bluuebunny/crossref_metadata_2025_split huggingface dataset:
Disruptive Social Work: Forms, Possibilities and Tensions
Authors: Feldman Guy 
Published: February 2021

Abstract
In recent years, a growing literature has rediscovered radical social work and the various forms it takes. In these debates, a key concept that has been developed and deployed is ‘resistance’. Studies provide growing evidence for the myriad ways in which social workers engage in resistance activities as part of their everyday practice. However, most of these studies portray resistance as an individualised activity and overlook the role of clients in such activities. Drawing on the concept of ‘disruptive power’, this article makes the case for what it terms ‘disruptive social work’, which involves collective resistance activities that disrupt institutions and social relations of everyday life to create meaningful change. After providing a definition of disruptive social work, the article suggests that this practice can be carried out at two levels. At the professional level, social workers occupy an important structural position that allows them to disrupt the workings of the social service system. At the client level, social workers can help their differently positioned clients develop a sense of their own disruptive power and activate it. Examples of disruptive social work are presented throughout the article. It concludes by highlighting the practical and ethical challenges this practice poses for social workers today.
Usefulness of multi-labelling artificial intelligence in detecting rhythm disorders and acute ST-elevation myocardial infarction on 12-lead electrocardiogram
Authors: Chang Kuan-Cheng , Hsieh Po-Hsin , Wu Mei-Yao , Wang Yu-Chen , Wei Jung-Ting , Shih Edward S C , Hwang Ming-Jing , Lin Wan-Ying , Lin Wan-Ting , Lee Kuan-Jung , Wang Ti-Hao 
Published: February 2021

Abstract

Aims
To develop an artificial intelligence-based approach with multi-labelling capability to identify both ST-elevation myocardial infarction (STEMI) and 12 heart rhythms based on 12-lead electrocardiograms (ECGs).

Methods and results
We trained, validated, and tested a long short-term memory (LSTM) model for the multi-label diagnosis of 13 ECG patterns (STEMI + 12 rhythm classes) using 60 537 clinical ECGs from 35 981 patients recorded between 15 January 2009 and 31 December 2018. In addition to the internal test above, we conducted a real-world external test, comparing the LSTM model with board-certified physicians of different specialties using a separate dataset of 308 ECGs covering all 13 ECG diagnoses. In the internal test, the area under the curves (AUCs) of the LSTM model in classifying the 13 ECG patterns ranged between 0.939 and 0.999. For the external test, the LSTM model for multi-labelling of the 13 ECG patterns evaluated by AUC was 0.987 ± 0.021, which was superior to those of cardiologists (0.898 ± 0.113, P &lt; 0.001), emergency physicians (0.820 ± 0.134, P &lt; 0.001), internists (0.765 ± 0.155, P &lt; 0.001), and a commercial algorithm (0.845 ± 0.121, P &lt; 0.001). Of note, the LSTM model achieved an accuracy of 0.987, AUC of 0.997, and precision, recall, and F1 score of 0.952, 0.870, and 0.909, respectively, in detecting STEMI.

Conclusions
We demonstrated the usefulness of an LSTM model in the multi-labelling detection of both rhythm classes and STEMI in competitive testing against board-certified physicians. This AI tool exceeding the cardiologist-level performance in detecting STEMI and rhythm classes on 12-lead ECG may be useful in prioritizing chest pain triage and expediting clinical decision-making in healthcare.
Imaging surveillance after open aortic repair: a feasibility study of three-dimensional growth mapping
Authors: Ahmed Yunus , Nama Nitesh , Houben Ignas B. , van Herwaarden Joost A. , Moll Frans L. , Williams David M. , Figueroa C. Alberto , Patel Himanshu J. , Burris Nicholas S. 
Published: February 2021

Abstract

OBJECTIVES
Confident growth assessment during imaging follow-up is often limited by substantial variability of diameter measurements and the fact that growth does not always occur at standard measurement locations. There is a need for imaging-based techniques to more accurately assess growth. In this study, we investigated the feasibility of a three-dimensional aortic growth assessment technique to quantify aortic growth in patients following open aortic repair.

METHODS
Three-dimensional aortic growth was measured using vascular deformation mapping (VDM), a technique which quantifies the localized rate of volumetric growth at the aortic wall, expressed in units of Jacobian (J) per year. We included 16 patients and analysed 6 aortic segments per patient (96 total segments). Growth was assessed by 3 metrics: clinically reported diameters, Jacobian determinant and targeted diameter re-measurements.

