bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patient Experience in Obstetrics in a Military Patient Satisfaction Survey: Findings and Recommendations for Improvement
Authors: Marshall-Aiyelawo Kimberley , Gliner Melissa , Pedraza Omar , Beekman Janine , Messinger Seth , Roshwalb Alan 
Published: November 2021

ABSTRACT

Introduction
This study examines the care experience of obstetric patients within the Military Health System and compares them to those of medical and surgical care patients. Specifically, the study seeks to (1) examine how obstetric inpatient experience ratings differ from medical and surgical inpatient experience ratings, (2) understand specific aspects of care that drive overall experience ratings within this population, (3) test whether adherence to nursing practices such as hourly rounding and nurse leader visits affect experience ratings, and (4) describe ways that patient experience information can be presented to healthcare providers to improve performance.

Materials and Methods
Data for this study include Military Health System patient experience survey data (based on the Hospital Consumer Assessment of Healthcare Providers and Systems) collected from 2011 through 2019. Analysis includes data collected from 338,124 patients aged 18 years and older. Our analysis involved z-test comparisons of patient experience measure scores, trend analysis, logistic regression-based driver analysis, and correlations.

Results
Obstetric ratings are generally lower than those of medical and surgical patients; however, they have been improving at a slightly faster rate year over year. Effective nurse communications with patients are a particularly strong driver for improving their overall care experiences, and practices like hourly nurse rounding, nurse leader visits, and nurse–patient shift change conversations are positively correlated with obstetric patient experience ratings.

Conclusions
This study contextualizes how obstetric inpatient experience ratings differ from those of medical and surgical care patients. Healthcare administrators and policymakers should be aware that obstetric patients may have unique needs and expectations that lead to patient experience ratings differing from those of medical and surgical patients. Effective nurse–patient communications, hourly rounding, nurse leader visits, and nurse–patient shift change conversations could be strategies used to improve obstetric experience ratings.
A Descriptive Analysis of Supermassive Transfusion Recipients Among US and Coalition Forces During Combat Operations in Afghanistan and Iraq
Authors: Fisher Andrew D , Lavender Jason S , April Michael D , Hill Ronnie , Bynum James , Schauer Steven G 
Published: November 2021

ABSTRACT

Introduction
Hemorrhage is the leading cause of potentially preventable death on the battlefield. Resuscitation with blood products is essential to restore circulating volume, repay the oxygen debt, and prevent coagulopathy. Massive transfusion (MT) occurs frequently after major trauma; a subset of casualties requires a supermassive transfusion (SMT), and thus, mobilization of additional resources remains unclear.

Materials and Methods
This is a secondary analysis of a previously described dataset from the Department of Defense Trauma Registry. In this analysis, we isolated U.S. and Coalition casualties that received at least 1 unit of packed red blood cells (PRBCs) or whole blood (WB). Given a lack of consensus on the definition of SMT recipients, we included those patients receiving the top quartile of PRBC and WB administered within the first 24 hours following arrival to a military treatment facility.

Results
We identified 25,897 adult casualties from January 1, 2007 to March 17, 2020. Within this dataset, 2,608 (9.0%) met inclusion for this analysis. The median number of total products administered within the first 24 hours was 8 units of PRBC or WB. The upper quartile was 18 units (n = 666). Compared to all other blood product recipients, patients in the SMT cohort had a higher median injury severity score (27 vs 18, P &lt; 0.001), were most frequently injured by explosives (84.9% vs 68.6%, P &lt; 0.001), had a higher mean emergency department (ED) pulse (128 vs 111, P &lt; 0.001), a lower mean systolic blood pressure (122 vs 132 mm Hg, P &lt; 0.001), and a higher mean international normalized ratio (1.68 vs 1.38, P &lt; 0.001). SMT patients experienced lower survival to hospital discharge (85.8% vs 93.3%, P &lt; 0.001).

Conclusions
Compared to all other PRBC and WB recipients, SMT patients experienced more injury by explosives, severe injury patterns, ED vital sign derangements, and mortality. These findings may help identify those casualties who may require earlier aggressive resuscitation. However, more data is needed to define this population early in their clinical course for early identification to facilitate rapid resource mobilization. Identifying casualties who are likely to die within 24 hours compared to those who are likely to survive, may assist in determining a threshold for a SMT.
The Impact of Nosocomial Bloodstream Infections on Mortality: A Retrospective Propensity-Matched Cohort Study
Authors: Petersiel Neta , Sherman Assa , Paul Mical 
Published: November 2021

Abstract

Background
The mortality toll of nosocomial infections drives infection control efforts. We aimed to assess the contemporary mortality associated with nosocomial bloodstream infections (BSIs).

