bluuebunny/crossref_metadata_2025_split huggingface dataset:
135 A Quality Improvement Project Aimed to Reduce the Number of Patients on Bournville Ward Suffering with Constipation
Authors: Vasudev A , Mohamed I , Jacques H , Nicolson P 
Published: March 2021

Abstract

Introduction
Constipation is exceedingly common on geriatric wards, with 20–50% prevalence. It is associated with complications; including pain, delirium and obstruction. Laxatives, often considered the solution, introduce their own side effects and increase polypharmacy especially in elderly populations. Queen Elizabeth Hospital Birmingham guidelines advocate use of conservative measures, including adequate fluid and fibre intake and increasing exercise, to prevent and treat constipation prior to use of laxatives. However, we had observed that these methods were frequently underutilised, and cause of constipation was rarely considered. We aimed to reduce the prevalence of inpatient constipation and associated complications through the introduction of teaching sessions and multidisciplinary team (MDT) discussions, focusing on staff and patient education on the recognition and conservative managements of constipation.

Method
We audited notes weekly for the recognition of constipation, appropriate bowel examination, use of conservative management including patient education and any complications. Baseline data was collected from Bournville Ward over 4 weeks (n = 44), after which, teaching sessions for all regular ward staff and weekly MDT discussion for patients recognised as constipated were introduced. Patients having not opened bowels for &gt;2 days were targeted for early simple non-laxative interventions. A further 4-week cycle of data was collected (n = 43).

Results
Constipation was recognised in 57% of patients studied, of which 64% developed constipation during inpatient stay and 20% experienced associated complications. The introduction of teaching session and MDT reviews increased patient education, cause recognition and non-laxative methods use by 19%, 27% and 30% respectively. Constipation developed during inpatient stay and associated complications decreased by 6% and 4% respectively.

Conclusion
Despite increased patient education, cause recognition and utilisation of conservative non-laxative approaches, only a small impact was made in reducing inpatient constipation prevalence and associated complications occurring.
136 Readmissions to Hospital Following A Decision to Eat and Drink with Acknowledged Risk with Support From the Forward Care Bundle
Authors: Soar N , Birns J , Sommerville P , Lang A , Fitzgerald A , Archer S 
Published: March 2021

Abstract

Introduction
The FORWARD care bundle (Feeding via the Oral Route With Acknowledged Risk of Deterioration) is used to support patients with dysphagia eating and drinking with acknowledged risk (EDAR) at our Trust. Key aims of FORWARD include improving advanced care planning (ACP) and avoiding unnecessary readmissions. This study aimed to determine the incidence of EDAR related readmissions (RR-EDAR) after FORWARD, and the effects of ACP and discharge location.

Methods
Retrospective review of all patients supported by FORWARD during admissions between January 2018 and December 2019. Data were collected on number and reasons for in-Trust hospital readmissions 6 months post-discharge, preferred place of care ACPs in event of EDAR related deterioration and discharge destination. Readmission reasons were classified as RR-EDAR (e.g. chest infection, reduced oral intake) and no relation to EDAR. Means (SD) and percentages are presented with comparisons using Fishers Exact Test.

Results
316 patients were included; mean (SD) age 81(12). 64% (n = 202) of patients were discharged alive, 36% (n = 114) were alive at 6 months. 38% of live discharges (n = 75) were readmitted and 52% (n = 39) of these patients were RR-EDAR. Mean (SD) RR-EDAR number was 11, and 18% (n = 7) of patients had RR-EDAR &gt;1 (range 1–5). RR-EDAR was only 7% (n = 4) in patients wishing to remain at home vs 25% (n = 33) in those without a documented place of care (p &lt; 0.01). RR-EDAR was 23% (n = 29) in patients discharged to a private home vs 10% (n = 6) discharged to nursing/care homes (p &lt; 0.05).

