bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sexually transmitted infection point-of-care testing in resource-limited settings: a narrative review guided by an implementation framework
Authors: Chitneni Pooja , Owembabazi Moran , Muyindike Winnie , Asiimwe Stephen , Masete Godfrey , Mbalibulha Yona , Nakku-Joloba Edith , Manabe Yukari C. , Haberer Jessica , Matthews Lynn , Van Der Pol Barbara 
Published: July 2023

Abstract
Most sexually transmitted infections (STIs) are acquired in resource-limited settings (RLS) where laboratory diagnostic access is limited. Advancements in point-of-care testing (POC) technology have the potential to bring STI testing to many RLS. We define POC as performed near the patient and with results readily available to inform clinical practice. The World Health Organization Special Programme for Research and Training in Tropical Diseases further outlines desirable POC characteristics with the REASSURED criteria.
Despite advantages related to immediate test-and-treat care, integrating POC into RLS healthcare systems can present challenges that preclude reliance on these tests. In 2018, we incorporated molecular near-POC for chlamydia, gonorrhea, and trichomoniasis and SDBioline Treponemal immunochromatographic testing confirmed by rapid plasma reagin for syphilis diagnosis at the Mbarara University of Science and Technology Research Laboratory in rural southwestern Uganda. We describe our experiences with STI POC as a case example to guide a narrative review of the field using the Consolidated Framework for Implementation Research as a conceptual framework.
Though POC and near-POC are described as easy to use, the challenges of limited person-power, healthcare processes, limited infrastructure/resources, high costs, and quality control obstacles can impede the impact of these tests. Increased investment in operators, training, and infrastructure, restructuring healthcare systems to accommodate increased POC access, and optimizing costs are all crucial to the successful implementation of STI POC in RLS. Expanded STI POC in RLS will increase access to accurate diagnoses, appropriate treatment, and engagement in partner notification, treatment, and prevention efforts.
The outcome of using zolpidem for treatment of postoperative posterior fossa syndrome in children with brain tumor
Authors: AlAzmi Aeshah , Abdullah Shaker , Abdullah Khalid , Ruediger Stendel 
Published: July 2023

Abstract

Introduction:
At present, there is no supporting evidence-based therapy of proven efficacy to treat posterior fossa syndrome (PFS) after surgical resection of posterior fossa tumors in children where only 22% of patients may experience a full recovery. However, zolpidem, a nonbenzodiazepine hypnotics drug, seems to be a possible treatment option for PFS symptoms.

Methods and Materials:
This was a retrospective chart review for all children with brain tumors younger than 15 years diagnosed with confirmed PFS after surgical resection at King Abdulaziz Medical City, Jeddah, and received zolpidem to alleviate the PFS symptoms between May 2016 and April 2019.

Results:
A total of 6 pediatric patients who experienced PFS symptoms (median of 4 days, range 1–7 days) were included. The most commonly observed symptoms were irritability, hypotonia, swallowing deficit, unsteady walking, and delayed speech. To alleviate the PFS symptoms, zolpidem was commenced 2–5 days postoperatively. The median duration of use was 13.5 days. During the hospital course, recovery of speech was observed after 2 weeks in most patients (50%) while 83.3% of patients recovered their normal speech in 4 months although not fully ambulated. No discontinuation of zolpidem use was reported because of adverse events.

Conclusion:
Most of our children (83.3%) who experienced PFS postresection responded to zolpidem trials which may represent a promising research field.
Using Quality Improvement to Design Early Childhood Services Navigation in Primary Care
Authors: King Amy L. , Brown Courtney M. , White Cynthia C. , Copeland Kristen A. 
Published: July 2023

Introduction:
Enrollment in high-quality early childhood education (ECE) improves educational and health outcomes and can mitigate racial and economic disparities. Pediatricians are encouraged to promote ECE yet lack the time and knowledge to assist families effectively. In 2016, our academic primary care center hired an ECE Navigator to promote ECE and help families enroll. Our SMART aims were to increase the number of children with facilitated referrals to high-quality ECE programs from 0 to 15 per month and to confirm enrollment on a subset to achieve an enrollment rate of 50% by December 31, 2020.

