bluuebunny/crossref_metadata_2025_split huggingface dataset:
Registered Nurses’ and Medical Doctors’ Experiences of Patient Safety in Health Information Exchange During Interorganizational Care Transitions: A Qualitative Review
Authors: Hyvämäki Piia , Kääriäinen Maria , Tuomikoski Anna-Maria , Pikkarainen Minna , Jansson Miia 
Published: August 2021

Objective
This systematic review aimed to identify, critically appraise, and synthesize the best available literature on registered nurses’ and medical doctors’ experiences of patient safety in health information exchange (HIE) during interorganizational care transitions.

Methods
The review was conducted according to the JBI methodology for systematic reviews of qualitative evidence. A total of 5 multidisciplinary databases were searched from January 2010 to September 2020 to identify qualitative or mixed methods studies. The qualitative findings were pooled using JBI SUMARI with the meta-aggregation approach.

Results
The final review included 6 original studies. The 53 distinct findings were aggregated into 9 categories, which were further merged into 3 synthesized findings: (1) HIE efficiency and accuracy support patient safety during interorganizational care transitions; (2) inaccuracies in content and structure, along with poor HIE usability, jeopardize patient safety during interorganizational care transitions; and (3) health care professionals’ (HCP) actions in HIE are associated with patient safety during interorganizational care transitions.

Conclusions
The results of this review identified several advantages of HIE, namely, improvements in patient safety based on reduced human error. Nevertheless, a lack of usability and functionality can amplify the effects of human error and increase the risk of adverse events. In addition, HCPs’ individual actions in HIE were found to influence patient safety. Hence, the cognitive and sociotechnical perspectives of work related to HIE should be studied. In addition, HCPs’ experiences of each stage of HIE deployment should be clarified to ensure a high standard of patient safety. Registration: PROSPERO CRD42020220631, registered on November 13, 2020.
Safety of Elderly Fallers: Identifying Associated Risk Factors for 30-Day Unplanned Readmissions Using a Clinical Data Warehouse
Authors: El Abd Asmae , Schwab Camille , Clementz Alice , Fernandez Christine , Hindlet Patrick 
Published: August 2021

Background
Hospital readmissions are a major problem in the older people as they are frequent, costly, and life-threatening. Falls among older adults are the leading cause of injury, deaths, and emergency department visits for trauma.

Objective
The main objective was to determine risk factors associated with a 30-day readmission after index hospital admission for fall-related injuries.

Methods
A retrospective nested case-control study was conducted. Data from elderly patients initially hospitalized for fall-related injuries in 2019, in 11 of the Greater Paris University Hospitals and discharged home, were retrieved from the clinical data warehouse. Cases were admission of elderly patients who subsequently experienced a readmission within 30 days after discharge from the index admission. Controls were admission of elderly patients who were not readmitted to hospital.

Results
Among 670 eligible index admissions, 127 (18.9%) were followed by readmission within 30 days after discharge. After multivariate analysis, men sex (odds ratio [OR] = 2.29, 95% confidence interval [CI] = 1.45–3.61), abnormal concentration of C-reactive protein, and anemia (OR = 2.22, 95% CI = 1.28–3.85; OR = 1.85, 95% CI = 1.11–3.11, respectively) were associated with a higher risk of readmission. Oppositely, having a traumatic injury at index admission decreased this risk (OR = 0.47, 95% CI = 0.28–0.81).

Conclusions
Reducing early unplanned readmission is crucial, especially in elderly patients susceptible to falls. Our results indicate that the probability of unplanned readmission is higher for patients with specific characteristics that should be taken into consideration in interventions designed to reduce this burden.
Morphologic Change of In Vivo Porcine Liver Under 13 mm Hg Pneumoperitoneum Pressure
Authors: Zhang Wenyu , Yin Dalong , Chen Xiaoxia , Zhang Shugeng , Meng Fanzheng , Guo Hongrui , Liang Shuhang , Zhou Shuo , Liu Shuxun , Sun Linmao , Guo Xiao , Luo Huoling , He Baochun , Xiao Deqiang , Cai Wei , Fang Chihua , Liu Lianxin , Jia Fucang 
Published: August 2021

Background:
Clinically, the total and residual liver volume must be accurately calculated before major hepatectomy. However, liver volume might be influenced by pneumoperitoneum during surgery. Changes in liver volume change also affect the accuracy of simulation and augmented reality navigation systems, which are commonly first validated in animal models. In this study, the morphologic changes in porcine livers in vivo under 13 mm Hg pneumoperitoneum pressure were investigated.

