bluuebunny/crossref_metadata_2025_split huggingface dataset:
Health Systems Factors Associated With Adverse Events Among Hospitalized Obstetric Clients in a Tertiary Health Care Facility in Ghana
Authors: Otchi Elom Hillary , Esena Reuben Kwasi , Srofenyoh Emmanuel , Ameh Emmanuel Ogbada , Asah-Opoku Kwaku , Beyuo Titus , Ken-Amoah Sebastian , Oduro Frederick , Agbeno Evans Kofi , Marfo Kissinger 
Published: November 2021

Objectives
The risk of an adverse event (AE) in obstetric clients receiving care in hospitals is greater than the risk of dying in aviation, road traffic accidents, and breast cancer. There is little understanding of AEs with respect to their causes at hospitals. The study aimed at assessing factors that are associated with the occurrence of AEs among hospitalized obstetric clients in a tertiary hospital in Ghana.

Method
This was a case-control study of 650 obstetric clients (equal number in both arms) who were admitted between January 1 and December 31, 2015, at the study site. A retrospective review of the clients’ medical records was randomly allocated into both arms of the study. Descriptive and inferential statistics including confirmatory factor analysis were performed. Models were evaluated for goodness-of-fit measures. The reliability and validity of the scale were also tested using Cronbach α coefficient.

Results
The mean gestational age of the clients was 37.4 ± 4.9 weeks. Leadership and governance (inadequate use of protocol and adherence) accounted for the most cause of AEs among obstetric clients. The overall Kaiser-Meyer-Olkin score was also 0.87. The scale also demonstrated high reliability (Cronbach α = 0.995; composite reliability > 0.7) and validity (average variance extraction > 0.50). There was a marginal model fit (root mean square error of approximation, 0.067), and the χ2 test was statistically significant (P < 0.05).

Conclusions
Inadequate use of protocol and adherence is a major cause of preventable AEs identified in this study. There is an urgent need to address this to ensure a reduction in the prevalence of AEs among obstetric clients.
Adverse Event Reporting Priorities: An Integrative Review
Authors: Falcone Maureen L. , Van Stee Stephanie K. , Tokac Umit , Fish Anne F. 
Published: November 2021

Objectives
Adverse events remain the third leading cause of death in hospitals today, after heart disease and cancer. However, adverse events remain underreported. The purpose of this integrative review is to synthesize adverse event reporting priorities in acute care hospitals from quantitative, qualitative, and mixed-methods research articles.

Methods
A comprehensive review of articles was conducted using nursing, medicine, and communication databases between January 1, 1999, and May 3, 2021. The literature was described using standard reporting criteria.

Results
Twenty-nine studies met the eligibility criteria. Four key priorities emerged: understanding and reducing barriers, improving perceptions of adverse event reporting within healthcare hierarchies, improving organizational culture, and improving outcomes measurement.

Conclusions
A paucity of literature on adverse event reporting within acute care hospital settings was found. Perceptions of fear of blaming and retaliation, lack of feedback, and comfort level of challenging someone more powerful present the greatest barriers to adverse event reporting. Based on qualitative studies, obtaining trusting relationships and sustaining that trust, especially in hierarchical healthcare systems, are difficult to achieve. Given that patient safety training is a common strategy clinically to improve organizational culture, only 4 published articles examined its effectiveness. Further research in acute care hospitals is needed on all 4 key priorities. The findings of this review may ultimately be used by clinicians and researchers to reduce adverse events and develop future research questions.
Moderate effect of ankle foot orthosis versus ground reaction ankle foot orthosis on balance in children with diplegic cerebral palsy
Authors: Sanad Doaa Ahmed 
Published: November 2021

Background:
The children with diplegic cerebral palsy (CP) commonly have abnormal alignment of lower extremities affecting their abilities of keeping balance. Orthoses are one of the many approaches that can be prescribed to improve balance and walking in diplegic children.

Objective:
This study was conducted to assess the moderate effect of solid ankle foot orthosis (AFO) vs. the ground reaction ankle foot orthosis (GRAFO) on balance in children with diplegic CP.

