bluuebunny/crossref_metadata_2025_split huggingface dataset:
Addressing Workplace Safety in the Emergency Department
Authors: Vrablik Marie C. , Lawrence Madelyn , Ray Jessica M. , Moore Megan , Wong Ambrose H. 
Published: September 2020

Objective:
This study aims to identify interventions to address workplace violence in the emergency department based on direct evidence from experiences of patient assault.

Methods:
We performed de novo coding and thematic analysis of datasets from two geographically distinct institutions and five different sites that contained interviews with 80 health workers.

Results:
We identified concepts that corresponded to the micro (workers and patients), meso (organizations and clinical units), and macro (society at large, worldviews, and values) levels of the healthcare system. Within each level, potential interventions fell into the prevention, response, and recovery phases of emergency preparedness.

Conclusion:
Efforts to address workplace violence should consider interconnected influences from individual workers, organizations, and society at large. Comprehensive approaches at multiple phases of preparedness are needed to have sustained impact on safety.
Workers With Different Employment Status Have Different Exposures to Work Stressors and Different Responses to Identical Work Stressors
Authors: Park Jungsun , Kim Yangho 
Published: September 2020

Introduction:
This study evaluated the relationship between exposure to diverse work-related stressors and psychological well-being in workers with precarious employment.

Methods:
This was a secondary analysis of data from the fifth Korean Working Conditions Survey, conducted in 2017.

Results:
Daily workers were more likely to report poor psychological well-being than regular or temporary workers. Furthermore, higher proportions of daily workers reported exposure to the nine analyzed work stressors. However, only three of nine workplace stressors (lack of decision latitude, lack of reward, and lack of support from workplace managers) affected male and female daily workers.

Conclusion:
A strategy designed to improve the psychological well-being of workers with precarious employment that is based on typical job stressor evaluation tools, may have limited effects.
Recurrent glomerulonephritis after renal transplantation
Authors: Chukwu Chukwuma A. , Middleton Rachael , Kalra Philip A. 
Published: September 2020

Purpose of review
The current understanding of the incidence, predisposing factors, pathophysiology and effective treatment of recurrent glomerulonephritis (RGN) in renal transplants remains at best patchy and at worst, completely lacking. Current reports have been limited by inconsistencies in study design, sample populations and lengths of follow-up. Making sense of the available evidence will provide the tools to support transplant nephrologists in their management of allograft donors and recipients.

Recent findings
With better survival of renal allografts, RGN has become a dominant factor influencing allograft survival. Evidently, the risk of recurrence is proportional to the incremental time posttransplantation. The proposed risk factors for RGN include but are not limited to the severity of primary glomerulonephritis (PGN), younger recipient age, live-related donor allograft, minimal HLA mismatch, steroid avoidance and nonuse of induction therapy. Unfortunately, these findings are derived from retrospective cohort and registry studies; hence, true causality for RGN is hard to prove.

Summary
The management of RGN is improving, as we gain greater understanding of its pathophysiology, including the genetic, alloimmune and autoimmune contributions to recurrence. With better pretransplant risk stratification, posttransplant surveillance, novel biomarkers and new treatment strategies, we hope the transplant community will eventually have the tools to predict risk, prevent recurrence and personalise treatment of RGN.
GFR slope as a surrogate endpoint for CKD progression in clinical trials
Authors: Inker Lesley A. , Chaudhari Juhi 
Published: September 2020

Purpose of review
There is a paucity of therapies for chronic kidney disease (CKD), in part because of the slow nature of the disease which poses challenges in selection of endpoints in randomized controlled trials (RCT). There is increasing evidence for the use of glomerular filtration rate (GFR)-based endpoints either as percentage decline using time-to-event analyses, or as difference in slope between treatment arms. We reviewed the rationale for using surrogate endpoints and optimal methods for their evaluation prior to their use and evidence for GFR-based endpoints and particularly GFR slope as validated surrogate endpoints and considerations for their use in RCTs.

