bluuebunny/crossref_metadata_2025_split huggingface dataset:
Levels of Evidence Supporting the North American and European Perioperative Care Guidelines for Anesthesiologists between 2010 and 2020: A Systematic Review
Authors: Laserna Andres , Rubinger Daniel A. , Barahona-Correa Julian E. , Wright Noah , Williams Mark R. , Wyrobek Julie A. , Hasman Linda , Lustik Stewart J. , Eaton Michael P. , Glance Laurent G. 
Published: May 2021

Background
Although there are thousands of published recommendations in anesthesiology clinical practice guidelines, the extent to which these are supported by high levels of evidence is not known. This study hypothesized that most recommendations in clinical practice guidelines are supported by a low level of evidence.

Methods
A registered (Prospero CRD42020202932) systematic review was conducted of anesthesia evidence-based recommendations from the major North American and European anesthesiology societies between January 2010 and September 2020 in PubMed and EMBASE. The level of evidence A, B, or C and the strength of recommendation (strong or weak) for each recommendation was mapped using the American College of Cardiology/American Heart Association classification system or the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. The outcome of interest was the proportion of recommendations supported by levels of evidence A, B, and C. Changes in the level of evidence over time were examined. Risk of bias was assessed using Appraisal of Guidelines for Research and Evaluation (AGREE) II.

Results
In total, 60 guidelines comprising 2,280 recommendations were reviewed. Level of evidence A supported 16% (363 of 2,280) of total recommendations and 19% (288 of 1,506) of strong recommendations. Level of evidence C supported 51% (1,160 of 2,280) of all recommendations and 50% (756 of 1,506) of strong recommendations. Of all the guidelines, 73% (44 of 60) had a low risk of bias. The proportion of recommendations supported by level of evidence A versus level of evidence C (relative risk ratio, 0.93; 95% CI, 0.18 to 4.74; P = 0.933) or level of evidence B versus level of evidence C (relative risk ratio, 1.63; 95% CI, 0.72 to 3.72; P = 0.243) did not increase in guidelines that were revised. Year of publication was also not associated with increases in the proportion of recommendations supported by level of evidence A (relative risk ratio, 1.07; 95% CI, 0.93 to 1.23; P = 0.340) or level of evidence B (relative risk ratio, 1.05; 95% CI, 0.96 to 1.15; P = 0.283) compared to level of evidence C.

Conclusions
Half of the recommendations in anesthesiology clinical practice guidelines are based on a low level of evidence, and this did not change over time. These findings highlight the need for additional efforts to increase the quality of evidence used to guide decision-making in anesthesiology.

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CRYSTALENS REPOSITIONING WITH SCLERAL SUTURE TECHNIQUE
Authors: Smiddy William E. 
Published: May 2021

Purpose:
To present a surgical technique that allows rescue (repositioning) of a dislocated Crystalens model intraocular lens using scleral sutures.

Methods:
The surgical technique is described with supplemental video.

Results:
The technique was used in one patient with 3 months of follow-up information. The intraocular lens was well-positioned, and the visual acuity is 20/20, without adverse events.

Conclusion:
Scleral suture techniques for repositioning of the Crystalens offer a suitable alternative to intraocular lens exchange.
Changing Nurse Practitioner Students' Attitudes and Beliefs About Caring for Those With Opioid Use Disorders
Authors: Elliott Kathleen M. , Chin Elizabeth , Gramling Kathryn Louise , Sethares Kristen A. 
Published: May 2021

Abstract

Purpose
Nurse practitioners (NPs) are in a unique position to address the problem of opioid use disorders (OUDs) because they provide a large percentage of primary care services (Agency for Healthcare Research and Quality, 2014). This study aimed to increase doctoral NP students' beliefs/attitudes about their ability to care for and about individuals with OUDs through a multifaceted educational approach, guided by social cognitive theory.

Methods
Researchers used a quasi-experimental pre/post design. Five doctoral students attended lectures and 16 hours of direct clinical exposure to individuals with OUDs at a medication-assisted treatment center. The 22-item Drug and Drug Problems Perception Questionnaire examined students' attitudes toward individuals with OUDs before and after receiving this multifaceted education. Students completed reflective writings. Descriptive statistics and effect sizes were computed, and reflective writings were reviewed.

