal and neonatal characteristics. Laboratory investigations included serum bilirubin, reticulocyte count, ABO grouping, Rh typing and neonatal serum G6PD test. Mothers were interviewed individually using a structured, researcher-administered questionnaire to assess their perceptions of G6PD deficiency and NNJ.ResultsThe prevalence of G6PD deficiency was 10.10%. Neonates with G6PD deficiency showed higher levels of serum bilirubin (p<0.001). Male gender, family history of G6PD deficiency and consanguinity were risk factors for G6PD deficiency (OR=4.27, 95% CI 1.66 - 10.99; OR=9.54, 95% CI 4.80- 18.95; OR=10.219, 95% CI 5.39 - 19.33, respectively). Mothers’ perceptions of NNJ and G6PD were low, with only 30% having good knowledge on NNJ and 17.10% on G6PD deficiency, 46.8% with positive attitude towards NNJ and 45.0% towards G6PD deficiency, and 29.9% with good practice towards NNJ and 19.9% towards G6PD deficiency.ConclusionG6PD deficiency seems to be an important cause of NNJ. Mothers’ perceptions of both NNJ and G6PD deficiency were low. A mass health education programme on both of these diseases is needed to ensure better and early detection, good timing of treatment, and better prevention of the triggering factors to ensure better health for children.
Comparison of common interventions for the treatment of infantile colic: a systematic review of reviews and guidelines
Authors: Ellwood Julie , Draper-Rodi Jerry , Carnes Dawn 
Published: February 2020

ObjectiveTo conduct a systematic review of systematic reviews and national guidelines to assess the effectiveness of four treatment approaches (manual therapy, probiotics, proton pump inhibitors and simethicone) on colic symptoms including infant crying time, sleep distress and adverse events.MethodsWe searched PubMed, Embase, Cochrane and Mantis for studies published between 2009 and 2019. Inclusion criteria were systematic reviews and guidelines that used evidence and expert panel opinion. Three reviewers independently selected articles by title, abstract and full paper review. Data were extracted by one reviewer and checked by a second. Selected studies were assessed for quality using modified standardised checklists by two authors. Meta-analysed data for our outcomes of interest were extracted and narrative conclusions were assessed.ResultsThirty-two studies were selected. High-level evidence showed that probiotics were most effective for reducing crying time in breastfed infants (range −25 min to −65 min over 24 hours). Manual therapies had moderate to low-quality evidence showing reduced crying time (range −33 min to −76 min per 24 hours). Simethicone had moderate to low evidence showing no benefit or negative effect. One meta-analysis did not support the use of proton pump inhibitors for reducing crying time and fussing. Three national guidelines unanimously recommended the use of education, parental reassurance, advice and guidance and clinical evaluation of mother and baby. Consensus on other advice and treatments did not exist.ConclusionsThe strongest evidence for the treatment of colic was probiotics for breastfed infants, followed by weaker but favourable evidence for manual therapy indicated by crying time. Both forms of treatment carried a low risk of serious adverse events. The guidance reviewed did not reflect these findings.PROSPERO registration numberCRD42019139074.
Predictors of response and disease course in patients with inflammatory bowel disease treated with biological therapy—the Danish IBD Biobank Project: protocol for a multicentre prospective cohort study
Authors: Zhao Mirabella , Bendtsen Flemming , Petersen Andreas Munk , Larsen Lone , Dige Anders , Hvas Christian , Seidelin Jakob Benedict , Burisch Johan 
Published: February 2020

IntroductionInflammatory bowel diseases (IBDs) are chronic diseases of unknown cause characterised by a progressive and unpredictable disease course. In the last decade, biological treatment has become a cornerstone in the treatment of IBD. However, one-in-three-to-four patients do not respond to first-line biological agents and another third of patients see their response diminish over time. This highlights an unmet need for optimising the use of biologicals and the prediction of treatment response. Considering the multifaceted nature of IBD, we hypothesise that multiomics profiling of sequential samples from single patients could facilitate the discovery of predictive biomarkers of response to biological therapy and disease course.MethodsThis is a multicentre prospective cohort study which will enrol 840 biological-naïve patients with IBD who initiate biological therapy in a 3-year period. Primary outcomes are the occurrence of primary non-response (evaluated at weeks 14–16) and loss of response (evaluated during entire follow-up in patients who obtain partial or full response after induction period). Each patient will be followed up for their clinical data for at least 1 year or till the end of study period (up to 4 years). Blood and stool samples will be collected sequentially during the first year of biological treatment. Intestinal tissue will be sampled after 1 year of treatment and whenever an endoscopy is performed. Samples will undergo transcriptomic, proteomic and microbial DNA analyses. Omics data will be integrated with clinical data to identify a panel of predictive biomarkers of response to biological therapy and disease behaviour in patients with IBD.Ethics and disseminationEthical approval has been obtained from the Danish Ethics Committee (H-18064178). Inclusion is ongoing at three study centres and will be initiated in two additional centres. Both positive and negative study results will be disseminated through peer-reviewed journals according to Strengthening the Reporting of Observational Studies in Epidemiology guidelines, as well as presented at international conferences.
Association between C reactive protein and all-cause mortality in the ELSA-Brasil cohort
Authors: Maluf Chams B , Barreto Sandhi Maria , Giatti Luana , Ribeiro Antonio Luiz , Vidigal Pedro G , Azevedo Douglas R M , Griep Rosane H , Matos Sheila Maria Alvim , Ji Chen , Cappuccio Francesco P , Miller Michelle A 
Published: February 2020

Background
High-sensitivity C reactive protein (hsCRP) has been proposed as a marker of incident cardiovascular disease and vascular mortality, and may also be a marker of non-vascular mortality. However, most evidence comes from either North American or European cohorts. The present proposal aims to investigate the association of hsCRP with the risk of all-cause mortality in a multiethnic Brazilian population.