Study design:
A randomized controlled trial.

Methods:
Thirty children with spastic diplegic CP from both genders participated in this study; their ages were between 6 and 9 years. They were divided randomly into two study groups of equal numbers; the first study group A received the regular physical therapy program besides wearing the AFO for successive three months. The second study group B received the regular physical therapy program besides wearing the GRAFO for successive 3 months. All childrens' balance was evaluated before starting the treatment program and after 3 months by using the Biodex balance system (anteroposterior and mediolateral stability indices).

Results:
There were significant improvement of all stability indices in both groups (P < 0.05), with significant difference between groups when comparing post-treatment mean values of the measured indices in favor to study group B (P < 0.05).

Conclusion:
The GRAFO achieved more balance control in children with spastic diplegic CP compared with solid AFO.
Motion sickness: current concepts and management
Authors: Keshavarz Behrang , Golding John F. 
Published: November 2021

Purpose of review
Motion sickness is an ancient phenomenon that affects many people. Nausea, vomiting, disorientation, sweating, fatigue, and headache are just few of the many signs and symptoms that are commonly experienced during an episode of motion sickness. In the present review, we will provide an overview of the current research trends and topics in the domain of motion sickness, including theoretical considerations, physiological and neural mechanisms, individual risk factors, and treatment options, as well as recommendations for future research directions.

Recent findings
More recently, motion sickness has been in the focus of attention in the context of two global technological trends, namely automated vehicles and virtual reality. Both technologies bear the potential to revolutionize our daily lives in many ways; however, motion sickness is considered a serious concern that threatens their success and acceptance. The majority of recent research on motion sickness focuses on one of these two areas.

Summary
Aside from medication (e.g. antimuscarinics, antihistamines), habituation remains the most effective nonpharmacological method to reduce motion sickness. A variety of novel techniques has been investigated with promising results, but an efficient method to reliably prevent or minimize motion sickness has yet to emerge.
The functional role of episodic memory in spatial learning
Authors: Zeng Xiangshuai , Wiskott Laurenz , Cheng Sen 
Published: November 2021

AbstractEpisodic memory has been studied extensively in the past few decades, but so far little is understood about how it drives behavior. Here we propose that episodic memory can facilitate learning in two fundamentally different modes: retrieval and replay. We study their properties by comparing three learning paradigms using computational modeling based on visually-driven reinforcement learning. Firstly, episodic memory is retrieved to learn from single experiences (one-shot learning); secondly, episodic memory is replayed to facilitate learning of statistical regularities (replay learning); and, thirdly, learning occurs online as experiences arise with no access to past experiences (online learning). We found that episodic memory benefits spatial learning in a broad range of conditions, but the performance difference is meaningful only when the task is sufficiently complex and the number of learning trials is limited. Furthermore, the two modes of accessing episodic memory affect spatial learning distinctly. One-shot learning is initially faster than replay learning, but the latter reaches a better asymptotic performance. Our model accounts for experimental results where replay is inhibited, but the hippocampus, and hence episodic memory, is intact during learning. Understanding how episodic memory drives behavior will be an important step towards elucidating the nature of episodic memory.
Evaluating the impact of a pulse oximetry remote monitoring programme on mortality and healthcare utilisation in patients with covid-19 assessed in Accident and Emergency departments in England: a retrospective matched cohort study
Authors: Beaney T , Clarke J , Alboksmaty A , Flott K , Fowler A , Benger JR , Aylin P , Elkin S , Darzi A , Neves AL 
Published: November 2021

