bluuebunny/crossref_metadata_2025_split huggingface dataset:
Changes in Patient Experiences of Hospital Care During the COVID-19 Pandemic
Authors: Elliott Marc N. , Beckett Megan K. , Cohea Christopher W. , Lehrman William G. , Cleary Paul D. , Giordano Laura A. , Russ Chelsea , Goldstein Elizabeth H. , Fleisher Lee A. 
Published: August 2023

ImportanceIt is important to assess how the COVID-19 pandemic was adversely associated with patients’ care experiences.ObjectiveTo describe differences in 2020 to 2021 patient experiences from what would have been expected from prepandemic (2018-2019) trends and assess correlates of changes across hospitals.Design, Setting, and ParticipantsThis cohort study compared 2020 to 2021 data with 2018 to 2019 data from 3 900 887 HCAHPS respondents discharged from 3381 HCAHPS-participating US hospitals. The data were analyzed from 2022 to 2023.Main Outcomes and MeasuresThe primary outcome was an HCAHPS summary score (HCAHPS-SS), which averaged 10 HCAHPS measures. The primary analysis estimated whether HCAHPS scores from patients discharged from 2020 to 2021 differed from scores that would be expected based on quarterly and linear trends from 2018 to 2019 discharges. Secondary analyses stratified hospitals by prepandemic overall star ratings and staffing levels.ResultsOf the 3 900 887 HCAHPS 2020 to 2021 respondents, 59% were age 65 years or older, and 35% (11%) were in the surgical (maternity) service lines. Compared with trends expected based on prepandemic (2018-2019) data, HCAHPS-SS was 1.2 percentage points (pp) lower for quarter (Q) 2/2020 discharges and −1.9 to −2.0 pp for Q3/2020 to Q1/2021, which then declined to −3.6 pp by Q4/2021. The most affected measures (Q4/2021) were staff responsiveness (−5.6 pp) and cleanliness (−4.9 pp); the least affected were discharge information (−1.6 pp) and quietness (−1.8 pp). Overall rating and hospital recommendation measures initially exhibited smaller-than-average decreases, but then fell as much as the more specific experience measures by Q2/2021. Quietness did not decline until Q2/2021. The HCAHPS-SS fell most for hospitals with the lowest prepandemic staffing levels; hospitals with bottom-quartile staffing showed the largest decrements, whereas top-quartile hospitals showed smaller decrements in most quarters. Hospitals with better overall prepandemic quality showed consistently smaller HCAHPS-SS drops, with effects for 5-star hospitals about 25% smaller than for 1-star and 2-star hospitals.Conclusions and RelevanceThe results of this cohort study of HCAHPS-participating hospitals found that patient experience scores declined during 2020 to 2021. By Q4/2021, the HCAHPS-SS was 3.6 pp lower than would have been expected, a medium effect size. The most affected measures (staff responsiveness and cleanliness) showed large effect sizes, possibly reflecting high illness-associated hospital workforce absenteeism. Hospitals that were lower performing and less staffed prepandemic may have been less resilient to reduced staff availability and other pandemic-associated challenges. However, by Q4/2021, even prepandemic high-performing hospitals had similar declines.
Infrastructure tools to support an effective Radiation Oncology Learning Health System
Authors: Kapoor Rishabh , Sleeman William C , Ghosh Preetam , Palta Jatinder 
Published: August 2023

AbstractPurposeRadiation Oncology Learning Health System (RO‐LHS) is a promising approach to improve the quality of care by integrating clinical, dosimetry, treatment delivery, research data in real‐time. This paper describes a novel set of tools to support the development of a RO‐LHS and the current challenges they can address.MethodsWe present a knowledge graph‐based approach to map radiotherapy data from clinical databases to an ontology‐based data repository using FAIR concepts. This strategy ensures that the data are easily discoverable, accessible, and can be used by other clinical decision support systems. It allows for visualization, presentation, and data analyses of valuable information to identify trends and patterns in patient outcomes. We designed a search engine that utilizes ontology‐based keyword searching, synonym‐based term matching that leverages the hierarchical nature of ontologies to retrieve patient records based on parent and children classes, connects to the Bioportal database for relevant clinical attributes retrieval. To identify similar patients, a method involving text corpus creation and vector embedding models (Word2Vec, Doc2Vec, GloVe, and FastText) are employed, using cosine similarity and distance metrics.ResultsThe data pipeline and tool were tested with 1660 patient clinical and dosimetry records resulting in 504 180 RDF (Resource Description Framework) tuples and visualized data relationships using graph‐based representations. Patient similarity analysis using embedding models showed that the Word2Vec model had the highest mean cosine similarity, while the GloVe model exhibited more compact embeddings with lower Euclidean and Manhattan distances.ConclusionsThe framework and tools described support the development of a RO‐LHS. By integrating diverse data sources and facilitating data discovery and analysis, they contribute to continuous learning and improvement in patient care. The tools enhance the quality of care by enabling the identification of cohorts, clinical decision support, and the development of clinical studies and machine learning programs in radiation oncology.
A head and neck treatment planning strategy for a CBCT‐guided ring‐gantry online adaptive radiotherapy system
Authors: Nasser Nour , Yang George Q. , Koo Jihye , Bowers Mark , Greco Kevin , Feygelman Vladimir , Moros Eduardo G. , Caudell Jimmy J. , Redler Gage 
Published: August 2023

