bluuebunny/crossref_metadata_2025_split huggingface dataset:
Novel Web-Based Music Re-Engineering Software for Enhancement of Music Enjoyment Among Cochlear Implantees
Authors: Hwa Tiffany Peng , Tian Lisa Likun , Caruana Francesco , Chun Michael , Mancuso Dean , Cellum Ilana P. , Lalwani Anil K. 
Published: July 2021

Objectives:
Cochlear implant (CI) listeners experience diminished music perception and enjoyment from a variety of patient-related and implant-related factors. We investigate the hypothesis that patient-directed music re-engineering may enhance music enjoyment with CI.

Study Design:
Prospective cohort study.

Setting:
Academic cochlear implant center.

Subjects and Methods:
A multidisciplinary team of neurotologists, audiologists, and a sound/audio engineer collaborated with a web developer to create a music re-engineering application. Experienced adult CI listeners rated original excerpts from five major genres of music on enjoyment using a visual analog scale (VAS). Subjects were then allowed to re-engineer the original by adjusting treble frequencies, bass frequencies, percussion emphasis, and reverberation and again rated on enjoyment.

Results:
Total of 46 subjects, with a mean age of 57.6 years (SD = 16; range, 18–90) participated in the study. User-mixed audio was rated higher across all measures of enjoyment than original recordings (mean difference +0.92; p < 0.05, CI [0.22, 1.62]), an effect that was seen across all genres except for country music. Subjects preferred louder bass frequencies (mean difference +7.1 dB; p < 0.01, CI [2.15, 24.3]) and more reverberation (mean difference +6.6 ms; p < 0.01, CI [2.85, 10.7]). Re-engineered music increased enjoyment in 57%, and 79% reported an interest in being able to mix music of their own choosing.

Conclusion:
User-directed music re-engineering increases music enjoyment for CI listeners. The cochlear implantee preferred heightened bass, reverberation, and treble across musical genres. These findings support the implementation of patient-directed music re-engineering to enhance music enjoyment with technology that is readily available today.
Update on the management of penile and meatal strictures
Authors: Vetterlein Malte W. , Fisch Margit M. , Zumstein Valentin 
Published: July 2021

Purpose of review
Treatment of penile and distal urethral strictures including the fossa navicularis and the meatus remains challenging due to their adverse etiology and lack of ventral tissue support. In this contemporary review, we summarize the available evidence and recent advancements in reconstructive techniques.

Recent findings
Over the last years, several refinements of already established techniques have been added to the reconstructive armamentarium in the management of penile urethral strictures. These include the single-stage combination of flap and graft, the additional use of tissue glue, or an optimized single-stage tubularization using a free graft.

Summary
There is a shift toward an increased use of single-stage procedures even in complex strictures of the penile and distal urethra. This is reflected by advancements and refinements in operative techniques. Nonetheless, staged urethroplasty remains a cornerstone of curative management in such patients with durable success rates. Future research should focus on identifying distinct patient and stricture characteristics to determine the individual therapeutic approach with optimal functional outcomes.
Vascular Complications in Pediatric Pancreatitis: A Case Series
Authors: Dike Chinenye R. , Cress Gretchen , Fishman Douglas S. , Gonska Tanja , Ooi Chee Y. , Perito Emily R. , Troendle David , Tsai Cynthia M. , Lowe Mark E. , Uc Aliye 
Published: July 2021

ABSTRACT
We reviewed INSPPIRE (International Study Group of Pediatric Pancreatitis: In Search for a Cure) database for splanchnic venous thrombosis or arterial pseudoaneurysms to determine the incidence, risk factors and outcomes of peripancreatic vascular complications in children with acute recurrent pancreatitis (ARP) or chronic pancreatitis (CP). Of 410 children with diagnostic imaging studies, vascular complications were reported in five (1.2%); two had ARP, three CP. The vascular events were reported during moderately severe or severe acute pancreatitis (AP) in four, mild AP in one. Venous thrombosis occurred in four, arterial pseudoaneurysm (left gastric artery) in one. Two patients with venous thrombosis were treated with anticoagulant, one achieved recanalization (splenic vein). In two patients who did not receive anticoagulants, one re-canalized. No adverse effects were observed with anticoagulants. The child with pseudoaneurysm underwent aneurysmal coiling. Anti-coagulants appear to be safe in children with acute pancreatitis, their long-term benefit needs to be further investigated.
A Quality Approach to Reducing the Occurrence of Occluded Leukocyte Reduction Filters During Platelet Transfusion
Authors: Wongsa Cory , Ghiyassi Nava , Cornelius Marah , Villamin Colleen , Tomczak Nancy , Bates Tonita 
Published: July 2021

Background:
In 2019, an increase in clotted platelet filter occurrences was noted with the implementation of new leukocyte reduction filters through a volumetric pump.

