bluuebunny/crossref_metadata_2025_split huggingface dataset:
The association between midwifery staffing and reported harmful incidents: a cross-sectional analysis of routinely collected data
Authors: Turner Lesley , Ball Jane , Meredith Paul , Kitson-Reynolds Ellen , Griffiths Peter 
Published: March 2024

Abstract
Background
Independent inquiries have identified that appropriate staffing in maternity units is key to enabling quality care and minimising harm, but optimal staffing levels can be difficult to achieve when there is a shortage of midwives. The services provided and how they are staffed (total staffing, skill-mix and deployment) have been changing, and the effects of workforce changes on care quality and outcomes have not been assessed. This study aims to explore the association between daily midwifery staffing levels and the rate of reported harmful incidents affecting mothers and babies.

Methods
We conducted a cross-sectional analysis of daily reports of clinical incidents in maternity inpatient areas matched with inpatient staffing levels for three maternity services in England, using data from April 2015 to February 2020. Incidents resulting in harm to mothers or babies was the primary outcome measure. Staffing levels were calculated from daily staffing rosters, quantified in Hours Per Patient Day (HPPD) for midwives and maternity assistants. Understaffing was defined as staffing below the mean for the service. A negative binomial hierarchical model was used to assess the relationship between exposure to low staffing and reported incidents involving harm.

Results
The sample covered 106,904 maternal admissions over 46 months. The rate of harmful incidents in each of the three services ranged from 2.1 to 3.0 per 100 admissions across the study period. Understaffing by registered midwives was associated with an 11% increase in harmful incidents (adjusted IRR 1.110, 95% CI 1.002,1.229). Understaffing by maternity assistants was not associated with an increase in harmful incidents (adjusted IRR 0.919, 95% 0.813,1.039). Analysis of specific types of incidents showed no statistically significant associations, but most of the point estimates were in the direction of increased incidents when services were understaffed.

Conclusion
When there is understaffing by registered midwives, more harmful incidents are reported but understaffing by maternity assistants is not associated with higher risk of harms. Adequate registered midwife staffing levels are crucial for maintaining safety. Changes in the profile of maternity service workforces need to be carefully scrutinised to prevent mothers and babies being put at risk of avoidable harm.
Cost-effectiveness analysis of CTZ/TAZ for the treatment of ventilated hospital-acquired bacterial pneumonia and ventilator-associated bacterial pneumonia in Japan
Authors: Takaya Risako , Mori Nobuyoshi , Saito Eiko , Ohde Sachiko 
Published: March 2024

Abstract
Background
Resistant bacterial infections, particularly those caused by gram-negative pathogens, are associated with high mortality and economic burdens. Ceftolozane/tazobactam demonstrated efficacy comparable to meropenem in patients with ventilated hospital-acquired bacterial pneumonia in the ASPECT-NP study. One cost-effectiveness analysis in the United States revealed that ceftolozane/tazobactam was cost effective, but no Japanese studies have been conducted. Therefore, the objective of this study was to assess the cost-effectiveness of ceftolozane/tazobactam compared to meropenem for patients with ventilated hospital-acquired bacterial pneumonia/ventilator-associated bacterial pneumonia from a health care payer perspective.

Methods
A hybrid decision-tree Markov decision-analytic model with a 5-year time horizon were developed to estimate costs and quality-adjusted life-years and to calculate the incremental cost-effectiveness ratio associated with ceftolozane/tazobactam and meropenem in the treatment of patients with ventilated hospital-acquired bacterial pneumonia/ventilator-associated bacterial pneumonia. Clinical outcomes were based on the ASPECT-NP study, costs were based on the national fee schedule of 2022, and utilities were based on published data. One-way sensitivity analysis and probabilistic sensitivity analysis were also conducted to assess the robustness of our modeled estimates.