RESULTS
VDM was able to clearly depict the presence or absence of localized aortic growth and allows for an assessment of the distribution of growth and its relation to anatomic landmarks (e.g. anastomoses, branch arteries). Targeted diameter change showed a stronger and significant correlation with J (r = 0.20, P = 0.047) compared to clinical diameter change (r = 0.15, P = 0.141). Among 20/96 (21%) segments with growth identified by VDM, growth was confirmed by clinical measurements in 7 and targeted re-measurements in 11. Agreement of growth assessments between VDM and diameter measurements was slightly higher for targeted re-measurements (kappa = 0.38) compared to clinical measurements (kappa = 0.25).

CONCLUSIONS
Aortic growth is often uncertain and underappreciated when assessed via standard diameter measurements. Three-dimensional growth assessment with VDM offers a more comprehensive assessment of growth, allows for targeted diameter measurements and could be an additional tool to determine which post-surgical patients at high and low risk for future complications.
Assessing the Benefits and Economic Feasibility of Stand Improvement for Central Hardwood Forests
Authors: Wang Yangyang , Ma Wu , Farlee Lenny D , Jackson Elizabeth A , Shao Guofan , Ochuodho Thomas , Liang Jingjing , Zhou Mo 
Published: February 2021

Abstract
Stand improvement (SI) has been widely accepted as an effective forest management tool. Yet most studies on its economic feasibility for nonindustrial private forest (NIPF) landowners are outdated and focus on the single stand level. The objective of this study was to conduct an economic assessment of SI’s effects and feasibility in hardwood stands for a case study in the White River Basin in Indiana. It is shown that SI could make these forests more productive and sustainable than the prevalent “hands-off” practice by enhancing the timber value of the residual stand (TV), generating regular timber income, and to some degree, reversing the decline in oak dominance. On average, a 25% increment in the TV could be achieved. Although costly for some NIPFs, once combined with voluntary financial incentive programs, SI could meet landowners’ demands for low-cost, high-return investment options. In particular, participation in the Environmental Quality Incentive Program could, on average, increase the net present value of timber income from thinning activities by nearly $1,600 per hectare over the course of 30 years. The spatial analysis revealed that there existed considerable spatial heterogeneity in SI benefits and impacts, suggesting that public incentive programs should be spatially targeted to achieve greater efficiency.
How sequence populations persist inside bacterial genomes
Authors: Park Hye Jin , Gokhale Chaitanya S , Bertels Frederic 
Published: February 2021

AbstractCompared to their eukaryotic counterparts, bacterial genomes are small and contain extremely tightly packed genes. Repetitive sequences are rare but not completely absent. One of the most common repeat families is REPINs. REPINs can replicate in the host genome and form populations that persist for millions of years. Here, we model the interactions of these intragenomic sequence populations with the bacterial host. We first confirm well-established results, in the presence and absence of horizontal gene transfer (hgt) sequence populations either expand until they drive the host to extinction or the sequence population gets purged from the genome. We then show that a sequence population can be stably maintained, when each individual sequence provides a benefit that decreases with increasing sequence population size. Maintaining a sequence population of stable size also requires the replication of the sequence population to be costly to the host, otherwise the sequence population size will increase indefinitely. Surprisingly, in regimes with high hgt rates, the benefit conferred by the sequence population does not have to exceed the damage it causes to its host. Our analyses provide a plausible scenario for the persistence of sequence populations in bacterial genomes. We also hypothesize a limited biologically relevant parameter range for the provided benefit, which can be tested in future experiments.
Bioethical, Reproducibility, and Translational Challenges of Animal Models
Authors: Landi Margaret , Everitt Jeffrey , Berridge B 
Published: February 2021