Recent findings
In an individual patient meta-analysis of 47 studies (60 620 participants), treatment effects on the clinical endpoint were accurately predicted from treatment effects on 3-year total slope [median R
2 = 0.97 (95% Bayesian confidence interval (BCI), 0.78–1.00] and on the chronic slope [R
2 = 0.96 (95% BCI, 0.63–1.00)]. In a simulation study, GFR slope substantially reduced the required sample size and duration of follow-up compared to the clinical endpoint given high baseline GFR and absence of acute treatment effect. In the presence of acute effect, results were more complicated.

Summary
GFR decline is accepted, and GFR slope is being considered, by regulatory authorities as a validated surrogate endpoint for CKD RCTs.
VR and machine learning: novel pathways in surgical hands-on training
Authors: Veneziano Domenico , Cacciamani Giovanni , Rivas Juan Gomez , Marino Nicola , Somani Bhaskar K. 
Published: September 2020

Purpose of review
Surgical training has dramatically changed over the last decade. It has become not only the way to prepare surgeons for their everyday work, but also a way to certify their skills thus increasing patient safety. This article reviews advances in the use of machine learning and artificial intelligence applied to virtual reality based surgical training over the last 5 years.

Recent findings
Eight articles have been published which met the inclusion criteria. This included six articles about the use of machine learning and artificial intelligence for assessment purposes and two articles about the possibility of teaching applications, including one review and one original research article. All the research articles pointed out the importance of machine learning and artificial intelligence for the stratification of trainees, based on their performance on basic tasks or procedures simulated in a virtual reality environment.

Summary
Machine learning and artificial intelligence are designed to analyse data and use them to take decisions that typically require human intelligence. Evidence in literature is still scarce about this technology applied to virtual reality and existing manuscripts are mainly focused on its potential to stratify surgical performance and provide synthetic feedbacks about it. In consideration of the exponential growth of computer calculation capabilities, it is possible to expect a parallel increase of research about this topic within the next few years.
Ethical Considerations of Social Media to Recruit Caregivers of Children With Cancer
Authors: Tan Kelly R. , Killela Mary K. , Leckey Jill 
Published: September 2020

Background
Social media platforms are useful for recruiting hard-to-reach populations, such as caregivers of children with cancer, for research. However, there are unique ethical considerations in using social media.

Objectives
The aim of the study was to describe the methods used to recruit hard-to-reach caregivers (parents of children with cancer) for research and related ethical considerations.

Methods
We used The Belmont Report tenets (respect for persons, beneficence, and justice) as a guiding framework to identify issues relevant to social media recruitment of hard-to-reach populations and to describe how we addressed these issues in our study.

Results
We engaged leaders of two online communities that offer peer support for caregivers of children with cancer to help with recruitment to our study on financial effect of pediatric cancer. We identified issues in using social media for recruiting hard-to-reach populations in alignment with The Belmont Report, including risk for subject selection bias, privacy rights, protecting identity of participants, data security issues, and access to research. We addressed issues by deliberate study design decisions and engagement with online community advocates.

Discussion
Using social media to recruit hard-to-reach populations may be a successful way to engage them in research. Although researchers may remain compliant with the institutional review board of their facilities and are faithful to the tenets of The Belmont Report, unanticipated ethical issues may arise directly or indirectly as a result of using social media. This article identifies these issues and provides suggestions for dealing with them.
Biomarkers for Estimating Risk of Hospital Mortality and Long-Term Quality-of-Life Morbidity After Surviving Pediatric Septic Shock: A Secondary Analysis of the Life After Pediatric Sepsis Evaluation Investigation*
Authors: Wong Hector R. , Reeder Ron W. , Banks Russell , Berg Robert A. , Meert Kathleen L. , Hall Mark W. , McQuillen Patrick S. , Mourani Peter M. , Chima Ranjit S. , Sorenson Samuel , Varni James W. , McGalliard Julie , Zimmerman Jerry J. 
Published: September 2020

Objectives:
The Life After Pediatric Sepsis Evaluation investigation recently reported that one-third of children who survive sepsis experience significant health-related quality-of-life impairment compared with baseline at 1 year after hospitalization. Pediatric Sepsis Biomarker Risk Model is a multibiomarker tool for estimating baseline risk of mortality among children with septic shock. We determined if the Pediatric Sepsis Biomarker Risk Model biomarkers have predictive capacity for estimating the risk of hospital mortality and long-term health-related quality-of-life morbidity among children with community-acquired septic shock.