Methods
Baseline data (2008–2010) of a cohort of 14 238 subjects participating in the Brazilian Longitudinal Study of Adult Health were used. hsCRP was assayed with immunochemistry. The association of baseline covariates with all-cause mortality was calculated by Cox regression for univariate model and adjusted for different confounders after a mean follow-up of 8.0±1.1 years. The final model was adjusted for age, sex, self-rated race/ethnicity, schooling, health behaviours and prevalent chronic disease.

Results
The risk of death increased steadily by quartiles of hsCRP, from 1.45 (95% CI 1.05 to 2.01) in quartile 2 to 1.95 (95% CI 1.42 to 2.69) in quartile 4, compared with quartile 1. Furthermore, the persistence of a significant graded association after the exclusion of deaths in the first year of follow-up suggests that these results are unlikely to be due to reverse causality. Finally, the HR was unaffected by the exclusion of participants who had self-reported medical history of diabetes, cancer and chronic obstructive pulmonary disease.

Conclusions
Our study shows that hsCRP level is associated with mortality in a highly admixed population, independent of a large set of lifestyle and clinical variables.
High definition ultrasound imaging of the individual elements of the brachial plexus above the clavicle
Authors: Karmakar Manoj Kumar , Pakpirom Jatuporn , Songthamwat Banchobporn , Areeruk Pornpatra 
Published: February 2020

Background and objectivesUltrasonography of the brachial plexus (BP) has been described but there are limited data on visualization of the T1 ventral ramus and the inferior trunk. This prospective observational study aimed to evaluate a high definition ultrasound imaging technique to systematically identify the individual elements of the BP above the clavicle.MethodsFive healthy young volunteers underwent high definition ultrasound imaging of the BP above the clavicle. The ultrasound scan sequence (transverse oblique scan) commenced at the supraclavicular fossa after which the transducer was slowly swept cranially to the upper part of the interscalene groove and then in the reverse direction to the supraclavicular fossa. The unique sonomorphology of the C7 transverse process was used as the key anatomic landmark to identify the individual elements of the BP in the recorded sonograms.ResultsThe neural elements of the BP that were identified in all volunteers included the ventral rami of C5–T1, the three trunks, divisions of the superior trunk, and formation of the inferior trunk (C8–T1). The C6 ventral ramus exhibited echogenic internal septation with a split (bifid) appearance in four of the five volunteers. In three of the four volunteers with a bifid C6 ventral ramus, the C7 ventral ramus was also bifid.ConclusionWe have demonstrated that it is feasible to accurately identify majority of the main components of the BP above the clavicle, including the T1 ventral ramus and the formation of the inferior trunk, using high definition ultrasound imaging.Trial registration numberChiCTR1900021749.
Electroweak-QCD interference in hadronic vector bosons decays at the LHC
Authors: Ding Cathy , Fuller Ben , Jones Eleanor , Martin Aran , Murray William 
Published: February 2020

AbstractThe analysis of hadronic vector bosons decays at the LHC does not normally consider interference with QCD $$q\overline{q}$$qq¯ production. This paper explores the effect of this interference on the reconstructed peak positions and rates for several production modes. In particular, boosted vectors bosons and vector boson pairs are considered for the first time. Shifts of several GeV/c$$^2$$2 are seen in the positions of the W and Z bosons’ peaks, with a magnitude that depends strongly on the kinematics involved. For boosted vector bosons in regions currently studied, the effects are all found to be very small or negligible. If experiments were to access lower transverse momenta, for example in the experimental trigger systems, or in studies of low-recoil VV decaying semileptonically, the effect of interference could be much larger.
Mechanical, electronic and optical properties of bulk and monolayer GeSe2
Authors: Zeng Congcong , Zhang Ru , Wu Liyuan , Wang Qian , Chen Xi , Lu Pengfei 
Published: February 2020

[Formula: see text], a semiconductor with wide bandgap, has attracted wide attention due to its excellent workability in the short-wave region. Here, we reported the mechanical, electronic and optical properties of bulk and monolayer [Formula: see text] by using first-principles calculations. Our results show that both Young’s modulus and Poisson’s ratio of the monolayer [Formula: see text] exhibit anisotropic behaviors. From the bulk to the monolayer structure, the direct bandgap increases from 2.496 eV to 3.030 eV. Compared to the bulk structure, the monolayer [Formula: see text] exhibits the small average effective mass and significant anisotropy in optical absorption, indicating potential optoelectronic applications.
Geotechnical characterization of sulfur species in UK Jurassic mudrocks
Authors: St. John Thomas W. 
Published: February 2020