Local Problem:
Occluded platelet filters contribute to delays in platelet transfusions, additional nursing workflows, and potential wastage of platelets, leading to staff and patient dissatisfaction.

Methods:
Direct observation of nursing practice with priming platelet filters identified opportunities for improvement. Education was designed incorporating manufacturer recommendations with results of the observations. Nursing education was disseminated through small group sessions, one-to-one teaching, tip sheets, and an e-learning video.

Results:
Nursing education interventions resulted in a 170% reduction in the reported monthly filter occlusion rate.

Conclusion:
Engagement of nurses in quality improvement processes and collaboration across departments led to a sustained decrease in the clotted platelet filters.
Nursing Interventions Increase Influenza Vaccination Quality Measures for Home Telehealth Patients
Authors: Rand Maxine L. 
Published: July 2021

Background:
Influenza vaccinations are a preventive health quality measure. Home telehealth nursing staff interventions can reduce influenza disease burden and complications.

Purpose:
To improve seasonal flu vaccine rates using novel home telehealth clinical and technology interventions.

Methods:
A pre- and postintervention concurrent cohort study for 513 outpatients was conducted. Interventions included automated 2-way patient messaging using remote monitoring equipment, a new note template to record vaccination status in the electronic health record, and flu vaccine patient education.

Results:
Interventions resulted in vaccination rates of 70.4% for Veterans ages 19 to 65 years, and 81.7% for Veterans 66 years and older, exceeding national, regional, and local Veterans Administration targets.

Conclusions:
Two-way messaging and standardized documentation increased rates. Declinations persisted despite education. Reasons included fear of side effects, and rarely leaving home due to the COVID-19 pandemic. Nursing interventions can increase influenza vaccination quality measures for primary care home telehealth patients.
Geographic Distance to Extracorporeal Life Support Centers for Pediatric Patients Within the Continental United States
Authors: Farr Bethany J. , McEvoy L. T. Christian S. , Ross-Li Dan , Rice-Townsend Samuel E. , Ricca Robert L. 
Published: July 2021

OBJECTIVES:
Distance to subspecialty surgical care is a known impediment to the delivery of high-quality healthcare. Extracorporeal life support is of benefit to pediatric patients with specific medical conditions. Despite a continued increase in the number of extracorporeal life support centers, not all children have equal access to extracorporeal life support due to geographic constraints, creating a potential disparity in healthcare. We attempted to better define the variation in geographic proximity to extracorporeal life support centers for pediatric patients using the U.S. Decennial Census.

DESIGN:
A publicly available listing of voluntarily reporting extracorporeal life support centers in 2019 and the 2010 Decennial Census were used to calculate straight-line distances between extracorporeal life support zip code centroids and census block centroids. Disparities in distance to care associated with urbanization were analyzed.

SETTING:
United States.

PATIENTS:
None.

INTERVENTIONS:
Large database review.

MEASUREMENTS AND MAIN RESULTS:
There were 136 centers providing pediatric extracorporeal life support in 2019. The distribution varied by state with Texas, California, and Florida having the most centers. Over 16 million children (23% of the pediatric population) live greater than 60 miles from an extracorporeal life support center. Significant disparity exists between urban and rural locations with over 47% of children in a rural setting living greater than 60 miles from an extracorporeal life support center compared with 17% of children living in an urban setting.

CONCLUSIONS:
Disparities in proximity to extracorporeal life support centers were present and persistent across states. Children in rural areas have less access to extracorporeal life support centers based upon geographic distance alone. These findings may affect practice patterns and treatment decisions and are important to the development of regionalization strategies to ensure all children have subspecialty surgical care available to them, including extracorporeal life support.
Communication Patterns During Routine Patient Care in a Pediatric Intensive Care Unit: The Behavioral Impact of In Situ Simulation
Authors: Ulmer Francis F. , Lutz Andrea M. , Müller Fabienne , Riva Thomas , Bütikofer Lukas , Greif Robert 
Published: July 2021

Objective
Effective communication minimizes medical errors and leads to improved team performance while treating critically ill patients. Closed-loop communication is routinely applied in high-risk industries but remains underutilized in healthcare. Simulation serves as an educational tool to introduce, practice, and appreciate the efficacy of closed-loop communication.

