bluuebunny/crossref_metadata_2025_split huggingface dataset:
Can You Escape Sepsis? Using a Healthcare Escape Room as an Innovative Approach to Nursing Education
Authors: Dacanay Adrian P. , Sibrian Julia , Wyllie Colleen , Sorrentino Elizabeth , Dunbar Ghada 
Published: February 2021

Purpose/Objectives
The purpose of this article is to provide the clinical nurse specialist with an interactive, creative, and fun approach using an escape room to increase the retention and application of knowledge about caring for patients with sepsis and improve patient care outcomes.

Description of the Project
This project involved the design of a healthcare-based escape room, where clinical nurses and interprofessional learners engaged in a series of puzzles and problem-solving experiences to apply clinical judgment and critical thinking about patient care.

Theory and Frameworks
Knowles' theory of adult learning guided the development of this gamified learning.

Outcome
The clinical nurse specialist was critical to the success of the escape room. The escape room created an innovative learning environment, expanding opportunities to engage staff and promote high-quality care for best patient outcomes.

Conclusion
The benefits of incorporating adult learning principles with gamification-based education as a teaching strategy are evident in the feedback and overwhelmingly positive responses received from participants. The successes of the sepsis escape room have presented opportunities to continue supporting progressive, fun, and evidence-based learning environments and positively impact both nursing education and patient care outcomes.
“Effect of the intervention with omega-3 fatty acids on nutritional and clinical aspects in patients with breast cancer receiving medical treatment”
Authors: Edgardo Palma-Gutierrez , Erika Espinoza-Rado , Jessica Hanae Zafra-Tanaka 
Published: February 2021

ABSTRACTBackgroundIt is known that cancer can cause loss of body weight and muscle protein wasting, which leads to a state of malnutrition, which in turn worsens the prognosis and health of the cancer patient. It has been suggested that the promoting mechanism of this state is systemic inflammation, for which reason several clinical trials have used omega-3 fatty acids, especially eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), as adjuvants to antineoplastic treatment, mainly due to its anti-inflammatory effects. However, few systematic reviews and meta-analyzes have analyzed the effects of omega-3s in patients with breast cancer.ObjectiveThe aim of this study is to assess the effect of the supplementation with omega-3 fatty acids on nutritional and clinical outcomes in patients with breast cancer receiving medical treatment.MethodsA systematic review will be conducted, starting with a search in PubMed, CENTRAL and EMBASE using search terms related to omega-3 fatty acids and breast cancer. We will include only randomized controlled trials that assess the effects of omega-3 in patients with breast cancer receiving medical treatment.. Data will be extracted in a spread sheet. Study selection and data extraction will be conducted by two reviewers independently and the Cochrane Risk of Bias Tool for RCT will be used for assessment of risk of bias. Discrepancies will be reviewed with a third reviewer.ConclusionThis systematic review aims to provide an analysis on the outcomes of the usage of the intervention with omega-3 fatty acids on nutritional and clinical aspects in patients with breast cancer receiving medical treatment.
Place of preperitoneal pelvic packing in severe pelvic traumatisms: About 20 cases performed in a French military level one trauma center
Authors: Julie Hardy , Marie Coisy , Tristan Monchal , Stéphane Bourguoin , Thibaut Long Depaquit , Paul Chiron , Cardinale Mickael , Emmanuel Hornez , Paul Balandraud , Pierre-Henri Savoie 
Published: February 2021

