bluuebunny/crossref_metadata_2025_split huggingface dataset:
A meta-review of methods of measuring and monitoring safety in primary care
Authors: O’Connor Paul , Madden Caoimhe , O’Dowd Emily , Byrne Dara , Lydon SinÉad 
Published: August 2021

Abstract

Background
A major barrier to safety improvement in primary care is a lack of safety data. The aims of this systematic meta-review (registration: CRD42021224367) were to identify systematic reviews of studies that examine methods of measuring and monitoring safety in primary care; classify the methods of measuring and monitoring safety in the included systematic reviews using the five safety domains of Vincent et al.’s framework and use this information to make recommendations for improving the measurement and monitoring of safety in primary care.

Methods
Four databases (Medline, Academic Search Complete, Web of Science and CINAHL) and the grey literature were screened in November 2020, with searches updated in January 2021. Systematic reviews were included if they addressed the measurement of patient safety in primary care and were published in English. Studies were assessed using the Critical Appraisal Skills Programme for systematic reviews.

Results
A total of 6904 papers were screened, with 13 systematic reviews included. A commonly reported method of measuring ‘past harm’ was through patient record review. The most frequent methods for assessing the ‘reliability of safety critical processes’ were checklists, observations and surveys of staff. Methods used to assess ‘sensitivity to operations’ included observation, staff surveys, interviews, focus groups, active monitoring and simulated patients. Safety climate surveys were a commonly used as an approach to assess ‘anticipation and preparedness’. A number of the reviews concluded that safety data could, and should, be used for ‘integration and learning’. The main limitation of the meta-review was that it was of systematic reviews only.

Conclusions
Many of the methods for measuring and monitoring safety are readily available, quick to administer, do not require external involvement and are inexpensive. However, there is still a need to improve the psychometric properties of many measures. Researchers must support the development of psychometrically sound safety measures that do not over burden primary care practitioners. Policymakers must consider how primary care practitioners can be supported to implement these measures.
The Value of Targeted Ultrasound for the Primary Evaluation of Breast Symptoms in Pregnant Women of All Ages
Authors: Holtz Jamie N , Woodard Genevieve A , Hayward Jessica H , Ray Kimberly M , Kannan Neeta , Greenwood Heather I , Joe Bonnie N , Lee Amie Y 
Published: August 2021

Abstract

Objective
Data on breast imaging in symptomatic pregnant women are limited. Our aim was to assess the value of targeted breast US for the primary evaluation of breast symptoms in pregnant women of all ages.

Methods
This IRB-approved retrospective study included all pregnant patients who underwent targeted US for focal breast symptoms at an academic imaging facility over an 18-year period (2000–2018). Clinical, imaging, and pathology results were reviewed. Malignant outcomes were determined by histology. Benign outcomes were confirmed by pathology or ≥2 years of follow-up. Descriptive statistics and 2 × 2 contingency table analyses were performed at the presentation level.

Results
The study cohort comprised 178 presentations in 175 pregnant women. Mean age was 34.7 years (standard deviation, 5.2). The majority (153/178, 86.0%) were more than 30 years old. At presentation, 42.1% (75/178) were in the first trimester of pregnancy, 27.0% (48/178) in the second, and 29.8% (53/178) in the third. The most common presenting symptom was a palpable lump (162/178, 91.0%), followed by focal pain (7/178, 3.9%). The vast majority (174/178, 97.8%) of cases were non-malignant. However, targeted US detected all 4 malignancies (cancer detection rate, 22/1000; negative predictive value 136/136, 100%). Sensitivity and specificity were 100% (4/4) and 78.2% (136/174), respectively.