Materials and Methods:
Twenty male pigs were scanned with contrast-enhanced computed tomography without pneumoperitoneum and with 13 mm Hg pneumoperitoneum pressure.

Results:
The surface area and volume of the liver and the vascular diameter of the aortic lumen, inferior vena cava lumen, and portal vein lumen were measured. There were statistically significant differences in the surface area and volume of the liver (P=0.000), transverse diameter of the portal vein (P=0.038), longitudinal diameter of the inferior vena cava (P=0.033), longitudinal diameter of the portal vein (P=0.036), vascular cross-sectional area of the inferior vena cava (P=0.028), and portal vein (P=0.038) before and after 13 mm Hg pneumoperitoneum pressure.

Conclusions:
This study indicated that the creation of pneumoperitoneum at 13 mm Hg pressure in a porcine causes liver morphologic alterations affecting the area and volume, as well as the diameter of a blood vessel.
Modified Intraumbilical Versus Infraumbilical Entry Method at Laparoscopy: A Cohort Study
Authors: Cuevas-Toledano Javier-Fernando , Picazo-Yeste Joaquín-Salvelio , Moreno-Sanz Carlos 
Published: August 2021

Background:
There is no consensus on the optimal laparoscopic entry method. Whether a transumbilical or periumbilical incision is beneficial for the initial peritoneal access has been debated. These 2 methods have their own advocates, since each has its own benefits and disadvantages. Furthermore, the lack of consensus extends to the type of entry technique [Hasson, Veress needle (VN), direct trocar]. We have conducted a study comparing a modified intraumbilical technique (MIT), a novel method that combines a VN insertion through a modified direct-trocar access, with the standard infraumbilical VN technique. Our aim is to determine which technique is a better route for the initial umbilical trocar.

Materials and Methods:
A retrospective cohort study of 406 patients from a prospectively maintained database has been performed. Two cohorts of cases have been analyzed (VN=198; MIT=208). Primary outcomes were intraoperative access-related events, entry failure, and long-term wound complications. Clinical follow-up was performed at 1 and 6 months and yearly thereafter.

Results:
Subcutaneous emphysema, extraperitoneal insufflation, and difficult entry (>2 VN insertions) occurred more frequently in the VN group (P=0.011, 0.023, and 0.023, respectively). There were 5 (2.52%) failed entries in the VN group and none in the MIT group (P=0.085). Regarding postoperative complications, seroma of the wound occurred more frequently in the VN group (P=0.033). At a mean follow-up of 18.4 months, 13 (3.20%) trocar-site hernias were detected, equally distributed among both groups.

Conclusions:
MIT eliminates the risk of failed entries and some complications associated with the VN technique without an increase in umbilical wound infection and facilitates a proper closure of the umbilical incision to secure a low trocar-site hernia rate. Halfway between open and closed techniques for laparoscopic entry, MIT is a safe and feasible procedure that embodies the advantages of both methods and may constitute an advantageous alternative to the infraumbilical VN entry approach.
Incidence, prevalence and mortality of anorexia nervosa and bulimia nervosa
Authors: van Eeden Annelies E. , van Hoeken Daphne , Hoek Hans W. 
Published: August 2021

Purpose of review
To review the recent literature on the epidemiology of anorexia nervosa and bulimia nervosa in terms of incidence, prevalence and mortality.

Recent findings
Although the overall incidence rate of anorexia nervosa is considerably stable over the past decades, the incidence among younger persons (aged <15 years) has increased. It is unclear whether this reflects earlier detection or earlier age of onset. Nevertheless, it has implications for future research into risk factors and for prevention programs. For bulimia nervosa, there has been a decline in overall incidence rate over time. The lifetime prevalence rates of anorexia nervosa might be up to 4% among females and 0.3% among males. Regarding bulimia nervosa, up to 3% of females and more than 1% of males suffer from this disorder during their lifetime. While epidemiological studies in the past mainly focused on young females from Western countries, anorexia nervosa and bulimia nervosa are reported worldwide among males and females from all ages. Both eating disorders may carry a five or more times increased mortality risk.