Methods
Retrospective propensity-matched cohort study conducted in 1 hospital in Israel between January 2010–December 2020. Adults &gt;18 years old with nosocomial BSI were matched to controls using nearest neighbor matching of the propensity score for nosocomial BSI. We assessed all-cause mortality at 30 days, 90 days, and survival up to 1 year starting on the BSI day or matched hospital-day among controls; and the functional and cognitive change between admission and discharge using the Norton score among patients discharged alive. Residual differences between matched groups were addressed through Cox regression for 1-year survival.

Results
A total of 1361 patients with nosocomial BSI were matched to 1361 patients without BSI. Matching achieved similar patient groups, with small differences remaining in the Charlson score and albumin and hemoglobin levels. At 90 days, mortality was higher among patients with BSI (odds ratio [OR], 3.36 [95% confidence interval {CI}, 2.77–4.07]). ORs were higher when the BSI was caused by multidrug-resistant bacteria (OR, 5.22 [95% CI, 3.3–8.26]) and with inappropriate empirical antibiotics in the first 24 hours (OR, 3.85 [95% CI, 2.99–4.94]). Following full adjustment, the hazard ratio for 1-year mortality with nosocomial BSI was 2.28 (95% CI, 1.98–2.62). The Norton score declined more frequently among patients with BSI (OR, 2.27 [95% CI, 1.81–2.86]).

Conclusions
Nosocomial BSIs incur a highly significant mortality toll, particularly when caused by multidrug-resistant bacteria. Among hospital survivors, BSIs are associated with functional decline.
In-depth Characterization of Vaccine Breakthrough Infections With SARS-CoV-2 Among Health Care Workers in a Dutch Academic Medical Center
Authors: Rümke Lidewij W , Groenveld Femke C , van Os Yvonne M G , Praest Patrique , Tanja Anniek A N , de Jong Dorien T C M , Symons Jori , Schuurman Rob , Reinders Tessa , Hofstra L Marije , Nierkens Stefan , Thijsen Steven F T , Heron Michiel , Lebbink Robert-Jan , Beekman Jeffrey M , Nijhuis Monique , Wensing Annemarie M J 
Published: November 2021

Abstract
Severe acute respiratory syndrome coronavirus 2 infection after coronavirus disease 2019 vaccination raises concerns about the emergence of vaccine escape variants. Here we characterize 14 breakthrough infections among 5860 fully vaccinated Dutch health care workers ≥14 days after the final dose of vaccination with either BNT162b2, mRNA-1273, or Ad26.COV2.S. These breakthrough infections presented with regular B.1.1.7 (Alpha) and B.1.617.2 (Delta) variants and high viral loads, despite normal vaccine-induced B- and T-cell immune responses detected by live virus neutralization assays and ELISpot. High-risk exposure settings, such as in households, indicate a potential risk of viral transmission despite full vaccination.
Social Cognition Impairments in 22q11.2DS Individuals With and Without Psychosis: A Comparison Study With a Large Population of Patients With Schizophrenia
Authors: Accinni Tommaso , Buzzanca Antonino , Frascarelli Marianna , Carlone Luca , Ghezzi Francesco , Kotzalidis Georgios D , Bucci Paola , Giordano Giulia Maria , Girardi Nicoletta , Panzera Alessia , Montaldo Simone , Fanella Martina , Di Bonaventura Carlo , Putotto Carolina , Versacci Paolo , Marino Bruno , Pasquini Massimo , Biondi Massimo , Di Fabio Fabio 
Published: November 2021

Abstract

Background
22q11.2 Deletion Syndrome (22q11DS) represents one of the most important genetic risk factors for schizophrenia (SCZ) and a reliable biological model to study endophenotypic characters of SCZ. The aim of the study was to investigate Social Cognition impairments in subjects with 22q11.2DS compared to a considerable sample of schizophrenic patients.

