bluuebunny/crossref_metadata_2025_split huggingface dataset:
Rate and causes of inappropriate stays and the resulting financial burden in a single specialty burns hospital
Authors: Moradi Nasrin , Moradi Kianoosh , Bagherzadeh Rafat , Aryankhesal Aidin 
Published: December 2022

Abstract
Background
One of the most important challenges facing hospitals is inappropriate admissions and stays the reduction of which can contribute to a decline in healthcare costs without reducing the quality of services. The aim of this study was to estimate the rate and causes of inappropriate stays and their financial burden in a single specialty burns hospital.

Methods
This is mixed methods study conducted in 2021. In the quantitative phase, all medical records of patients admitted to a burn hospital were reviewed and 260 cases were randomly selected. The records were evaluated based on the Appropriateness Evaluation Protocol to estimate the rate and preliminary causes of inappropriate stays and their direct costs. Frequencies and logistic regression were used for the rates and the influential factors in causing inappropriate stay, respectively. In the qualitative phase, 13 senior and middle managers of the hospital were interviewed for their interpretation of the quantitative data and the main causes of inappropriate stays. Qualitative data were analyzed by using Graneheim-Lundman method.

Results
About 28.5% of the patients had at least 1 day of inappropriate stay and about 6% of the total hospitalization days were inappropriate. Marital status, insurance status, and the length of stay were significantly associated with inappropriate admission (p < 0.05). In addition, the annual inappropriate admission days and the direct cost imposed on the patients were estimated at 1490 days and $ 66,848.17. The main causes of inappropriate stays are categorized under themes of healthcare providers, service recipients, financial issues, extra-organizational features, and equipment.

Conclusion
A significant percentage of patients experience inappropriate admissions. The number of inappropriate stays, which imposes a high cost on patients, can be reduced by considering the standard criteria for appropriate admissions. In addition, hospital officials can prevent inappropriate stays as much as possible and reduce the costs and increase the productivity of hospitals through proper management and planning as well as a regular monitoring of physicians and patients.
Using a stakeholder-engaged, iterative, and systematic approach to adapting collaborative decision skills training for implementation in VA psychosocial rehabilitation and recovery centers
Authors: Treichler Emily B. H. , Mercado Robert , Oakes David , Perivoliotis Dimitri , Gallegos-Rodriguez Yuliana , Sosa Elijah , Cisneros Erin , Spaulding William D. , Granholm Eric , Light Gregory A. , Rabin Borsika 
Published: December 2022

Abstract
Background
Adaptation of interventions is inevitable during translation to new populations or settings. Systematic approach to adaptation can ensure that fidelity to core functions of the intervention are preserved while optimizing implementation feasibility and effectiveness for the local context. In this study, we used an iterative, mixed methods, and stakeholder-engaged process to systematically adapt Collaborative Decision Skills Training for Veterans with psychosis currently participating in VA Psychosocial Rehabilitation and Recovery Centers.

Methods
A modified approach to Intervention Mapping (IM-Adapt) guided the adaptation process. An Adaptation Resource Team of five Veterans, two VA clinicians, and four researchers was formed. The Adaptation Resource Team engaged in an iterative process of identifying and completing adaptations including individual qualitative interviews, group meetings, and post-meeting surveys. Qualitative interviews were analyzed using rapid matrix analysis. We used the modified, RE-AIM enriched expanded Framework for Reporting Adaptations and Modifications to Evidence-based interventions (FRAME) to document adaptations. Additional constructs included adaptation size and scope; implementation of planned adaptation (yes–no); rationale for non-implementation; and tailoring of adaptation for a specific population (e.g., Veterans).

Results
Rapid matrix analysis of individual qualitative interviews resulted in 510 qualitative codes. Veterans and clinicians reported that the intervention was a generally good fit for VA Psychosocial Rehabilitation and Recovery Centers and for Veterans. Following group meetings to reach adaptation consensus, 158 adaptations were completed. Most commonly, adaptations added or extended a component; were small in size and scope; intended to improve the effectiveness of the intervention, and based on experience as a patient or working with patients. Few adaptations were targeted towards a specific group, including Veterans. Veteran and clinician stakeholders reported that these adaptations were important and would benefit Veterans, and that they felt heard and understood during the adaptation process.