Summary
Anorexia nervosa and bulimia nervosa occur worldwide among females and males of all age groups and are associated with an increased mortality risk.
Child and adolescent mental health services and systems in low and middle-income countries: from mapping to strengthening
Authors: Simelane Simphiwe R.N. , de Vries Petrus J. 
Published: August 2021

Purpose of review
Most of the world's children and adolescents live in low and middle-income countries (LMICs) where mental health services are very limited. Here, we reviewed literature over the last 18 months describing the current landscape of child and adolescent mental health services and systems (CAMHSS) in LMICs, and present findings from systems strengthening research.

Recent findings
The challenges in CAMHSS are well described with little change over the last two decades. Fortunately, research has started to move from ‘mapping’ towards systems ‘strengthening’. Using the WHO Assessment Instrument for Mental Health Systems (WHO-AIMS) framework, we reviewed recent CAMHSS innovations. Clinical care and human resource innovations focused on primary care with validation of screening tools, training and task-sharing for capacity-building. Intersectoral collaboration emerged as a priority domain for strengthening, alongside a theme around the importance of participatory research to inform policy reforms. The potential role of digital technology to strengthen CAMHSS was identified as an emerging theme.

Summary
There is an urgent need to increase the priority of CAMHSS in LMICs. This will require innovations at multiple levels aimed at all CAMHSS domains, with active participation of all relevant local stakeholders to ensure the translation of research into policy and practice.
Anorexia nervosa and comorbid autism spectrum disorders
Authors: Saure Emma , Laasonen Marja , Raevuori Anu 
Published: August 2021

Purpose of review
Traits of autism spectrum disorder (ASD) are overrepresented among individuals with anorexia nervosa (AN) and may also moderate the behavioral manifestation of AN. This review aims to provide an overview of AN and comorbid ASD.

Recent findings
Elevated ASD traits do not seem to precede AN among some individuals but are rather related to the illness stage. However, studies have suggested that there are ASD-specific mechanisms for developing AN in a subgroup of individuals with AN. Pronounced traits of ASD and diagnosed ASD are associated with illness prolongation and poorer outcomes in AN, and individuals with AN and elevated ASD traits may benefit less from many of the current treatments. Studies do not support a specific genetic relationship between ASD and AN.

Summary
Recent research encourages the improved recognition of elevated ASD traits in individuals with AN and provides grounds for developing tailored treatments for those with this comorbidity.
CORONAVIRUS DISEASE 2019 IN A TERTIARY PEDIATRIC CENTER IN PORTUGAL
Authors: Silva Tiago Milheiro , Garcia Ana Margarida , Gouveia Catarina , Candeias Flora , João Brito Maria 
Published: August 2021

AbstractObjectivesDescribe the demographic, clinical, laboratory, and imaging features of SARS-CoV-2 infected children at a tertiary pediatric center in Portugal during the first 6 months of the COVID-19 pandemic.DesignSingle center, descriptive study of pediatric patients, who had a confirmed SARS-CoV-2 infection from March 7 to September 20, 2020.SettingTertiary Pediatric referral center.Patients18 years or younger.Main outcome measuresIncidence, mortality, age of infection, clinical characteristics, treatment prescribed and outcome.ResultsA total of 300 patients were included with a median age of 5 years (IQR 1-11) and in 67% a contact was identified (co-habitant in 52.7%). 56 (18.7%) had pre-existing medical conditions. A mode of three days mediated symptom appearance to diagnose. The most common symptoms were fever (55.7%), cough (38.3%), and nasal congestion (24%). 23% of the patients were admitted due to complications related to COVID-19 and 2% required intensive care. We used drugs with antiviral activity in 9% of the patients, immunomodulatory medication with corticosteroids in 3.3%, and intravenous immunoglobulin in 1.7%. Two (0.6%) children died and 2.3% reported short-term sequelae.ConclusionsCOVID-19 is usually a mild disease in children, but a small proportion of patients develop severe and critical disease. Fatal outcomes were rare overall and exclusive of severe previous medical conditions. Suspecting and diagnosing COVID-19 in children based on their symptoms without epidemiologic information and virus testing is very challenging. Our data also reflect the uncertainties regarding specific treatment options, highlighting that additional data on antiviral and immunomodulatory drugs are urgently needed.
Assessing the impact of adherence to Non-pharmaceutical interventions and indirect transmission on the dynamics of COVID-19: a mathematical modelling study
Authors: Iyaniwura Sarafa A. , Rabiu Musa , David Jummy F. , Kong Jude D. 
Published: August 2021