Results
According to our base-case analysis, compared with meropenem, ceftolozane/tazobactam increased the total costs by 424,731.22 yen (£2,626.96) and increased the quality-adjusted life-years by 0.17, resulting in an incremental cost-effectiveness ratio of 2,548,738 yen (£15,763.94) per quality-adjusted life-year gained for ceftolozane/tazobactam compared with meropenem. One-way sensitivity analysis showed that although the incremental cost-effectiveness ratio remained below 5,000,000 yen (£30,925) for most of the parameters, the incremental net monetary benefit may have been less than 0 depending on the treatment efficacy outcome, especially the cure rate and mortality rate for MEPM and mortality rate for CTZ/TAZ. 53.4% of the PSA simulations demonstrated that CTZ/TAZ was more cost-effective than MEPM was.

Conclusion
Although incremental cost-effectiveness ratio was below ￥5,000,000 in base-case analysis, whether ceftolozane/tazobactam is a cost-effective alternative to meropenem for ventilated hospital-acquired bacterial pneumonia/ventilator-associated bacterial pneumonia in Japan remains uncertain. Future research should examine the unobserved heterogeneity across patient subgroups and decision-making settings, to characterise decision uncertainty and its consequences so as to assess whether additional research is required.
Comparative analysis of gene expression between mice and humans in acetaminophen-induced liver injury by integrating bioinformatics analysis
Authors: Zhao Shanmin , Feng Yan , Zhang Jingyuan , Zhang Qianqian , Wang Junyang , Cui Shufang 
Published: March 2024

Abstract
Objective
Mice are routinely utilized as animal models of drug-induced liver injury (DILI), however, there are significant differences in the pathogenesis between mice and humans. This study aimed to compare gene expression between humans and mice in acetaminophen (APAP)-induced liver injury (AILI), and investigate the similarities and differences in biological processes between the two species.

Methods
A pair of public datasets (GSE218879 and GSE120652) obtained from GEO were analyzed using “Limma” package in R language, and differentially expressed genes (DEGs) were identified, including co-expressed DEGs (co-DEGs) and specific-expressed DEGS (specific-DEGs). Analysis of Gene Set Enrichment Analysis (GSEA), Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) were performed analyses for specific-DEGs and co-DEGs. The co-DEGs were also used to construct transcription factor (TF)-gene network, gene-miRNA interactions network and protein-protein interaction (PPI) network for analyzing hub genes.

Results
Mouse samples contained 1052 up-regulated genes and 1064 down-regulated genes, while human samples contained 1156 up-regulated genes and 1557 down-regulated genes. After taking the intersection between the DEGs, only 154 co-down-regulated and 89 co-up-regulated DEGs were identified, with a proportion of less than 10%. It was suggested that significant differences in gene expression between mice and humans in drug-induced liver injury. Mouse-specific-DEGs predominantly engaged in processes related to apoptosis and endoplasmic reticulum stress, while human-specific-DEGs were concentrated around catabolic process. Analysis of co-regulated genes reveals showed that they were mainly enriched in biosynthetic and metabolism-related processes. Then a PPI network which contains 189 nodes and 380 edges was constructed from the co-DEGs and two modules were obtained by Mcode. We screened out 10 hub genes by three algorithms of Degree, MCC and MNC, including CYP7A1, LSS, SREBF1, FASN, CD44, SPP1, ITGAV, ANXA5, LGALS3 and PDGFRA. Besides, TFs such as FOXC1, HINFP, NFKB1, miRNAs like mir-744-5p, mir-335-5p, mir-149-3p, mir-218-5p, mir-10a-5p may be the key regulatory factors of hub genes.

Conclusions
The DEGs of AILI mice models and those of patients were compared, and common biological processes were identified. The signaling pathways and hub genes in co-expression were identified between mice and humans through a series of bioinformatics analyses, which may be more valuable to reveal molecular mechanisms of AILI.
Unusual presentation and delayed diagnosis of cardiac angiosarcoma
Authors: Zaheer Salman , Zhou Alice L. , Gross John M. , Kilic Ahmet 
Published: March 2024

Abstract
Background
Primary cardiac angiosarcomas are very rare and present aggressively with high rates of metastasis. Given the poor prognosis, particularly once disease has spread, early diagnosis and multidisciplinary treatment is essential.