AbstractObjectivesTo identify the impact of a national pulse oximetry remote monitoring programme for covid-19 (COVID Oximetry @home; CO@h) on health service use and mortality in patients attending Accident and Emergency (A&E) departments.DesignRetrospective matched cohort study of patients enrolled onto the CO@h pathway from A&E.SettingNational Health Service (NHS) A&E departments in England.ParticipantsAll patients with a positive covid-19 test from 1stOctober 2020 to 3rdMay 2021 who attended A&E from three days before to ten days after the date of the test. All patients who were admitted or died on the same or following day to the first A&E attendance within the time window were excluded.InterventionsParticipants enrolled onto CO@h were matched using demographic and clinical criteria to participants who were not enrolled.Main outcome measuresFive outcome measures were examined within 28 days of first A&E attendance: i) death from any cause; ii) any subsequent A&E attendance; iii) any emergency hospital admission; iv) critical care admission; and v) length of stay.Results15,621 participants were included in the primary analysis, of whom 639 were enrolled onto CO@h and 14,982 were controls. Odds of death were 52% lower in those enrolled (95% CI: 7%-75% lower) compared to those not enrolled on CO@h. Odds of any A&E attendance or admission were 37% (95% CI: 16-63%) and 59% (95% CI: 16-63%) higher, respectively, in those enrolled. Of those admitted, those enrolled had 53% (95% CI: 7%-76%) lower odds of critical care admission. There was no significant impact on length of stay.ConclusionsThese findings indicate that for patients assessed in A&E, pulse oximetry remote monitoring may be a clinically effective and safe model for early detection of hypoxia and escalation, leading to increased subsequent A&E attendance and admissions, and reduced critical care requirement and mortality.
Premorbid frailty predicts short and long term outcomes of reperfusion treatment in acute stroke
Authors: Pilotto Andrea , Brass Cora , Fassbender Klaus , Merzou Fatma , Morotti Andrea , Kämpfer Niklas , Antonio Siniscalchi A , Alessandro Padovani A , Lochner Piergiorgio 
Published: November 2021

ABSTRACTBackgroundFrailty is the most important short and long term predictor of disability in the elderly and thus might influence the clinical outcome of acute treatment of stroke.Objectiveto evaluate whether frailty predicts short- and long term all-cause mortality and neurological recovery in elderly patients who underwent reperfusion acute treatment of stroke.Methodsthe study included consecutive patients older than 65 years who underwent reperfusion treatment in a single stroke Unit from 2015 to 2016. Predictors of stroke outcomes were assessed including demographics, baseline NIHSS, time to needle, treatment and medical complications. Premorbid Frailty was assessed with a comprehensive geriatric assessment (CGA) including functional, nutritional, cognitive, social and comorbidities status. At three and twelve months, all-cause death and clinical recovery (using modified Ranking scale, mRS) were evaluated.ResultsOne-hundred and two patients who underwent acute reperfusion treatment for stroke entered the study (mean age 77.5, 65-94 years). Frailty was diagnosed in 32 out of 70 patients and associated with older age (p=0.001) but no differences in baseline NIHSS score, vascular risk profile or treatment management strategy. Frailty status was associated with worse improvement at 24 hours and higher in-hospital mortality. At follow-up, frail patients showed poorer survival at 3 (25% vs 3%, p=0.008) and 12 (38% vs 7%, p=0.001) months. Frailty was the best predictor of neurological recovery at one year follow-up (mRS 3.2 ± 1.9 vs 1.9 ± 1.9).Discussionfrailty is an important predictor of efficacy of acute treatment of stroke beyond classical predictors of stroke outcomes. Larger longitudinal studies are thus warranted in order to evaluate the risk-benefit of reperfusion treatment in the growing elderly frail population.
What does the mean mean? A simple test for neuroscience
Authors: Tlaie A. , Shapcott K. A. , van der Plas T. , Rowland J. , Lees R. , Keeling J. , Packer A. , Tiesinga P. , Schölvinck M. L. , Havenith M. N. 
Published: November 2021