Conclusion
Benign causes of symptoms in pregnant women were far more common; malignancy was rare, accounting for only 2.2% (4/178) of cases. Targeted breast US detected all malignancies, supporting US as the primary imaging modality for evaluating symptomatic pregnant women, regardless of age.
Mental Health Without Well-being
Authors: Wren-Lewis Sam , Alexandrova Anna 
Published: August 2021

AbstractWhat is it to be mentally healthy? In the ongoing movement to promote mental health, to reduce stigma, and to establish parity between mental and physical health, there is a clear enthusiasm about this concept and a recognition of its value in human life. However, it is often unclear what mental health means in all these efforts and whether there is a single concept underlying them. Sometimes, the initiatives for the sake of mental health are aimed just at reducing mental illness, thus implicitly identifying mental health with the absence of diagnosable psychiatric disease. More ambitiously, there are high-profile proposals to adopt a positive definition, identifying mental health with psychic or even overall well-being. We argue against both: a definition of mental health as mere absence of mental illness is too thin, too undemanding, and too closely linked to psychiatric value judgments, while the definition in terms of well-being is too demanding and potentially oppressive. As a compromise, we sketch out a middle position. On this view, mental health is a primary good, that is, the psychological preconditions of pursuing any conception of the good life, including well-being, without being identical to well-being.
Germline SUCLG2 Variants in Patients With Pheochromocytoma and Paraganglioma
Authors: Hadrava Vanova Katerina , Pang Ying , Krobova Linda , Kraus Michal , Nahacka Zuzana , Boukalova Stepana , Pack Svetlana D , Zobalova Renata , Zhu Jun , Huynh Thanh-Truc , Jochmanova Ivana , Uher Ondrej , Hubackova Sona , Dvorakova Sarka , Garrett Timothy J , Ghayee Hans K , Wu Xiaolin , Schuster Bjoern , Knapp Philip E , Frysak Zdenek , Hartmann Igor , Nilubol Naris , Cerny Jiri , Taieb David , Rohlena Jakub , Neuzil Jiri , Yang Chunzhang , Pacak Karel 
Published: August 2021

Abstract

Background
Pheochromocytoma and paraganglioma (PPGL) are neuroendocrine tumors with frequent mutations in genes linked to the tricarboxylic acid cycle. However, no pathogenic variant has been found to date in succinyl-CoA ligase (SUCL), an enzyme that provides substrate for succinate dehydrogenase (SDH; mitochondrial complex II [CII]), a known tumor suppressor in PPGL.

Methods
A cohort of 352 patients with apparently sporadic PPGL underwent genetic testing using a panel of 54 genes developed at the National Institutes of Health, including the SUCLG2 subunit of SUCL. Gene deletion, succinate levels, and protein levels were assessed in tumors where possible. To confirm the possible mechanism, we used a progenitor cell line, hPheo1, derived from a human pheochromocytoma, and ablated and re-expressed SUCLG2.

Results
We describe 8 germline variants in the guanosine triphosphate–binding domain of SUCLG2 in 15 patients (15 of 352, 4.3%) with apparently sporadic PPGL. Analysis of SUCLG2-mutated tumors and SUCLG2-deficient hPheo1 cells revealed absence of SUCLG2 protein, decrease in the level of the SDHB subunit of SDH, and faulty assembly of the complex II, resulting in aberrant respiration and elevated succinate accumulation.

Conclusions
Our study suggests SUCLG2 as a novel candidate gene in the genetic landscape of PPGL. Large-scale sequencing may uncover additional cases harboring SUCLG2 variants and provide more detailed information about their prevalence and penetrance.
Challenges in the Diagnosis and Management of Recurrent and Severe Clostridioides difficile Infection in Children
Authors: Sattler Matthew M , Crews Jonathan D 
Published: August 2021

Abstract
Children with Clostridioides difficile infection (CDI) can experience recurrent or severe disease. Recurrent CDI occurs in 20%-30% of children with an initial CDI episode. A careful clinical evaluation is important to distinguish recurrent CDI from other disorders that cause recurring gastrointestinal symptoms. Multiple treatment options exist for recurrent CDI, but the optimal therapeutic approach remains undefined. Severe or fulminant CDI can result in poor outcomes and significant morbidity in children. Since there is not a validated definition for severe CDI in children, physicians must use their clinical judgment to identify patients with severe CDI to institute appropriate therapy. In this review, we describe the diagnostic and management challenges in caring for children with recurrent and severe CDI.
Neutral CGM as damped Ly α absorbers at high redshift
Authors: Stern Jonathan , Sternberg Amiel , Faucher-Giguère Claude-André , Hafen Zachary , Fielding Drummond , Quataert Eliot , Wetzel Andrew , Anglés-Alcázar Daniel , El-Badry Kareem , Kereš Dušan , Hopkins Philip F 
Published: August 2021