Design:
Secondary analysis.

Setting:
Twelve academic PICUs.

Patients:
A subset of Life After Pediatric Sepsis Evaluation subjects (n = 173) with available blood samples.

Interventions:
None.

Measurements and Main Results:
Three predefined outcomes from the Life After Pediatric Sepsis Evaluation investigation were evaluated: all-cause hospital mortality (n = 173), and the composite outcome of mortality or persistent, serious deterioration of health-related quality of life (> 25% below baseline) among surviving children at 1 month (n = 125) or 3 months (n = 117). Pediatric Sepsis Biomarker Risk Model had an area under the receiver operating characteristic curve of 0.73 (95% CI, 0.59–0.87; p = 0.002) for estimating the risk of hospital mortality and was independently associated with increased odds of hospital mortality. In multivariable analyses, Pediatric Sepsis Biomarker Risk Model was not independently associated with increased odds of the composite outcome of mortality or deterioration of persistent, serious deterioration health-related quality of life greater than 25% below baseline. A new decision tree using the Pediatric Sepsis Biomarker Risk Model biomarkers had an area under the receiver operating characteristic curve of 0.87 (95% CI, 0.80–0.95) for estimating the risk of persistent, serious deterioration health-related quality of life at 3 months among children who survived septic shock.

Conclusions:
Pediatric Sepsis Biomarker Risk Model had modest performance for estimating hospital mortality in an external cohort of children with community-acquired septic shock. The Pediatric Sepsis Biomarker Risk Model biomarkers appear to have utility for estimating the risk of persistent, serious deterioration of health-related quality of life up to 3 months after surviving septic shock. These findings suggest an opportunity to develop a clinical tool for early assignment of risk for long-term health-related quality-of-life morbidity among children who survive septic shock.
A Quality Improvement Approach to Reduce Unplanned Extubation in the NICU While Avoiding Sedation and Restraints
Authors: Bertoni C. Briana , Bartman Thomas , Ryshen Gregory , Kuehne Brandon , Larouere Marissa , Thomas Leslie , Wishloff Erin , Shepherd Edward , Dillard Julie , Pavlek Leeann R. , Moallem Mohannad 
Published: September 2020

Introduction:
The unplanned extubation (UE), a common adverse event in the neonatal intensive care unit (NICU), may result in airway trauma, cardiopulmonary resuscitation, and, in extreme cases, death. As part of the Nationwide Children’s Hospital NICU’s effort to optimize NICU graduates’ neurodevelopmental outcomes, skin-to-skin care of intubated infants is encouraged, while sedation and restraints to prevent UE are strongly discouraged. This project aimed to decrease the UE rate from 1.85 to 1.5 per 100 endotracheal tube (ETT) days.

Methods:
The project occurred in a 114-bed, level-IV NICU with approximately 850 admissions per year and 100% outborn infants. A multidisciplinary team began biweekly meetings to review all UE events, later separating these into preventable and nonpreventable. Important ongoing tests of change included assigning a single process owner for UE reporting, ensuring proper ETT securement, and using 2 clinical staff during patient and/or ETT manipulation.

Results:
Early in the project, enhanced detection led to an increased rate from 1.85 to 3.26 per 100 ETT days. However, identifying preventable events empowered staff to decrease the frequency to 2.03 per 100 ETT days. In August 2017, an ETT taping method change produced an increase in special causes due to decreased compliance. However, when securement methods were enhanced, noncompliance reversed and is now trending favorably.