Conclusions
The majority of FORWARD patients are not readmitted. RR-EDAR comprises half of all readmitted patients and some have multiple admissions. Fewer patients with ACPs were RR-EDAR suggesting these are effective. Most patients RR-EDAR were from private homes, suggesting residential care may provide more support. Further work includes increasing ACPs, supporting patients with multiple RR-EDAR and those discharged to private homes.
Abolition’s Afterlives
Authors: Insko Jeffrey , Stancliff Michael , DeLombard Jeannine Marie , James Joy , Fielder Brigitte , James Jennifer C , Goddu Teresa A 
Published: March 2021

Abstract
The positioning of movements for social and political change as forms of postemancipation abolition democracy has a long history. Abolition has been the watchword under which initiatives proceed to eradicate the death penalty, human trafficking, nuclear weapons, the hegemony of Wall Street, prisons, police, the deportation of immigrants, and more. The essays in this forum examine nineteenth-century abolitionism’s complicated legacy through the prism of contemporary frameworks and agitations for justice and social transformation. The working papers reflect vital ongoing debates about abolition’s afterlives while meditating upon a series of pressing current concerns: migrant justice, the humanitarian rhetoric of some anti-racist initiatives, the activism of Erica Garner following the murder by police of her father, the racialization of madness and violence, the prison-abolition movement, and climate activism. By addressing the mobilization of rhetorics of slavery and abolition in our own vexed political moment, the contributors reveal that to think abolition now is necessarily to rethink abolition then.
GPDBN: deep bilinear network integrating both genomic data and pathological images for breast cancer prognosis prediction
Authors: Wang Zhiqin , Li Ruiqing , Wang Minghui , Li Ao 
Published: March 2021

Abstract

Motivation
Breast cancer is a very heterogeneous disease and there is an urgent need to design computational methods that can accurately predict the prognosis of breast cancer for appropriate therapeutic regime. Recently, deep learning-based methods have achieved great success in prognosis prediction, but many of them directly combine features from different modalities that may ignore the complex inter-modality relations. In addition, existing deep learning-based methods do not take intra-modality relations into consideration that are also beneficial to prognosis prediction. Therefore, it is of great importance to develop a deep learning-based method that can take advantage of the complementary information between intra-modality and inter-modality by integrating data from different modalities for more accurate prognosis prediction of breast cancer.

Results
We present a novel unified framework named genomic and pathological deep bilinear network (GPDBN) for prognosis prediction of breast cancer by effectively integrating both genomic data and pathological images. In GPDBN, an inter-modality bilinear feature encoding module is proposed to model complex inter-modality relations for fully exploiting intrinsic relationship of the features across different modalities. Meanwhile, intra-modality relations that are also beneficial to prognosis prediction, are captured by two intra-modality bilinear feature encoding modules. Moreover, to take advantage of the complementary information between inter-modality and intra-modality relations, GPDBN further combines the inter- and intra-modality bilinear features by using a multi-layer deep neural network for final prognosis prediction. Comprehensive experiment results demonstrate that the proposed GPDBN significantly improves the performance of breast cancer prognosis prediction and compares favorably with existing methods.

Availabilityand implementation
GPDBN is freely available at https://github.com/isfj/GPDBN.

Supplementary information
Supplementary data are available at Bioinformatics online.
Association of transport time with adverse outcome in paediatric trauma
Authors: Träff Helen , Hagander Lars , Salö Martin 
Published: March 2021

Abstract

Background
It is unclear how the length of prehospital transport time affects outcome in paediatric trauma. This study evaluated the association of transport time from alarm to arrival at hospital with adverse outcome in paediatric trauma patients in Sweden.

Methods
This was a retrospective study based on prospectively collected data from the Swedish trauma registry between 2012 and 2019 of children less than 18 years with major trauma (New Injury Severity Score (NISS) greater than 15). The primary outcome was 30-day mortality, and secondary outcomes were emergency interventions (e.g., chest tube or laparotomy) and low functional outcome (Glasgow Outcome Scale 2–3). Primary exposure was transport time from alarm to arrival at hospital. Co-variables in multivariable regressions were gender, age, ASA score before injury, injury intention, dominant injury type, NISS, Glasgow Coma Scale score, prehospital competence and hospital level.