AbstractBackgroundThe overall mortality of hemodynamically unstable pelvic fractures is high. Hemorrhage triggers off the Moore lethal triad. Hemostatic management during the golden hour is essential. Combined with pelvic stabilisation, preperitoneal pelvic packing (PPP) is proposed to control venous and bony bleeding, while arterioembolisation can stop arterial bleeding. No international consensus has yet prioritized these procedures. The aim of this study was to analyse a serie of PPP in a military level one trauma center and propose an algorithm for hemodynamically unstable pelvic traumas regardless of the military facility.MethodFrom January 2010 to December 2020, every patient from our military institution with a hemodynamically unstable pelvic fracture underwent PPP combined with pelvic stabilisation. Before 2012 data were retrospectively collected from database (PMSI), after 2012 data were prospectively recorded in our polytrauma database and retrospectively analysed. The care algorithm applied focused on hemodynamic status of polytraumatised patients on admission. Primary criteria were early hemorrhage-induced mortality (<24h) and overall mortality (<30d). Secondary criteria were systolic blood pressure (SBP) and red blood cells (RBC) units administered.Results20 patients with a pelvic fracture had a PPP. Mean age was 49,65 +/-23,97 years and median ISS was 49 (31; 67). The decrease of blood transfusion and increase of SBP between pre- and postoperative values were statistically significant. Eight patients (40%) had postoperative arterial pelvic blush and 7 patients were embolised. The early mortality by refractory hemorrhagic shock was 25% (5/20). Overall mortality at 30 days was 50% (10/20).ConclusionPPP is a quick, easy, efficient and safe procedure. It can control venous, bony and sometimes arterial bleeding. PPP is part of damage control surgery and we propose it in first line. Angio-embolization remains complementary. Besides, PPP is the only means available in precarious conditions of practice, notably in military forward units.
CLINICAL PERFORMANCE OF THE CALL SCORE FOR THE PREDICTION OF ADMISSION TO ICU AND DEATH IN HOSPITALIZED PATIENTS WITH COVID-19 PNEUMONIA IN A REFERENCE HOSPITAL IN PERU
Authors: Pichardo-Rodriguez Rafael , Saavedra-Velasco Marcos , Peña-Oscuvilca Willy , Ascarza-Saldaña Jhonnathan , Sanchez-Alvarez Cesar , Patron-Ordoñez Gino , Ruiz-Franco Oscar , De La Cruz-Vargas Jhony A. , Garcia-Perdomo Herney Andres 
Published: February 2021

ABSTRACTObjectiveDetermine the CALL SCORE’s diagnostic accuracy for the prediction of ICU admission and death in patients hospitalized for COVID-19 pneumonia in a reference hospital in Peru.MethodsWe performed an analytical cross-sectional observational study. We included patients with COVID-19 pneumonia treated at the “Dos de Mayo” National Hospital. Patients over 18 years old with a diagnosis confirmed by rapid or molecular testing were included. Those with an incomplete, illegible, or missing medical history and/or bacterial or fungal pneumonia were excluded. Data were extracted from medical records. The primary outcomes were mortality and admission to the ICU. The Call Score was calculated for each patient (4 to 13 points) and classified into three risk groups. Summary measures were presented for qualitative and quantitative variables. The area under the model curve and the operational characteristics (sensitivity, specificity) were calculated for the best cut-off point.ResultsThe Call Score reported an area under the curve of 0.59 (IC95%: 0.3 to 0.07), p = 0.43 for predicting death. However, for a cut-off point of 5.5, a sensitivity of 87%and a specificity of 65%were obtained. The area under the curve for ICU admission was 0.67 (95%CI: 0.3 to 0.07), p = 0.43; the 5.5 cut-off point showed a sensitivity of 82%and a specificity of 51%.ConclusionsThe Call Score shows a low performance for predicting mortality and admission to the ICU in Peruvian patients.
Quantitative genome-scale analysis of human liver reveals dysregulation of glycosphingolipid pathways in progressive nonalcoholic fatty liver disease
Authors: Sen Partho , Govaere Olivier , Sinioja Tim , McGlinchey Aidan , Geng Dawei , Ratziu Vlad , Bugianesi Elisabetta , Schattenberg Jörn M. , Vidal-Puig Antonio , Allison Michael , Cockell Simon , Daly Ann K. , Hyötyläinen Tuulia , Anstee Quentin M. , Orešič Matej 
Published: February 2021

AbstractNonalcoholic fatty liver disease (NAFLD) is an increasingly prevalent disease that is associated with multiple metabolic disturbances, yet the metabolic pathways underlying its progression are poorly understood. Here we studied metabolic pathways of the human liver across the full histological spectrum of NAFLD. We analyzed whole liver tissue transcriptomics and serum metabolomics data obtained from a large, prospectively enrolled cohort of 206 histologically characterized patients derived from the European NAFLD Registry and developed genome-scale metabolic models (GEMs) of human hepatocytes at different stages of NAFLD. We identified several metabolic signatures in the liver and blood of these patients, specifically highlighting the alteration of vitamins (A, E) and glycosphingolipids, and their link with complex glycosaminoglycans in advanced fibrosis. Furthermore, we derived GEMs and identified metabolic signatures of three common NAFLD-associated gene variants(PNPLA3, TM6SF2andHSD17B13). The study demonstrates dysregulated liver metabolic pathways which may contribute to the progression of NAFLD.
Distinct gut and vaginal microbiota profile in women with Recurrent Implantation Failure and Unexplained Infertility
Authors: Patel Nayna , Patel Nidhi , Pal Sejal , Nathani Neelam , Pandit Ramesh , Patel Molina , Patel Niket , Joshi Chaitanya , Parekh Bhavin 
Published: February 2021