ABSTRACT
Recent searches for the hosts of z ∼ 4 damped Ly α absorbers (DLAs) have detected bright galaxies at distances of tens of kpc from the DLA. Using the FIRE-2 cosmological zoom simulations, we argue that these relatively large distances are due to a predominantly cool and neutral inner circumgalactic medium (CGM) surrounding high-redshift galaxies. The inner CGM is cool because of the short cooling time of hot gas in ${\lesssim}10^{12}\, {\rm M_{\odot }}$ haloes, which implies that accretion and feedback energy are radiated quickly, while it is neutral due to high volume densities and column densities at high redshift that shield cool gas from photoionization. Our analysis predicts large DLA covering factors (${\gtrsim}50{{\ \rm per\ cent}}$) out to impact parameters ∼0.3[(1 + z)/5]3/2Rvir from the central galaxies at z ≳ 1, equivalent to a proper distance of ${\sim}21\, M_{12}^{1/3} \left(\left(1+z\right)/5\right)^{1/2}\, {\rm kpc}$ (Rvir and M12 are the halo virial radius and mass in units of $10^{12}\, {\rm M_{\odot }}$, respectively). This implies that DLA covering factors at z ∼ 4 may be comparable to unity out to a distance ∼10 times larger than stellar half-mass radii. A predominantly neutral inner CGM in the early universe suggests that its mass and metallicity can be directly constrained by absorption surveys, without resorting to the large ionization corrections as required for ionized CGM.
Identification of emission-line stars in transition phase from pre-main sequence to main sequence
Authors: Bhattacharyya Suman , Mathew Blesson , Banerjee Gourav , Anusha R , Paul K T , Kartha Sreeja S 
Published: August 2021

ABSTRACT
Pre-main-sequence (PMS) stars evolve into main-sequence (MS) phase over a period of time. Interestingly, we found a scarcity of studies in existing literature that examine and attempt to better understand the stars in PMS to MS transition phase. The purpose of this study is to detect such rare stars, which we named as ‘transition phase’ (TP) candidates – stars evolving from the PMS to the MS phase. We identified 98 TP candidates using photometric analysis of a sample of 2167 classical Be (CBe) and 225 Herbig Ae/Be (HAeBe) stars. This identification is done by analysing the near- and mid-infrared excess and their location in the optical colour–magnitude diagram. The age and mass of 58 of these TP candidates are determined to be between 0.1–5 Myr and 2–10.5 M⊙, respectively. The TP candidates are found to possess rotational velocity and colour excess values in between CBe and HAeBe stars, which is reconfirmed by generating a set of synthetic samples using the machine learning approach.
Radius measurement in binary stars: simulations of intensity interferometry
Authors: Rai Km Nitu , Basak Soumen , Saha Prasenjit 
Published: August 2021

ABSTRACT
Mass and radius measurements of stars are important inputs for models of stellar structure. Binary stars are of particular interest in this regard, because astrometry and spectroscopy of a binary together provide the masses of both stars as well as the distance to the system, while interferometry can both improve the astrometry and measure the radii of the stars. In this work, we simulate parameter recovery from intensity interferometry, especially the challenge of disentangling the radii of two stars from their combined interferometric signal. Two approaches are considered: separation of the visibility contributions of each star with the help of differing brightness ratios at different wavelengths, and direct fitting of the intensity correlation to a multiparameter model. Full image reconstructions is not attempted. Measurement of angular radii, angular separation, and first-order limb-darkening appears readily achievable for bright binary stars with current instrumentation.
A new approach of estimating the galactic thermal dust and synchrotron polarized emission template in the microwave bands
Authors: Adak Debabrata 
Published: August 2021