AbstractPurposeA planning strategy was developed and the utility of online‐adaptation with the Ethos CBCT‐guided ring‐gantry adaptive radiotherapy (ART) system was evaluated using retrospective data from Head‐and‐neck (H&N) patients that required clinical offline adaptation during treatment.MethodsClinical data were used to re‐plan 20 H&N patients (10 sequential boost (SEQ) with separate base and boost plans plus 10 simultaneous integrated boost (SIB)). An optimal approach, robust to online adaptation, for Ethos‐initial plans using clinical goal prioritization was developed. Anatomically‐derived isodose‐shaping helper structures, air‐density override, goals for controlling hotspot location(s), and plan normalization were investigated. Online adaptation was simulated using clinical offline adaptive simulation‐CTs to represent an on‐treatment CBCT. Dosimetric comparisons were based on institutional guidelines for Clinical‐initial versus Ethos‐initial plans and Ethos‐scheduled versus Ethos‐adapted plans. Timing for five components of the online adaptive workflow was analyzed.ResultsThe Ethos H&N planning approach generated Ethos‐initial SEQ plans with clinically comparable PTV coverage (average PTVHigh V100% = 98.3%, Dmin,0.03cc = 97.9% and D0.03cc = 105.5%) and OAR sparing. However, Ethos‐initial SIB plans were clinically inferior (average PTVHigh V100% = 96.4%, Dmin,0.03cc = 93.7%, D0.03cc = 110.6%). Fixed‐field IMRT was superior to VMAT for 93.3% of plans. Online adaptation succeeded in achieving conformal coverage to the new anatomy in both SEQ and SIB plans that was even superior to that achieved in the initial plans (which was due to the changes in anatomy that simplified the optimization). The average adaptive workflow duration for SIB, SEQ base and SEQ boost was 30:14, 22.56, and 14:03 (min: sec), respectively.ConclusionsWith an optimal planning approach, Ethos efficiently auto‐generated dosimetrically comparable and clinically acceptable initial SEQ plans for H&N patients. Initial SIB plans were inferior and clinically unacceptable, but adapted SIB plans became clinically acceptable. Online adapted plans optimized dose to new anatomy and maintained target coverage/homogeneity with improved OAR sparing in a time‐efficient manner.
Dosimetry and acute radiation enteritis comparison between prone and supine position in IMRT for gynecological cancers
Authors: Yan Huamei , Wu Manya , Wang Wan , Wang Donghui , Huang Xiaoqing , Dong Jie , Chen Luxi , Li Zhenghuan , Xu Xiangying 
Published: August 2023