Case presentation
We present the case of a 46-year-old male who presented with chest pain, intermittent fevers, and dyspnea. Workup with computed tomography scan and transesophageal echocardiography demonstrated a right atrial pseudoaneurysm. Given the concern for rupture, the patient was taken to the operating room, where resection of the pseudoaneurysm and repair using a bovine pericardial patch was performed. Histopathology report initially demonstrated perivascular lymphocyte infiltrate. Six weeks later, the patient represented with chest pain and new word finding difficulty. Workup revealed multiple solid lung, pericardial, brain, and bone nodules. Eventual biopsy of a cardiophrenic nodule demonstrated angiosarcoma, and rereview of the original pathology slides confirmed the diagnosis of primary cardiac angiosarcoma.

Conclusions
Primary cardiac angiosarcomas are often misdiagnosed given the rarity of these tumors, but early diagnosis and initiation of treatment is essential. The unique presentation of our case demonstrates that clinical suspicion for cardiac angiosarcoma should be maintained for spontaneous pseudoaneurysm originating from the right atrium.
The digital divide in rural and regional communities: a survey on the use of digital health technology and implications for supporting technology use
Authors: Jongebloed Hannah , Anderson Kate , Winter Natalie , Nguyen Lemai , Huggins Catherine E. , Savira Feby , Cooper Paul , Yuen Eva , Peeters Anna , Rasmussen Bodil , Reddy Sandeep , Crowe Sarah , Bhoyroo Rahul , Muhammad Imran , Ugalde Anna 
Published: March 2024

Abstract
Objective
A digital divide exists for people from rural and regional areas where they are less likely and confident to engage in digital health technologies. The aim of this study was to evaluate the digital health literacy and engagement of people from rural and regional communities, with a focus on identifying barriers and facilitators to using technology.

Results
Forty adults living in rural/regional areas completed a survey consisting of the eHealth Literacy Scale (eHEALS) with additional items surveying participants’ experience with a range of digital health technologies. All participants had used at least one digital health technology. Most (80%) participants had an eHEALS score of 26 or above indicating confidence in online health information. Commonly reported barriers to digital health technology use centred on product complexity and reliability, awareness of resources, lack of trust, and cost. Effective digital health technology use is becoming increasingly important, there may be a need to prioritise and support people with lower levels of digital health literacy. We present opportunities to support community members in using and accessing digital health technology.
Shower dehumidification to reduce nontuberculous mycobacteria aerosolization
Authors: Kostecki Michael X. , Chan Yvonne L. , Honda Jennifer R. 
Published: March 2024

Abstract
Objective
Nontuberculous mycobacteria (NTM) are environmentally acquired opportunistic pathogens that can cause recalcitrant lung disease. Prior reports have demonstrated links between shower use and infections, yet the aerosolization of NTM from showerheads, as well as the humidity levels that may modulate NTM aerosolization from showerheads is less studied. The objective of the current study was to investigate the role of humidity in NTM aerosolization among showers in homes located in a geographic area with high lung disease incidence, Hawai’i, and test whether deployment of a dehumidifier in well-ventilated bathrooms reduce NTM exposure.

Results
Across two sampling events and five showers, existing NTM showerhead biofilms along with shower air were sampled at three points: pre-shower, post-shower, and post-dehumidification. In each of the sampling events, respiratory relevant NTM species were identified from shower biofilms, which were also detected in aerosolized shower air after showering events, but not after the shower was dehumidified and bathrooms vented. While sample size was small, these data suggest running a shower is a possible source of NTM aerosolization and using a commercial household dehumidifier in conjunction with opening bathroom doors and windows may be simple, cost-effective interventions to reduce environmental NTM exposures.
Optimising total knee replacement imaging: a novel 3D printed PET/CT anthropomorphic phantom for metal artefact simulation
Authors: Assiri Rajeh , Knapp Karen , Fulford Jon , Chen Junning 
Published: March 2024