Methods:
We used the Institute for Healthcare Improvement’s Model for Improvement. Interventions included system changes in partnership with ECE agencies (eg, interactive map of subsidized preschool options, streamlined enrollment forms), case management with families, and population-based approaches to understand families’ needs and the program’s overall impact. We plotted the number of monthly facilitated referrals and the percentage of referrals enrolled on run and control charts. We used standard probability-based rules to identify special causes.

Results:
Facilitated referrals increased from 0 to 29 per month and remained above 15. The percentage of enrolled referrals increased from 30% to 74% in 2018, then decreased to 27% in 2020 when childcare availability declined during the pandemic.

Conclusions:
Our innovative ECE partnership improved access to high-quality ECE. Interventions could be adopted in part or whole by other clinical practices or WIC offices to equitably improve early childhood experiences for low-income families and racial minorities.
Let us to the TWISST; Plan, Simulate, Study and Act
Authors: Colman Nora , Hebbar Kiran B. 
Published: July 2023

Introduction:
Translational Work Integrating Simulation and Systems Testing (TWISST) is a novel application of simulation that augments how we discover, understand, and mitigate errors in our system. TWISST is a diagnostic and interventional tool that couples Simulation-based Clinical Systems Testing with simulation-based training (SbT). TWISST tests environments and work systems to identify latent safety threats (LSTs) and process inefficiencies. In SbT, improvements made to the work system are embedded in hard wire system improvements, ensuring optimal integration into clinical workflow.

Methods:
Simulation-based Clinical Systems Testing approach includes simulated scenarios, Summarize, Anchor, Facilitate, Explore, Elicit debriefing, and Failure Mode and Effect Analysis. In iterative Plan-Simulate-Study-Act cycles, frontline teams explored work system inefficiencies, identified LSTs, and tested potential solutions. As a result, system improvements were hardwired through SbT. Finally, we present a case study example of the TWISST application in the Pediatric Emergency Department.

Results:
TWISST identified 41 latent conditions. LSTs were related to resource/equipment/supplies (n = 18, 44%), patient safety (n = 14, 34%), and policies/procedures (n = 9, 22%). Work system improvements addressed 27 latent conditions. System changes that eliminated waste or modified the environment to support best practices mitigated 16 latent conditions. System improvements that addressed 44% of LSTs cost the department $11,000 per trauma bay.

Conclusions:
TWISST is an innovative and novel strategy that effectively diagnoses and remediates LSTs in a working system. This approach couples highly reliable work system improvements and training into 1 framework.
Quasi-experimental, Nonrandomized Initiative to Minimize Sleep Disruptions among Hospitalized Children
Authors: Glover Brianna , Bederman Leonid , Orenstein Evan , Kandaswamy Swaminathan , Cooley Anthony , Bryant Christy , Thompson Sarah , Thomas Sindhu , Graham Sarah , Yamasaki Selena , Thornton Michelle , Perry Linda , Hames Nicole 
Published: July 2023

Introduction:
Hospitalized children experience frequent sleep disruptions. We aimed to reduce caregiver-reported sleep disruptions of children hospitalized on the pediatric hospital medicine service by 10% over 12 months.

Methods:
In family surveys, caregivers cited overnight vital signs (VS) as a primary contributor to sleep disruption. We created a new VS frequency order of “every 4 hours (unless asleep between 2300 and 0500)” as well as a patient list column in the electronic health record indicating patients with this active VS order. The outcome measure was caregiver-reported sleep disruptions. The process measure was adherence to the new VS frequency. The balancing measure was rapid responses called on patients with the new VS frequency.

Results:
Physician teams ordered the new VS frequency for 11% (1,633/14,772) of patient nights on the pediatric hospital medicine service. Recorded VS between 2300 and 0500 was 89% (1,447/1,633) of patient nights with the new frequency ordered compared to 91% (11,895/13,139) of patient nights without the new frequency ordered (P = 0.01). By contrast, recorded blood pressure between 2300 and 0500 was only 36% (588/1,633) of patient nights with the new frequency but 87% (11,478/13,139) of patient nights without the new frequency (P < 0.001). Overall, caregivers reported sleep disruptions on 24% (99/419) of reported nights preintervention, which decreased to 8% (195/2,313) postintervention (P < 0.001). Importantly, there were no adverse safety issues related to this initiative.

