bluuebunny/crossref_metadata_2025_split huggingface dataset:
Designing a Process for Cardiology Patient Transfers: A Quality Improvement, Descriptive Study on Interprovider Communication and Resident Education
Authors: Kulesa John T. , Balsara Sheri L. , Ghebremariam Emanuel T. , Colyer Jessica 
Published: May 2020

Background:
Patient transitions create vulnerability for care teams. Failures in the handoff process result in communication errors and knowledge gaps, mainly when the handoff occurs between resident and expert-level subspecialty clinicians. The authors set out to develop a standardized handoff using resident comfort as a proxy for implementation. The primary measurable aim of this study was to increase the percentage of pediatric residents who self-reported comfort in assuming care of patients transitioned from the cardiac intensive care unit to the cardiology acute care unit.

Methods:
Investigators surveyed residents at a 323-bed pediatric hospital on their handoff experiences. The study team performed a Failure Mode Effect Analysis and created a key driver diagram. Interventions included a transfer checklist and algorithm, a huddle between care teams, and education surrounding the transfer process.

Results:
Residents completed a survey before (n = 74) or after (n = 23) intervention. The percentage of residents who reported feeling “always” or “very often” prepared to care for patients at the time of transfer increased from 15% to 83%. The percentage of residents who reported that they “always” or “very often” had concerns about floor appropriateness decreased from 23% to 4%.

Conclusions:
The authors designed a transfer process to improve communication, resident-level education, and psychological safety among team members to ensure safe, thorough handoffs between providers with different levels of training. Although we cannot definitively conclude that resident comfort improved due to a small “n” postintervention, we offer a description outlining process changes, barriers to implementation, and lessons learned.
Physician-to-Nurse Handover: A Systematic Review on the Effectiveness of Different Models
Authors: Odone Anna , Bossi Eleonora , Scardoni Alessandro , Balzarini Federica , Orlandi Carlo , Arrigoni Cristina , Signorelli Carlo , Garancini Paola 
Published: May 2020

Objectives
Effective professional communication and accurate transfer of relevant clinical information are crucial components of healthcare delivery. National and international health authorities strongly recommend the adoption of effective handover practice. Still, scant evidence is available on the impact of different multiprofessional handover models.

Methods
We carried out a systematic review following the Prepared Items for Systematic Reviews and Meta-Analysis guidelines to retrieve, pool, and critically appraise the available evidence on the effectiveness of different physician-to-nurse handover models adopted in inpatient settings.

Results
We identified 1.243 citations searching the databases Medline, Embase, and CINAHL. After screening, 10 studies were included in the review reporting results on the effectiveness of 8 different handover models, measured on 44 different outcomes, grouped into: (1) process of care and efficiency outcomes, (2) patients’ outcomes, and (3) healthcare professionals–related outcomes. Overall, applying structured handover tools improve healthcare practice and selected outcomes; however, not only solid evidence on the effectiveness of different handover models is scant but also global consensus is lacking on which standardized measures and indicators to use to assess their impact.

Conclusions
In times of healthcare delivery models of growing complexity, multiprofessional handover is a key component of care paths. Although there is overall consensus on the need for improving the quality and safety of multiprofessional handover, the evidence on the tools available to achieve it and the metrics to measure their impact is heterogeneous. We urge that rigorous studies are conducted to inform the planning, implementation, and monitoring of effective handover, with the ultimate aim of improving quality of care and patient safety.
A Mixed-Methods Systematic Review of the Effectiveness and Experiences of Quality Improvement Interventions in Radiology
Authors: Jabin MD Shafiqur Rahman , Schultz Tim , Mandel Catherine , Bessen Taryn , Hibbert Peter , Wiles Louise , Runciman William 
Published: May 2020

Objective
This study aimed to compile and synthesize evidence regarding the effectiveness of quality improvement interventions in radiology and the experiences and perspectives of staff and patients.

Methods
Databases searched for both published and unpublished studies were as follows: EMBASE, MEDLINE, CINAHL, Joanna Briggs Institute, Cochrane Central Register of Controlled Trials, PsycINFO, Scopus, Web of Science, Mednar, Trove, Google Gray, OCLC WorldCat, and Dissertations and Theses. This review included both qualitative and quantitative studies of patients undergoing radiological examinations and/or medical imaging health care professionals; a broad range of quality improvement interventions including introduction of health information technology, effects of training and education, improved reporting, safety programs, and medical devices; the experiences and perspectives of staff and patients; context of radiological setting; a broad range of outcomes including patient safety; and a result-based convergent synthesis design.