Results
Among 597 patients, 30-day mortality was 9.8 per cent, emergency interventions were performed in 34.7 per cent and low functional outcome was registered in 15.9 per cent. Median transport time was 51 (i.q.r. 37–68) minutes. After adjustment for patient, injury and hospital characteristics, no association between longer transport time and 30-day mortality, frequency of emergency interventions or lower functional outcome could be found. Treatment at a university hospital was associated with a lower risk for 30-day mortality (odds ratio 0.23 (95 per cent c.i. 0.08 to 0.68), P = 0.008).

Conclusion
Longer transport time after major paediatric trauma was not associated with adverse outcome. Hence, it seems that longer transport distances should not be an obstacle against centralization of paediatric trauma care. Further studies should focus on the role of prehospital competence and other transport-associated parameters and their association with adverse outcome.
Linked Social–Communication Dimensions and Connectivity in Functional Brain Networks in Autism Spectrum Disorder
Authors: Xiao Jinming , Chen Huafu , Shan Xiaolong , He Changchun , Li Ya , Guo Xiaonan , Chen Heng , Liao Wei , Uddin Lucina Q , Duan Xujun 
Published: March 2021

AbstractMuch recent attention has been directed toward elucidating the structure of social interaction–communication dimensions and whether and how these symptom dimensions coalesce with each other in individuals with autism spectrum disorder (ASD). However, the underlying neurobiological basis of these symptom dimensions is unknown, especially the association of social interaction and communication dimensions with brain networks. Here, we proposed a method of whole-brain network-based regression to identify the functional networks linked to these symptom dimensions in a large sample of children with ASD. Connectome-based predictive modeling (CPM) was established to explore neurobiological evidence that supports the merging of communication and social interaction deficits into one symptom dimension (social/communication deficits). Results showed that the default mode network plays a core role in communication and social interaction dimensions. A primary sensory perceptual network mainly contributed to communication deficits, and high-level cognitive networks mainly contributed to social interaction deficits. CPM revealed that the functional networks associated with these symptom dimensions can predict the merged dimension of social/communication deficits. These findings delineate a link between brain functional networks and symptom dimensions for social interaction and communication and further provide neurobiological evidence supporting the merging of communication and social interaction deficits into one symptom dimension.
Stepwise regression of non-culprit lipid-rich plaque observed using serial near-infrared spectroscopy–intravascular ultrasound and optical coherence tomographic measurements after aggressive cholesterol-lowering treatment: a case report
Authors: Takahashi Norihito , Dohi Tomotaka , Endo Hirohisa , Okazaki Shinya 
Published: March 2021

Abstract

Background
Lipid-rich plaques (LRP) in the non-culprit lesions (NCL) in patients with the acute coronary syndrome may trigger lesion-related, adverse cardiovascular events. Aggressive lipid-lowering therapy may stabilize LRP; however, the times of stabilization remain undefined.

Case summary
A 60-year-old man presented with unstable angina. Coronary angiography revealed a severely stenotic lesion (culprit lesion) in the left descending artery, and another non-obstructive lesion in the distal left main trunk artery. Near-infrared spectroscopy (NIRS) imaging showed LRP with a maximum lipid core burden index (LCBI)4mm of 422. Optical coherence tomographic (OCT) imaging showed the vulnerable plaque as a thin cap fibroatheroma with a thickness of 50 µm. We prescribed aggressive lipid-lowering treatment with a proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor, and serially observed this lesion for 24 months. The NIRS imaging showed that the LCBI gradually decreased over time (max LCBI4mm of 422, 417, 318, 265, and 106 conducted at index percutaneous coronary intervention, 3, 8, 12, and 24 months, respectively). As plaque regression and stabilization of high-risk LRP were observed, we promptly discontinued treatment with the PCSK9i inhibitor.

