bluuebunny/crossref_metadata_2025_split huggingface dataset:
SafePsych: improving patient safety by delivering high-impact simulation training on rare and complex scenarios in psychiatry
Authors: Tong Kezanne , McMahon Eimear , Reid-McDermott Bronwyn , Byrne Dara , Doherty Anne M 
Published: September 2021

IntroductionDespite an evidence base demonstrating simulation to be an effective medical education tool, it is not commonly used in postgraduate psychiatry training as it is in other medical specialties.ObjectiveThis paper outlines the development and effectiveness of a hybrid-virtual simulation-based workshop designed to improve patient care by improving clinical skills of non-consultant hospital doctors (NCHDs) in detecting and managing rare and complex psychiatric emergencies.MethodsThree clinical vignettes based on near-miss psychiatric cases were developed by a multidisciplinary team of physicians and nurses in psychiatry and experts in simulation-based medical education. The workshop, ‘SafePsych’ was delivered in a simulation laboratory while and broadcast via Zoom video-conferencing platform to observers. Debriefing followed each clinical scenario. Participants completed preworkshop and postworkshop questionnaires to evaluate clinical knowledge.ResultsThe workshop was attended by consultants (n=12) and NCHDs in psychiatry and emergency medicine (n=19), and psychiatric nurses (n=5). In the psychiatry NCHD group, test scores significantly improved following the workshop (p<0.001). There were significant improvements in the test scores with a mean difference of 2.56 (SD 1.58, p<0.001). Feedback from participants and observers was positive, with constructive appraisals to improve the virtual element of the workshop.ConclusionSimulation-based training is effective in teaching high risk, rare complex psychiatric cases to psychiatry NCHDs. Further exploration of the learning needs of nursing staff is required. Future workshop delivery is feasible in the COVID-19 environment and beyond, using a virtual element to meet social distancing requirements while enhancing the reach of the training.
Assessing the feasibility and acceptability of online measurements of exhaled volatile organic compounds (VOCs) in children with preschool wheeze: a pilot study
Authors: Holden Karl , Makinde Misty , Wilde Michael , Richardson Matthew , Coats Tim , Monks Paul , Gaillard Erol A 
Published: September 2021

BackgroundInvestigating airway inflammation and pathology in wheezy preschool children is both technically and ethically challenging. Identifying and validating non-invasive tests would be a huge clinical advance. Real-time analysis of exhaled volatile organic compounds (VOCs) in adults is established, however, the feasibility of this non-invasive method in young children remains undetermined.AimTo determine the feasibility and acceptability of obtaining breath samples from preschool children by means of real-time mass spectrometry analysis of exhaled VOCs.MethodsBreath samples from preschool children were collected and analysed in real time by proton transfer reaction–time of flight–mass spectrometry (PTR–TOF–MS) capturing unique breath profiles. Acetone (mass channel m/z 59) was used as a reference profile to investigate the breath cycle in more detail. Dynamic time warping (DTW) was used to compare VOC profiles from adult breath to those we obtained in preschool children.Results16 children were recruited in the study, of which eight had acute doctor-diagnosed wheeze (mean (range) age 3.2 (1.9–4.5) years) and eight had no history of wheezing (age 3.3 (2.2–4.1) years). Fully analysable samples were obtained in 11 (68%). DTW was used to ascertain the distance between the time series of mass channel m/z 59 (acetone) and the other 193 channels. Commonality of 12 channels (15, 31, 33, 41, 43, 51, 53, 55, 57, 60, 63 and 77) was established between adult and preschool child samples despite differences in the breathing patterns.ConclusionReal-time measurement of exhaled VOCs by means of PTR–MS is feasible and acceptable in preschool children. Commonality in VOC profiles was found between adult and preschool children.
Ten-year trend of care practices, morbidities and survival of very preterm neonates in the Malaysian National Neonatal Registry: a retrospective cohort study
Authors: Boo Nem Yun , Chee Seok Chiong , Neoh Siew Hong , Ang Eric Boon-Kuang , Ang Ee Lee , Choo Pauline , Ahmad Kamar Azanna , Syed-Abdullah Farah Inaz , Wong Ann Cheng 
Published: September 2021