Conclusions
A stakeholder-engaged, iterative, and mixed methods approach was successful for adapting Collaborative Decision Skills Training for immediate clinical application to Veterans in a psychosocial rehabilitation center. The ongoing interactions among multiple stakeholders resulted in high quality, tailored adaptations which are likely to be generalizable to other populations or settings. We recommend the use of this stakeholder-engaged, iterative approach to guide adaptations.
Ideational factors and their association with insecticide treated net use in Magoe District, Mozambique
Authors: Yukich Joshua O. , Hutchinson Paul , Candrinho Baltazar , Butts Jessica , Murimirgua Filipe , Eisele Thomas P. , Zulliger Rose 
Published: December 2022

Abstract
Background
Insecticide treated bed nets (ITN) are considered a core malaria vector control tool by the WHO and are the main contributor to the large decline in malaria burden in sub-Saharan Africa over the past 20 years, but they are less effective if they are not broadly and regularly used. ITN use may depend on factors including temperature, relative humidity, mosquito density, seasonality, as well as ideational or psychosocial factors including perceptions of nets and perceptions of net use behaviours.

Methods
A cross–sectional household survey was conducted as part of a planned randomized controlled trial in Magoe District, Mozambique. Interviewers captured data on general malaria and ITN perceptions including ideational factors related to perceived ITN response efficacy, self-efficacy to use an ITN, and community norms around ITN using a standardized questionnaire. Only households with sufficient ITNs present for all children to sleep under (at least one ITN for every two children under the age of five years) were eligible for inclusion in the study. Additional questions were added about seasonality and frequency of ITN use.

Results
One-thousand six hundred sixteen mother–child dyads were interviewed. Responses indicated gaps in use of existing nets and net use was largely independent of ideational factors related to ITNs. Self-reported ITN use varied little by season nor meaningfully when different methods were used to solicit responses on net use behaviour. Mothers’ perceived response efficacy of ITNS was negatively associated with net use (high perceived response efficacy reduced the log-odds of net use by 0.27 (95% CI − 0.04 to − 0.51), implying that stronger beliefs in the effectiveness of ITNs might result in reduced net use among their children.

Conclusions
In this context, ITN use among children was not clearly related to mothers’ ideational factors measured in the study. Scales used in solicitation of ideation around ITN use and beliefs need careful design and testing across a broader range of populations in order to identify ideational factors related to ITN use among those with access.
Identification of ocular refraction based on deep learning algorithm as a novel retinoscopy method
Authors: Zou Haohan , Shi Shenda , Yang Xiaoyan , Ma Jiaonan , Fan Qian , Chen Xuan , Wang Yibing , Zhang Mingdong , Song Jiaxin , Jiang Yanglin , Li Lihua , He Xin , Jhanji Vishal , Wang Shengjin , Song Meina , Wang Yan 
Published: December 2022

Abstract
Background
The evaluation of refraction is indispensable in ophthalmic clinics, generally requiring a refractor or retinoscopy under cycloplegia. Retinal fundus photographs (RFPs) supply a wealth of information related to the human eye and might provide a promising approach that is more convenient and objective. Here, we aimed to develop and validate a fusion model-based deep learning system (FMDLS) to identify ocular refraction via RFPs and compare with the cycloplegic refraction. In this population-based comparative study, we retrospectively collected 11,973 RFPs from May 1, 2020 to November 20, 2021. The performance of the regression models for sphere and cylinder was evaluated using mean absolute error (MAE). The accuracy, sensitivity, specificity, area under the receiver operating characteristic curve, and F1-score were used to evaluate the classification model of the cylinder axis.