Results
Changes in Drug and Drug Problems Perception Questionnaire scores before and after intervention showed a fairly large effect size. This suggests that the intervention may have clinical significance for practice and is likely to attain statistical significance with a larger sample size. Greatest changes occurred in students' perceptions of role adequacy and self-esteem scores, indicative of higher self-efficacy. Measured score increases correspond to increases in confidence, knowledge, and skills to therapeutically engage with this population.

Conclusion
Doctoral NP students had more positive attitudes and beliefs about individuals with OUDs after the multifaceted intervention. Enhancement of self-esteem and adequacy in the caregiver role for this population were promising signals that education can reduce stigma. Further study is warranted with a larger and more diverse sample.
The Missing Link
Authors: Danda Michelle C. 
Published: May 2021

Abstract
Harm reduction is becoming integrated into the hospital setting, yet there is a dearth of published academic literature on the topic of harm reduction in mental health nursing practice. No results were found in a literature search focused specifically on harm reduction policies in the inpatient psychiatric settings using the databases CINAHL, Google Scholar, and PubMed. The purpose of this article was to provide a historical overview of harm reduction in Canadian nursing from 1998 to 2018. The aim was to help direct care nurses, educators, and administrators understand past and present trends and to identify future possibilities for integration in inpatient mental health care. A historical perspective was used to identify and explore Canadian harm reduction literature published from 1998 to 2018 to establish the significance to inform nursing practice. The exploration began with a brief description of outreach nursing in early Canada. Focus shifted to the human immunodeficiency virus/acquired immunodeficiency syndrome epidemic of the 1980s and 1990s, on to the 2000s when a broader lens of harm reduction was adopted, looking beyond the goal of reducing sexually transmitted illnesses. Literature published in the mid-2000s focused on marginalized populations, highlighting the connection between ethical practice and harm reduction philosophy. At the beginning of the 2010s, the Canadian Nursing Association released position statements that explicitly identified the role of harm reduction in nursing practice. Toward the end of the 2010s, the opioid overdose crisis promoted harm reduction nurses taking a broader focus, entering the hospital settings.
Situations That Lead Women to Seek Treatment for Drug Addiction
Authors: Moll Marciana F. , Santos Vanessa O. , Duarte Cleudiane F. , Silva Paulline S. , Ventura Carla A. A. 
Published: May 2021

Abstract

Introduction
Investigating the situations that lead women to seek treatment for drug addiction is necessary, as women experience the organic, social, and family damage caused by addiction intensely.

Objective
The aim of this study was to describe situations that lead women to seek treatment for drug addiction.

Method
This is an exploratory, descriptive study, with a qualitative approach, carried out in a CAPS Ad service in the state of Minas Gerais (CAAE: 92864518.4.0000.5145). Open interviews were conducted in September 2018 with 24 of 28 women assisted by the service. The discourse of the collective subject was the basis of the data analysis.

Results
Social, family, and health problems were the main damaging impact of drug addiction among the women and were represented by the following: death of loved ones, violence from partners, theft, cognitive problems, hypertension, and diabetes. Specifically, it was affective and material losses experienced during the period of addiction that led the women to seek treatment.

Final Considerations
It is necessary to facilitate women's access to treatment for drug addiction and to incorporate their families into the treatment through activities that will reinforce the former's commitment to any proposed therapeutics; in addition, goals to reconstruct bonds within the family environment should be established.
Residual SYNTAX II Score and long-term outcomes post-ST-elevation myocardial infarction in an urban US cohort: the Montefiore STEMI Registry
Authors: Bortnick Anna E. , Shitole Sanyog G. , Hashim Hayder , Khullar Pankaj , Park Michael , Weinreich Michael , Seibert Stephen , Rauch Judah , Weisz Giora , Kizer Jorge R. 
Published: May 2021

Background
Higher residual anatomic disease was associated with increased mortality in a recent randomized controlled trial of revascularization after ST-elevation myocardial infarction (STEMI). Less is known about the impact of residual disease post-STEMI in race-ethnic minorities.

Methods
Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery (SYNTAX)- II (SS-II) score is an established scoring method for anatomic disease and prevalent co-morbidities to describe patient complexity. We evaluated residual (r) SS-II in 165 patients from a single center urban US registry (n = 1208) presenting for primary percutaneous coronary intervention of STEMI and treated for 3-vessel or left main and any combination of 0, 1, 2 or 3-vessel disease.