Results
Eighteen studies were selected from 4846 identified by a systematic literature search. Five groups of interventions were identified: health information technology (n = 6), training and education (n = 6), immediate and critical reporting (n = 3), safety programs (n = 2), and the introduction of mobile radiography (n = 1), with demonstrated improvements in outcomes, such as improved operational and workflow efficiency, report turnaround time, and teamwork and communication.

Conclusions
The findings were constrained by the limited range of interventions and outcome measures. Further research should be conducted with study designs that might produce findings that are more generalizable, examine the other dimensions of quality, and address the issues of cost and risk versus benefit.
The Effect of Various β Values on Image Quality and Semiquantitative Measurements in 68Ga-RM2 and 68Ga-PSMA-11 PET/MRI Images Reconstructed With a Block Sequential Regularized Expectation Maximization Algorithm
Authors: Baratto Lucia , Duan Heying , Ferri Valentina , Khalighi Mehdi , Iagaru Andrei 
Published: May 2020

PurposeTo compare the block sequential regularized expectation maximization (BSREM) algorithm with the ordered subsets expectation maximization (OSEM) algorithm and to evaluate how different penalty factors (bvalues) influence image quality and SUV measurements.MethodsWe analyzed data from 78 prostate cancer patients who underwent68Ga-RM2 (n = 42) or68Ga-prostate-specific membrane antigen (PSMA)-11 (n = 36) PET/MRI. The raw PET data were retrospectively reconstructed using both time-of-flight (TOF)–BSREM withbvalues of 250, 350, 500, 750, and 1000 and TOF-OSEM. Each reconstruction was reviewed independently by 3 nuclear medicine physicians and scored qualitatively using a Likert scale (1 = poor, 5 = excellent quality). SUV measurements were analyzed as well.ResultsFifty-seven lesions were detected (21 on68Ga-RM2 and 36 on68Ga-PSMA-11 PET/MRI); SUVmax decreased with the increase of β values for both tracers. Background noise (SUVsd) decreased with increasing of β values for both tracers. The mean ± SD scores for68Ga-RM2 PET images were 2.4 ± 0.5 forb= 250 reconstructions, 3.2 ± 0.6 forb= 350, 4 ± 0.6 forb= 500, 4.5 ± 0.5 forb= 750, 4.4 ± 0.7 forb= 1000, and 3.4 ± 0.6 for TOF-OSEM. The mean ± SD scores for68Ga-PSMA-11 PET images were 3.2 ± 0.8 forb= 250 reconstructions, 4.1 ± 0.8 forb= 350, 4.7 ± 0.6 forb= 500, 4.8 ± 0.4 forb= 750, 4.7 ± 0.6 forb= 1000, and 3.8 ± 0.5 for TOF-OSEM.ConclusionsTime-of-flight–BSREM algorithm improves image quality. Differentbvalues should be used for different68Ga-labeled radiopharmaceuticals such as those targeting GRPR and PSMA receptors. Once selected, the samebvalue should be consistently used because SUVmax measurements differ with differentbvalues.
Cardiac Variation of Internal Jugular Vein as a Marker of Volume Change in Hemorrhagic Shock
Authors: Tokunaga Kurato , Nakamura Kensuke , Inokuchi Ryota , Hayase Naoki , Terada Rui , Tomioka Yuji , Ikeda Toshiyuki , Kobayashi Etsuko , Okazaki Hitoshi , Sakuma Ichiro , Doi Kent , Morimura Naoto 
Published: May 2020

ABSTRACT

Background:
Fluid resuscitation, which is critical to counter acute hemorrhagic shock, requires prompt and accurate intravascular volume estimation for optimal fluid administration. This study aimed to evaluate whether cardiac variation of internal jugular vein (IJV), evaluated by ultrasonography, could detect hypovolemic status and predict response to fluid resuscitation.

Methods:
Patients undergoing autologous blood transfusion for elective surgery who were prospectively enrolled at the study blood donation center between August 2014 and January 2015. Vertical B-mode ultrasonography movies of IJV were recorded at five timepoints during blood donation: before donation, during donation, end of donation, end of fluid replacement, and after hemostasis. Cardiac variation of the IJV area and circumference were objectively measured using an automated extraction program together with blood pressure and heart rate.