AbstractPurposeTo probe the differences of dosimetry and acute radiation enteritis between prone and supine position in gynecological cancer patients treated with intensity‐modulate radiotherapy (IMRT).MethodsGynecologic tumor patients who received IMRT from January 2020 to July 2021 were analyzed. 60 patients were enrolled and divided into the supine or prone position group according to different radiotherapy positions, including 34 patients in prone position and 26 patients in supine position. The dose‐volume histogram of organs at risk (OARs) and the incidence of acute radiation enteritis were compared between the two groups. Multivariate logistic regression analysis was conducted to show the clinical characteristics and dose volume metrics to the association of acute radiation enteritis.ResultsThe percentage of volume receiving 5 Gy, 10 Gy, 15 Gy, 20 Gy, 30 Gy, 40 Gy, and 45 Gy doses for the small intestine were 79.0%, 67.4%, 59.6%, 44.3%, 17.0%, 8.9%, and 6.0%, respectively in the prone group, which were lower than those in the supine group (P < 0.05). The mean radiation dose (Dmean) of the small intestine exposure in prone group was decreased (P < 0.001). Compared with the supine group, the prone group who suffered from acute radiation enteritis were much less. The probability of indigestion, nausea, vomiting, diarrhea, and abdominal pain in the prone position were 35.29%, 29.41%, 17.65%, 38.24%, and 5.88%, respectively. The differences in indigestion, nausea, and diarrhea between the two groups were statistically significant (P = 0.012, P = 0.029, and P = 0.041). Multivariate logistic regression analysis was shown that prone position was found to be protective against indigestion (P = 0.002), nausea (P = 0.013), vomiting (P = 0.035), and abdominal pain (P = 0.021).ConclusionProne position in IMRT for gynecological cancers could significantly reduce radiation dose to the small bowel and colon, which would decrease the occurrence and severity of acute intestinal side effects possibly.
Synergistic Effect of Sodium Cyanoborohydride in Pb‐Sn Perovskite Solar Cells
Authors: Song Jing , Kong Tengfei , Zhang Yang , Liu Xufu , Saliba Michael , Bi Dongqin 
Published: August 2023

AbstractPb‐Sn mixed perovskite has received extensive attention because of its high research value in environmental protection and theoretical prospects. However, the film defects brought on by the quick crystallization of Pb‐Sn mixed perovskites and the facile oxidation of Sn2+ to Sn4+ are detrimental to the performance of Pb‐Sn perovskite solar cells (PSCs). Here, aiming at the interface of Pb‐Sn PSCs, which has been less studied, a reducing agent is first introduced on the top of Pb‐Sn mixed perovskite interface. The results show that in NaBH3CN(SC), B─H can suppress the oxidation of Sn2+ and C≡N can enhance the perovskite crystallinity and passivate the surface defects. Benefitting from this synergistic effect, a champion power conversion efficiency of 21.3% is obtained for Pb‐Sn PSCs. In addition, the encapsulated device can maintain good stability under maximum power point tracking conditions.
Key Role of Local Chemistry in Lattice Nitrogen‐Participated N2‐to‐NH3 Electrocatalytic Cycle over Nitrides
Authors: Zhang Mingcheng , Ai Xuan , Liang Xiao , Chen Hui , Zou Xiaoxin 
Published: August 2023

AbstractMetal nitrides offer great opportunities for improving activity and selectivity of electrocatalytic nitrogen reduction reaction (ENRR) via the lattice nitrogen‐participated mechanism. Understanding the role of local chemistry of lattice nitrogen is important for establishing rational design principles of nitride catalysts. Herein, high‐throughput theoretical calculations are employed to investigate lattice nitrogen‐participated ENRR over a family of antiperovskite nitrides (M′M3N, M and M′ are different metal atoms) with highly tunable surrounding environments of N atoms. The M′M3N structure comprises isolated N atoms in the center, M atoms in the first coordination shells, and M′ atoms in the second coordination shells. An appropriate M‐N bond strength is found to be crucial for designing ideal nitride catalysts. Specifically, weak M‐N bonding facilitates the participation of lattice nitrogen and better activity, but too weak M‐N bonding results in structural instability of antiperovskite. The type of M element governs M‐N bond strength through adjusting hybridization interactions between M orbital and N orbital, and the M′ element can further finely regulate M‐N bond strength via M‐M′ polarization effects. Finally, AgBa3N, AlBa3N, GaBa3N catalysts are screened to possess greater ENRR activity than the benchmarking Ru (0001) catalysts and high selectivity toward hydrogen evolution reaction.
From “100%” Utilization of MAX/MXene to Direct Engineering of Wearable, Multifunctional E‐Textiles in Extreme Environments
Authors: Li Bin , Wu Na , Wu Qilei , Yang Yunfei , Pan Fei , Liu Wei , Liu Jiurong , Zeng Zhihui 
Published: August 2023