Results
The median age was 62 years (IQR 52–70), 29.1% women, 44.9% Hispanic/Latino and 19.4% non-Hispanic Black. Over median of 4.9 years (IQR 2.9–6.3), higher rSS-II was associated with increased death [hazard ratio 2.46 per SD increment in log rSS-II (~five-fold increment on the original scale) 95% CI 1.51, 3.99], death or all-cause readmission (hazard ratio 1.37 per SD increment in log rSS-II 95% CI, 1.11–1.70) and death or cardiovascular disease readmission (hazard ratio 1.46 per SD increment in log rSS-II 95% CI, 1.14–1.88). rSS-II was higher in older women with more co-morbidities, but not different by race-ethnicity.

Conclusions
In summary, higher rSS-II was associated with long-term outcomes post-STEMI in a prospective urban, minority cohort, suggesting a potential role for risk stratification with this measure in a non-trial setting.
Performance Measurement Outcomes: An Analysis of Health Care–Associated Infections in New York State
Authors: Pitocco Christine , Lewis Herbert F. , Liu Jonathan 
Published: May 2021

Background and Objectives:
Comparing outcome measures in health care is a relatively common practice. Reports are designed to compare hospital infection rates in an accurate and fair manner. The current methodology used by New York State (NYS) has some limitations and flaws. This research provides a methodology that overcomes these limitations and flaws.

Methods:
The methodology is a replication study using data from NYS and includes the use of the binomial and Poisson distribution to calculate upper tail (UTP) and lower tail probabilities (LTP). The UTP is used to screen for poor performers, and the LTP is used to screen for good performers.

Results:
The results we obtained using the tail probability method compared with NYS's confidence interval approach are similar across all health care–associated infection (HAI) categories but have the benefit of allowing for the analysis of any hospital regardless of the number of procedures, number of central line-days, or number of patient-days. In addition, we provide an evaluation of a hospital's performance over time where we identified hospitals that were consistently performing poorly and others consistently performing well.

Conclusion:
Identifying hospitals that are consistently performing poorly and hospitals consistently performing well will allow administrators and clinicians to focus their efforts including budgetary to where improvements are needed. Patient care and the reduction of HAIs are a priority for health care institutions. While the results are similar to those reported by NYS, this approach can be used more comprehensively and can be interpreted more easily by administrators and practitioners. Health care administrators and clinicians may find the information useful to address infection rates. Hospitals consistently performing well may be used as a benchmark.
COVID-19 vaccination in California: Are we equitable yet?
Authors: Schmidt Alec J. , Daza-Torres Maria L. , García Yury E. , Ashby Joan L. , Pollock Bradley H. , Sharpnack James , Nuño Miriam 
Published: May 2021

AbstractBackgroundBy March 2021, California had one of the least equitable COVID-19 vaccine distribution programs in the US. To rectify this, Governor Newsom ordered 4 million vaccine doses be reserved for the census tracts in the lowest quartile of the Healthy Places Index (HPI). California plans to lift state-wide restrictions on June 15th, 2021, as long as test positivity and vaccine equity thresholds are met in the state’s most vulnerable neighborhoods. This short investigation examines current vaccine equity and forecasts where California can expect to be when the economy fully reopens.MethodsCurrent vaccine equity was investigated with simple linear regression between the county mean HPI and both single and full-dose vaccination rate. Future vaccination coverage per county were predicted using a compartmental mathematical model based on the average rate over the previous 30 days with four different rate-change scenarios.ResultsCounty mean HPI had a strong positive association with both single and full dose vaccination rates (R2: 0.716 and 0.737, respectively). We predict the overall state rate will exceed 50% fully vaccinated by June 15th if the current rates are maintained; however, the bulk of this coverage comes from the top 18 counties while the remaining 40 counties lag behind.DiscussionThe clear association between county HPI and current vaccination rates shows that California is not initiating opening plans from an equitable foundation, despite previous equity programs. If nothing changes, many of the most vulnerable counties will not be prepared to open without consequences come June 15th.
A ratiometric dual-color luciferase reporter for fast characterization of transcriptional regulatory elements
Authors: González-Grandío E. , Demirer G. S. , Ma W. , Brady S.M. , Landry M.P. 
Published: May 2021