Abstract
Purpose
Arthroplasty phantoms, including total knee replacement (TKR) phantoms, have been frequently used to test metal artefact reduction methods applied to positron emission tomography/computed tomography (PET/CT) images. These phantoms generally simulate either simple anatomical features or simple activity distribution around the metal inserts in the PET/CT scans. 3D printing has been used recently to fabricate fillable anthropomorphic phantoms that accurately simulate volume and geometry. This study aims to describe the process of image segmentation, phantom modelling, 3D printing and validation of a population-based fillable TKR phantom that simulates human TKR PET/CT metal artefacts.

Methods
10 participants (5 male and 5 female) were scanned using 3T MRI and the images were segmented to create average male and average female 3D knee models, inversely with void cortical and porous trabecular compartments for 3D printing and contrast media. Virtual total knee replacement (TKR) surgery was implemented on these models to prepare the insertion locations for knee prosthetic implants. Subsequently, TKR models were printed using a 3D photopolymer resin printer and then injected with normal saline to test the phantoms for any leaks. Subsequently, diluted iodinated contrast media was injected into the cortical compartment and saline with 18F-FDG was injected into the trabecular compartment and the phantom was scanned with PET/CT. The images were then evaluated and compared to the human knee radiographic features reported in the literature.

Results
Phantoms were shown to be fluid-tight with distinct compartments. They showed comparable volume and geometry to the segmented human MRI knees. The phantoms demonstrated similar values for x-ray attenuation and Hounsfield units (HU) to the literature for both cortical and trabecular compartments. The phantoms displayed a uniform distribution for the radioactive tracer, resembling that seen in human trabecular bone PET. TKR phantom PET/CT images with metal inserts replicated the clinical metal artefacts seen clinically in the periprosthetic area.

Conclusion
This novel, 3D-printed, and customisable phantom effectively mimics the geometric, radiographic and radiotracer distribution features of real TKRs. Importantly, it simulates TKR image metal artefacts, making it suitable for repeatable and comprehensive evaluation of various metal artefact reduction methods in future research.
Determinants of digital technology development in sub-Saharan African countries: evidence from panel data analysis
Authors: Beyene Elfenesh , Bedemo Amsalu , Gebremeskel Atnafu 
Published: March 2024

AbstractThe primary objective of this research is to explore the elements that shape the progression of digital technology in Sub-Saharan African nations. The study employs data obtained from 16 countries, covering the period between 2000 and 2020. Employing fixed effect panel regression analysis, our research indicates that various non-technological factors significantly impact digital technology development in the region. The results highlight that variables including general government final consumption expenditure, inflation rate, employment growth rate, financial development, ease of doing business index, logistics performance index, international migration, access to electricity, and access to safe drinking water have a positive impact on the development of digital technology. Conversely, international trade is identified as a negative influence, primarily due to insufficient infrastructural development. These findings underscore the significance of non-technological elements, encompassing aspects like globalization, economic conditions, favorable digital ecosystems, and the fulfillment of basic human needs, in shaping the landscape of digital technology in the region. The study, while acknowledging limitations in terms of selected indicators, years, and countries, emphasizes the need for broader investigations in future research. Practically, the study suggests that governments in the region should prioritize addressing these non-technological factors to fully leverage the potential of digital technology development. The originality and value of this research lies in its exploration of non-technological determinants, shedding light on their pivotal role in shaping the digital technology landscape in sub-Saharan Africa.
Resilience and systems- A traffic flow case example
Authors: Mayar Khalilullah , Carmichael David G. , Shen Xuesong 
Published: March 2024