Methods
This observational before-and-after study investigates behavioral changes in communication among nurses brought on by simulation team training in a pediatric intensive care unit (PICU). The communication patterns of PICU nurses, who had no prior simulation experience, were observed during routine bedside care before and after undergoing in situ simulation.
One month before and 1 and 3 months after simulation (intervention), 2 trained raters recorded nurse communications relative to callouts, uttered by the sender, and callbacks, reciprocated by the recipient. The impact of simulation on communication patterns was analyzed quantitatively.

Results
Among the 15 PICU nurses included in this study, significant changes in communication behavior were observed during patient care after communication-focused in situ simulation. The PICU nurses were significantly less likely to let a callout go unanswered during clinical routine. The effect prevailed both 1 month (P = 0.039) and 3 months (P = 0.033) after the educational exposure.

Conclusions
This observational before-and-after study describes the prevalence and pattern of communication among PICU nurses during routine patient care and documents PICU nurses transferring simulation-acquired communication skills into their clinical environment after a single afternoon of in situ simulation. This successful transfer of simulation-acquired skills has the potential to improve patient safety and outcome.
Late-phase dominance of a single epitope-specific CD8+ T-cell response in passive neutralizing antibody-infused simian immunodeficiency virus controllers
Authors: Kanno Yoshiaki , Hau Trang Thi Thu , Kurokawa Rise , Nomura Takushi , Nishizawa Masako , Matano Tetsuro , Yamamoto Hiroyuki 
Published: July 2021

Objective:
Analysis of the quantity and quality of epitope-specific CD8+ T-cell responses is crucial for understanding the mechanism of HIV/simian immunodeficiency virus (SIV) replication control. We have previously shown that acute-phase passive infusion of neutralizing antibodies (NAbs) results in augmented broad T-cell responses and robust SIVmac239 control in rhesus macaques. Analyzing long-term dynamics of CD8+ T-cell responses in these SIV controllers provides important insights into designing lasting anti-HIV immunity.

Design:
We analyzed dynamics and metabolic/functional profiles of SIV-specific CD8+ T-cell responses in rhesus macaques that controlled SIVmac239 replication following acute-phase passive NAb infusion.

Methods:
SIV epitope-specific CD8+ T-cell responses in peripheral blood at multiple chronic-phase time points were investigated in four passive NAb-infused SIV controllers. In particular, expression patterns of Eomesodermin (Eomes), phosphorylated AMP kinase (pAMPK), CD28 and programmed death-1 (PD-1) were examined.

Results:
In the NAb-infused SIV controllers, a single epitope-specific CD8+ T-cell response detected from acute infection and maintaining low levels up to year 1 showed a surge thereafter, up to year 2 postchallenge. Retention of an effector-skewed and unexhausted Eomes-high/pAMPK-low/CD28-negative/PD-1-low subpopulation in these epitope-specific CD8+ T cells implicated their front-line commitment in residual viral replication control.

Conclusion:
In long-term SIV control following acute-phase passive NAb infusion, a single-epitope, high-quality CTL response was dominantly induced in the chronic phase. These results likely describe one favorable pattern of immunodominant epitope-specific CD8+ T-cell preservation and suggest the importance of incorporating metabolic marker signatures for understanding NAb/T-cell synergism-based HIV/SIV control.
A Novel Technique of Negative Pressure Wound Therapy for Pharyngeal Cutaneous Fistulas Around Tracheostomas
Authors: Kashimura Tsutomu , Yoshida Kotoku , Soejima Kazutaka 
Published: July 2021

