bluuebunny/crossref_metadata_2025_split huggingface dataset:
Designing for Patient Safety and Efficiency: Simulation-Based Hospital Design Testing
Authors: Colman Nora , Edmond Mary Bond , Dalpiaz Ashley , Walter Sarah , Miller David C. , Hebbar Kiran 
Published: May 2020

Objective: In the schematic design phase of a new freestanding children’s hospital, Simulation-based Hospital Design Testing (SbHDT) was used to evaluate the proposed design of 11 clinical areas. The purpose of this article is to describe the SbHDT process and how it can help identify and mitigate safety concerns during the facility design process. Background: In the design of new healthcare facilities, the ability to mitigate risk in the preconstruction period is imperative. SbHDT in a full-scale cardboard mock-up can be used to proactively test the complex interface between people and the built environment. Method: This study was a prospective investigation of SbHDT in the schematic design planning phase for a 400-bed freestanding children’s hospital where frontline staff simulated episodes of care. Latent conditions related to design were identified through structured debriefing. Failure mode and effect analysis was used to categorize and prioritize simulation findings and was used by the architect team to inform design solutions. A second round of testing was conducted in order to validate design changes. Results: A statistically significant reduction in criticality scores between Round 1 ( n = 201, median = 16.14, SD = 5.8) and Round 2 ( n = 201, median score of 7.68, SD = 5.26, p < .001) was identified. Bivariate analysis also demonstrated a statistically significant reduction in very high/high criticality scores between Round 1 and Round 2. Conclusions: SbHDT in the schematic phase of design planning was effective in mitigating risk related to design prototypes through effective identification of latent conditions and validation of design changes.
Secondary sclerosing cholangitis in critically ill patients has a poor outcome but lower tumour incidence than primary sclerosing cholangitis
Authors: Kirstein Martha M , Book Thorsten , Manns Michael P , von Hahn Thomas , Voigtländer Torsten 
Published: May 2020

BackgroundSecondary sclerosing cholangitis in critically ill patients (SSC‐CIP) is an emerging disease with grim prognosis.ObjectiveOur aim was the analysis of prognostic factors, long‐term outcome and risk of tumour development in SSC‐CIP compared with primary sclerosing cholangitis (PSC) patients.MethodsRetrospective analysis between 2008 and 2018.ResultsOne hundred and eleven patients with SSC‐CIP and 408 PSC patients were identified. Median orthotopic liver transplantation (OLT)‐free survival was 16 months for SSC‐CIP and 147 months for PSC (p  < 0.001). OLT was performed in 18/111 SSC‐CIP compared with 166/408 PSC patients (p  < 0.001). Malignant tumours were detected in 17.9% of PSC patients (73/408) compared with 2.7% (3/111) in SSC‐CIP (p  < 0.001). In multivariate Cox regression analysis low levels of C‐reactive protein (hazard ratio 4.687 (95% confidence interval (CI) 1.144–19.199, p  = 0.032) were significantly associated with a prolonged survival whereas higher age (hazard ratio 0.488 (95% CI 0.23–1.038), p  = 0.062) showed a trend for shorter survival in SSC‐CIP. For PSC malignancies (hazard ratio 0.42 (95% CI 0.313–0.575), p  < 0.001) and higher age (hazard ratio 0.709 (95% CI 0.544–0.922), p  = 0.01) were associated with a shorter OLT‐free survival.ConclusionSSC‐CIP is characterized by acute onset of liver disease and poor prognosis but with lower tumour incidence compared with PSC.
Evaluation of a web-based, tailored intervention to encourage help-seeking for lung cancer symptoms: a randomised controlled trial
Authors: Mueller Julia , Davies Alan , Jay Caroline , Harper Simon , Todd Chris 
Published: May 2020