Results
Overall, 7873 RFPs were retained for analysis. For sphere and cylinder, the MAE values between the FMDLS and cycloplegic refraction were 0.50 D and 0.31 D, representing an increase of 29.41% and 26.67%, respectively, when compared with the single models. The correlation coefficients (r) were 0.949 and 0.807, respectively. For axis analysis, the accuracy, specificity, sensitivity, and area under the curve value of the classification model were 0.89, 0.941, 0.882, and 0.814, respectively, and the F1-score was 0.88.

Conclusions
The FMDLS successfully identified the ocular refraction in sphere, cylinder, and axis, and showed good agreement with the cycloplegic refraction. The RFPs can provide not only comprehensive fundus information but also the refractive state of the eye, highlighting their potential clinical value.
Telemedicine in community shelters: possibilities to improve chronic care among people experiencing homelessness in Hungary
Authors: Békási Sándor , Girasek Edmond , Győrffy Zsuzsa 
Published: December 2022

Abstract
Background
Digital health has expanded during the COVID-19 pandemic, while the exclusion of vulnerable populations with limited access to these technologies widens the gap to receive proper care. There is very little data available on the feasibility of telemedicine solutions regarding the chronic care of homeless persons.

Methods
In our study, 75 participants experiencing homelessness were recruited from four social institutions in Budapest, Hungary. The telecare pilot service consisted of six online consultations with a physician and was available in shelters biweekly. Self-developed questionnaires were used after every online session on the originating and remote sites as well, while a follow-up study was also completed among patients after four to six months of pilot closure. Parameters as frequencies, averages, and percentage distributions were analyzed and two linear regression models were built on explaining the doctors’ and patients’ overall rating of visits.

Results
During the pilot, 92.2% (n = 415) of originally planned visits were delivered and 55 clients (73.3%) attended the full program. Both the patients’ and physicians’ overall satisfaction was very high (4.52 and 4.79, respectively, on a 5-point Likert scale) and the patients’ overall rating remained similarly high during the follow-up. Comparing the first and sixth visits, physicians reported significant improvements in almost all aspects. The linear regression models proved that confidence in the patients’ assessment and diagnosis had the most prominent effect on the physicians’ overall rating, while ease of use and lack of communication gaps influenced positively the patients’ rating.

Conclusion
The results suggest that telehealth services represent a promising tool to ensure better care continuity while using shelter infrastructure and on-site assistance might reduce the digital exclusion of people experiencing homelessness.
The effect of sampling health facilities on estimates of effective coverage: a simulation study
Authors: Carter Emily D. , Maiga Abdoulaye , Do Mai , Sika Glebelho Lazare , Mosso Rosine , Dosso Abdul , Munos Melinda K. 
Published: December 2022

Abstract
Background
Most existing facility assessments collect data on a sample of health facilities. Sampling of health facilities may introduce bias into estimates of effective coverage generated by ecologically linking individuals to health providers based on geographic proximity or administrative catchment.

Methods
We assessed the bias introduced to effective coverage estimates produced through two ecological linking approaches (administrative unit and Euclidean distance) applied to a sample of health facilities. Our analysis linked MICS household survey data on care-seeking for child illness and childbirth care with data on service quality collected from a census of health facilities in the Savanes region of Cote d’Ivoire. To assess the bias introduced by sampling, we drew 20 random samples of three different sample sizes from our census of health facilities. We calculated effective coverage of sick child and childbirth care using both ecological linking methods applied to each sampled facility data set. We compared the sampled effective coverage estimates to ecologically linked census-based estimates and estimates based on true source of care. We performed sensitivity analyses with simulated preferential care-seeking from higher-quality providers and randomly generated provider quality scores.

Results
Sampling of health facilities did not significantly bias effective coverage compared to either the ecologically linked estimates derived from a census of facilities or true effective coverage estimates using the original data or simulated random quality sensitivity analysis. However, a few estimates based on sampling in a setting where individuals preferentially sought care from higher-quality providers fell outside of the estimate bounds of true effective coverage. Those cases predominantly occurred using smaller sample sizes and the Euclidean distance linking method. None of the sample-based estimates fell outside the bounds of the ecologically linked census-derived estimates.