AbstractTransition metal carbides/nitrides (MXenes) show great potential for preparing wearable, flexible multifunctional e‐textiles due to the exceptional electrical and mechanical properties and easy processing in aqueous medium. At present, MXene‐based e‐textiles face challenges including high production costs, low utilization of precursor titanium aluminum carbide (MAX), poor durability in extreme environments, and the inability to achieve a balance between large‐scale fabrication and high performance. Here, this work proposes a “100%” utilization of MAX/MXene strategy to produce additive‐free conductive inks with controllable viscosity, subsequently enabling an accessible, scalable direct‐blade‐coating followed by chemical cross‐linking approach for creating wearable, high‐performance, multifunctional MXene‐based e‐textiles that perform in extreme conditions. The structural design provides integrated multifunctionality involving controllable and exceptional electromagnetic interference (EMI) shielding within an ultrabroadband frequency range, visual electrothermal conversion, electrothermal deicing, remarkable visual photothermal, and antibacterial performance. This work employs a fabrication process that is simple, cost‐effective, and scalable, presenting a novel “100% efficiency” and “waste‐to‐wealth” strategy to manufacture robust, durable, multifunctional e‐textiles. This approach provides exciting potential for the next generation of wearable electronics, EMI compatibility, visual heating, thermotherapy, antibacterial treatments, deicing, defense, and aerospace applications.
Harnessing Transition Metal Scaffolds for Targeted Antibacterial Therapy
Authors: Weng Cheng , Tan Yong Leng Kelvin , Koh Wayne Gareth , Ang Wee Han 
Published: August 2023

AbstractAntimicrobial resistance, caused by persistent adaptation and growing resistance of pathogenic bacteria to overprescribed antibiotics, poses one of the most serious and urgent threats to global public health. The limited pipeline of experimental antibiotics in development further exacerbates this looming crisis and new drugs with alternative modes of action are needed to tackle evolving pathogenic adaptation. Transition metal complexes can replenish this diminishing stockpile of drug candidates by providing compounds with unique properties that are not easily accessible using pure organic scaffolds. We spotlight four emerging strategies to harness these unique properties to develop new targeted antibacterial agents.
The Lived Experience of Ambulatory and Perioperative RNs Displaced During the COVID‐19 Pandemic: A Phenomenological Study
Authors: Withall Jennifer , Lavin Patricia M. , Rich Ellen 
Published: August 2023

ABSTRACTDuring the patient surge associated with the onset of the COVID‐19 pandemic in the spring of 2020, perioperative and ambulatory RNs at an acute‐care specialty orthopedic hospital were redeployed to medical‐surgical inpatient nursing units to care for patients with the disease. The purpose of this phenomenological study was to describe perioperative and ambulatory RNs’ experiences during the redeployment. We used purposeful sampling to obtain representatives who worked routinely in perioperative (including postanesthesia care) and ambulatory settings before redeployment. Data saturation was reached after eight in‐depth interviews that yielded rich descriptions of the nurses’ experiences. Most participants indicated that the fundamental structure of the experience involved being “thrown into a war without weapons” and needing to find ways to fight. The results of this study provide a unique contribution to nursing literature and may assist nurses and leaders in the future.
Teratology research in the shadow of theDobbsdecision
Authors: Lyerly Anne Drapkin 
Published: August 2023

AbstractFollowing the 2022 US Supreme Court decision inDobbsvs.Jackson Women's Health Organization, numerous states have passed laws banning or severely restricting abortion. The consequences of the decision stretch beyond abortion contexts, including progress on developing a more robust evidence base for care in pregnancy. In this Robert L. Brent lecture, I explore the impact of theDobbsdecision on teratology research, arguing that it is of importance even and perhaps especially for those concerned about the moral complexities of ending a pregnancy. For as abortion restrictions threaten teratology research, they also threaten its life‐affirming aims. First, I show how teratology research and abortion are intertwined, highlighting the stories of Sherri Finkbine and Frances Kelsey, two courageous women whose lives intersected with both. Second, I describe how restrictions on abortion make teratology research more difficult and ethically complex, highlighting additional risks to research participants and staff, as well as new challenges to scientific validity and feasibility. And third, foregrounding yet another story of courage (and heartbreak), I highlight how abortion restrictions make teratology research more important than ever. Honoring Dr. Brent's legacy requires addressing—rather than avoiding—the ethical challenges of pregnancy‐related research, especially now in the post‐Dobbsera.
Large‐scale evaluation of staff training in programs for adults with intellectual and developmental disabilities
Authors: Kamana Bertilde U. , Dozier Claudia L. , Kanaman Nicole A. , DiGennaro Reed Florence , Glaze Stephanie M. , Markowitz Ali M. , Hangen Marcella M. , Harrison Kelley L. , Bernstein Alec M. , Jess Rachel L. , Erath Tyler G. 
Published: August 2023