ObjectivesTo determine a 10-year trend of survival, morbidities and care practices, and predictors of in-hospital mortality in very preterm neonates (VPTN, gestation 22 to <32 weeks) in the Malaysian National Neonatal Registry.DesignRetrospective cohort study.Setting43 Malaysian neonatal intensive care units.Patients29 010 VPTN (without major malformations) admitted between 1 January 2009 and 31 December 2018.Main outcome measuresCare practices, survival, admission hypothermia (AH, <36.5°C), late-onset sepsis (LOS), pneumothorax, necrotising enterocolitis grade 2 or 3 (NEC), severe intraventricular haemorrhage (sIVH, grade 3 or 4) and bronchopulmonary dysplasia (BPD).ResultsDuring this 10-year period, there was increased use of antenatal steroid (ANS), lower segment caesarean section (LSCS) and early continuous positive airway pressure (eCPAP); but decreased use of surfactant therapy. Survival had increased from 72% to -83.9%. The following morbidities had decreased: LOS (from 27.9% to 7.1%), pneumothorax (from 6.0% to 2.7%), NEC (from 8.1% to 4.7%) and sIVH (from 12.2% to 7.5%). However, moderately severe AH (32.0°C–35.9°C) and BPD had increased. Multiple logistic regression analyses showed that lower birth weight, no ANS, no LSCS, admission to neonatal intensive care unit with <100 VPTN admissions/year, no surfactant therapy, no eCPAP, moderate and severe AH, LOS, pneumothorax, NEC and sIVH were significant predictors of mortality.ConclusionSurvival and major morbidities had improved modestly. Failure to use ANS, LSCS, eCPAP and surfactant therapy, and failure to prevent AH and LOS increased risk of mortality.
Evidence of disparities in the provision of the maternal postpartum 6-week check in primary care in England, 2015–2018: an observational study using the Clinical Practice Research Datalink (CPRD)
Authors: Li Yangmei , Kurinczuk Jennifer J , Gale Christopher , Siassakos Dimitrios , Carson Claire 
Published: September 2021

BackgroundA maternal postpartum 6-week check (SWC) with a general practitioner (GP) is now considered an essential service in England, a recent policy change intended to improve women’s health. We aimed to provide an up-to-date snapshot of the prevalence of SWC prior to the policy change as a baseline, and to explore factors associated with having a late or no check.MethodsWe conducted a cohort study using primary care records in England (Clinical Practice Research Datalink (CPRD)). 34 337 women who gave birth between 1 July 2015 and 30 June 2018 and had ≥12 weeks of follow-up post partum were identified in the CPRD Pregnancy Register. The proportion who had evidence of an SWC with a GP was calculated, and regression analysis was used to assess the association between women’s characteristics and risks of a late or no check.ResultsSixty-two per cent (95% CI 58% to 67%) of women had an SWC recorded at their GP practice within 12 weeks post partum, another 27% had other consultations. Forty per cent had an SWC at the recommended 6–8 weeks, 2% earlier and 20% later. A late or no check was more common among younger women, mothers of preterm babies or those registered in more deprived areas.ConclusionsNearly 40% of women did not have a postpartum SWC recorded. Provision or uptake was not equitable; younger women and those in more deprived areas were less likely to have a record of such check, suggesting postpartum care in general practice may be missing some women who need it most.
Comparative evaluation of coronary disease burden: bicuspid valve disease is not atheroprotective
Authors: Dolmaci Onur Baris , Driessen Antoine H G , Klautz Robert J M , Poelmann Robert , Lindeman Jan H N , Grewal Nimrat 
Published: September 2021

ObjectiveBicuspid aortic valve (BAV) has been associated with less atherosclerosis as compared with tricuspid aortic valve (TAV) patients. It, however, remains unclear whether this reflects the older age of TAV patients and/or accumulation of atherosclerotic risk factors or that the BAV phenotype is atheroprotective. Therefore, we compared the atherosclerotic disease burden of BAV and TAV patients, with that of the general (age-matched) population.MethodsThe prevalence of coronary artery disease (CAD) and CAD risk factors in BAV and TAV patients who underwent aortic valve surgery were compared with the Dutch general practitioners registry data. BAV (n=454) and TAV (n=1101) patients were divided into four groups: BAV with aortic valve stenosis (BAV-AoS), BAV with aortic valve regurgitation (BAV-AR), TAV with AoS (TAV-AoS) and TAV with AR (TAV-AR). The atherosclerotic disease burden of each group was compared with that of the corresponding age cohort for the general population.ResultsCAD risk factors hypertension and hypercholesterolaemia were more prevalent in the surgery groups than the age-matched general population (all p<0.001). All BAVs (BAV-AoS and BAV-AR) and TAV-AR had a similar incidence of CAD history as compared to the age-matched general populations (p=0.689, p=0.325 and p=0.617 respectively), whereas TAV-AoS had a higher incidence (21.6% versus 14.9% in the age-matched general population, p<0.001).ConclusionsStenotic TAV disease is part of the atherosclerotic disease spectrum, while regurgitant TAV and all BAVs are not. Although the prevalence of cardiovascular risk factors is higher in all BAV patients, the prevalence of CAD is similar to the general population.
Ultrafast dynamics with the exact factorization
Authors: Agostini Federica , Gross E. K. U. 
Published: September 2021