AbstractAdherence to public health policies such as the non-pharmaceutical interventions implemented against COVID-19 plays a major role in reducing infections and controlling the spread of the diseases. In addition, understanding the transmission dynamics of the disease is also important in order to make and implement efficient public health policies. In this paper, we developed an SEIR-type compartmental model to assess the impact of adherence to COVID-19 non-pharmaceutical interventions and indirect transmission on the dynamics of the disease. Our model considers both direct and indirect transmission routes and stratifies the population into two groups: those that adhere to COVID-19 non-pharmaceutical interventions (NPIs) and those that do not adhere to the NPIs. We compute the control reproduction number and the final epidemic size relation for our model and study the effect of different parameters of the model on these quantities. Our results show that direct transmission has more effect on the reproduction number and final epidemic size, relative to indirect transmission. In addition, we showed that there is a significant benefit in adhering to the COVID-19 NPIs.
Ambulatory Duchenne Muscular Dystrophy Children: Cross-sectional Correlation between Function, Quantitative Muscle Ultrasound and MRI
Authors: Abdulhady Hala , Sakr Hossam M. , Elsayed Nermine S. , El-Sobky Tamer A. , Fahmy Nagia , Saadawy Amr M. , Elsedfy Heba 
Published: August 2021

AbstractIntroduction/AimsDuchenne muscular dystrophy (DMD) is a progressive genetic muscle disease. Quantitative muscle ultrasound (MUS), muscle MRI, and functional tools are important to delineate characteristics of muscle involvement. We aimed to establish correlations between clinical/functional and above-named imaging tools respecting their diagnostic and prognostic role in DMD children.MethodsA Prognostic cross-sectional retrospective study of 27 steroid-naive, ambulant male children/adolescents with genetically-confirmed DMD (mean age, 8.8 ± 3.3 years). Functional performance was assessed using motor function measure (MFM) which assess standing/transfer (D1), proximal (D2) and distal (D3) motor function. And six-minute-walk test (6MWT). Imaging evaluation included quantitative muscle MRI which measured muscle fat content in a specific location of right rectus femoris by mDixon sequence. Quantitative MUS measured muscle brightness in standardized US image as an indicator of muscle fat content.ResultsWe found a highly significant positive correlation between the mean MFM total score and 6MWT (R=0.537, P=0.007). And a highly significant negative correlation between fat content by MUS and MFM total score (R=-0.603, P=0.006) and its D1 subscore (R=-0.712, P=0.001). And a significant negative correlation between fat content by US and 6MWT (R=-0.529, P=0.02). And a significant positive correlation between muscle fat content by mDixon MRI and patient’s age (R=0.617, P=0.01).DiscussionQuantitative MUS correlates significantly with clinical/functional assessment tools as MFM and 6MWT, and augments their role in disease-tracking of DMD. Quantitative MUS has the potential to act as a substitute to functional assessment tools. The role for quantitative muscle MRI in disease-tracking should be further explored after elimination of confounding factors.Graphical abstractDivergent arrows represent negative correlations, while convergent the arrow represents a positive correlation.
Interpreting Wastewater SARS-CoV-2 Results using Bayesian Analysis
Authors: Curtis Kyle , Gonzalez Raul A. 
Published: August 2021