Background People with lung cancer often wait for several months before presenting symptoms to health services. Some patients report seeking information online to help them appraise symptoms. No research has evaluated whether websites about lung cancer present information in an optimal manner to encourage help-seeking. Objective To evaluate the effectiveness of an online, tailored, theory-based intervention in encouraging help-seeking behaviour among people with potential lung cancer symptoms. Methods The intervention consisted of a specialised website which provided tailored information about lung cancer and included a component to address beliefs about help-seeking, based on the Theory of Planned Behaviour (TPB-component). Individuals with undiagnosed symptoms were randomised to receive information about lung cancer in a factorial design (tailored/untailored × TPB-component/no TPB-component). Pre and post viewing webpages, participants reported perceived likelihood of seeking help. Data were analysed using robust mixed factorial ANOVA. Results Data from 253 participants (73.9% female) were analysed. No effect for the TPB-component was found ( p = 0.16), nor for tailoring ( p = 0.27). Self-reported likelihood of seeking help increased significantly from pre to post ( p < 0.001), regardless of tailoring and TPB-components. Conclusion Self-reported likelihood of seeking help for potential lung cancer symptoms may increase after viewing information online. This does not appear to be affected by information tailoring and components to address beliefs. However, intentions remained unchanged in the majority of the sample. This suggests further efforts are needed to improve lung cancer websites if they are to be a useful resource for those seeking advice about their symptoms.
Evaluation of the pharmacokinetic interaction and safety of ubrogepant coadministered with acetaminophen or nonsteroidal anti-inflammatory drugs: A randomized trial
Authors: Jakate Abhijeet , Boinpally Ramesh , Butler Matthew , Lu Kaifeng , Womack Kristi , McGeeney Danielle , Periclou Antonia 
Published: May 2020

Background: Ubrogepant is a novel, oral calcitonin gene–related peptide receptor antagonist approved by the US Food and Drug Administration for acute treatment of migraine with or without aura in adults. Objectives: To assess potential pharmacokinetic (PK) drug–drug interactions in healthy participants and inform the safety and tolerability of ubrogepant alone and in combination with acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs) in healthy participants and participants with migraine. Methods: Two phase 1, three-way crossover studies randomized healthy adults to 100 mg ubrogepant alone, 1000 mg acetaminophen or 500 mg naproxen alone, and 100 mg ubrogepant plus 1000 mg acetaminophen or 500 mg naproxen. Geometric mean ratios (GMRs) and 90% confidence intervals were calculated based on statistical comparison of maximum plasma drug concentration ( C max) and area under the plasma drug concentration–time curve (AUC) for treatment in combination versus alone. Two phase 3 randomized trials included adults with migraine. Treatment-emergent adverse events (TEAEs) were evaluated. Results: Time to C max and terminal elimination half-life for all treatments were unchanged when coadministered. Ubrogepant C max and AUC increased by approximately 40% when coadministered with acetaminophen. Acetaminophen C max decreased by 24% (GMR = 0.76) when coadministered with ubrogepant. There were no significant PK interactions between ubrogepant and naproxen. TEAE rates in the acetaminophen and NSAID rescue medication groups were similar to ubrogepant alone. Conclusions: Coadministration of ubrogepant and acetaminophen resulted in a statistically significant increase in ubrogepant exposure and a decrease in acetaminophen C max; however, these changes were not clinically relevant. No statistically or clinically relevant changes in PK were associated with ubrogepant and naproxen coadministration. No safety concerns were identified for ubrogepant alone or in combination with acetaminophen or NSAIDs.
Epidermal growth factor receptor–dependent DNA repair promotes murine and human hematopoietic regeneration
Authors: Fang Tiancheng , Zhang Yurun , Chang Vivian Y. , Roos Martina , Termini Christina M. , Signaevskaia Lia , Quarmyne Mamle , Lin Paulina K. , Pang Amara , Kan Jenny , Yan Xiao , Javier Anna , Pohl Katherine , Zhao Liman , Scott Peter , Himburg Heather A. , Chute John P. 
Published: May 2020