BackgroundImplantation failure limits the success rate of natural and in vitro fertilization (IVF)-assisted conceptions. Evidence suggests dysbiosis in the female reproductive tract impacts implantation failure. However, whether gut dysbiosis influences implantation failure and whether it accompanies reproductive tract dysbiosis remains unexplored.MethodWe recruited 11fertile women as the controls, and a cohort of 20 women diagnosed with implantation-failure associated infertility, which included 10 women diagnosed with recurrent implantation failure (RIF), and 10 women diagnosed with unexplained infertility (UE). Using next-generation amplicon sequencing, we compared the diversity, structure, and composition of fecal and vaginal bacteria of the controls with that of the infertile cohort. While we sequenced fecal samples of all the participants (n=31), we could only sequence 8 vaginal samples in each group (n=24).ResultsCompared with the controls, α-diversity of the gut bacteria, analysed by Chao 1 and Shannon indices, among the infertile groups declined (p□<□0.05). β-diversity between the controls and infertile cohort, measured by both Bray-Curtis and Jaccard distances, differed significantly (p□<□0.05). Taxa analysis of the gut bacteria revealed enrichment of Gram-positive bacteria, mainly of the phylum Firmicutes, in the RIF group. In contrast, Gram-negative bacteria were relatively more abundant in the UE group. Additionally, mucus-producing bacteria genera such as Prevotella and Sutterella declined in the infertile cohort (p□<□0.05). Intriguingly, significant enrichment (p□<□0.05) of the genus Hungatella, associated with trimethylamine N-oxide (TMAO) production, occurred in the infertile cohort. Vaginal microbiota was dominated by L. iners across the groups, with the UE group showing the highest levels. Of the three groups, the RIF group had the least diverse vaginal microbiota. Taxa analysis showed higher levels of anaerobic bacteria such as Leptotrichia, Snethia, and Prevotella in the controls.ConclusionWe posit that in the setting of the compromised gut mucosal barrier, the phyla Firmicutes generates TNF-α-driven systemic inflammation, leading to RIF, whereas an overload of Gram-negative bacteria induces IL-6-driven systemic inflammation, leading to UE. Additionally, Hungatella-induced elevation of TMAO levels causes platelet hypercoagulability, synergistically contributing to implantation failure. Finally, vaginal dysbiosis does not appear to co-occur with gut dysbiosis.
Diet-dependentNatriuretic Peptide Receptor Cexpression in adipose tissue is mediated by PPARγ via long-range distal enhancers
Authors: Shi Fubiao , Simandi Zoltan , Nagy Laszlo , Collins Sheila 
Published: February 2021

AbstractIn addition to their established role to maintain blood pressure and fluid volume, the cardiac natriuretic peptides (NPs) can stimulate adipocyte lipolysis and control the brown fat gene program of nonshivering thermogenesis. The NP “clearance” receptor C (NPRC) functions to clear NPs from the circulation via peptide internalization and degradation and thus is an important regulator of NP signaling and adipocyte metabolism. It is well appreciated that theNprcgene is highly expressed in adipose tissue and is dynamically regulated with nutrition and environmental changes. However, the molecular basis for howNprcgene expression is regulated is still poorly understood. Here we identified Peroxisome Proliferator-Activated Receptor gamma (PPARγ) as a transcriptional regulator ofNprcexpression in mouse adipocytes. During 3T3-L1 adipocyte differentiation, levels ofNprcexpression increase in parallel with PPARγ induction. Rosiglitazone, a classic PPARγ agonist, increases, while siRNA knockdown of PPARγ reduces,Nprcexpression in 3T3-L1 adipocytes. We demonstrate that PPARγ controlsNprcgene expression in adipocytes through its long-range distal enhancers. Furthermore, the induction ofNprcexpression in adipose tissue during high-fat diet feeding is associated with increased PPARγ enhancer activity. Our findings define PPARγ as a mediator of adipocyteNprcgene expression and establish a new connection between PPARγ and the control of adipocyte NP signaling in obesity.
Associations between measures of social distancing and SARS-CoV-2 seropositivity: a nationwide population-based study in the Netherlands
Authors: Vos Eric R.A. , van Boven Michiel , den Hartog Gerco , Backer Jantien A. , Klinkenberg Don , van Hagen Cheyenne C.E. , Boshuizen Hendriek , van Binnendijk Rob S. , Mollema Liesbeth , van der Klis Fiona R.M. , de Melker Hester E. 
Published: February 2021