Conclusions:
Decreasing UE in a neurodevelopmentally friendly unit, which avoids sedation and restraints, is challenging. Using a multidisciplinary quality improvement approach and after appropriately capturing events, we reduced UE, with the highest impact of intervention being ETT securement standardization.
HIV Stigma and Viral Suppression Among People Living With HIV in the Context of Universal Test and Treat: Analysis of Data From the HPTN 071 (PopART) Trial in Zambia and South Africa
Authors: Hargreaves James R. , Pliakas Triantafyllos , Hoddinott Graeme , Mainga Tila , Mubekapi-Musadaidzwa Constance , Donnell Deborah , Piwowar-Manning Estelle , Agyei Yaw , Mandla Nomhle F. , Dunbar Rory , Macleod David , Floyd Sian , Bock Peter , Fidler Sarah , Hayes Richard J. , Seeley Janet , Stangl Anne , Bond Virginia , Ayles Helen ,   on behalf of the HPTN 071 (PopART) Study Team
Published: September 2020

Background:
The impact of HIV stigma on viral suppression among people living with HIV (PLHIV) is not well characterized.

Setting:
Twenty-one communities in Zambia and South Africa, nested within the HPTN 071 (PopART) trial.

Methods:
We analyzed data on viral suppression (<400 copies HIV RNA/mL) among 5662 laboratory-confirmed PLHIV aged 18–44 years who were randomly sampled within the PopART trial population cohort 24 months after enrolment (PC24). We collected data on experiences and internalization of stigma from those PLHIV who self-reported their HIV status (n = 3963/5662) and data on perceptions of stigma from a 20% random sample of all PLHIV (n = 1154/5662). We also measured stigma at the community-level among PLHIV, community members, and health workers. We analyzed the association between individual- and community-level measures of HIV stigma and viral suppression among PLHIV, adjusting for confounding.

Results:
Of all 5662 PLHIV, 69.1% were virally suppressed at PC24. Viral suppression was highest among those 3963 cohort participants who self-reported living with HIV and were on ART (88.3%), and lower among those not on treatment (37.5%). Self-identifying PLHIV who reported internalized stigma were less likely to be virally suppressed (75.0%) than those who did not (80.7%; adjusted risk ratio, 0.94 95% CI: 0.89 to 0.98). Experiences, perceptions, and community-level measures of stigma were not associated with viral suppression.

Conclusion:
Internalized stigma among PLHIV was associated with a lower level of viral suppression; other dimensions of stigma were not. Stigma reduction approaches that address internalized stigma should be an integral component of efforts to control the HIV epidemic.
The Impact of Psychopathology, Social Adversity and Stress-relevant DNAm on Prospective Risk for Post-traumatic Stress: A Machine Learning Approach
Authors: Wani Agaz H. , Aiello Allison E. , Kim Grace S. , Xue Fei , Martin Chantel L. , Ratanatharathorn Andrew , Qu Annie , Koenen Karestan , Galea Sandro , Wildman Derek E. , Uddin Monica 
Published: September 2020

AbstractBackgroundA range of factors have been identified that contribute to greater incidence, severity, and prolonged course of post-traumatic stress disorder (PTSD), including: comorbid and/or prior psychopathology; social adversity such as low socioeconomic position, perceived discrimination, and isolation; and biological factors such as genomic variation at glucocorticoid receptor regulatory network (GRRN) genes. This complex etiology and clinical course make identification of people at higher risk of PTSD challenging. Here we leverage machine learning (ML) approaches to identify a core set of factors that may together predispose persons to PTSD.MethodsWe used multiple ML approaches to assess the relationship among DNA methylation (DNAm) at GRRN genes, prior psychopathology, social adversity, and prospective risk for PTS severity (PTSS).ResultsML models predicted prospective risk of PTSS with high accuracy. The Gradient Boost approach was the top-performing model with mean absolute error of 0.135, mean square error of 0.047, root mean square error of 0.217, and R2of 95.29%. Prior PTSS ranked highest in predicting the prospective risk of PTSS, accounting for >88% of the prediction. The top ranked GRRN CpG site was cg05616442, inAKT1, and the top ranked social adversity feature was loneliness.ConclusionMultiple factors including prior PTSS, social adversity, and DNAm play a role in predicting prospective risk of PTSS. ML models identified factors accounting for increased PTSS risk with high accuracy, which may help to target risk factors that reduce the likelihood or course of PTSD, potentially pointing to approaches that can lead to early intervention.
TailTimer:an open-source device for automating the rodent tail immersion assay
Authors: Udell Mallory E. , Martinez Angel Garcia , Wang Tengfei , Ni Jie , Hurt Christian , Mulligan Megan , Redei Eva E. , Chen Hao 
Published: September 2020