Abstract
The exact factorization of the time-dependent electron–nuclear wavefunction has been employed successfully in the field of quantum molecular dynamics simulations for interpreting and simulating light-induced ultrafast processes. In this work, we summarize the major developments leading to the formulation of a trajectory-based approach, derived from the exact factorization equations, capable of dealing with nonadiabatic electronic processes, and including spin-orbit coupling and the non-perturbative effect of an external time-dependent field. This trajectory-based quantum-classical approach has been dubbed coupled-trajectory mixed quantum-classical (CT-MQC) algorithm, whose performance is tested here to study the photo-dissociation dynamics of IBr.

Graphic abstract
Equilibrium Spin Distribution From Detailed Balance
Authors: Wang Ziyue , Guo Xingyu , Zhuang Pengfei 
Published: September 2021

AbstractAs the core ingredient for spin polarization, the equilibrium spin distribution function that eliminates the collision terms is derived from the detailed balance principle. The kinetic theory for interacting fermionic systems is applied to the Nambu–Jona-Lasinio model at quark level. Under the semi-classical expansion with respect to $$\hbar $$
ħ
, the kinetic equations for the vector and axial-vector distribution functions are obtained with collision terms. For an initially unpolarized system, spin polarization can be generated at the first order of $$\hbar $$
ħ
from the coupling between the vector and axial-vector charges. Different from the classical transport theory, the collision terms in a quantum theory vanish only in global equilibrium with Killing condition.
SUSY-breaking scenarios with a mildly violated $$\varvec{R}$$ symmetry
Authors: Pallis Constantinos 
Published: September 2021

AbstractNew realizations of the gravity-mediated SUSY breaking are presented consistently with an R symmetry. We employ monomial superpotential terms for the hidden-sector (goldstino) superfield and Kähler potentials parameterizing compact or non-compact Kähler manifolds. Their scalar curvature may be systematically related to the R charge of the goldstino so that Minkowski solutions without fine tuning are achieved. A mild violation of the R symmetry by a higher order term in the Kähler potentials allows for phenomenologically acceptable masses for the R axion. In all cases, non-vanishing soft SUSY-breaking parameters are obtained and a solution to the $$\mu $$
μ
problem of MSSM may be accommodated by conveniently applying the Giudice–Masiero mechanism.
Italian Twitter semantic network during the Covid-19 epidemic
Authors: Mattei Mattia , Caldarelli Guido , Squartini Tiziano , Saracco Fabio 
Published: September 2021

AbstractThe Covid-19 pandemic has had a deep impact on the lives of the entire world population, inducing a participated societal debate. As in other contexts, the debate has been the subject of several d/misinformation campaigns; in a quite unprecedented fashion, however, the presence of false information has seriously put at risk the public health. In this sense, detecting the presence of malicious narratives and identifying the kinds of users that are more prone to spread them represent the first step to limit the persistence of the former ones. In the present paper we analyse the semantic network observed on Twitter during the first Italian lockdown (induced by the hashtags contained in approximately 1.5 millions tweets published between the 23rd of March 2020 and the 23rd of April 2020) and study the extent to which various discursive communities are exposed to d/misinformation arguments. As observed in other studies, the recovered discursive communities largely overlap with traditional political parties, even if the debated topics concern different facets of the management of the pandemic. Although the themes directly related to d/misinformation are a minority of those discussed within our semantic networks, their popularity is unevenly distributed among the various discursive communities.
Integrative Genomic Analysis of Pediatric Myeloid-Related Acute Leukemias Identifies Novel Subtypes and Prognostic Indicators
Authors: Fornerod Maarten , Ma Jing , Noort Sanne , Liu Yu , Walsh Michael P. , Shi Lei , Nance Stephanie , Liu Yanling , Wang Yuanyuan , Song Guangchun , Lamprecht Tamara , Easton John , Mulder Heather L. , Yergeau Donald , Myers Jacquelyn , Kamens Jennifer L. , Obeng Esther A. , Pigazzi Martina , Jarosova Marie , Kelaidi Charikleia , Polychronopoulou Sophia , Lamba Jatinder K. , Baker Sharyn D. , Rubnitz Jeffrey E. , Reinhardt Dirk , van den Heuvel-Eibrink Marry M. , Locatelli Franco , Hasle Henrik , Klco Jeffery M. , Downing James R. , Zhang Jinghui , Pounds Stanley , Zwaan C. Michel , Gruber Tanja A. 
Published: September 2021