Methods
Forty-four individuals with 22q11.2DS (DEL) and 18 patients with 22q11.2DS and psychosis (DEL_SCZ) were enrolled; these groups were compared to 887 patients with schizophrenia (SCZ) and 780 healthy controls (HCs); the latter groups were recruited by the Italian Network for Research on Psychoses (NIRP) to which our Centre took part. Social cognition was evaluated through The Awareness of Social Inference Test (TASIT). A resampling procedure was employed to balance differences in samples size.

Results
All clinical groups (DEL; DEL_SCZ; and SCZ) showed worse performance on TASIT than HCs, except in Sincere scale. No differences between-clinical groups were found, except for Simple Sarcasm, Paradoxical Sarcasm and Enriched Sarcasm scales.

Conclusions
SC was impaired in individuals with 22q11.2DS regardless of psychotic symptomatology, similarly to people with SCZ. Therefore, SC deficits may represent potential endophenotypes of SCZ contributing to the vulnerability to psychosis.
Time-sequential detection of quantitative trait loci and candidate genes underlying the dynamic growth of Salix suchowensis
Authors: Wei Suyun , Yang Guo , Yang Yonghua , Yin Tongming 
Published: November 2021

Abstract
Elucidating the genetic factors underlying long-term biological processes remains challenging since the relevant genes and their effects may vary across different developmental stages. In this study, we carried out a large-scale field trial of the progeny of an F1 full-sib pedigree of Salix suchowensis and measured plant height and ground diameter periodically over a time course of 240 days. With the obtained data, we characterized plant growth rhythms and performed time-sequential analyses of quantitative trait loci underlying the dynamic growth of the plants. The dynamic mapping of quantitative trait loci revealed that stem height and ground diameter were under the control of four quantitative trait loci, and the effects of these quantitative trait loci varied greatly throughout the growth process, in which two quantitative trait loci were found to exert a pleiotropic effect determining the correlation between stem height and ground diameter. The analysis of candidate genes in the target genetic intervals showed that the pleiotropic effect of the two quantitative trait loci arises from the colocalization of genes with independent effects on stem height and ground diameter. Further examination of the expression patterns of the candidate genes indicated that height and circumference growth involve different activities of leaf and cambium tissues. This study provides unprecedented information to help us understand the dynamic growth of plants and presents an applicable strategy for elucidating the genetic mechanism underlying a long-term biological process by using plant growth as an example.
Is osteoarthritis a mitochondrial disease? What is the evidence
Authors: Fernández-Moreno Mercedes , Rego-Pérez Ignacio , Blanco Francisco J. 
Published: November 2021

Propose of review
To summarize the evidence that suggests that osteoarthritis (OA) is a mitochondrial disease.

Recent findings
Mitochondrial dysfunction together with mtDNA damage could contribute to cartilage degradation via several processes such as: (1) increased apoptosis; (2) decreased autophagy; (3) enhanced inflammatory response; (4) telomere shortening and increased senescence chondrocytes; (5) decreased mitochondrial biogenesis and mitophagy; (6) increased cartilage catabolism; (7) increased mitochondrial fusion leading to further reactive oxygen species production; and (8) impaired metabolic flexibility

Summary
Mitochondria play an important role in some events involved in the pathogenesis of OA, such as energy production, the generation of reactive oxygen and nitrogen species, apoptosis, authophagy, senescence and inflammation. The regulation of these processes in the cartilage is at least partially controlled by retrograde regulation from mitochondria and mitochondrial genetic variation. Retrograde regulation through mitochondrial haplogroups exerts a signaling control over the nuclear epigenome, which leads to the modulation of nuclear genes, cellular functions and development of OA. All these data suggest that OA could be considered a mitochondrial disease as well as other complex chronic disease as cancer, cardiovascular and neurologic diseases.
Diesel exhaust exposure and risk of non-Hodgkin lymphoma: a meta-analysis
Authors: Vilardi Valeria , Boffetta Paolo 
Published: November 2021

Objective
We aimed at carrying out a systematic review and meta-analysis of epidemiological studies on the association between occupational and non-occupational exposures to diesel exhaust and risk of non-Hodgkin lymphoma.

Methods
We conducted a systematic search of the literature and identified 16 cohort studies and 7 case-control studies that analyzed non-Hodgkin lymphoma alone or combined with Hodgkin lymphoma or multiple myeloma, from which we extracted 29 independent risk estimates. We performed random-effects meta-analyses for ever-exposure to diesel exhaust, overall and after stratification for outcome and study design.