Trial-averaged metrics, e.g. tuning curves or population response vectors, are a ubiquitous way of characterizing neuronal activity. But how relevant are such trial-averaged responses to neuronal computation itself? Here we present a simple test to estimate whether average responses reflect aspects of neuronal activity that contribute to neuronal processing. The test probes two assumptions implicitly made whenever average metrics are treated as meaningful representations of neuronal activity:Reliability: Neuronal responses repeat consistently enough across trials that they convey a recognizable reflection of the average response to downstream regions.Behavioural relevance: If a single-trial response is more similar to the average template, it is more likely to evoke correct behavioural responses.We apply this test to two data sets: (1) Two-photon recordings in primary somatosensory cortices (S1 and S2) of mice trained to detect optogenetic stimulation in S1; and (2) Electrophysiological recordings from 71 brain areas in mice performing a contrast discrimination task. Under the highly controlled settings of data set 1, both assumptions were largely fulfilled. Moreover, better-matched single-trial responses predicted correct behaviour. In contrast, the less restrictive paradigm of data set 2 met neither assumption, with the match between single-trial and average responses being neither reliable nor predictive of behaviour. Simulations confirmed these results. We conclude that when behaviour is less tightly restricted, average responses do not seem particularly relevant to neuronal computation, potentially because information is encoded more dynamically. Most importantly, we encourage researchers to apply this simple test of computational relevance whenever using trial-averaged neuronal metrics, in order to gauge how representative cross-trial averages are in a given context.
Pseudotime analysis reveals exponential trends in DNA methylation aging with mortality associated timescales
Authors: Lapborisuth Kalsuda , Farrell Colin , Pellegrini Matteo 
Published: November 2021

AbstractThe epigenetic trajectory of DNA methylation profiles has a nonlinear relationship with time, reflecting rapid changes in DNA methylation early in life that progressively slow. In this study, we use pseudotime analysis to determine these trajectories. Unlike epigenetic clocks that constrain the functional form of methylation changes with time, pseudotime analysis orders samples along a path based on similarities in a latent dimension to provide an unbiased trajectory. We show that pseudotime analysis can be applied to DNA methylation in human blood and brain tissue and find that it is highly correlated with the epigenetic states described by the Epigenetic Pacemaker. Moreover, we show that the pseudotime nonlinear trajectory can be modeled using a sum of two exponentials with coefficients that are close to the timescales of human age-associated mortality. Thus, for the first time, we can identify age-associated molecular changes that appear to track the exponential dynamics of mortality risk.
Unequal impact of the Covid-19 pandemic on excess deaths, life expectancy, and premature mortality across Spanish regions in 2020 and 2021
Authors: Islam Nazrul , García López Fernando J. , Jdanov Dmitri A. , Royo- Bordonada Miguel Ángel , Khunti Kamlesh , Lewington Sarah , Lacey Ben , White Martin , Morris Eva JA , Zunzunegui María Victoria 
Published: November 2021

AbstractSpain is one of the most heavily affected countries by the Covid-19 pandemic. In this study, we estimated the regional inequalities in excess deaths and premature mortality in Spain. Between January 2020 and June 2021, an estimated 89,200 (men: 48,000; women: 41,200) excess deaths occurred in the 17 Spanish regions with a substantial variability (highest in Madrid: 22,000, lowest in Canary Islands: -210). Highest reductions in life expectancy at birth (e0) in 2020 were observed in Madrid (men: -3.48 years, women: -2.15), Castile La Mancha (men: -2.67, women: -2.30), and Castile and León (men: -2.00, women: -1.32). In the first six months of 2021, the highest reduction ine0was observed in Valencian Community (men: -2.04, women: -1.63), Madrid (men: - 2.37), and Andalusia (men: -1.75; women: -1.43). In some Spanish regions, life expectancy at age 65 during the Covid-19 pandemic in 2020 was comparable to that observed as far back as 20 years ago.
Correlative cryo-imaging of the cellular universe with soft X-rays and laser light used to track F-actin structures in mammalian cells
Authors: Koronfel Mohamed , Kounatidis Ilias , Mwangangi Dennis M. , Vyas Nina , Okolo Chidinma , Jadhav Archana , Fish Tom , Chotchuang Phatcharin , Schulte Albert , Robinson Robert C. , Harkiolaki Maria 
Published: November 2021