Results:
A total of 140 patients were screened, and data from 104 patients were included in the final analyses. Among the variables analyzed, only collapse index area and collapse index circumference could detect both intravascular volume loss and response to fluid administration.

Conclusions:
Cardiac variation of IJV may be a reliable indicator of intravascular volume loss and response to fluid administration in hemorrhagic shock.
Serum Hydrogen Sulfide and Outcome Association in Pneumonia by the SARS-CoV-2 Coronavirus
Authors: Renieris Georgios , Katrini Konstantina , Damoulari Christina , Akinosoglou Karolina , Psarrakis Christos , Kyriakopoulou Magdalini , Dimopoulos George , Lada Malvina , Koufargyris Panagiotis , Giamarellos-Bourboulis Evangelos J. 
Published: May 2020

ABSTRACT

Background:
The pneumonia of COVID-19 illness has often a subtle initial presentation making mandatory the use of biomarkers for evaluation of severity and prediction of final patient disposition. We evaluated the use of hydrogen sulfide (H2S) for the outcome of COVID-19 pneumonia.

Patients and Methods:
We studied 74 patients with COVID-19. Clinical data were collected, and survival predictors were calculated. Blood was collected within 24 h after admission (day 1) and on day 7. H2S was measured in sera by monobromobimane derivation followed by high-performance liquid chromatography and correlated to other markers like procalcitonin and C-reactive protein (CRP). Tumor necrosis factor alpha and interleukin (IL)-6 were also measured in serum.

Results:
Survivors had significantly higher H2S levels on days 1 and 7 after admission. A cut-off point of 150.44 μM could discriminate survivors from non-survivors with 80% sensitivity, 73.4% specificity, and negative predictive value 95.9%. Mortality after 28 days was 32% with admission levels lower than or equal to 150.44 μM and 4.1% with levels above 150.44 μM (P: 0.0008). Mortality was significantly greater among patients with a decrease of H2S levels from day 1 to day 7 greater than or equal to 36% (p: 0.0005). Serum H2S on day 1 was negatively correlated with IL-6 and CRP and positively correlated with the absolute lymphocyte count in peripheral blood.

Conclusion:
It is concluded that H2S is a potential marker for severity and final outcome of pneumonia by the SARS-CoV-2 coronavirus. Its correlation with IL-6 suggests anti-inflammatory properties.
DCD Renal Transplantation From Donors With Acute Kidney Injury
Authors: Lia Daniel , Singer Pamela , Nair Vinay , Yang Jingyan , Teperman Lewis , Grodstein Elliot 
Published: May 2020

Background.
Deceased donor kidneys with acute kidney injury (AKI) and donation after circulatory death (DCD) kidneys are viable sources of organs. The outcomes of renal transplantation from DCD donors with AKI are not known.

Methods.
A retrospective review of deceased donor renal transplants performed from 2006 to 2016 was conducted using the United Network for Organ Sharing dataset. Donors were stratified by DCD or brain dead status and by AKI stage. Recipients were followed until graft failure or the end of study. Cox regression was used to adjust for donor, recipient, and transplant covariates known to affect the incidence of delayed graft function and graft survival.

Results.
A total of 135 644 patients were included in the study. The odds of delayed graft function among DCD recipients were significantly higher across all donor AKI stages. The unadjusted risk of overall and death-censored graft failure were similar between the 2 groups. After adjusting for covariates, there was a significant increase in the risk of overall graft failure in recipients of DCD allografts from donors with stage 2 AKI. There was also a higher risk of death-censored graft failure among stage 1 and 2 AKI DCD recipients.