Abstract
Fistula formation after free jejunal transplantation is relatively common; however, treating esophago-jejunal anastomosis fistulas is difficult. Herein, the authors report a case of esophago-jejunal anastomosis fistula adjacent to the permanent tracheostoma after free jejunal transplantation that was closed using negative pressure wound therapy (NPWT). A 70-year-old man underwent total pharyngo-laryngo-cervical esophagectomy and free jejunal transplantation for hypopharyngeal cancer. After reconstruction, an esophago-jejunal anastomosis fistula developed on the permanent tracheostoma margin. The fistula was sutured, but it recurred. Therefore, NPWT was performed to close the fistula via the bridge method and balloon compression using a tracheal cannula. NPWT requires the maintenance of local negative pressure. However, esophago-jejunal anastomosis fistula formation after free jejunal transplantation makes this difficult because of the unevenness of the permanent tracheostoma and moist surface of the tracheal mucosa. NPWT performed using the bridge method and balloon compression is an effective option for fistula treatment.
High-sensitivity Cardiac Troponin Is Not Associated With Acute Cellular Rejection After Heart Transplantation
Authors: Fitzsimons Sarah J. , Evans Jonathan D. W. , Rassl Doris M. , Lee Kuan Ken , Strachan Fiona E. , Parameshwar Jayan , Mills Nicholas L. , Pettit Stephen J. 
Published: July 2021

Background.
Acute cellular rejection (ACR) is common in the first year after cardiac transplantation, and regular surveillance endomyocardial biopsy (EMB) is required. An inexpensive, simple noninvasive diagnostic test would be useful. Prior studies suggest cardiac troponin (cTn) has potential as a “rule-out” test to minimize the use of EMB. Our aim was to determine whether a new high-sensitivity cardiac troponin I (hs-cTnI) assay would have utility as a “rule-out” test for ACR after heart transplantation.

Methods.
Blood samples at patient follow-up visits were collected and stored over a period of 5 y. Serum cTnI concentrations were measured using the ARCHITECT
STAT
hs-cTnI assay and compared with an EMB performed on the same day. Receiver-operator curve analysis based on mixed-effects logistic regression models that account for repeated measurements in individuals was performed to determine a serum troponin level below which ACR could be reliably excluded.

Results.
One hundred seventy patients had 883 serum hs-cTnI results paired to a routine surveillance EMB. Fifty-one (6%) EMB showed significant ACR (grade ≥2R). Receiver-operator curve analysis approximated the null hypothesis area under the curve 0.509 (95% CI, 0.428-0.591). Sub-analysis including repeated hs-cTnI levels in a single individual, and early (<3 mo) EMB also showed no diagnostic utility of hs-cTnI measurement (area under the curve 0.512).

Conclusions.
In the largest published study to date, we found no association between hs-cTnI concentration and the presence of significant ACR on surveillance EMB. Measurement of hs-cTnI may not be a useful technique for diagnosis or exclusion of ACR after heart transplantation.
Ultra-Deep Sequencing Reveals the Mutational Landscape of Classical Hodgkin Lymphoma
Authors: Gomez Felicia , Mosior Matthew , McMichael Joshua , Skidmore Zachary L. , Duncavage Eric J. , Miller Christopher A. , Abel Haley J. , Li Yi-Shan , Krysiak Kilannin , Russler-Germain David A. , Watkins Marcus P. , Ramirez Cody , Schmidt Alina , Rodrigues Fernanda Martins , Trani Lee , Khanna Ajay , Wagner Julia A. , Fulton Robert S. , Fronick Catrina , O’Laughlin Michelle , Schappe Timothy , Cashen Amanda , Mehta-Shah Neha , Kahl Brad S. , Walker Jason , Bartlett Nancy L. , Griffith Malachi , Fehniger Todd A. , Griffith Obi L. 
Published: July 2021

AbstractThe malignant Hodgkin and Reed Sternberg (HRS) cells of classical Hodgkin lymphoma (cHL) are scarce in affected lymph nodes, creating a challenge to detect driver somatic mutations. As an alternative to cell purification techniques, we hypothesized that ultra-deep exome sequencing would allow genomic study of HRS cells, thereby streamlining analysis and avoiding technical pitfalls. To test this, 31 cHL tumor/normal pairs were exome sequenced to ∼1000x median depth of coverage. An orthogonal error-corrected sequencing approach verified >95% of the discovered mutations. We identified mutations in genes novel to cHL including:CDH5andPCDH7;novel mutations inIL4R, and a novel pattern of recurrent mutations in pathways regulating Hippo signaling. This study provides proof-of-principle that ultra-deep exome sequencing can be utilized to identify recurrent mutations in HRS cells, allowing for the analysis for clinically relevant genomic variants in large cohorts of cHL patients.
Evidence of widespread endemic populations of highly multidrug-resistant Klebsiella pneumoniae seen concurrently through the lens of two hospital intensive care units in Vietnam
Authors: Pham My H. , Hoi Le Thi , Beale Mathew A. , Khokhar Fahad , Hoa Nguyen Thi , Musicha Patrick , Blackwell Grace , Long Hoang Bao , Huong Dang Thi , Binh Nguyen Gia , Co Dao Xuan , Giang Tran , Bui Cuong , Tran Hai Ninh , Bryan James , Herrick Archie , Feltwell Theresa , Nadjm Behzad , Parkhill Julian , van Doorn H. Rogier , Trung Nguyen Vu , Van Kinh Nguyen , Estée Török M. , Thomson Nicholas R. 
Published: July 2021