Conclusions
Our analyses suggest that current health facility sampling approaches do not significantly bias estimates of effective coverage produced through ecological linking. Choice of ecological linking methods is a greater source of bias from true effective coverage estimates, although facility sampling can exacerbate this bias in certain scenarios. Careful selection of ecological linking methods is essential to minimize the potential effect of both ecological linking and sampling error.
Influence of magnetic nanoparticle biotransformation on contrasting efficiency and iron metabolism
Authors: Yaremenko Alexey V. , Zelepukin Ivan V. , Ivanov Ilya N. , Melikov Roman O. , Pechnikova Nadezhda A. , Dzhalilova Dzhuliia Sh. , Mirkasymov Aziz B. , Bragina Vera A. , Nikitin Maxim P. , Deyev Sergey M. , Nikitin Petr I. 
Published: December 2022

AbstractMagnetic nanoparticles are widely used in biomedicine for MRI imaging and anemia treatment. The aging of these nanomaterials in vivo may lead to gradual diminishing of their contrast properties and inducing toxicity. Here, we describe observation of the full lifecycle of 40-nm magnetic particles from their injection to the complete degradation in vivo and associated impact on the organism. We found that in 2 h the nanoparticles were eliminated from the bloodstream, but their initial biodistribution changed over time. In 1 week, a major part of the nanoparticles was transferred to the liver and spleen, where they degraded with a half-life of 21 days. MRI and a magnetic spectral approach revealed preservation of contrast in these organs for more than 1 month. The particle degradation led to the increased number of red blood cells and blood hemoglobin level due to released iron without causing any toxicity in tissues. We also observed an increase in gene expression level of Fe-associated proteins such as transferrin, DMT1, and ferroportin in the liver in response to the iron particle degradation. A deeper understanding of the organism response to the particle degradation can bring new directions to the field of MRI contrast agent design.
A systematic literature review of breastfeeding interventions among Black populations using the RE-AIM framework
Authors: Pereira Emiliane Lemos , Estabrooks Paul A. , Arjona Alejandro , Cotton-Curtis Wyconda , Lin Judith C. P. , Saetermoe Carrie L. , Blackman Kacie C. A. 
Published: December 2022

Abstract
Background
Lactation support resources are less likely to be located in close proximity to where Black families live and there is a systemic racist health care belief that Black women prefer bottle feeding (with infant formula) over breastfeeding. Together, these lead to lower reported breastfeeding rates of Black babies compared to other racial / ethnic groups. It is imperative to have a deeper understanding of the cultural aspects as well as the underlying limitations that prevent Black women / persons from being supported to breastfeed. There is a need to know how effective breastfeeding interventions are in reaching the intended population; how well they work in promoting breastfeeding initiation and continuation; and how successful they are when implemented at the setting and staff level. The purpose of this investigation was to establish the level of internal and external validity that was reported by breastfeeding intervention studies among Black communities.

Methods
Studies on breastfeeding interventions on Black people that were published between the years 1990 and 2019 were carefully examined through PubMed, EBSCOhost, Web of Science, and OneSearch. A total of 31 studies fulfilled the requirements to be included for this evaluation. In order to extract the information from the articles, the reach, effectiveness, adoption, implementation, and maintenance (RE-AIM) framework extraction tool was utilized.

Results
On average, the proportion of studies that reported across reach, effectiveness, adoption, implementation, and maintenance indicators was 54, 35, 19, 48, and 9%, respectively. Across core RE-AIM indicators only sample size (100%) and breastfeeding outcomes (90%) were reported consistently. External validity indicators related to representativeness of participants (16%) and sites (3%) were rarely reported. Similarly, adherence to intervention protocol, and indicator of internal validity, was reported in a small proportion of articles (19%).