Abstract
There is no prescribed stage or standardized point at which an animal model protocol is reviewed for reproducibility and translatability. The method of review for a reproducible and translatable study is not consistently documented in peer literature, and this is a major challenge for those working with animal models of human diseases. If the study is ill designed, it is impossible to perform an accurate harm/benefit analysis. In addition, there may be an ethical challenge if the work is not reproducible and translatable. Animal welfare regulations and other documents of control clearly state the role of the Institutional Animal Care and Use Committees are to look at science justification within the context of animal welfare. This article, concentrating on models not governed by regulations, outlines issues and offers recommendations for refining animal model review with a goal to improve study reproducibility and translatability.
Assessing the value of second opinion pathology review
Authors: Farooq Ayesha , Abdelkader Amrou , Javakhishivili Nino , Moreno Gustavo A , Kuderer Pilar , Polley Marisa , Hunt Bryan , Giorgadze Tamar A , Jorns Julie M 
Published: February 2021

Abstract

Background
Second opinion review of pathology cases can identify diagnostic errors that impact patient care.

Objective
We sought out to determine discrepancy rates and clinical impact of review of pathology cases to reassess our policy of review on all second opinion cases.

Methods
All second opinion pathology cases over 1 year (2018) were retrospectively reviewed for discrepancy, multiple pathologist review and clinicopathologic features via chart and slide review. Cases were categorized as no significant discordance, major discordance without management change and major discordance with management change.

Results
Among 4239 second opinion cases, 3.7% (156/4239) had major discordance with no change in management and 1% (42/4239) had major discordance with change in management. Discordance was significantly associated with multiple pathologist review at our institution (P &lt; 0.001). Highest rates of discordance were observed for thyroid fine needle aspiration (15.3%, 26/170), tissue biopsy of bone/soft tissue (9.6%), endocrine (8.8%), genitourinary (6.7%), gynecologic (6.2%), hematopathology (4%), gastrointestinal/liver (3.7%) and thoracic (3%) sites.

Conclusions
Our study showed a 1% major discordance rate with resulting significant change in clinical management, spread across nearly all subspecialties. Thus, we support recommendations for review of relevant outside pathology material for all patients for which review has the potential to illicit management change such as instituting a major medical or surgical therapy.
Effects of Computerised Clinical Decision Support on Adherence to VTE Prophylaxis Clinical Practice Guidelines among Hospitalised Patients
Authors: Titi Maher A , Alotair Hadil A , Fayed Amel , Baksh Maram , Alsaif Faisal Abdullah Abdulaziz , Almomani Ziad , Atallah Mohammad , Alsharif Asrar F , Jamal Amr A , Amer Yasser S 
Published: February 2021

Abstract

Objective
Venous thromboembolism (VTE) is an important patient safety concern. VTE leads to significant mortality and morbidity and a burden on healthcare resources. Despite the widespread availability of evidence-based clinical practice guidelines on VTE prophylaxis, we found that only 50.9% of our patients were receiving appropriate prophylaxis. The purpose of this study was to evaluate the impact of automation of an adapted VTE prophylaxis CPG using a clinical decision support system (the VTE–CDSS) on VTE prevention among hospitalised adult patients.

Design and setting
A quasi-experimental study (pre- and post-implementation) was conducted at a large 900-bed tertiary teaching multi-specialty hospital in Riyadh, Saudi Arabia.

Participants
The 1809 adult patients in the study included 871 enrolled during the pre-implementation stage and 938 enrolled during the post-implementation stage.

Intervention
Multi-faceted implementation interventions were utilised, including leadership engagement and support, quality and clinical champions, staff training and education and regular audit and feedback.

Main outcome measure
Two rate-based process measures were calculated for each admission cohort (i.e. pre- and post-implementation): the percentage of inpatients who were assessed for VTE risk on admission and the percentage of inpatients who received appropriate VTE prophylaxis. Two outcome measures were calculated: the prevalence of hospital-acquired VTE (HA-VTE) events and the in-hospital all-cause mortality.

Results
The percentage of inpatients risk assessed for VTE on admission increased from 77.4% to 93.3% (P &lt; 0.01). The percentage of patients who received appropriate VTE prophylaxis increased from 50.9% to 81.4% (P &lt; 0.01). The HA-VTE events decreased by 50% from 0.33% to 0.15% (P &lt; 0.01).All-cause in-hospital mortality did not significantly change after implementation of the VTE-CDSS compared with pre-implementation mortality (P &gt; 0.05).