Conclusion:
This study safely implemented a new VS frequency with reduced overnight blood pressure readings and caregiver-reported sleep disruptions.
A Quality Improvement Initiative to Improve Pediatric Discharge Medication Safety and Efficiency
Authors: Ring Lisa M. , Cinotti Jamie , Hom Lisa A. , Mullenholz Mary , Mangum Jordan , Ahmed-Winston Sameeya , Cheng Jenhao Jacob , Randolph Ellie , Harahsheh Ashraf S. 
Published: July 2023

Introduction:
Medication errors are a leading safety concern, especially for families with limited English proficiency and health literacy, and patients discharged on multiple medications with complex schedules. Integration of a multilanguage electronic discharge medication platform may help decrease medication errors. This quality improvement (QI) project’s primary aim (process measure) was to increase utilization in the electronic health record (EHR) of the integrated MedActionPlanPro (MAP) for cardiovascular surgery and blood and marrow transplant patients at hospital discharge and for the first clinic follow-up visit to 80% by July 2021.

Methods:
This QI project occurred between August 2020 and July 2021 on 2 subspecialty pediatric acute care inpatient units and respective outpatient clinics. An interdisciplinary team developed and implemented interventions, including integration of MAP within EHR; the team tracked and analyzed outcomes for discharge medication matching, and efficacy and safety MAP integration occurred with a go-live date of February 1, 2021. Statistical process control charts tracked progress.

Results:
Following the implementation of the QI interventions, there was an increase from 0% to 73% in the utilization of the integrated MAP in the EHR across the acute care cardiology unit-cardiovascular surgery/blood and marrow transplant units. The average user hours per patient (outcome measure) decreased 70% from the centerline of 0.89 hours during the baseline period to 0.27 hours. In addition, the medication matching between Cerner inpatient and MAP inpatient increased significantly from baseline to postintervention by 25.6% (P < 0.001).

Conclusion:
MAP integration into the EHR was associated with improved inpatient discharge medication reconciliation safety and provider efficiency.
Quantitative Magnetic Resonance Imaging for the Pancreas
Authors: Fukukura Yoshihiko , Kanki Akihiko 
Published: July 2023

AbstractMagnetic resonance imaging (MRI) is important for evaluating pancreatic disorders, and anatomical landmarks play a major role in the interpretation of results. Quantitative MRI is an effective diagnostic modality for various pathologic conditions, as it allows the investigation of various physical parameters. Recent advancements in quantitative MRI techniques have significantly improved the accuracy of pancreatic MRI. Consequently, this method has become an essential tool for the diagnosis, treatment, and monitoring of pancreatic diseases. This comprehensive review article presents the currently available evidence on the clinical utility of quantitative MRI of the pancreas.
A Novel Phenotype of Calvarial Thickening and Increased Rates of Premature Calvarial Suture Closure in Children With Chronic Lung Disease
Authors: Zapatero Zachary D. , Zhang Huayan , Zandifar Alireza , Nilan Kathleen A. , Calabria Andrew C. , Swanson Jordan W. , Vossough Arastoo , Taylor Jesse A. , Lang Shih-Shan , Bartlett Scott P. 
Published: July 2023

Purpose:
The purpose of this study was to characterize a novel type of calvarial thickening and provide objective measurements of skull thickness and calvarial suture morphology in patients with bronchopulmonary dysplasia.

Methods:
Infants with severe bronchopulmonary dysplasia who also had undergone computed tomography (CT) scans were identified from the neonatal chronic lung disease program database. Thickness analysis was performed using Materialise Mimics.