Conclusions.
DCD renal allografts from donors experiencing stage 1 and 2 AKI have a higher adjusted risk of death-censored graft failure than AKI stage-matched donation after brain death renal allografts. Their use, however, is still associated with improved outcomes compared with waitlist mortality.
DNA methylation mediates the effect of cocaine use on HIV severity
Authors: Shu Chang , Justice Amy C. , Zhang Xinyu , Wang Zuoheng , Hancock Dana B. , Johnson Eric O. , Xu Ke 
Published: May 2020

AbstractBackgroundCocaine use accelerates human immunodeficiency virus (HIV) progression and worsens HIV outcomes. We assessed whether DNA methylation in blood mediates the association between cocaine use and HIV severity in a veteran population.MethodsWe analyzed 1,435 HIV-positive participants from the Veterans Aging Cohort Study Biomarker Cohort (VACS-BC). HIV severity was measured by the Veteran Aging Cohort Study (VACS) index. We assessed the effect of cocaine use on VACS index and mortality among the HIV-positive participants. We selected candidate mediators that were associated with both persistent cocaine use and VACS index by epigenome-wide association (EWA) scans at a liberal p-value cutoff of 0.001. Mediation analysis of the candidate CpG sites between cocaine’s effect and the VACS index was conducted, and the joint mediation effect of multiple CpGs was estimated. A two-step epigenetic Mendelian randomization (MR) analysis was conducted as validation.ResultsMore frequent cocaine use was significantly associated with a higher VACS index (β=1.00, p=2.7E-04), and cocaine use increased the risk of 10-year mortality (hazard ratio=1.10, p=0.011) with adjustment for confounding factors. Fifteen candidate mediator CpGs were selected from the EWA scan. Twelve of these CpGs showed significant mediation effects, with each explaining 11.3%-29.5% of the variation. The mediation effects for 3 of the 12 CpGs were validated by the two-step epigenetic MR analysis. The joint mediation effect of the 12 CpGs accounted for 47.2% of cocaine’s effect on HIV severity. Genes harboring these 12 CpGs are involved in the antiviral response(IFIT3, IFITM1, NLRC5, PLSCR1, PARP9)and HIV progression(CX3CR1, MX1).ConclusionsWe identified 12 DNA methylation CpG sites that appear to play a mediation role in the association between cocaine use and HIV severity.
Problems of Deploying CNN Transfer Learning to Detect COVID-19 from Chest X-rays
Authors: Majeed Taban , Rashid Rasber , Ali Dashti , Asaad Aras 
Published: May 2020

AbstractThe Covid-19 first occurs in Wuhan, China in December 2019. After that the virus spread all around the world and at the time of writing this paper the total number of confirmed cases are above 4.7 million with over 315000 deaths. Machine learning algorithms built on radiography images can be used as a decision support mechanism to aid radiologists to speed up the diagnostic process. The aim of this work is to conduct a critical analysis to investigate the applicability of convolutional neural networks (CNNs) for the purpose of COVID-19 detection in chest X-ray images and highlight the issues of using CNN directly on the whole image. To achieve this task, we first use 12-off-the-shelf CNN architectures in transfer learning mode on 3 publicly available chest X-ray databases together with proposing a shallow CNN architecture in which we train it from scratch. Chest X-ray images fed into CNN models without any preprocessing to follow the many of researches using chest X-rays in this manner. Next, a qualitative investigation performed to inspect the decisions made by CNNs using a technique known as class activation maps (CAM). Using CAMs, one can map the activations contributed most to the decision of CNNs back to the original image to visualize the most discriminating regions on the input image.We conclude that CNN decisions should not be taken into consideration, despite their high classification accuracy, until clinicians can visually inspect, and approve, the region(s) of the input image used by CNNs that lead to its prediction.
Who is lonely in lockdown? Cross-cohort analyses of predictors of loneliness before and during the COVID-19 pandemic
Authors: Bu Feifei , Steptoe Andrew , Fancourt Daisy 
Published: May 2020

AbstractBackgroundThere are concerns internationally that lockdown measures taken during the COVID-19 pandemic could lead to a rise in loneliness. As loneliness is recognised as a major public health concern, it is therefore vital that research considers the impact of the current COVID-19 pandemic on loneliness in order to provide necessary support. But it remains unclear who is lonely in lockdown?MethodsThis study compared socio-demographic predictors of loneliness before and during the COVID-19 pandemic using cross-cohort analyses of data from UK adults captured before the pandemic (UK Household Longitudinal Study, n=31,064) and during the pandemic (UCL COVID-19 Social Study, n=60,341).ResultsRisk factors for loneliness were near identical prior to and during the pandemic. Young adults, women, people with lower education or income, the economically inactive, people living alone, and urban residents had a higher risk of being lonely. Some people who were already at risk for being lonely (e.g. young adults aged 18-30, people with low household income, and adults living alone) experienced a heightened risk during the COVID-19 pandemic compared to prior to COVID-19 emerging. Further, being a student emerged as a higher risk factor during lockdown than usual.ConclusionsFindings suggest that interventions to reduce or prevent loneliness during COVID-19 should be targeted at those socio-demographic groups already identified as high-risk in previous research. These groups are likely not just to experience loneliness during the pandemic but to have an even higher risk than normal of experiencing loneliness relative to low-risk groups.
Serological prevalence of antibodies to SARS CoV-2 amongst cancer centre staff
Authors: Sikora Karol , Barwick Ian , Hamilton Ceri 
Published: May 2020