Abstract

Genomic characterization of pediatric patients with acute myeloid leukemia (AML) has led to the discovery of somatic mutations with prognostic implications. Although gene-expression profiling can differentiate subsets of pediatric AML, its clinical utility in risk stratification remains limited. Here, we evaluate gene expression, pathogenic somatic mutations, and outcome in a cohort of 435 pediatric patients with a spectrum of pediatric myeloid-related acute leukemias for biological subtype discovery. This analysis revealed 63 patients with varying immunophenotypes that span a T-lineage and myeloid continuum designated as acute myeloid/T-lymphoblastic leukemia (AMTL). Within AMTL, two patient subgroups distinguished by FLT3-ITD and PRC2 mutations have different outcomes, demonstrating the impact of mutational composition on survival. Across the cohort, variability in outcomes of patients within isomutational subsets is influenced by transcriptional identity and the presence of a stem cell–like gene-expression signature. Integration of gene expression and somatic mutations leads to improved risk stratification.

Significance:
Immunophenotype and somatic mutations play a significant role in treatment approach and risk stratification of acute leukemia. We conducted an integrated genomic analysis of pediatric myeloid malignancies and found that a combination of genetic and transcriptional readouts was superior to immunophenotype and genomic mutations in identifying biological subtypes and predicting outcomes.
This article is highlighted in the In This Issue feature, p. 549
Long-Term Survival, Causes of Death, and Trends in 5-Year Mortality After Intracerebral Hemorrhage: The Tromsø Study
Authors: Carlsson Maria , Wilsgaard Tom , Johnsen Stein Harald , Johnsen Liv-Hege , Løchen Maja-Lisa , Njølstad Inger , Mathiesen Ellisiv B. 
Published: September 2021

Background and Purpose:
Data on long-term survival after intracerebral hemorrhage (ICH) are scarce. In a population-based nested case-control study, we compared long-term survival and causes of death within 5 years in 30-day survivors of first-ever ICH and controls, assessed the impact of cardiovascular risk factors on 5-year mortality, and analyzed time trend in 5-year mortality in ICH patients over 2 decades.

Methods:
We included 219 participants from the population-based Tromsø Study, who after the baseline participation had a first-ever ICH between 1994 to 2013 and 1095 age- and sex-matched participants without ICH. Cumulative survival was presented using the Kaplan-Meier method. Hazard ratios (HRs) for mortality and for the association between cardiovascular risk factors and 5-year mortality in 30-day survivors were estimated by stratified Cox proportional hazards models. Trend in 5-year mortality was assessed by logistic regression.

Results:

Risk of death during follow-up (median time, 4.8 years) was increased in the ICH group compared with controls (HR, 1.62 [95% CI, 1.27–2.06]). Cardiovascular disease was the leading cause of death, with a higher proportion in ICH patients (22.9% versus 9.0%;
P
<0.001). Smoking increased the risk of 5-year mortality in cases and controls (HR, 1.59 [95% CI, 1.15–2.19]), whereas serum cholesterol was associated with 5-year mortality in cases only (HR, 1.39 [95% CI, 1.04–1.86]). Use of anticoagulants at ICH onset increased the risk of death (HR, 2.09 [95% CI, 1.09–4.00]). There was no difference according to ICH location (HR, 1.15 [95% CI, 0.56–2.37]). Five-year mortality did not change during the study period (odds ratio per calendar year, 1.01 [95% CI, 0.93–1.09]).