Results:
The chronic lung disease team treated 319 patients during the study interval of which, 58 patients (18.2%) had head CT available. Twenty-eight (48.3%) were found to have calvarial thickening. The rate of premature suture closure in the study population was 36.2% (21 of 58 patients), with 50.0% of affected cohort having evidence of premature suture closure on the first CT scan. Multivariate logistic regression identified 2 risk factors, requiring invasive ventilation at 6 months of age and fraction of inspired oxygen requirement at 6 months of age. Increased head circumference at birth protected against the development of calvarial thickening.

Conclusions:
We have described a novel subset of patients with chronic lung disease of prematurity who have calvarial thickening with remarkably high rates of premature closure of cranial sutures. The exact etiology of the association is unknown. In this patient population with radiographic evidence of premature suture closure, operative decision should be made after considering unequivocal evidence of elevated intracranial pressure or dysmorphology and balanced against the risk of the procedure.
A SYSTEMATIC RE-ANALYSIS OF COPY NUMBER LOSSES OF UNCERTAIN CLINICAL SIGNIFICANCE
Authors: Burghel George J , Ellingford Jamie M , Wright Ronnie , Bradford Lauren , Miller Jake , Watt Christopher , Edgerley Jonathan , Naeem Farah , Banka Siddharth 
Published: July 2023

AbstractBackgroundRe-analysis of whole exome/genome data improves diagnostic yield. However, the value of re-analysis of clinical array comparative genomic hybridisation (aCGH) data has never been investigated. Case-by-case re-analysis is impractical in busy diagnostic laboratories.Methods and ResultsWe harmonised historical post-natal clinical aCGH results from ∼16,000 patients tested via our diagnostic laboratory over ∼7 years with current clinical guidance. This led to identification of 33,857 benign, 2,173 class 3, and 979 pathogenic copy number losses (CNLs). We found benign CNLs to be significantly less likely to encompass haploinsufficient genes compared to the pathogenic or class 3 CNLs in our database. Using this observation, we developed a re-analysis pipeline (using up-to-date disease association data and haploinsufficiency scores) and shortlisted 207 class 3 CNLs encompassing at least one autosomal dominant disease-gene associated with haploinsufficiency or loss-of-function mechanism. Clinical scientist review led to reclassification of 7.2% shortlisted class 3 CNLs as pathogenic or likely pathogenic. This included first cases of CNV-mediated disease for some genes where all previously described cases involved only point variants. Interestingly, some CNLs could not be re-classified because the phenotypes of patients with CNLs seemed distinct from the known clinical features resulting from point variants, thus raising questions about accepted underlying disease mechanisms. Several potential novel disease-genes were identified that would need further validation.ConclusionsRe-analysis of clinical aCGH data increases diagnostic yield and demonstrates their research value. In future, the aCGH reanalysis program should be expanded to include other copy number variant types.
Extracellular lactate as an alternative energy source for retinal bipolar cells
Authors: Garcia Victor Calbiague , Chen Yiyi , Cádiz Bárbara , Paquet-Durand François , Schmachtenberg Oliver 
Published: July 2023

AbstractRetinal bipolar and amacrine cells receive visual information from photoreceptors and participate in the first steps of image processing in the retina. Several studies have suggested the operation of aerobic glycolysis and a lactate shuttle system in the retina due to the high production of this metabolite under aerobic conditions. However, whether bipolar cells form part of this metabolic circuit remains unclear. Here, we show that the lactate transporter MCT2 is functionally expressed in inner retinal neurons and demonstrate their ability to consume extracellular lactate as an alternative to glucose. In rod bipolar cells, lactate is used to maintain homeostasis of various ions and electrical responses. Overall, our data contribute to a better understanding of inner retinal metabolism.
XENTURION, a multidimensional resource of xenografts and tumoroids from metastatic colorectal cancer patients for population-level translational oncology
Authors: Leto Simonetta M. , Grassi Elena , Avolio Marco , Vurchio Valentina , Cottino Francesca , Ferri Martina , Zanella Eugenia R. , Blasio Laura di , Somale Desiana , Vara-Messler Marianela , Galimi Francesco , Sassi Francesco , Lupo Barbara , Catalano Irene , Pinnelli Marika , Viviani Marco , Sperti Luca , Mellano Alfredo , Ferrero Alessandro , Zingaretti Caterina C. , Puliafito Alberto , Primo Luca , Bertotti Andrea , Trusolino Livio 
Published: July 2023