Discussion
During the long-term, 24-month, follow-up using serial NIRS–IVUS imaging, we observed the gradual decrease in LCBI over time, due to aggressive lipid-lowering therapy. Compared with the lowering of low-density lipoprotein cholesterol, the stabilization of vulnerable plaques may require longer times of about 2 years. Evaluation of NCL-related adverse cardiac events by serial intravascular imaging over time, using NIRS–IVUS or OCT, may be warranted in such cases.
Dynamics of transposable elements in recently diverged fungal pathogens: lineage-specific transposable element content and efficiency of genome defenses
Authors: Lorrain Cécile , Feurtey Alice , Möller Mareike , Haueisen Janine , Stukenbrock Eva 
Published: March 2021

AbstractTransposable elements (TEs) impact genome plasticity, architecture, and evolution in fungal plant pathogens. The wide range of TE content observed in fungal genomes reflects diverse efficacy of host-genome defense mechanisms that can counter-balance TE expansion and spread. Closely related species can harbor drastically different TE repertoires. The evolution of fungal effectors, which are crucial determinants of pathogenicity, has been linked to the activity of TEs in pathogen genomes. Here, we describe how TEs have shaped genome evolution of the fungal wheat pathogen Zymoseptoria tritici and four closely related species. We compared de novo TE annotations and repeat-induced point mutation signatures in 26 genomes from the Zymoseptoria species-complex. Then, we assessed the relative insertion ages of TEs using a comparative genomics approach. Finally, we explored the impact of TE insertions on genome architecture and plasticity. The 26 genomes of Zymoseptoria species reflect different TE dynamics with a majority of recent insertions. TEs associate with accessory genome compartments, with chromosomal rearrangements, with gene presence/absence variation, and with effectors in all Zymoseptoria species. We find that the extent of RIP-like signatures varies among Z. tritici genomes compared to genomes of the sister species. The detection of a reduction of RIP-like signatures and TE recent insertions in Z. tritici reflects ongoing but still moderate TE mobility.
Global mantle flow retrodictions for the early Cenozoic using an adjoint method: evolving dynamic topographies, deep mantle structures, flow trajectories and sublithospheric stresses
Authors: Ghelichkhan S , Bunge H-P , Oeser J 
Published: March 2021

SUMMARY
During the Cenozoic, the Earth experienced multiple first-order geological events that are likely mantle flow related. These include the termination of large-scale marine inundation in North America in the Palaeocene, the late Tertiary rise of Africa relative to other continents and the long-wavelength tilting of Australia since the late Cretaceous, which occurred when the continent approached the southeast Asia subduction systems on its northward passage from Antartica. Here we explore a suite of eight high-resolution, compressible, global mantle flow retrodictions going back to 50 Ma, using an adoint method with $\approx$670 million finite elements. These retrodictions show for the first time that these events emerge jointly as part of global Cenozoic mantle flow histories. Our retrodictions involve the dynamic effects from an upper mantle low-viscosity zone, assimilate a past plate-motion model for the tangential surface velocity field, probe the influence of two different present-day mantle state estimates derived from seismic tomography, and acknowledge the rheological uncertainties of dynamic Earth models by taking in four different realizations for the radial mantle viscosity profile, two of which were published previously. We find the retrodicted mantle flow histories are sensitive to the present-day mantle state estimate and the rheological properties of the Earth model, meaning that this input information is testable with inferences gleaned from the geological record. For a deep mantle viscosity of $1.7\times 10^{22}$ Pa s and a purely thermal interpretation of seismic structure, lower mantle flow velocities exceed 7 cm yr–1 in some regions, meaning they are difficult to reconcile with the existence of a hotspot reference frame. Conversely, a deep mantle viscosity of $10^{23}$ Pa s yields modest flow velocities (&lt; 3 cm yr–1 ) and stability of deep mantle heterogeneity for much of the retrodiction time, albeit at the expense that African uplift is delayed into the latest Neogene. Retrodictions allow one to track material back in time from any given sampling location, making them potentially useful, for example, to geochemical studies. Our results call for improved estimates on non-isostatic vertical motion of the Earth’s surface—provided, for instance, by basin analysis, seismic stratigraphy, landform studies, thermochronological data or the sedimentation record—to constrain the recent mantle flow history and suggest that mantle flow retrodictions may yield synergies across different Earth science disciplines.
Differences in prevalence of multiple paternity in the spiny spider crabMaja brachydactylain two localities that differ in female fecundity, fishing intensity, and management measures
Authors: Rodríguez-Pena E , Verísimo P , Tully O , Fernández L , Martínez-Lage A 
Published: March 2021