Results
The meta-relative risk of non-Hodgkin lymphoma was 0.97 (95% confidence interval, 0.93–1.01; P-heterogeneity = 0.43). The meta-relative risk of results of cohort studies was 0.97 (95% confidence interval, 0.94–1.01) that of case-control studies was 1.00 (95% confidence interval, 0.84–1.17). Similar results were obtained when the meta-analysis was restricted to studies that analyzed only non-Hodgkin lymphoma. There was no indication of publication bias.

Conclusion
Our meta-analysis provided no overall evidence of an increased risk of non-Hodgkin lymphoma in subjects exposed to diesel exhausted.
Sutureless Transconjunctival Insertion of Eyelid Weights: A Novel Technique
Authors: Elahi Ebby , Afshin Evan E. , Guthrie Ashley J. , Lo Christopher 
Published: November 2021

Purpose:
To describe a novel surgical technique for implanting eyelid weights via a sutureless transconjunctival approach. In comparison to the traditional supratarsal crease approach, this technique does not involve any external incisions or suture placement. The procedure can reduce surgical time and complications associated with the traditional external approach.

Methods:
This case series includes 13 patients who underwent eyelid weight placement via the transconjunctival approach for paralytic lagophthalmos secondary to facial nerve paralysis (12 patients had unilateral paralysis and 1 patient had bilateral) with a total of 14 eyelid weights placed. The procedures were performed at an outpatient office-based surgical center. All procedures were performed or supervised by the same surgeon. Patients were followed for an average 6-month postoperative period for postoperative complications.

Results:
The sutureless transconjunctival approach to eyelid weight insertion was successful in achieving the desired functional and aesthetic outcomes. Patients undergoing this technique avoided the discomfort of postoperative suture removal. All patients achieved comparable outcomes postoperatively. There were no complications reported across the 13 patients throughout the 6-month postoperative period.

Conclusions:
This case series demonstrates that the transconjunctival approach for metal eyelid weight insertion is practical, relatively easy to perform, and associated with functional outcomes that are comparable to those achieved with the traditional approach, however, without external incision or placement of sutures.
Diagnosis of invasive fungal disease in coronavirus disease 2019: approaches and pitfalls
Authors: White P. Lewis 
Published: November 2021

Purpose of review
This review will comment on the current knowledge for the diagnosis of the main causes of COVID-19-associated invasive fungal disease (IFD); it will discuss the optimal strategies and limitations and wherever available, will describe international recommendations.

Recent findings
A range of secondary IFDs complicating COVID-19 infection have been described and while COVID-19-associated pulmonary aspergillosis was predicted, the presentation of significant numbers of COVID-19-associated candidosis and COVID-19-associated mucormycosis was somewhat unexpected. Given the range of IFDs and prolonged duration of risk, diagnostic strategies need to involve multiple tests for detecting and differentiating various causes of IFD. Although performance data for a range of tests to diagnose COVID-19-associated pulmonary aspergillosis is emerging, the performance of tests to diagnose other IFD is unknown or based on pre-COVID performance data.

Summary
Because of the vast numbers of COVID-19 infections, IFD in COVID-19 critical-care patients represents a significant burden of disease, even if incidences are less than 5%. Optimal diagnosis of COVID-19-associated IFD requires a strategic approach. The pandemic has highlighted the potential impact of IFD outside of the typical high-risk clinical cohorts, given the ever-increasing population at risk of IFD and enhanced surveillance of fungal infections is required.
Beyond antivirals: virus-specific T-cell immunotherapy for BK virus haemorrhagic cystitis and JC virus progressive multifocal leukoencephalopathy
Authors: Nelson Adam S. , Yalamarthi Niveditha , Yong Michelle K. , Blyth Emily 
Published: November 2021

Purpose of review
The clinical manifestations of the polyomaviruses BK and JC in immunocompromised patients include BK virus (BKV) induced haemorrhagic cystitis and nephropathy, and JC virus (JCV) associated progressive multifocal leukoencephalopathy (PML) and are typically a consequence of impaired adaptive immunity in the host. To date, little clinical success has been achieved with antiviral agents or other drug therapies to treat these conditions. Here we review the methods and outcomes of the most recent clinical studies utilising adoptive immunotherapy with BK and/or JC virus-specific T-cells (VST) as either prophylaxis or treatment alternatives.