ABSTRACTBackgroundExtended spectrum beta-lactamases-producing (ESBL-P) and/or carbapenem-resistant (CR) Klebsiella pneumoniae have severely restricted available treatment options in healthcare settings in Vietnam. Understanding the diversity and transmission mechanisms of ESBL- and carbapenemase-encoding K. pneumoniae is important in both hospital and community settings for patient management.MethodsWe conducted a 6-month prospective cohort study of 69 Intensive care unit (ICU) patients from two hospitals in Hanoi, Vietnam. Longitudinally collected samples from patients and the ICU environment were cultured on selective media, and 357 K. pneumoniae colonies were whole genome sequenced. We performed phylogenetic analyses, and correlated phenotypic antimicrobial susceptibility testing with genotypic features of K. pneumoniae isolates. We constructed transmission networks of patient samples, relating ICU admission times and locations with genetic similarity of infecting K. pneumoniae.FindingsDespite being geographically and clinically separated, the two hospitals shared closely related strains carrying the same array of antimicrobial resistance genes. Many patients carried the same resistant K. pneumoniae clone from admission to discharge. 45.9% of total isolates carried both ESBL- and carbapenemase-encoding genes, with high minimum inhibitory concentrations. We found a novel co-occurrence of blaKPC-2 and blaNDM-1 in 46. 6% of samples from the globally successful ST15 lineage.InterpretationThese results highlight the high prevalence of ESBL-positive carbapenem-resistant K. pneumoniae in Vietnamese ICUs. Through studying K. pneumoniae ST15 in detail, we illustrated how important resistance genes are coalescing in stains carried broadly by patients entering the two hospitals directly or through referral.FundingThis study was supported by the Medical Research Council Newton Fund, United Kingdom (grant MR/N029399/1); the Ministry of Science and Technology, Vietnam (grant HNQT/SPÐP/04.16); This research was funded in whole by the Wellcome Trust (grant 206194). For the purpose of Open Access, the author has applied a CC BY public copyright licence to any Author Accepted Manuscript version arising from this submission.
Importance of epidemic severity and vaccine mode of action and availability for delaying the second vaccine dose
Authors: Berec Luděk , Levínský René , Weiner Jakub , Šmíd Martin , Neruda Roman , Vidnerová Petra , Suchopárová Gabriela 
Published: July 2021

Following initial optimism regarding the potential for rapid vaccination, delays and shortages in vaccine supplies have occurred in many countries. Various strategies to counter this gloomy reality and speed up vaccination have been set forth, of which the most popular approach has been to delay the second vaccine dose for a longer period than originally recommended by the manufacturers. Controversy has surrounded this strategy, and overly simplistic models have been developed to shed light on this issue. Here we use three different epidemic models, all accounting for the actual COVID-19 epidemic in the Czech Republic, including the rise and eventual prevalence of the B.1.1.7 variant of SARS-CoV-2 virus and real vaccination rollout strategy, to explore when delaying the second vaccine dose from 21 days to 42 days is advantageous. Using the numbers of COVID-19-related deaths as a quantity for comparing various model scenarios, we find that vaccine mode of action at the beginning of the infection course (preventing contagion and symptom appearance), mild epidemic and sufficient vaccine supply rate call for the original inter-delay scenario of 21 days regardless of vaccine efficacy. On the contrary, for vaccine mode of action at the end of infection course (preventing severe symptoms and death), severe epidemic and low vaccine supply rate, the 42-day inter-dose period is preferable, at any plausible vaccine efficacy.One sentence summaryWe address when delaying the second vaccine dose is advantageous, considering various epidemic severities and various vaccine actions and availabilities.