ABSTRACTThe breadth and depth at which cancer models are interrogated contribute to successful translation of drug discovery efforts to the clinic. In colorectal cancer (CRC), model availability is limited by a dearth of large-scale collections of patient-derived xenografts (PDXs) and paired tumoroids from metastatic disease, the setting where experimental therapies are typically tested. XENTURION is a unique open-science resource that combines a platform of 129 PDX models and a sister platform of 129 matched PDX-derived tumoroids (PDXTs) from patients with metastatic CRC, with accompanying multidimensional molecular and therapeutic characterization. A PDXT-based population trial with the anti-EGFR antibody cetuximab revealed variable sensitivities that were consistent with clinical response biomarkers, mirrored tumor growth changes in matched PDXs, and recapitulated the outcome of EGFR genetic deletion. Adaptive signals upregulated by EGFR blockade were computationally and functionally prioritized, and inhibition of top candidates increased the magnitude of response to cetuximab. These findings illustrate the probative value and accuracy of largeex vivoandin vivoliving biobanks, highlight the importance of cross-platform and cross-methodology systematic validation, and offer avenues for molecularly informed preclinical research.
Integrated single-cell multiomics uncovers foundational regulatory mechanisms of lens development and pathology
Authors: Tangeman Jared A , Rebull Sofia M , Grajales-Esquivel Erika , Weaver Jacob M , Bendezu-Sayas Stacy , Robinson Michael L , Lachke Salil A , Rio-Tsonis Katia Del 
Published: July 2023

AbstractOcular lens development entails epithelial to fiber cell differentiation, defects in which cause congenital cataract. We report the first single-cell multiomic atlas of lens development, leveraging snRNA-seq, snATAC-seq, and CUT&RUN-seq to discover novel mechanisms of cell fate determination and cataract-linked regulatory networks. A comprehensive profile ofcis- andtrans-regulatory interactions, including for the cataract-linked transcription factor MAF, is established across a temporal trajectory of fiber cell differentiation. Further, we divulge a conserved epigenetic paradigm of cellular differentiation, defined by progressive loss of H3K27 methylation writer Polycomb repressive complex 2 (PRC2). PRC2 localizes to heterochromatin domains across master-regulator transcription factor gene bodies, suggesting it safeguards epithelial cell fate. Moreover, we demonstrate that FGF hyper-stimulationin vivoleads to MAF network activation and the emergence of novel lens cell states. Collectively, these data depict a comprehensive portrait of lens fiber cell differentiation, while defining regulatory effectors of cell identity and cataract formation.
Understanding the challenges of 5G deployment in India
Authors: Gupta Kriti Priya 
Published: July 2023

Purpose
This study aims to understand the challenges of 5G deployment in India from the perspectives of telecom operators. These challenges are also mapped to different contexts within the technological-organizational-environmental (TOE) framework.

Design/methodology/approach
The study uses a qualitative approach comprising in-depth semi-structured interviews of employees working in telecom companies in India. Thematic analysis is used to analyse the qualitative data.

Findings
The author has identified nine challenges that are categorized under three dimensions of the TOE framework. Specifically, the findings indicate three technological challenges: hardware/device challenges, security concerns and limited use cases; two organization challenges: financial challenges and lack of skilled workforce; and four environmental challenges: inadequate infrastructure, regulatory and administrative challenges, consumers’ attitudes and competitive market conditions.

Practical implications
The results of this study would help understand the key factors that can act as barriers to the 5G rollout in India. Based on the findings of the study, the government and regulatory bodies could design conducive policies and regulatory frameworks to successfully deploy 5G in India.

Originality/value
The study is one of the very few studies to empirically examine the telecom operators’ perspectives on the challenges of 5G deployment in India. The study contributes to the TOE framework as its application in the context of identifying barriers to 5G deployment is probably for the first time.