Conclusion
This body of literature under-reported on aspects associated to both internal and external validity across all RE-AIM domains. The reporting of the individual level of representativeness; the setting level of representativeness; the intervention’s adherence to the protocol; the expenses; and the factors of sustainability would benefit from improvement in future research.
Effects of Shenling Baizhu powder on pyrotinib-induced diarrhea: analysis of gut microbiota, metabonomics, and network pharmacology
Authors: Lai Jingjiang , Jiang Fengxian , Zhuo Xiaoli , Xu Xiaoying , Liu Lei , Yin Ke , Wang Jingliang , Zhao Jing , Xu Wei , Liu Hongjing , Wang Xuan , Jiang Wen , Wang Ke , Yang Shuping , Guo Honglin , Qi Fanghua , Yuan Xiaotian , Lin Xiaoyan , Fu Guobin 
Published: December 2022

Abstract
Background
Shenling Baizhu Powder (SBP) is a traditional Chinese medicine (TCM) prescription, which has the good efficacy on gastrointestinal toxicity. In this study, we used gut microbiota analysis, metabonomics and network pharmacology to investigate the therapeutic effect of SBP on pyrotinib-induced diarrhea.

Methods
24 Rats were randomly divided into 4 groups: control group, SBP group (3.6 g/kg /bid SBP for 10 days), pyrotinib model group (80 mg/kg/qd pyrotinib) and pyrotinib + SBP treatment group. A 16S rRNA sequencing was used to detect the microbiome of rat fecal bowel. Metabolic profiles were collected by non-targeted metabolomics and key metabolic pathways were identified using MetaboAnalyst 5.0. The antitumor effect of SBP on cells treated with pyrotinib was measured using a CCK-8 assay. Network pharmacology was used to predict the target and action pathway of SBP in treating pyrotinib-related diarrhea.

Results
In vivo study indicated that SBP could significantly alleviate pyrotinib-induced diarrhea, reaching a therapeutic effect of 66.7%. SBP could regulate pyrotinib-induced microbiota disorder. LEfSe research revealed that the SBP could potentially decrease the relative abundance of Escherichia, Helicobacter and Enterobacteriaceae and increase the relative abundance of Lachnospiraceae, Bacilli, Lactobacillales etc. In addition, 25-Hydroxycholesterol, Guanidinosuccinic acid, 5-Hydroxyindolepyruvate and cAMP were selected as potential biomarkers of SBP for pyrotinib-induced diarrhea. Moreover, Spearman's analysis showed a correlation between gut microbiota and metabolite: the decreased 25-hydroxycholesterol in the pyrotinib + SBP treatment group was negatively correlated with Lachnospiraceae while positively correlated with Escherichia and Helicobacter. Meanwhile, SBP did not affect the inhibitory effect of pyrotinib on BT-474 cells and Calu-3 cells in vitro. Also, the network analysis further revealed that SBP treated pyrotinib-induced diarrhea through multiple pathways, including inflammatory bowel disease, IL-17 signaling pathway, pathogenic Escherichia coli infection and cAMP signaling pathway.

Conclusions
SBP could effectively relieve pyrotinib-induced diarrhea, revealing that intestinal flora and its metabolites may be involved in this process.
Molecular cytogenetic and phenotypic characterization of Phelan McDermid and 22q13 duplication syndrome: a case report
Authors: Khalifa Yousif , Hassan Hisham Y. , Weise Anja , Liehr Thomas , Alkhayyat Haya 
Published: December 2022

Abstract
Background
Phelan-McDermid syndrome (PHMDS) is a rare genetic disorder mostly caused by haploinsufficincy of SHANK3 gene, and characterized by neonatal hypotonia, developmental delay, minor dysmorphic features, seizures and behavior problems. Literature of this syndrome is scanty and confusing, and represents a challenge for pediatricians, in terms of finding the correct diagnoses.

Case presentation
In a postnatal case with hypotonia and dysmorphic features a de novo ring chromosome r(22) leading to in parallel microdeletion and micro duplication in 22q13 was diagnosed by banding cytogenetics, and further characterized in detail by molecular cytogenetic and chromosomal microarray.

Conclusion
Here a rare PHMDS case caused by a r(22) is presented. Less than 10 comparable cases are reported in the literature. The present case highlights the importance of conducting genetic counseling and appropriate genetic tests for newborns with mild dysmorphic features.