AbstractPlant synthetic biology requires precise characterization of genetic elements to construct complex genetic circuits that can improve plant traits or confer them new characteristics. Transcriptional reporter assays are essential to quantify the effect of gene expression regulator elements. Therefore, transcriptional reporter systems are a key tool in understanding control of gene expression in biology.In this work we construct and characterize a dual-color luciferase ratiometric reporter system that possesses several advantages over currently used reporters. It is ratiometric, reducing variability and increasing consistency between experiments; it is fast, as both reporters can be measured at the same time in a single reaction, and it is cheaper to perform than current dual-luciferase reporter assays. We have validated our system quantifying the transcriptional capability of a panel of promoters and terminators commonly used in synthetic biology with a broad range of expression magnitudes, and in a biologically relevant system, nitrate response.
KIR gene content imputation from single-nucleotide polymorphisms in the Finnish population
Authors: Ritari Jarmo , Hyvärinen Kati , Partanen Jukka , Koskela Satu 
Published: May 2021

AbstractThe killer cell immunoglobulin-like receptor (KIR) gene cluster on chromosome 19 encodes cell surface glycoproteins that bind class I human leukocyte antigen (HLA) molecules as well as some other ligands. Through regulation of natural killer (NK) cell activity KIRs participate in tumour surveillance and clearing viral infections. KIR gene gene copy number variation associates with the outcome of transplantations and susceptibility to immune-mediated diseases. Inferring KIR gene content from genetic variant data is therefore desirable for immunogenetic analysis, particularly in the context of growing biobank genome data collections that rely on genotyping by microarray. Here we describe a stand-alone and freely available gene content imputation for 12 KIR genes. The models were trained using 818 Finnish biobank samples genotyped for 5774 KIR-region SNPs and analysed for KIR gene content with targeted sequencing. Cross-validation results demonstrate a high mean overall accuracy of 99.2% (95% CI: 97.8-99.7%) which compares favourably with previous methods including short-read sequencing based approaches.
Coral: a web-based visual analysis tool for creating and characterizing cohorts
Authors: Adelberger Patrick , Eckelt Klaus , Bauer Markus J. , Streit Marc , Haslinger Christian , Zichner Thomas 
Published: May 2021

AbstractSummaryA main task in computational cancer analysis is the identification of patient subgroups (i.e., cohorts) based on metadata attributes (patient stratification) or genomic markers of response (biomarkers). Coral is a web-based cohort analysis tool that is designed to support this task: Users can interactively create and refine cohorts, which can then be compared, characterized, and inspected down to the level of single items. Coral visualizes the evolution of cohorts and also provides intuitive access to prevalence information. Furthermore, findings can be stored, shared, and reproduced via the integrated session management. Coral is pre-loaded with data from over 128,000 samples from the AACR Project GENIE, The Cancer Genome Atlas, and the Cell Line Encyclopedia.Availability and ImplementationCoral is publicly available at https://coral.caleydoapp.org. The source code is released at https://github.com/Caleydo/coral.Contactthomas.zichner@boehringer-ingelheim.comSupplementary informationSupplementary data are available at Bioinformatics online.
Cingulate-motor circuits update rule representations for sequential choice decisions
Authors: Takeuchi Daigo , Roy Dheeraj , Muralidhar Shruti , Kawai Takashi , Lovett Chanel , Sullivan Heather A. , Wickersham Ian R. , Tonegawa Susumu 
Published: May 2021

AbstractAnterior cingulate cortex mediates the flexible updating of an animal’s choice responses upon rule changes in the environment. However, how anterior cingulate cortex entrains motor cortex to reorganize rule representations and generate required motor outputs remains unclear. Here, we demonstrate that chemogenetic silencing of the projection terminals of cingulate cortical neurons in secondary motor cortex disrupted sequential choice performance in trials immediately following rule switches, suggesting that these inputs are necessary to update rule representations for choice decisions stored in the motor cortex. Indeed, the silencing of cingulate cortex decreased rule selectivity of secondary motor cortical neurons. Furthermore, optogenetic silencing of cingulate cortical neurons that was temporally targeted to error trials immediately after rule switches exacerbated errors in following trials. These results suggest that cingulate cortex monitors behavioral errors and update rule representations in motor cortex, revealing a critical role for cingulate-motor circuits in adaptive choice behaviors.
Early Covid-19 Treatment With SARS-CoV-2 Neutralizing Antibody Sotrovimab
Authors: Gupta Anil , Gonzalez-Rojas Yaneicy , Juarez Erick , Casal Manuel Crespo , Moya Jaynier , Falci Diego Rodrigues , Sarkis Elias , Solis Joel , Zheng Hanzhe , Scott Nicola , Cathcart Andrea L. , Hebner Christy M. , Sager Jennifer , Mogalian Erik , Tipple Craig , Peppercorn Amanda , Alexander Elizabeth , Pang Phillip S. , Free Almena , Brinson Cynthia , Aldinger Melissa , Shapiro Adrienne E. ,   for the COMET-ICE Investigators
Published: May 2021