AbstractMany marine species are under high fishing pressure, which can cause alterations in their mating systems and the structure of their populations. The spiny spider crab Maja brachydactyla is a commercial decapod on the east Atlantic coast. In Galicia, the most exploited region in Spain, the landing of ovigerous females is prohibited, favouring exploitation focused on males. The removal of males, especially the largest ones, may lead to sperm limitation and a reduction in the average size over generations. In these cases, polyandry can work as a mechanism to protect females against sperm limitation and to increase genetic diversity and effective population size. This study analyses the multiple paternity in M. brachydactyla in two localities that differ in female fecundity, fishing intensity, and management measures. Our results showed multiple paternity in this species for the first time, with a moderate bias between sires. However, the frequency of multiple paternity was almost seven times higher in the intensely exploited Golfo Ártabro (NW Spain; 69%) than in Carna (W Ireland; 10%), where exploitation levels and female fecundity are lower.
Implementing an emergency department pharmacy service and its effect on medication safety
Authors: Sinopoulou Vassiliki , Rutter Paul , Price Gareth , Heald Victoria , Kaba Suhail , Kwok Jon 
Published: March 2021

Abstract

Objectives
This service innovation project examined the effect an Emergency Department (ED) pharmacy service had on medication-related safety markers.

Methods
A pre-test/post-test design captured medication-related safety markers on admission data at ward level after patients had been seen in the ED. The markers were, medication omitted, incorrect medicines prescribed and the number of incorrect doses or frequency of doses.

Key findings
All three safety markers saw reductions. Mean (SD) medications omitted were reduced from 2.19 (±3.01) to 0.48 (±1.3), incorrect medication from 0.35 (±1.11) to 0.08 (±0.36) and the number of incorrect doses or frequency of doses from 0.38 (±0.69) to 0.13 (±0.38) per patient. All differences were statistically significant (P = 0.00).

Conclusions
The service reduced medication error and the findings allowed a permanent pharmacy service to be introduced.
Utilizing a health information exchange to facilitate COVID-19 VA primary care follow-up for Veterans diagnosed in the community
Authors: Sherman Rachel L , Judon Kimberly M , Koufacos Nicholas S , Guerrero Aquino Vivian M , Raphael Shaniqua M , Hollander Judith T , Boockvar Kenneth S 
Published: March 2021

Abstract
The use of alerts from the Bronx RHIO, a health information exchange (HIE) to identify James J. Peters VAMC patients diagnosed with COVID-19 in the community was described to facilitate COVID-19 VA primary care follow-up. COVID-19 hospitalization and testing alerts were delivered on a Bronx RHIO facility report. VA COVID-19 follow-up care by telephone and video was guided by local COVID-19 clinical pathways, electronic health record (EHR) templates, and tracking through a database. VA received 180 RHIO alerts for 111 unique patients, and 88 had positive non-VA testing from March to June 2020. 41% of the 88 had non-VA admissions and 23% died. 63% received VA primary care follow-up of COVID-19 symptoms documented by custom EHR templates. The HIE identified 11% of the facility COVID-19 patients. HIE alerts can be used to identify facility COVID-19 patients diagnosed in the community and facilitate follow-up by their VA primary care teams.