Conclusions:
Survival rates were significantly lower in cases than in controls, driven by a 2-fold increased risk of cardiovascular death. Smoking, serum cholesterol, and use of anticoagulant drugs were associated with increased risk of death in ICH patients. Five-year mortality rates in ICH patients remained stable over time.
Comparing Warfarin and 4 Direct Oral Anticoagulants for the Risk of Dementia in Patients With Atrial Fibrillation
Authors: Lee So-Ryoung , Choi Eue-Keun , Park Sang-Hyun , Jung Jin-Hyung , Han Kyung-Do , Oh Seil , Lip Gregory Y.H. 
Published: September 2021

Background and Purpose:
Atrial fibrillation is a risk factor for dementia, and oral anticoagulant use is associated with a decreased risk of dementia in patients with atrial fibrillation. We aimed to investigate whether the risk of dementia would be different between patients treated with direct oral anticoagulants (DOACs) compared with those with warfarin.

Methods:
Using the Korean nationwide claims database from January 2014 to December 2017, we identified oral anticoagulant–naive nonvalvular atrial fibrillation patients aged ≥40 years. For the comparisons, warfarin and DOAC groups were balanced using the inverse probability of treatment weighting method. The primary outcome was incident dementia.

Results:
Among 72 846 of total study patients, 25 948 were treated with warfarin, and 46 898 were treated with DOAC (17 193 with rivaroxaban, 9882 with dabigatran, 11 992 with apixaban, and 7831 with edoxaban). During mean 1.3±1.1 years of follow-up, crude incidence of dementia was 4.87 per 100 person-years (1.20 per 100 person-years for vascular dementia and 3.30 per 100 person-years for Alzheimer dementia). Compared with warfarin, DOAC showed a comparable risks of dementia, vascular dementia, and Alzheimer dementia. In subgroup analyses, DOAC was associated with a lower risk of dementia than warfarin, particularly in patients aged 65 to 74 years (hazard ratio, 0.815 [95% CI, 0.709–0.936]) and in patients with prior stroke (hazard ratio, 0.891 [95% CI, 0.820–0.968]). When comparing individual DOACs with warfarin, edoxaban was associated with a lower risk of dementia (hazard ratio, 0.830 [95% CI, 0.740–0.931]).

Conclusions:
In this large Asian population with atrial fibrillation, DOAC showed a comparable risk of dementia with warfarin overall. DOACs appeared more beneficial than warfarin, in those aged 65 to 74 years or with a history of stroke. For specific DOACs, only edoxaban was associated with a lower risk of dementia than warfarin.
Factors Associated With Decreased Accuracy of Modified Thrombolysis in Cerebral Infarct Scoring Among Neurointerventionalists During Thrombectomy
Authors: Pressman Elliot , Waqas Muhammad , Sands Victoria , Siddiqui Adnan , Snyder Kenneth , Davies Jason , Levy Elad , Ionita Ciprian , Guerrero Waldo , Ren Zeguang , Mokin Maxim 
Published: September 2021

Background and Purpose:
The modified Thrombolysis in Cerebral Infarct (mTICI) score is used to grade angiographic outcome after endovascular thrombectomy. We sought to identify factors that decrease the accuracy of intraprocedural mTICI.

Methods:
We performed a 2-center retrospective cohort study comparing operator (n=6) mTICI scores to consensus scores from blinded adjudicators. Groups were also assessed by dichotomizing mTICI scores to 0–2a versus 2b–3.

Results:
One hundred thirty endovascular thrombectomy procedures were included. Operators and adjudicators had a pairwise agreement in 96 cases (73.8%). Krippendorff α was 0.712. Multivariate analysis showed endovascular thrombectomy overnight (odds ratio [OR]=3.84 [95% CI, 1.22–12.1]), lacking frontal (OR, 5.66 [95 CI, 1.36–23.6]), or occipital (OR, 7.18 [95 CI, 2.12–24.3]) region reperfusion, and higher operator mTICI scores (OR, 2.16 [95 CI, 1.16–4.01]) were predictive of incorrectly scoring mTICI intraprocedurally. With dichotomized mTICI scores, increasing number of passes was associated with increased risk of operator error (OR, 1.93 [95 CI, 1.22–3.05]).

Conclusions:
In our study, mTICI disagreement between operator and adjudicators was observed in 26.2% of cases. Interventions that took place between 22:30 and 4:00, featured frontal or occipital region nonperfusion, higher operator mTICI scores, and increased number of passes had higher odds of intraprocedural mTICI inaccuracy.