ABSTRACTThis large nationwide population-based seroepidemiological study provides evidence on the effectiveness of physical distancing (>1.5m) and indoor group size reductions on SARS-CoV-2 infection. Additionally, young adults seem to play a significant role in viral spread, opposed to children up until the primary school age with whom close contact is permitted.
CATALYST trial protocol: A multicentre, open-label, phase II, multi-arm trial for an early and accelerated evaluation of the potential treatments for COVID-19 in hospitalised adults
Authors: Veenith Tonny , Fisher Benjamin A. , Slade Daniel , Rowe Anna , Sharpe Rowena , Thickett David R. , Whitehouse Tony , Rowland Matthew , Scriven James , Parekh Dhruv , Bowden Sarah J. , Savage Joshua S. , Richards Duncan , Bion Julian , Kearns Pamela , Gates Simon 
Published: February 2021

AbstractIntroductionSevere SARS-CoV-2 infection is associated with a dysregulated immune response. Inflammatory monocytes and macrophages are crucial, promoting injurious, pro-inflammatory sequelae. Immunomodulation is, therefore, an attractive therapeutic strategy and we sought to test licensed and novel candidate drugs.Methods and analysisThe CATALYST trial is a multi-arm, open-label, multi-centre, phase II platform trial designed to identify candidate novel treatments to improve outcomes of patients hospitalised with COVID-19 compared with usual care. Treatments with evidence of biomarker improvements will be put forward for larger-scale testing by current national phase III platform trials. Hospitalised patients >16 years with a clinical picture strongly suggestive of SARS-CoV-2 pneumonia (confirmed by chest X-ray or CT scan, with or without a positive reverse transcription polymerase chain reaction (RT-PCR) assay) and a C-Reactive Protein (CRP) ≥40 mg/L are eligible. The primary outcome measure is CRP, measured serially from admission to day 14, hospital discharge or death. Secondary outcomes include the WHO Clinical Progression Improvement Scale as a principal efficacy assessment.Ethics and disseminationThe protocol was approved by the East Midlands - Nottingham 2 Research Ethics Committee (20/EM/0115) and given Urgent Public Health status; initial approval was received on 05-May-2020, current protocol version (v6.0) approval on 12-Oct-2020. The MHRA also approved all protocol versions. The results of this trial will be disseminated through national and international presentations and peer-reviewed publications.Trial registration numberEudraCT Number: 2020-001684-89ISRCTN Number: 40580903Strengths and limitations of this trialCATALYST will provide a rapid readout on the safety and proof-of-concept of candidate novel treatmentsCATALYST will enable phase III trial resources to be focussed and allocated for agents with a high likelihood of successCATALYST uses Bayesian multi-level models to allow for nesting of repeated measures data, with factors for each individual patient and treatment arm, and allowing for non-linear responsesCATALYST is not designed to provide a definitive signal on clinical outcomes
Symptom reporting in over 1 million people: community detection of COVID-19
Authors: Elliott Joshua , Whitaker Matthew , Bodinier Barbara , Riley Steven , Ward Helen , Cooke Graham , Darzi Ara , Chadeau-Hyam Marc , Elliott Paul 
Published: February 2021

SummaryControl of the SARS-CoV-2 epidemic requires rapid identification and isolation of infected individuals and their contacts. Community testing in England (Pillar 2) by polymerase chain reaction (PCR) is reserved for those reporting at least one of four ‘classic’ COVID-19 symptoms (loss or change of sense of smell, loss or change of sense of taste, fever, new continuous cough).1 Detection of positive cases in the community might be improved by including additional symptoms and their combinations. We used data from the REal-time Assessment of Community Transmission-1 (REACT-1) study to investigate symptom profiles for PCR positivity at different ages. Among rounds 2–7 (June to December 2020), an age-stratified, variable selection approach stably selected chills (all ages), headache (5–17 years), appetite loss (18–54 and 55+ years) and muscle aches (18–54 years) as jointly and positively predictive of PCR positivity together with the classic four symptoms. Between round 7 (November to December 2020) and round 8 (January 2021) when new variant B.1.1.7 predominated, only loss or change of sense of smell (more predictive in round 7) and (borderline) new persistent cough (more predictive in round 8) differed between cases. At any level of PCR testing, triage based on the symptoms identified here would result in more cases detected than the current approach.
Screening plans for SARS-CoV-2 based on sampling and rotation: an example in the school setting
Authors: Baccini Michela , Cereda Giulia 
Published: February 2021