ABSTRACT
The Internal Linear Combination (ILC) method has been extensively used to extract the cosmic microwave background (CMB) anisotropy map from foreground contaminated multifrequency maps. However, the performance of simple ILC is limited and can be significantly improved by heavily constraint equations, dubbed constrained ILC (cILC). The standard ILC and cILC work on spin-0 fields. Recently, a generalised version of ILC has been developed, named polarization ILC (PILC), in which Q ± iU at multiple frequencies are combined using complex coefficients to estimate Stokes Q and U maps. A statistical moment expansion method has recently been developed for high-precision modelling of the galactic foregrounds. This paper develops a semiblind component separation method combining the moment approach of foreground modelling with a generalised version of the PILC method for heavily constraint equations. The algorithm is developed in pixel space over a spin-2 field. We demonstrate the performance of the method on three sets of absolutely calibrated simulated maps at WMAP and Planck frequencies with varying foreground models. We apply this component separation technique in simultaneous estimation of Stokes Q and U maps of the thermal dust at 353 GHz and synchrotron at 30 GHz. We also recover both dust and synchrotron maps at 100 and 143 GHz, where separating two components is challenging.
An observational determination of the evolving extragalactic background light from the multiwavelength HST/CANDELS survey in the Fermi and CTA era
Authors: Saldana-Lopez Alberto , Domínguez Alberto , Pérez-González Pablo G , Finke Justin , Ajello Marco , Primack Joel R , Paliya Vaidehi S , Desai Abhishek 
Published: August 2021

ABSTRACT
The diffuse extragalactic background light (EBL) is formed by ultraviolet (UV), optical, and infrared (IR) photons mainly produced by star formation processes over the history of the Universe and contains essential information about galaxy evolution and cosmology. Here, we present a new determination of the evolving EBL spectral energy distribution using a novel approach purely based on galaxy data aiming to reduce current uncertainties on the higher redshifts and IR intensities. Our calculations use multiwavelength observations from the UV to the far-IR of a sample of approximately 150 000 galaxies detected up to z ∼ 6 in the five fields of the Cosmic Assembly Near-Infrared Deep Extragalactic Legacy Survey from the Hubble Space Telescope. This is one of the most comprehensive and deepest multiwavelength galaxy data sets ever obtained. These unprecedented resources allow us to derive the overall EBL evolution up to z ∼ 6 and its uncertainties. Our results agree with cosmic observables estimated from galaxy surveys and γ-ray attenuation such as monochromatic luminosity densities, including those in the far-IR, and star formation rate densities, also at the highest redshifts. Optical depths from our EBL approximation, which will be robust at high redshifts and for γ-rays up to tens of TeV, will be reported in a companion paper.
From aniline to phenol: carbon-nitrogen bond activation via uranyl photoredox catalysis
Authors: Hu Deqing , Zhou Yilin , Jiang Xuefeng 
Published: August 2021

Abstract
Carbon-nitrogen bond activation, via uranyl photoredox catalysis with water, enabled the conversion of 40 protogenetic anilines, 8 N-substituted anilines and 9 aniline-containing natural products/pharmaceuticals to the corresponding phenols in an ambient environment. A single-electron transfer process between a protonated aniline and uranyl catalyst, which was disclosed by radical quenching experiments and Stern-Volmer analysis, facilitated the following oxygen atom transfer process between the radical cation of protonated anilines and uranyl peroxide originating from water-splitting. 18O labeling and 15N tracking unambiguously depicted that the oxygen came from water and amino group left as ammonium salt. The 100-fold efficiency of the flow operation demonstrated the great potential of the conversion process for industrial synthetic application.
Implementation and Use of Workplace-Based Assessment in Clinical Learning Environments: A Scoping Review
Authors: Anderson Hannah L. , Kurtz Joshua , West Daniel C. 
Published: August 2021

Purpose
Workplace-based assessment (WBA) serves a critical role in supporting competency-based medical education (CBME) by providing assessment data to inform competency decisions and support learning. Many WBA systems have been developed, but little is known about how to effectively implement WBA. Filling this gap is important for creating suitable and beneficial assessment processes that support large-scale use of CBME. As a step toward filling this gap, the authors describe what is known about WBA implementation and use to identify knowledge gaps and future directions.

Method
The authors used Arksey and O’Malley’s 6-stage scoping review framework to conduct the review, including: (1) identifying the research question; (2) identifying relevant studies; (3) study selection; (4) charting the data; (5) collating, summarizing, and reporting the results; and (6) consulting with relevant stakeholders.