AbstractBackgroundCoronavirus disease 2019 (Covid-19) disproportionately results in hospitalization and death in older patients and those with underlying comorbidities. Sotrovimab is a pan-sarbecovirus monoclonal antibody designed to treat such high-risk patients early in the course of disease, thereby preventing Covid-19 progression.MethodsIn this ongoing, multicenter, double-blind, phase 3 trial, nonhospitalized patients with symptomatic Covid-19 and at least one risk factor for disease progression were randomized (1:1) to an intravenous infusion of sotrovimab 500 mg or placebo. The primary efficacy endpoint was the proportion of patients with Covid-19 progression, defined as hospitalization longer than 24 hours or death, through day 29.ResultsIn this preplanned interim analysis, which included an intent-to-treat population of 583 patients (sotrovimab, 291; placebo, 292), the primary efficacy endpoint was met. The risk of Covid-19 progression was significantly reduced by 85% (97.24% confidence interval, 44% to 96%; P = 0.002) with a total of three (1%) patients progressing to the primary endpoint in the sotrovimab group versus 21 (7%) patients in the placebo group. All five patients admitted to intensive care, including one who died by day 29, received placebo. Safety was assessed in 868 patients (sotrovimab, 430; placebo, 438). Adverse events were reported by 17% and 19% of patients receiving sotrovimab and placebo, respectively; serious adverse events were less common with sotrovimab (2%) versus placebo (6%).ConclusionSotrovimab reduced progression of Covid-19 in patients with mild/moderate disease, was well tolerated, and no safety signals were identified.Funded by Vir Biotechnology, Inc. and GlaxoSmithKline; ClinicalTrials.govNCT04545060
Physachenolide C induces complete regression of established murine melanoma tumors via apoptosis and cell cycle arrest
Authors: Adams Anngela C. , Macy Anne M. , Kang Paul , Castro-Ochoa Karla F. , Wijeratne E. M. Kithsiri , Xu Ya-Ming , Liu Manping X. , Charos Alexandra , Bosenberg Marcus W. , Gunatilaka A. A. Leslie , Sertil Aparna R. , Hastings K. Taraszka 
Published: May 2021

AbstractMelanoma is an aggressive skin cancer that metastasizes to other organs. While immune checkpoint blockade with anti-PD-1 has transformed the treatment of advanced melanoma, many melanoma patients fail to respond to anti-PD-1 therapy or develop acquired resistance. Thus, effective treatment of melanoma still represents an unmet clinical need. Our prior studies support the anti-cancer activity of the 17β-hydroxywithanolide class of natural products, including physachenolide C (PCC). As single agents, PCC and its semi-synthetic analog demonstrated direct cytotoxicity in a panel of murine melanoma cell lines, which share common driver mutations with human melanoma; the IC50 values ranged from 0.18 – 1.7 µM. PCC treatment induced apoptosis of tumor cells both in vitro and in vivo. In vivo treatment with PCC alone caused the complete regression of established melanoma tumors in all mice, with a durable response in 33% of mice after discontinuation of treatment. T cell-mediated immunity did not contribute to the therapeutic efficacy of PCC or prevent tumor recurrence in YUMM2.1 melanoma model. In addition to apoptosis, PCC treatment induced G0-G1 cell cycle arrest of melanoma cells, which upon removal of PCC, re-entered the cell cycle. PCC-induced cycle cell arrest likely contributed to the in vivo tumor recurrence in a portion of mice after discontinuation of treatment. Thus, 17β-hydroxywithanolides have the potential to improve the therapeutic outcome for patients with advanced melanoma.