AbstractWastewater surveillance of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has proven a practical complement to clinical data for assessing community-scale infection trends. Clinical assays, such as the CDC-promulgated N1, N2, and N3 have been used to detect and quantify viral RNA in wastewater but, to date, have not included estimates of reliability of true positive or true negative. Bayes’ Theorem was applied to estimate Type I and Type II error rates for detections of the virus in wastewater. Conditional probabilities of true positive or true negative were investigated when one assay was used, or multiple assays were run concurrently. Cumulative probability analysis was used to assess the likelihood of true SARS-CoV-2 detection using multiple samples. Results demonstrate highly reliable positive (>0.86 for priors >0.25) and negative (>0.80 for priors = 0.50) results using a single assay. Using N1 and N2 concurrently caused greater reliability (>0.99 for priors <0.05) when results concurred but generated potentially counterintuitive interpretations when results were discordant. Regional wastewater surveillance data was investigated as a means of setting prior probabilities. Probability of true detection with a single marker was investigated using cumulative probability across all combinations of positive and negative results for a set of three samples. Findings using a low (0.11) and uniformed (0.50) initial prior resulted in high probabilities of detection (>0.95) even when a set of samples included one or two negative results, demonstrating the influence of high sensitivity and specificity values. Analyses presented here provide a practical framework for understanding analytical results generated by wastewater surveillance programs.
Controlled evaLuation of Angiotensin Receptor Blockers for COVID-19 respIraTorY disease (CLARITY): Statistical analysis plan for a randomised controlled Bayesian adaptive sample size trial
Authors: McGree J. M. , Hockham C. , Kotwal S. , Wilcox A. , Bassi A. , Pollock C. , Burrell L. M. , Snelling T. , Jha V. , Jardine M. , Jones M. ,   for the CLARITY Trial Steering Committee
Published: August 2021

SummaryThe CLARITY trial (Controlled evaLuation of Angiotensin Receptor Blockers for COVID-19 respIraTorY Disease) investigates the effectiveness of angiotensin receptor blockers in addition to standard care compared to placebo (in Indian sites) with standard care in reducing the duration and severity of lung failure in patients with COVID-19. The CLARITY trial is a multi-centre, randomised controlled Bayesian adaptive trial with regular planned analyses where pre-specified decision rules will be assessed to determine whether the trial should be stopped due to sufficient evidence of treatment effectiveness or futility. Here we describe the statistical analysis plan for the trial, and define the pre-specified decision rules, including those that could lead to the trial being halted. The primary outcome is clinical status on a 7-point ordinal scale adapted from the WHO Clinical Progression scale assessed at Day 14. The primary analysis will follow the intention-to-treat principle. A Bayesian adaptive trial design was selected because there is considerable uncertainty about the extent of potential benefit of this treatment.Trial registrationClinicalTrials.gov,NCT04394117. Registered on 19 May 2020.https://clinicaltrials.gov/ct2/show/NCT04394117Clinical Trial Registry of India: CTRI/2020/07/026831Version and revisionsVersion 1.0. No revisions.
Rapid spread of a SARS-CoV-2 Delta variant with a frameshift deletion in ORF7a
Authors: Foster Charles S.P. , Rawlinson William D. 
Published: August 2021

AbstractAustralia is currently experiencing COVID-19 outbreaks from infection with SARS-CoV-2 Delta variants (B.1.617.2, AY.3). Analysis of the index case reveals a sub-consensus level of sequencing reads (∼25%) that support a 17-nucleotide deletion in ORF7a (ORF7aΔ17del). ORF7aΔ17del induces a frameshift mutation in ORF7a, which truncates the peptide and potentially leads to reduced suppression of host restriction factor BST-2/CD317/Tetherin. Despite this, the mutation has rapidly become represented at the consensus level in subsequent cases: approximately 72% of SARS-CoV-2 genomes in the Australian outbreak possess ORF7aΔ17del, and 99.7% (1534/1538) of Delta genomes on GISAID with ORF7aΔ17del originate from the current Australian outbreak (5 August 2021). The global abundance of this mutation might be underestimated given the difficulty of variant calling software correctly calling insertion/deletions (indels), the common inability of phylogenetics software to take indels into account, and the tendency of GISAID to not release submissions that contain a frameshift mutation (unless specifically requested). Overall, the rapid increase of persistent ORF7aΔ17del variants is concerning, and suggests either a chance founder effect with a neutral mutation yet to be purged, or that the ORF7aΔ17del mutation provides a direct selective advantage.