AbstractThe tail immersion assay is a widely used method for measuring acute thermal pain in a way which is quantifiable and reproducible. It is non-invasive and measures response to a stimulus that may be encountered by an animal in its natural environment. However, tail withdrawal latency data are usually collected manually, and precise temperatures of the water at the time of measurement are most often not recorded. These two factors can reduce the reproducibility of tail immersion assay data. We designed a device,TailTimer, which uses the Raspberry Pi single-board computer and a temperature sensor, to automatically record both tail withdrawal latency and water temperature. The device has a radio frequency identification (RFID) system that can record the ID of animals. Our software recognizes several specific RFID keys as user interface commands, which allowsTailTimerto be operated via RFID fobs. We also programmed the device to only allow tests to be conducted when the water is within ± 0.25 °C of the target temperature. Data recorded using theTailTimerdevice showed a linear relationship between tail withdrawal latency and water temperature when tested between 47 - 50 °C. We also observed a profound effect of water mixing speed on tail withdrawal latency. Our data further revealed significant strain and sex differences, valorizingTailTimerin its ability to detect genetically-determined variations in thermal pain sensitivity.Significance StatementQuantification of tail withdrawal latency in response to thermal pain has essentially remained the same since the method was first introduced decades ago and relies on manual recording of water temperature and tail withdrawal latency. Such manual methods engender relatively substantial variability and are potential contributors to some of the discrepancies present among relevant research. The open sourceTailTimerdevice we report here is simple and inexpensive to manufacture. The RFID-based user interface is ergonomic, especially in animal facilities where space is limited and gloves are mandatory. We anticipate that the increased reproducibility of tail withdrawal latency provided byTailTimerwill augment its utility in nociception and addiction research.
Attempted fractionation of LB Lennox medium via reversed phase high performance liquid chromatography
Authors: Ng Wenfa 
Published: September 2020

AbstractMass balance analysis is a highly useful tool for chemical engineering analysis of biological processes. Specifically, composition and amounts of inputs to a cell could be correlated with measurement of metabolic byproducts and outputs for inferring metabolic fluxes flowing through specific cellular metabolic pathways. However, the composition of many common microbiological growth medium remains ill-defined with batch-to-batch variation. Thus, a need exists for developing methods for effective fractionation and separation of common growth medium. Using 5 g/L yeast extract, 10 g/L tryptone, and LB Lennox medium as model systems, this work attempted the fractionation of the three complex growth mixtures using C-18 reversed phase high performance liquid chromatography (RP-HPLC). Results revealed no effective fractionation of the three mixtures. More importantly, experiment results indicated that appropriate choice of detection wavelength for visualizing the chromatogram made a huge difference to understanding the effectiveness of fractionation achieved. Specifically, in the case of yeast extract, tryptone and LB Lennox medium, 194 nm may be a more appropriate detection wavelength compared to 280 nm. Collectively, C-18 RP-HPLC was not effective in separating 5 g/L yeast extract, 10 g/L tryptone and LB Lennox medium with hydrophilic mobile phases (ethanol/water mixture).Graphical abstractShort description:Visualization of the reversed phase HPLC chromatogram at 194 nm revealed broad peaks and lack of distinct peaks indicative of fractionation of LB Lennox medium by the chromatography method. More importantly, complex ensemble of different components in the growth medium present a significant separation challenge that precludes separation or fractionation by modern liquid chromatography methods. Overall, combinatorial use of both hydrophobic and hydrophilic mobile phase with a C-18 reversed phase column could reveal the presence of a couple of main fractions in a mixture otherwise unable to be separated into distinct components.