Imaging of actin filaments is crucial due to the integral role that they play in many cellular functions such as intracellular transport, membrane remodelling and cell motility. Visualizing actin filaments has so far relied on fluorescence microscopy and electron microscopy/tomography. The former lacks the capacity to capture the overall local ultrastructure, while the latter requires rigorous sample preparation that can lead to potential artefacts, and only delivers relatively small volumes of imaging data at the thinnest areas of a cell. In this work, a correlative approach utilizing in situ super-resolution fluorescence imaging and cryo X-ray tomography was used to image bundles of actin filaments deep inside cells under near-native conditions. In this case, fluorescence 3D imaging localized the actin bundles within the intracellular space, while X-ray tomograms of the same areas provided detailed views of the local ultrastructure. Using this new approach, actin trails connecting vesicles in the perinuclear area and hotspots of actin presence within and around multivesicular bodies were observed. The characteristic prevalence of filamentous actin in cytoplasmic extensions was also documented.
The diffusion of mobile QR-code payment: an empirical evaluation for a pandemic
Authors: Le Xuan Cu 
Published: November 2021

PurposeThe research purpose is to explore the diffusion of mobile QR-code payment (MQP) in a coronavirus disease (COVID-19) context by formulating a behavioral response model based on an integration between protection motivation theory (PMT) and unified theory of acceptance and use of technology (UTAUT). This study also investigates the importance of physical distancing norm for behavioral intention toward MQP.Design/methodology/approachA web-based survey was designed and data were accumulated from 411 validated respondents who have used MQP or tend to utilize it in Vietnam. Statistical analysis was conducted using SPSS and AMOS to verify the hypotheses.FindingsResults illustrated that behavioral intention is motivated by key antecedents of PMT (including perceived severity, perceived susceptibility and self-efficacy) and important factors of UTAUT (including performance expectancy, effort expectancy and social influence), and physical distancing norm. Moreover, perceived severity promotes performance expectancy, whereas self-efficacy boosts effort expectancy in MQP. Lastly, behavioral intention and recommendation were indicators of the diffusion of MQP under COVID-19.Practical implicationsMQP is just in its infant stage in Vietnam; thus, the findings provide managerial implications, which will aid service providers and firms to adopt marketing strategies that enhance consumers' acceptability and recommendation of MQP to the public.Originality/valueLittle is empirically considered the effects of perceived threat-related factors in PMT and physical distancing norm on behavioral intention toward MQP in a salient pandemic setting. Furthermore, the antecedents in UTAUT contribute greatly to behavioral intention. This study enlightens the diffusion of MQP based on behavioral intention and recommendation.
Consumers' purchase intention of wild freshwater fish in China from the perspective of ecological protection
Authors: Chen Tinggui , Wang Hui 
Published: November 2021

PurposeThe purpose of this paper is to investigate consumers' purchase intention of wild freshwater fish. Facing the endangering ecology in the Yangtze River Basin, the Chinese government has implemented a ten-year fishing ban policy to protect the wild freshwater fishery resources from 2020. In this context, such questions are raised as how do consumers react to this and are they willing to reduce or even refuse to purchase wild freshwater fish to protect the aquatic biological resources in the Yangtze River Basin?Design/methodology/approachA total of 1,235 consumers from eight provinces (including two province-level municipalities) in the Yangtze River Basin filled out the online questionnaires. The data (n = 1,096) are analyzed by structural equation model (SEM) to verify the relationships between the variables.FindingsThe results show that subjective norm is the strongest direct determinant of purchase intention, followed by personal norm, attitude, environmental concern and perceived behavioral control. It is also found that attitude, subjective norm, perceived behavioral control and environmental concern have significant effects on personal norm which plays a significant mediating role in forming purchase intention. On this basis, specific policy recommendations are proposed.Originality/valueThis paper investigates consumers' purchase intention from the perspective of ecological protection and obtains a more comprehensive explanation of the purchase intention by combining the theory of planned behavior (TPB) and theory of norm activation.