Conclusion
The VTE-CDSS improved patient safety by enhancing adherence to the VTE prophylaxis best practice and adapted CPG. The multi-faceted implementation strategies approach improved the compliance rate of risk assessment and the adherence to prophylaxis recommendations and substantially reduced the HA-VTE prevalence. A successful CDSS requires a set of critical components to ensure better user compliance and positive patient outcomes.
The effect of distraction on the quality of patient handoff: a randomized study*
Authors: Persad Vashisht , McLaren Rodney , Joslin-Roher Sophia , Narayanamoorthy Sujatha , Silver Michael , Minkoff Howard 
Published: February 2021

AbstractObjectiveThe number of patient handoffs has increased in recent years. In addition, technology has advanced in the medical field, leading to most providers carrying smartphones at work. Little is known about the effect of mobile devices and quality of patient handoffs. The objective of this study was to determine whether distraction affects the quality of sign-out among obstetrical providers.DesignA randomized, prospective study was conducted.SettingHospital.Participants InterventionObstetrical providers listened to a recorded sign-out vignette. Provider groups either were or were not exposed to a distraction while listening to the vignette. All providers had been told that they would be participating in a trial of two methods of sign-out, although in actuality they were all assigned to a single method. In the distraction arm, the participants were exposed to a ‘distracting event’ (a phone ring, which was answered by the proctor and followed by a brief conversation) that occurred midway through the vignette.Main Outcome MeasureProviders answered a 14-question survey testing recall of facts included in the vignette. The results of each group were analyzed using Fisher’s exact test and Student’s t-test.ResultsEighty-eight providers were randomized, 44 in the distraction group and 44 in the non-distracted group. The average scores on the survey were similar between groups (11.0 and 10.8, P = 0.57). In addition, the average scores for questions that occurred after the distraction did not differ between the distracted and non-distracted groups (6.4 vs 6.2, P = 0.42).ConclusionsWe observed that a phone ring and brief response did not affect the obstetrical providers’ recall of details of a standardized sign-out. More studies are warranted to determine if more frequent or longer distractions would change results.
Particulate Hexavalent Chromium Inhibits E2F1 Leading to Reduced RAD51 Nuclear Foci Formation in Human Lung Cells
Authors: Speer Rachel M , Toyoda Jennifer H , Croom-Perez Tayler J , Liu Ke Jian , Wise John Pierce 
Published: February 2021

Abstract
Lung cancer is the leading cause of cancer death; however, the mechanisms of lung carcinogens are poorly understood. Metals, including hexavalent chromium [Cr(VI)], induce chromosome instability, an early event in lung cancer. Failure of homologous recombination repair is a key mechanism for chromosome instability. Particulate Cr(VI) causes DNA double-strand breaks and prolonged exposure impairs homologous recombination targeting a key effector protein in this pathway, RAD51. Reduced RAD51 protein is a key endpoint of particulate Cr(VI) exposure. It is currently unknown how Cr(VI) reduces RAD51 protein. E2F1 is the predominant transcription factor for RAD51. This study sought to identify if E2F1 modulates the RAD51 response to particulate Cr(VI). Particulate Cr(VI) reduced RAD51 protein and mRNA levels but had a minimal effect on RAD51 half-life. E2F1 protein and mRNA were also inhibited by particulate Cr(VI) exposure. To connect these two outcomes, we tested if modulating E2F1 affects RAD51 outcomes after particulate Cr(VI) exposure. E2F1 knockdown inhibited RAD51 nuclear foci formation after acute particulate Cr(VI) exposure. These data indicate reduced RAD51 protein levels after prolonged particulate Cr(VI) exposure are predominantly due to inhibited expression. Particulate Cr(VI) also inhibits E2F1 expression. However, although loss of E2F1 does not modulate RAD51 expression after particulate Cr(VI) exposure, RAD51 nuclear foci formation is inhibited. These findings suggest E2F1 is important for RAD51 localization to double-strand breaks, but not expression after particulate Cr(VI) exposure in human lung cells.
Delivery in Pregnant Women Infected With SARS-Co-2: A Fast Review
Authors: Parazzini F. , Bortolus R. , Mauri P.A. , Favilli A. , Gerli S. , Ferrazzi E. 
Published: February 2021