AbstractChemotherapy and irradiation cause DNA damage to hematopoietic stem cells (HSCs), leading to HSC depletion and dysfunction and the risk of malignant transformation over time. Extrinsic regulation of HSC DNA repair is not well understood, and therapies to augment HSC DNA repair following myelosuppression remain undeveloped. We report that epidermal growth factor receptor (EGFR) regulates DNA repair in HSCs following irradiation via activation of the DNA-dependent protein kinase–catalytic subunit (DNA-PKcs) and nonhomologous end joining (NHEJ). We show that hematopoietic regeneration in vivo following total body irradiation is dependent upon EGFR-mediated repair of DNA damage via activation of DNA-PKcs. Conditional deletion of EGFR in hematopoietic stem and progenitor cells (HSPCs) significantly decreased DNA-PKcs activity following irradiation, causing increased HSC DNA damage and depressed HSC recovery over time. Systemic administration of epidermal growth factor (EGF) promoted HSC DNA repair and rapid hematologic recovery in chemotherapy-treated mice and had no effect on acute myeloid leukemia growth in vivo. Further, EGF treatment drove the recovery of human HSCs capable of multilineage in vivo repopulation following radiation injury. Whole-genome sequencing analysis revealed no increase in coding region mutations in HSPCs from EGF-treated mice, but increased intergenic copy number variant mutations were detected. These studies demonstrate that EGF promotes HSC DNA repair and hematopoietic regeneration in vivo via augmentation of NHEJ. EGF has therapeutic potential to promote human hematopoietic regeneration, and further studies are warranted to assess long-term hematopoietic effects.
Nosocomial outbreak of COVID-19 pneumonia in Wuhan, China
Authors: Wang Xiaorong , Zhou Qiong , He Yukun , Liu Lingbo , Ma Xinqian , Wei Xiaoshan , Jiang Nanchuan , Liang Limei , Zheng Yali , Ma Ling , Xu Yu , Yang Dong , Zhang Jianchu , Yang Bohan , Jiang Ning , Deng Tao , Zhai Bingbing , Gao Yang , Liu Wenxuan , Bai Xinghua , Pan Tao , Wang Guoqing , Chang Yujun , Zhang Zhi , Shi Huanzhong , Ma Wan-Li , Gao Zhancheng 
Published: May 2020

BackgroundThe novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), infected over 3300 healthcare workers in early 2020 in China. Little information is known about nosocomial infections of healthcare workers in the initial period. We analysed data from healthcare workers with nosocomial infections in Wuhan Union Hospital (Wuhan, China) and their family members.MethodsWe collected and analysed data on exposure history, illness timelines and epidemiological characteristics from 25 healthcare workers with laboratory-confirmed coronavirus disease 2019 (COVID-19) and two healthcare workers in whom COVID-19 was highly suspected, as well as 10 of their family members with COVID-19, between 5 January and 12 February 2020. The demographics and clinical features of the 35 laboratory-confirmed cases were investigated and viral RNA of 12 cases was sequenced and analysed.ResultsNine clusters were found among the patients. All patients showed mild to moderate clinical manifestation and recovered without deterioration. The mean period of incubation was 4.5 days, the mean±sdclinical onset serial interval (COSI) was 5.2±3.2 days, and the median virus shedding time was 18.5 days. Complete genomic sequences of 12 different coronavirus strains demonstrated that the viral structure, with small irrelevant mutations, was stable in the transmission chains and showed remarkable traits of infectious traceability.ConclusionsSARS-CoV-2 can be rapidly transmitted from person to person, regardless of whether they have symptoms, in both hospital settings and social activities, based on the short period of incubation and COSI. The public health service should take practical measures to curb the spread, including isolation of cases, tracing close contacts, and containment of severe epidemic areas. Besides this, healthcare workers should be alert during the epidemic and self-quarantine if self-suspected of infection.
A major genetic determinant of autoimmune diseases is associated with the presence of autoantibodies in hypersensitivity pneumonitis
Authors: Buendía-Roldán Ivette , Santiago-Ruiz Luis , Pérez-Rubio Gloria , Mejía Mayra , Rojas-Serrano Jorge , Ambrocio-Ortiz Enrique , Benítez-Valdez Geovanni , Selman Moisés , Falfán-Valencia Ramcés 
Published: May 2020