Weathering of pyritic mudrocks results in the oxidation of sulfides and generation of sulfates in concentrations potentially hazardous to civil engineering works. Geochemical and petrographic analyses undertaken on samples from sites underlain by the Kimmeridge Clay Formation and Oxford Clay Formation proved three distinct zones: an upper sulfur-leached zone, an intermediate weathered zone with sulfate-rich horizons and a lower relatively unweathered zone of low-sulfate, high-sulfide material. It was found that water-soluble sulfate and total potential sulfate may vary by up to 1500 mg SO
4
2−
l
−1
and 8% SO
4
2−
respectively, over a depth interval of only 0.2 m. A targeted sampling strategy and ground aggressivity assessment approach can be applied to these formations based upon the sulfur species zones identified.
Region-specific effects of HIV-1 Tat on intrinsic electrophysiological properties of pyramidal neurons in mouse prefrontal cortex and hippocampus
Authors: Cirino Thomas J. , Harden Scott W. , McLaughlin Jay P. , Frazier Charles J. 
Published: February 2020

Human immunodeficiency virus (HIV)-1 transactivator of transcription protein (Tat) is a viral protein that promotes transcription of the HIV genome and possesses cell-signaling properties. Long-term exposure of central nervous system (CNS) tissue to HIV-1 Tat is theorized to contribute to HIV-associated neurodegenerative disorder (HAND). In the current study, we sought to directly evaluate the effect of HIV-1 Tat expression on the intrinsic electrophysiological properties of pyramidal neurons located in layer 2/3 of the medial prefrontal cortex and in area CA1 of the hippocampus. Toward that end, we drove Tat expression with doxycycline (100 mg·kg−1·day−1 ip) in inducible Tat (iTat) transgenic mice for 7 days and then performed single-cell electrophysiological studies in acute tissue slices made through the prefrontal cortex and hippocampus. Control experiments were performed in doxycycline-treated G-tg mice, which retain the tetracycline-sensitive promoter but do not express Tat. Our results indicated that the predominant effects of HIV-1 Tat expression are excitatory in medial prefrontal cortical pyramidal neurons yet inhibitory in hippocampal pyramidal neurons. Notably, in these two populations, HIV-1 Tat expression produced differential effects on neuronal gain, membrane time constant, resting membrane potential, and rheobase. Similarly, we also observed distinct effects on action potential kinetics and afterhyperpolarization, as well as on the current-voltage relationship in subthreshold voltage ranges. Collectively, these data provide mechanistic evidence of complex and region-specific changes in neuronal physiology by which HIV-1 Tat protein may promote cognitive deficits associated with HAND. NEW & NOTEWORTHY We drove expression of human immunodeficiency virus (HIV)-1 transactivator of transcription protein (Tat) protein in inducible Tat (iTat) transgenic mice for 7 days and then examined the effects on the intrinsic electrophysiological properties of pyramidal neurons located in the medial prefrontal cortex (mPFC) and in the hippocampus. Our results reveal a variety of specific changes that promote increased intrinsic excitability of layer II/III mPFC pyramidal neurons and decreased intrinsic excitability of hippocampal CA1 pyramidal neurons, highlighting both cell type and region-specific effects.
Generalizing movement patterns following shoulder fixation
Authors: Maeda Rodrigo S. , Zdybal Julia M. , Gribble Paul L. , Pruszynski J. Andrew 
Published: February 2020

Generalizing newly learned movement patterns beyond the training context is challenging for most motor learning situations. Here we tested whether learning of a new physical property of the arm during self-initiated reaching generalizes to new arm configurations. Human participants performed a single-joint elbow reaching task and/or countered mechanical perturbations that created pure elbow motion with the shoulder joint free to rotate or locked by the manipulandum. With the shoulder free, we found activation of shoulder extensor muscles for pure elbow extension trials, appropriate for countering torques that arise at the shoulder due to forearm rotation. After locking the shoulder joint, we found a partial reduction in shoulder muscle activity, appropriate because locking the shoulder joint cancels the torques that arise at the shoulder due to forearm rotation. In our first three experiments, we tested whether and to what extent this partial reduction in shoulder muscle activity generalizes when reaching in different situations: 1) different initial shoulder orientation, 2) different initial elbow orientation, and 3) different reach distance/speed. We found generalization for the different shoulder orientation and reach distance/speed as measured by a reliable reduction in shoulder activity in these situations but no generalization for the different elbow orientation. In our fourth experiment, we found that generalization is also transferred to feedback control by applying mechanical perturbations and observing reflex responses in a distinct shoulder orientation. These results indicate that partial learning of new intersegmental dynamics is not sufficient for modifying a general internal model of arm dynamics. NEW & NOTEWORTHY Here we show that partially learning to reduce shoulder muscle activity following shoulder fixation generalizes to other movement conditions, but it does not generalize globally. These findings suggest that the partial learning of new intersegmental dynamics is not sufficient for modifying a general internal model of the arm’s dynamics.