Recent findings
In the last 12–18 months, several clinical trials have been published in the post-haemopoietic stem cell transplant (HSCT) setting showing good clinical success with the use of VST for treatment of BK viremia ± haemorrhagic cystitis. Between 82 and 100% clinical response has been observed in haemorrhagic cystitis using either third-party or donor-derived VST. The therapy was well tolerated with few cases of graft versus host disease in HSCT recipients, but immune mediated renal allograft loss was observed in one renal transplant recipient. Studies using BKV/JCV VST to treat PML are hindered by few patients who are sufficiently stable to receive VST. In a condition that otherwise carries such poor prognosis, VST were associated with clearance of JC virus, clinical and radiological improvement in some patients. Immune reconstitution inflammatory syndrome was a noted adverse event.

Summary
Restoration of BK and JC virus immunity using VST immunotherapy has shown good clinical outcomes in BKV associated infections. Further evaluation with the administration of VST earlier in the course of disease is warranted for the treatment of BKV associated nephropathy in renal allograft and in JCV PML. In both indications, larger cohorts and standardisation of dosing and outcome measures would be of benefit.
Physical Profile and Epidemiological Analysis of Injuries in a College Athletics Team: A Retrospective Analysis
Authors: Tenorio Pedro Rocha , de Oliveira Santos Jean Kleber , de Melo Mariana Emanuela Higa , Mariano Thaoan Bruno 
Published: November 2021

ABSTRACTIntroductionAthletics is a sport based on natural patterns and activities. As a sport, presents an array of benefices such as the improvement of physical condition and personal interaction, however, is not free of risks such as injuries related to training and competition.ObjectivesAnalyze the physical profile and associated sports injuries in an athletics college team.MethodsSubjects enrolled in a medicine college athletics team from Jan to Oct of 2021 of both genders had their characteristics collected and answered to a survey modified from the “NCAA Injury Surveillance System”.Results31 subjects answer the survey. 65% of the subjects present at least 1 injury, 73.9% of injuries were classified as severe, 0.27 injuries were reported per 1000 hours of exposure. Injured athletes had a practice time 2-fold greater than uninjured athletes. Quadriceps and shin injuries represent 52.17% of the injuries.ConclusionCollege athletics seems to present a high risk of severe sports injuries in the lower body, and the greater risk factor seems to be the practice time.
Development of a mathematical model to predict the health impact and duration of SARS-CoV-2 outbreaks on board cargo vessels
Authors: Ng Kok Yew , Codreanu Tudor A. , Gui Meei Mei , Biglarbeigi Pardis , Finlay Dewar , McLaughlin James 
Published: November 2021

AbstractThe Coronavirus Disease (COVID-19) pandemic has brought significant impact onto the maritime activities worldwide, including disruption to global trade and supply chains. The ability to predict the evolution and duration of a COVID-19 outbreak on cargo vessels would inform a more nuanced response to the event and provide a more precise return-to-trade date. A SEIQ(H)R (Susceptibility-–Exposed–Infected—Quarantine-–(Hospitalisation)—Removed/Recovered) model is developed and fit-tested to simulate the transmission dynamics of COVID-19 on board cargo vessels of up to 60 crew. Due to specific living and working circumstances on board cargo vessels, instead of utilising the reproduction number, we consider the highest fraction of crew members who share the same nationality to quantify the transmissibility of the disease. The performance of the model is verified using case studies based on data collected during COVID-19 outbreaks on three cargo vessels in Western Australia during 2020. The simulations show that the model can forecast the time taken for the transmission dynamics on each vessel to reach their equilibriums, providing informed predictions on the evolution of the outbreak, including hospitalisation rates and duration. The model demonstrates that (a) all crew members are susceptible to infection; (b) their roles on board is a determining factor in the evolution of the outbreak; (c) an unmitigated outbreak could affect the entire crew and continue on for many weeks. The ability to model the evolution of an outbreak, both in duration and severity, is essential to predict outcomes and to plan for the best response strategy. At the same time, it offers a higher degree of certainty regarding the return to trade, which is of significant importance to multiple stakeholders.