AbstractBehavioral skills training and on‐the‐job feedback are effective in changing staff behavior as evidenced by years of staff‐training research. However, community programs for adults with intellectual and developmental disabilities (IDD) often do not utilize these best‐practice training methods. The purpose of the current study was to train four empirically derived practices to staff who work with adults with IDD. We trained the staff to provide positive interactions, provide effective instructions, provide correct responses to problem behavior, and promote consumer engagement with items and activities. We used behavioral skills training and on‐the‐job feedback to increase staff implementation of these practices on a large scale in a community‐based organization despite some barriers such as high staff turnover rates. Overall, results showed that our training procedure was effective in increasing staff implementation of the four practices in many homes and programs.
Exploring the effect of artificial intelligence intellect on consumer decision delegation: The role of trust, task objectivity, and anthropomorphism
Authors: Song Jinzhu , Lin Hengyu 
Published: August 2023

AbstractThis study examines the impact of AI intelligence levels on consumer decision delegation through three experimental studies. Study 1 manipulates AI intelligence levels (low vs. high) to establish the main effect. Study 2 explores the mediating role of trust and the moderating effect of task types (subjective vs. objective) on the relationship between AI intelligence and trust. Study 3 investigates the role of AI anthropomorphism in AI delegation. The findings reveal that increasing AI intelligence enhances consumer decision delegation for both subjective and objective consumption tasks, with trust serving as a mediating factor. However, objective tasks are more likely to be delegated to AI. Moreover, anthropomorphic appearance positively influences trust but does not moderate the relationship between intelligence and trust. This research expands the literature on AI decision delegation, shedding light on the psychological processes related to AI‐powered product design, consumer perceptions, and consumption situations, while also offering practical implications.
Phenolics from Chilean Bee Bread Exhibit Antioxidant and Antibacterial Properties: The First Prospective Study
Authors: Jorquera Bairon , Mayorga Ailin , Quintero‐Pertuz Helena , Mejía Jessica , Núñez Gabriel , Núñez Pizarro Paula , Arias‐Santé María Fernanda , Montenegro Gloria , Costa de Camargo Adriano , Bridi Raquel 
Published: August 2023

AbstractBee bread (BB) is a beehive product generated upon fermentation of pollen combined with flower nectar and glandular secretions. The potential application of BB is related to its nutritional and functional components, including phenolic compounds. This is the first prospective study on palynological parameters, phenolics, antioxidant, and antibacterial activity of Chilean bee bread in vitro. The tested material exhibited high levels of phenolics (1340±186 mg GAE/100 g BB) and showed antioxidant capacity as determined by the FRAP (51±2 μmol Trolox equivalent/g BB) and ORAC‐FL (643±64 μmol Trolox equivalent/g BB) and antibacterial activity against Streptococcus pyogenes. Furthermore, the phenolic acids and flavonoids was determined using liquid chromatography‐mass spectrometry, and the concentration was determined using liquid chromatography with diode array detection. Kaempferol, quercetin, ferulic acid, and rutin were the main phenolics found. This study demonstrates the bioactive potential of Chilean BB and supports the evidence that this bee product is a promising source of antioxidants and antimicrobial compounds.
Melamine Modification of the Carrier Regulating the Performance of PtBi/AC in Heptanol Oxidation
Authors: Ma Xinzheng , Guo Luyao , Zhao Ziang , Meng Yu , Mou Xiaoling , Lin Ronghe , Li Yihui , Yan Li , Zhu Hejun , Ding Yunjie 
Published: August 2023

AbstractDifferent bimetallic platinum and bismuth catalysts supported on melamine‐modified activated carbon (AC) are designed by a co‐impregnation method. Through controlling the activation temperatures of the melamine−AC mixture, a series of N‐doped and C3N4‐modified AC (N−AC and C3N4−AC) are prepared. Combined powder X‐ray diffractions, X‐ray photoelectron spectroscopic, and high‐angle annual dark‐field scanning transmission electron microscopic studies demonstrate that the introduction of C3N4 favors the formation of PtBi alloy and leads to increased particle sizes in comparison to the pristine and N‐doped AC‐supported bimetallics. The catalytic performance of the developed catalysts is evaluated in the oxidation of n‐heptanol oxidation in a batch mode using O2 as the oxidant. PtBi/C3N4−AC exhibits significantly boosted activity as well as selectivity to heptanoic acid as compared with the other catalysts. A high yield of heptanoic acid of 69 % can be achieved under the optimized reaction conditions. Furthermore, our work points to the PtBi alloy as the most active sites for the alcohol oxidation. Catalyst deactivation occurs in the cycling tests, mainly due to the collapse of the alloy phase and likely the decrease in particle sizes.