BackgroundHypersensitivity pneumonitis is an immune-mediated disease triggered by exposure to organic particles in susceptible individuals. It has been reported that a subgroup of patients with hypersensitivity pneumonitis develops autoantibodies with or without clinical manifestations of autoimmune disease. However, the mechanisms involved in this process and the effect of the autoantibodies on clinical course in hypersensitivity pneumonitis is unknown. We evaluated the association between human leukocyte antigen (HLA) class II alleles and hypersensitivity pneumonitis patients with and without autoantibodies.Methods170 hypersensitivity pneumonitis patients were included. We analysed the presence of antinuclear antibodies, rheumatoid factor, anti-SSA/Ro, anti-SSB/La and anti-CCP at the time of diagnosis. In addition, in a subset of patients we evaluated anti-Scl-70, anti-neutrophil cytoplasmic antibody, and anti-DNA. HLA typing was performed using PCR sequence-specific primers in a high-resolution modality, includingHLA-DRB1andHLA-DQB1loci. Statistical analysis was performed employing Epi-Info v7 and SPSS v20.Results60 hypersensitivity pneumonitis patients showed sera autoantibodies (HPAbs+), and 110 hypersensitivity pneumonitis patients did not (HPAbs−). The frequency of the alleleHLA-DRB1*03:01was remarkably increased in the HPAbs+group (10.8%versus0.45%; OR 30.14, 95% CI 3.83–237.1; p=1.65×10-4after Bonferroni's correction). Likewise, we found that the haplotypeDRB1*03:01-DQB1*02:01, which is part of the 8.1 ancestral haplotype, a major genetic determinant of autoimmune diseases, confers significant risk to develop autoantibodies (OR 19.23, 95% CI 2.37–155.9; p=0.0088 after Bonferroni's correction). In addition, theHLA-DRB1*03:01allele was associated with higher mortality in patients with hypersensitivity pneumonitis (adjusted OR 5.9, 95% CI 1.05–33.05; p=0.043).ConclusionsA subset of hypersensitivity pneumonitis patients presents circulating autoantibodies and higher mortality that are associated with some alleles of 8.1 ancestral haplotype.
Normal spirometry predictive values for the Western Indian adult population
Authors: Agarwal Dhiraj , Parker Richard A. , Pinnock Hilary , Roy Sudipto , Ghorpade Deesha , Salvi Sundeep , Khatavkar Parag , Juvekar Sanjay 
Published: May 2020

Interpretation of spirometry involves comparing lung function parameters with predicted values to determine the presence/severity of the disease. The Global Lung Function Initiative (GLI) derived reference equations for healthy individuals aged 3–95 years from multiple populations but highlighted India as a “particular group” for whom further data are needed. We aimed to derive predictive equations for spirometry in a rural Western Indian adult population.We used spirometry data previously collected (2008–2012) from 1258 healthy adults (aged 18 years and over) by the Vadu Health and Demographic Surveillance System. We constructed sex-stratified prediction equations for forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), and FEV1/FVC using the Generalised Additive Model for Location, Scale and Shape (GAMLSS) method to derive the best fitting model of each outcome as a function of age and height.When compared with GLI Ethnicity Codes 1 (White Caucasian) and 5 (Other/Mixed), the Western Indian adult population appears to have lower lung volumes on average, though the FEV1/FVC ratio is comparable. Both age and height were predictive of mean FEV1and FVC; and for females, the variability of response was also dependent on age. FEV1/FVC appears to have a very strong age effect, highlighting the limitations of using a fixed 0.7 cut-off value.The use of GLI normal values may result in overdiagnosis of lung disease in this population. We recommend that the values and equations generated from this study should be used by physicians in their routine practice for diagnosing disease and its severity in adults from the Western Indian population.
High Photon Absorptivity of Quantum Dot Infrared Photodetectors Achieved by the Surface Plasmon Effect of Metal Nanohole Array
Authors: Liu Hongmei , Kang Yongqiang , Meng Tianhua , Tian Cuifeng , Wei Guodong 
Published: May 2020

AbstractWith the increasing demand for small-scale photodetector devices, quantum dot–based infrared photodetectors have attracted more and more attention in the past decades. In this work, periodic metal nanohole array structures are introduced to the quantum dot infrared photodetectors to enhance the photon absorptivity performance via the surface plasmon enhancement effect in order to overcome the bottleneck of low optical absorption efficiency that exists in conventional photodetectors. The results demonstrate that the optimized metal nanohole array structures can greatly enhance the photon absorptivity up to 86.47% in the specific photodetectors, which is 1.89 times than that of conventional photodetectors without the metal array structures. The large enhancement of the absorptivity can be attributed to the local coupling surface plasmon effect caused by the metal nanohole array structures. It is believed that the study can provide certain theoretical guidance for high-performance nanoscale quantum dot–based infrared photodetectors.
Prehospital acute traumatic pain assessment and management practices in the Western Cape, South Africa: a retrospective review
Authors: Lourens Andrit , Parker Romy , Hodkinson Peter 
Published: May 2020

Abstract
Background
Trauma is a common aetiology of acute pain in the emergency setting, and traumatic injuries have been recognised as a global public health crisis leading to numerous deaths and disabilities. This study aimed to identify the prevalence of acute pain among high acuity trauma patients presenting to a public sector emergency medical service and to describe prehospital acute traumatic pain assessment and management practices amongst emergency care providers in the Western Cape Province, South Africa.