(Int J Gynecol Obstet. 2020;150:41–46)
There is still much to be learned about the effects of coronavirus disease 2019 (COVID-19) on pregnant women. The risk of transmission of the virus to the fetus is still unclear. There are now some published case reports and clinical series on pregnancies and deliveries in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This study aimed to review the current evidence concerning mode of delivery, immediate neonatal outcomes, and vertical or peripartum transmission in pregnant patients with confirmed SARS-CoV-2 infection.
What are the Risks of COVID-19 Infection in Pregnant Women?
Authors: Qiao J. 
Published: February 2021

(Lancet. 2020;395:760–761)
The 2019 novel coronavirus disease (COVID-19) broke out in China in December 2019 and by February 11, 2020, had caused 38,800 cases and 1113 (2.9%) deaths in China. Chinese health officials have published guidelines for the prevention, diagnosis, and treatment of pneumonia caused by COVID-19 based on emerging evidence. In developing prevention and treatment practices for pregnant women with COVID-19, as well as determining the risk of vertical transmission, more evidence is needed.
Uterine Balloon Tamponade for the Treatment of Postpartum Hemorrhage: A Systematic Review and Meta-analysis
Authors: Suarez S. , Conde-Agudelo A. , Borovac-Pinheiro A. , Suarez-Rebling D. , Eckardt M. , Theron G. , Burke T.F. 
Published: February 2021

(Am J Obstet Gynecol. 2020;222:293.e1–293.e52)
A leading cause of worldwide maternal death is postpartum hemorrhage (PPH). In 2017, there were 38,000 maternal deaths worldwide, with over 90% occurring in low- and middle-income countries. In addition, an annual 1.5 million women experience hemorrhage-related complications during pregnancy or postpartum. Effective treatment for PPH includes uterotonics, uterine massage, uterine artery embolization, tranexamic acid, uterine balloon tamponade (UBT), and additional surgical intervention. The aim of this study was to conduct a meta-analysis and systematic review to determine the effectiveness, efficacy, and safety of UBT for the treatment of PPH.
Neuraxial Labor Analgesia Utilization, Incidence of Postdural Puncture Headache, and Epidural Blood Patch Placement for Privately Insured Parturients in the United States (2008-2015)
Authors: Delgado C. , Bollag L. , Van Cleve W. 
Published: February 2021

(Anesth Analg. 2020;131:850–856)
Neuraxial labor analgesia (NLA) is a common and effective approach to pain relief during labor, but it is also associated with postdural puncture headache (PDPH). Epidural blood patch (EBP) placement is considered to be a more effective intervention for PDPH than conservative treatments. Yet, the incidence of PDPH and EBP is unclear because most studies assessing these incidence rates have been conducted at single institutions or academic medical centers. The aim of this study was to estimate the incidence of NLA, PDPH, and EBP among privately insured women in the United States.
Third-trimester Prediction of Successful Vaginal Birth After One Cesarean Delivery: A Swedish Model
Authors: Fagerberg M.C. , Källén K. 
Published: February 2021

(Acta Obstet Gynecol Scand. 2020;99:660–668)
In women with one previous cesarean delivery (CD), the decision to deliver by cesarean or trial of labor can be a difficult one. In Sweden, ∼75% of women choosing a trial of labor after cesarean (TOLAC) would have a successful vaginal birth after cesarean (VBAC). The study aimed to adapt and validate a US prediction model for use in Sweden, adding several important factors and the rate of VBAC in TOLAC for the specific delivery ward.
Characteristics and Outcomes of Pregnant Women Admitted to Hospital With Confirmed SARS-CoV-2 Infection in the UK: National Population-based Cohort Study
Authors: Knight M. , Bunch K. , Vousden N. , Morris E. , Simpson N. , Gale C. , O’Brien P. , Quigley M. , Brocklehurst P. , Kurinczuk J.J. 
Published: February 2021

(BMJ. 2020;369:m2107)
Although cases of coronavirus disease 2019 (COVID-19) continue to rise, information on the transmission, effect, and prevalence of the disease in pregnant women and their newborns is still emerging. This study aimed to describe the characteristics and outcomes of a national cohort of pregnant women in the UK hospitalized with COVID-19, the disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
Genomic Insights Into Stillbirth
Authors: Wojcik M.H. 
Published: February 2021

(N Engl J Med. 2020;383;1182–1183)
The majority of stillbirths in the United States are unexplained. Over the past few years, technology for sequencing and interpreting genomic data have improved, but it’s unclear if techniques will be useful in addressing unexplained stillbirth.