AbstractScreening plans for prevention and containment of SARS-CoV-2 infection should take into account the epidemic context, the fact that undetected infected individuals may transmit the disease, and that the infection spreads through outbreaks, creating clusters in the population. In this paper, we compare the performance of six screening plans based on poorly sensitive individual tests, in detecting infection outbreaks at the level of single classes in a school context. The performance evaluation is done by simulating different epidemic dynamics within the class during the five weeks following the day of the first infection. The plans have different costs in terms of number of individual tests required for the screening and are based on recurrent evaluations on all students or subgroups of students in rotation. Especially in scenarios where the rate of contagion is high, at an equal cost, testing half of the class in rotation every week appears to be better in terms of sensitivity than testing all students every two weeks. Similarly, testing one-fourth of the students every week is comparable with testing all students every two weeks, despite the first one is a much cheaper strategy. In the presence of natural clusters in the population, testing subgroups of individuals belonging to the same cluster in rotation may have a better performance than testing all the individuals less frequently. The proposed simulations approach can be extended to evaluate more complex screening plans than those presented in the paper.
Maternal depression and child human capital: A genetic instrumental-variable approach
Authors: Menta Giorgia , Lepinteur Anthony , Clark Andrew E. , Ghislandi Simone , D’Ambrosio Conchita 
Published: February 2021

AbstractWe here address the causal relationship between maternal depression and child human capital using UK cohort data. We exploit the conditionally-exogenous variation in mothers’ genomes in an instrumental-variable approach, and describe the conditions under which mother’s genetic variants can be used as valid instruments. An additional episode of maternal depression between the child’s birth up to age nine reduces both their cognitive and non-cognitive skills by 20 to 45% of a SD throughout adolescence. Our results are robust to a battery of sensitivity tests addressing, among others, concerns about pleiotropy and the maternal transmission of genes to her child.
CD8+ T cell responses in COVID-19 convalescent individuals target conserved epitopes from multiple prominent SARS-CoV-2 circulating variants
Authors: Redd Andrew D , Nardin Alessandra , Kared Hassen , Bloch Evan M , Pekosz Andrew , Laeyendecker Oliver , Abel Brian , Fehlings Michael , Quinn Thomas C , Tobian Aaron AR 
Published: February 2021

AbstractThis study examined whether CD8+ T-cell responses from COVID-19 convalescent individuals(n=30) potentially maintain recognition of the major SARS-CoV-2 variants. Out of 45 mutations assessed, only one from the B.1.351 Spike overlapped with a low-prevalence CD8+ epitope, suggesting that virtually all anti-SARS-CoV-2 CD8+ T-cell responses should recognize these newly described variants.
Surface-aerosol stability and pathogenicity of diverse MERS-CoV strains from 2012 - 2018
Authors: van Doremalen Neeltje , Letko Michael , Fischer Robert J. , Bushmaker Trenton , Yinda Claude Kwe , Schulz Jonathan , Seifert Stephanie N. , Kim Nam Joong , Hemida Maged G , Kayali Ghazi , Park Wan Beom , Perera Ranawaka APM , Tamin Azaibi , Thornburg Natalie J. , Tong Suxiang , Queen Krista , van Kerkhove Maria D. , Choi Young Ki , Oh Myoung-don , Assiri Abdullah M. , Peiris Malik , Gerber Susan I. , Munster Vincent J. 
Published: February 2021

AbstractMiddle East Respiratory Syndrome coronavirus (MERS-CoV) is a coronavirus that infects both humans and dromedary camels and is responsible for an ongoing outbreak of severe respiratory illness in humans in the Middle East. While some mutations found in camel-derived MERS-CoV strains have been characterized, the majority of natural variation found across MERS-CoV isolates remains unstudied. Here we report on the environmental stability, replication kinetics and pathogenicity of several diverse isolates of MERS-CoV as well as SARS-CoV-2 to serve as a basis of comparison with other stability studies. While most of the MERS-CoV isolates exhibited similar stability and pathogenicity in our experiments, the camel derived isolate, C/KSA/13, exhibited reduced surface stability while another camel isolate, C/BF/15, had reduced pathogenicity in a small animal model. These results suggest that while betacoronaviruses may have similar environmental stability profiles, individual variation can influence this phenotype, underscoring the importance of continual, global viral surveillance.