Results
In 2019–2020, the authors searched and screened 726 papers for eligibility using defined inclusion and exclusion criteria. One hundred sixty-three met inclusion criteria. The authors identified 5 themes in their analysis: (1) Many WBA tools and programs have been implemented, and barriers are common across fields and specialties; (2) Theoretical perspectives emphasize the need for data-driven implementation strategies; (3) User perceptions of WBA vary and are often dependent on implementation factors; (4) Technology solutions could provide useful tools to support WBA; and (5) Many areas of future research and innovation remain.

Conclusions
Knowledge of WBA as an implemented practice to support CBME remains constrained. To remove these constraints, future research should aim to generate generalizable knowledge on WBA implementation and use, address implementation factors, and investigate remaining knowledge gaps.
A Quality Improvement Initiative to Provide Timely Central Vascular Access in a Neonatal Intensive Care Unit
Authors: Kristoff Kimberly , Wang Rui , Munson David , Dysart Kevin , Stracuzzi Lauren , Wade Kelcey , Birnbaum Shira 
Published: August 2021

Background:
Timely central venous access is essential in the care of critically ill neonates. Peripherally inserted central catheters (PICCs) are the preferred form of central venous access when umbilical venous catheters cannot be placed or are discontinued. However, time delays increase risk for injury from peripheral intravenous lines and may contribute to inconsistent delivery of necessary fluids and medications.

Purpose:
The aim of this quality improvement project was to decrease wait times for PICC placement in the neonatal intensive care unit (NICU).

Methods:
A unit-based PICC team was developed consisting of NICU nurses and attending neonatologists and implemented in 2 phases. Data were collected from chart reviews before, during, and after implementation of the team. We tracked time between PICC order and placement and number of attempts. Hospital metrics on peripheral intravenous line infiltrations and central line–associated blood stream infection were also monitored. At the end of the project, we continued tracking outcomes to determine whether gains would be sustained past the project period.

Results:
Implementation of a unit-based interdisciplinary specialty team led to a 50% reduction in mean PICC wait times from 1.2 days to 0.58 days. Benefits of the initiative were sustained past the initial project period.

Implications for Practice:
The development of a dedicated, local team played a key role in improving vascular access in the NICU.

Implications for Research:
Proximity of specialized teams provides a solution to address gaps in care in the NICU.
Management of Salter-Harris II distal femur fractures – what is the state of practice? A survey of Pediatric Orthopaedic Society of North America membership
Authors: Weltsch Daniel , Williams Brendan A. , Gohel Shivani , Ganley Theodore J. , Baldwin Keith D. 
Published: August 2021

Appropriate treatment of Salter-Harris (SH) II distal femoral physeal fractures is crucial due to risks of growth arrest and angular deformity. Low incidence renders sufficiently powered, prospective research difficult. This study aimed to assess the current state of management of these fractures on the basis of the Pediatric Orthopaedic Society of North America (POSNA) membership experience. POSNA members were surveyed via an emailed REDCAP survey. Questions included respondent demographics, experience, practice environment and clinical questions regarding preferred treatment and postoperative management based, in part, on an illustrative case of a nighttime presentation of a displaced SH-II distal femur fracture. Descriptive statistics were performed to summarize the preferred management among POSNA members. Twenty-eight percent (376/1344) of contacted POSNA members responded to the survey meeting sample size criteria of membership representation. Respondents’ median years in practice were 17 (IQR 7–27). Surgical management of the presented case was preferred by most (96.3%) respondents. If no vascular compromise was present (ABI >0.9), most (86.6%) felt it was appropriate to wait for intervention on the following day. One-third (32.7%) of respondents considered every SH-II as an indication for surgical treatment. Screw fixation is the most common implant selection for operatively managed injuries, with the majority choosing not to electively remove screws. Those who opted for pin fixation tended to remove pins by 3–4 weeks postoperatively. For immediate postoperative immobilization, long leg casting (44.4%) was selected more commonly than splinting or knee immobilizers. Nearly all (99.7%) respondents preferred follow-up until skeletal maturity. In cases of suspected growth arrest, 76% felt MRI was necessary for further evaluation. Operative management of SH-II distal femur fractures is preferred among POSNA members, particularly in cases of displaced fractures or when closed reduction had failed. Except for immediate postoperative immobilization preferences, pediatric orthopedic surgeons appear to have a majority consensus regarding treatment practices, postoperative management and indications and timing of hardware removal.

Level of evidence
Level V Expert Opinion.