AbstractObjectivesthe aim of this study was to test Rutherford Health (RH) staff for the presence of SARS CoV-2 antibodies to reduce the risk of infection to cancer patients.SettingBetween 14 and 24 April 2020 we tested 161 staff at four locations: our cancer centres in Reading - Berkshire, Newport - S Wales, Liverpool - Merseyside, and Bedlington in Northumberland.ParticipantsTesting was available to all staff who were on site at the four locations named above at the time the study was carried out. 161 staff (80 men, 81 women) gave voluntary consent to have the tests and all testing gave rise to valid results.InterventionsWe used the South Korean test for antibodies to SARS CoV-2: Sugentech SGTi-flex COVID-19 IgM/IgG1. For each test, blood was collected and added to the sample well of the test cassette and buffer solution added. The test result was legible after 15 minutes. Outcome measures: The number of tests positive for the presence of antibodies was the primary outcome measure. The ratio of tests positive for the presence of IgM antibodies versus IgG antibodies was the secondary outcome measure.ResultsBetween 14 and 24 April 2020, 161 staff (age m = 43) were tested at four Rutherford Cancer Care centres that offer proton beam therapy, radiotherapy and chemotherapy. Out of 161, 12 samples (7.50%) tested positive of which 7 samples (4.35%) detected IgM only, 2 samples (1.24%) detected IgG only and 3 samples (1.86%) detected both IgM and IgG.ConclusionsThe low seroconversion rate in the sample population limits the current utility of the test as a way of reducing risk to vulnerable patient populations but longitudinal retesting will provide further data.Strengths and limitations of the studyThis is the first UK study on SARS CoV-2 antibody testing using the Sugentech SGTi-flex COVID-19 IgM/IgG in the workplace;This is the first UK study testing a population of cancer centre staff for SARS CoV-2 antibodies;This study builds on similar studies in other countries3-4, albeit with a smaller sample;Data on previous clinical symptoms is not included. We are in the process of revising consent paperwork for the test to include a question about previous symptoms like temperature, dry/persistent cough;Patient data is not included. We will consider testing patients once the pilot test with staff has reached conclusions about the efficacy and value of the test.
Time series forecasting of COVID-19 confirmed cases with ARIMA model in the South East Asian countries of India and Thailand: a comparative case study
Authors: Chandu Viswa Chaitanya 
Published: May 2020

AbstractBackgroundAs economic burden makes it increasingly difficult for countries to continue imposing control measures, it is vital for countries to make predictions using time series forecasting before making decisions on lifting the restrictions.AimSince apparent differences were noted in the disease transmission between the two South East Asian countries of India and Thailand, the study aims to draw comparative account of the progression of COVID 19 in near future between these two countries.MethodsThe study used data of COVID 19 confirmed cases in India and Thailand from WHO COVID 19 situation reports during the time period between 25th March, 2020 and 14th May, 2020. After determination of stationarity in the data and differencing, observation of autocorrelation function (ACF) and partial autocorrelation function (PACF), Auto Regressive Integrated Moving Average (ARIMA) (2,2,1) model was used to forecast the COVID 19 confirmed cases in both these countries for two weeks (i.e. 28th May, 2020). IBM SPSS version 20.0 software was used for data analysis.ResultsThe study demonstrated a possible increasing trend in number of COVID 19 cases in India in the coming two weeks with an estimated point forecast of 1,28,772 (95% CI 115023–142520) by 28th May, 2020. A stationary phase was forecasted for Thailand with a difference of only 43 cases between 14th May (the last case of input data) and 28th May.ConclusionThe time series forecasting employed in the present study warrants thorough preparation on part of the Indian health care system and authorities and calls for caution with regard to decisions made on lifting the control measures. The difference in the time series forecasting between these two South East Asian countries also highlights the need for strengthening of public health systems.