AbstractResilience has increasingly become a crucial topic to the function of various real-world systems as our planet undergoes a rising trend of uncertainty and change due to natural, human and technological causes. Despite its ubiquitous use, the term resilience is poorly and often inconsistently used in various disciplines, hindering its universal understanding and application. This study applies the resilience system interpretation framework, which defines resilience irrespective of its disciplinary association, in the form of adaptation and adaptive systems, to two traffic flow systems. The system framework defines resilience as the ability of the system state and form to return to their initial or other suitable state or form through passive and active feedback structures. Both components of the system framework are demonstrated through practical simulation scenarios on the modified viscous Burgers’ equation and the LWR-Greenshields model equipped with an adaptive Extremum seeking control, respectively. This novel and systematic understanding of resilience will advance resilience analysis, design, and measurement processes in various real-world systems in a unified fashion and subsequently pave the way for resilience operationalization and its integration into industry standards.
Reconsidering the nomenclature of the flexor digiti minimi muscles: a proposed solution to ambiguity in anatomical description
Authors: Ogut Eren 
Published: March 2024

Abstract
Background
The nomenclature surrounding the 'flexor digiti minimi brevis' muscle prompts deliberation concerning its accuracy and potential variations. Addressing this uncertainty entails expunging the term 'brevis' from nomenclature references to the muscle, opting instead for the term 'flexor digiti minimi.' This nomenclatural adjustment currently being advocated raises inquiries about the necessity for descriptors denoting the muscle's specific placement along the upper or lower extremities. This study was conducted with a dual objective: to illuminate this topic and consolidate existing research on this issue.

Main body of the abstract
Research encompassing the terms 'flexor digiti minimi' OR 'flexor digiti minimi brevis' was screened within this field. The inclusion criteria involved original articles, case reports, case series, relevant books, and book chapters. Excluded from this review were articles mentioning 'flexor digiti minimi' and 'digiti minimi' that were unrelated to the subject, as well as poster presentations, proceedings, conference materials, abstracts, and atlases.

Short conclusion
In summary, changing the name of the muscle enhances anatomical understanding, promotes clarity and precision in communication, facilitates research efforts, and helps prevent confusion in medical education and clinical practice. These benefits highlight the importance of revising nomenclature to reflect anatomical accuracy and improve healthcare outcomes. It also promotes consistency in studies and allows for more meaningful comparisons across studies, ultimately advancing our understanding of anatomical variations and their clinical significance. Furthermore, it allows for more effective teaching and learning experiences, enabling medical practitioners to make accurate diagnoses, develop effective treatment strategies.
Renal Hypokalemia: An Endocrine Perspective
Authors: Culver Silas A , Suleman Nawar , Kavuru Varun , Siragy Helmy M 
Published: March 2024

Abstract
The majority of disorders that cause renal potassium wasting present with abnormalities in adrenal hormone secretion. While these findings frequently lead patients to seek endocrine evaluation, clinicians often struggle to accurately diagnose these conditions, delaying treatment and adversely impacting patient care. At the same time, growing insight into the genetic and molecular basis of these disorders continues to improve their diagnosis and management. In this review, we outline a practical integrated approach to the evaluation of renal hypokalemia syndromes that are seen in endocrine practice while highlighting recent advances in understanding of the genetics and pathophysiology behind them.
Whence Automation? The History (and Possible Futures) of a Concept
Authors: Elzway Salem , Resnikoff Jason 
Published: March 2024

Abstract
Rather than a dispassionate term of engineering, automation is what scholars of STS (Science, Technology, and Society) call a “sociotechnical imaginary.” It offers a seductive and ready-to-hand teleological narrative about history, work, and technological change that obscures the politics behind seemingly incontestable and objective realities. Far from an accounting of the apolitical development of productive forces, the history of automation—as discourse, as process, and as technoscience—is inseparable from the development of the “technopolitics” of work, or the intersection between the built world and the contingency of political life. Technopolitics can help labor historians break out of these narrative traps, strip terms like automation of their explanatory authority, and reveal just how much of the labor process remains contingent and open to political negotiation. Frameworks provided by STS allow us to see how automation fails to explain changes to the workplace over the better part of the past century and how it, in fact, codified class domination in the American technopolitical regime of the postwar period.