Methods
A retrospective review of electronic patient care reports of trauma patients treated by the South African Western Cape Emergency Medical Services between January 1 and December 31, 2017 was conducted. Stratified random sampling was utilised to select 2401 trauma patients out of 24,575 that met the inclusion criteria.

Results
Of the 2401 patients reviewed, 435 (18.1%) had a pain score recorded, of which 423 (97.2%) were experiencing pain. An additional 8.1% (n = 194) of patients had pain or tenderness mentioned in the working diagnosis but no pain score noted. Eighty-one (18.6%) patients experienced mild pain, 175 (40.2%) moderate pain and 167 (38.2%) severe pain. No association was found between a pain score recorded and age group (≤ 14 versus > 14 years) (p = 0.649) or gender (p = 0.139). Only 7.6% of patients with moderate-to-severe pain and 2.8% of all trauma patients received any form of analgesic medication. No association was found between the administration of analgesia and age group (≤ 14 versus > 14 years) (p = 0.151) or gender (p = 0.054). Patients were more likely to receive analgesia if they had a pain score recorded (p < 0.001), were managed by advanced life support practitioners (p < 0.001) or had severe pain (p = 0.001).

Conclusion
Acute trauma pain assessment and management practices in this prehospital cohort are less well established than reported elsewhere and whether this reflects emergency care training, institutional culture, scopes of practice or analgesic resources, requires further research. Emergency medical services need to monitor and promote quality pain care, enhance pain education and ensure that all levels of emergency care providers have access to analgesic medication approved for prehospital use. Clear and rational guidelines would enable better pain management by all cadres of providers, for all levels of pain.
Main findings and advances in bioinformatics and biomedical engineering- IWBBIO 2018
Authors: Valenzuela Olga , Rojas Fernando , Rojas Ignacio , Glosekotter Peter 
Published: May 2020

AbstractIn the current supplement, we are proud to present seventeen relevant contributions from the 6th International Work-Conference on Bioinformatics and Biomedical Engineering (IWBBIO 2018), which was held during April 25-27, 2018 in Granada (Spain). These contributions have been chosen because of their quality and the importance of their findings.
Toronto aortic stenosis quality of life questionnaire (TASQ): validation in TAVI patients
Authors: Styra Rima , Dimas Michelle , Svitak Kathy , Kapoor Mamta , Osten Mark , Ouzounian Maral , Devins Gerald , Deckert Amy , Horlick Eric 
Published: May 2020

Abstract
Background
Aortic stenosis (AS) is a common cardiac condition whose prevalence increases with age. The symptom burden associated with severe aortic stenosis (AS) can introduce significant lifestyle disruptions and if left untreated can lead to a poor prognosis. Quality of life (QoL) is an important consideration in these patients. The TASQ is a QoL tool that was developed for aortic stenosis patients. We evaluated the psychometric properties of this specific questionnaire in patients who underwent transcatheter aortic valve implantation (TAVI), which is a therapeutic option for patients with severe aortic stenosis (AS).

Methods
The properties of the TASQ in measuring QoL were evaluated in AS patients undergoing TAVI. Patients presenting for the TAVI procedure (N = 62) were evaluated pre-TAVI, at discharge, 1-month, and 3-month follow-ups. Demographic information as well as caregiver status, and daily activities were recorded. In addition to the TASQ, they completed the KCCQ (Kansas City Cardiomyopathy Questionnaire) and the IIRS (Illness Intrusiveness Rating Scale).

Results
The TASQ is a 16-item self-administered questionnaire that assesses AS-specific QoL across five domains: physical symptoms; physical limitations; emotional impact; social limitations, and health expectations. TASQ subscales are internally consistent (α = 0.74–0.96) and showed significant improvements from baseline across assessments (p < 0.001). Construct validity evidence was demonstrated by correlations consistent with theoretically derived hypotheses across time points.

Conclusions
The TASQ is a brief measure of AS-specific QoL that is sensitive to change in patients undergoing TAVI. Items on the TASQ capture important QoL concerns reported by AS patients, suggesting this is a measure of relevant and meaningful outcomes for this patient population. Detection of early improvements in QoL by the TASQ is promising, with important implications for the evaluation of procedural outcomes in this population.