bluuebunny/crossref_metadata_2025_split huggingface dataset:
Optimizing Transfer of Postcesarean Patients to Postoperative Ward Through a Quality Improvement (QI) Project: Curtailing Delays, Improving Care
Authors: Nain Shilpi , Puri Manju , Agrawal Swati , Kumari Darshana , Satheesh Lylaja , Chhillar Ekta , Sharma Poornima , Meena Deepika , Singh Meenakshi , Kapur Aishwarya 
Published: March 2023

Background and Objectives:
Close monitoring of patients in the first 2 hours after cesarean delivery (CD) is crucial. Delays in shifting of the post-CD patients led to a chaotic environment in the postoperative ward, suboptimal monitoring, and inadequate nursing care. Our aim was to increase the percentage of post-CD patients shifted from transfer trolley to bed within 10 minutes of arrival in the postoperative ward from a baseline of 64% to 100%, and to maintain that rate for more than 3 weeks.

Methods:
A quality improvement team including physicians, nurses, and workers was constituted. Problem analysis revealed lack of communication among the caregivers as the main cause of delay. The percentage of post-CD patients shifted from trolley to bed within 10 minutes of being wheeled into the postoperative ward out of the total number of post-CD patients transferred from the operation theater to the postoperative ward was taken as the outcome indicator for the project. Multiple Plan-Do-Study-Act cycles based on the Point of Care Quality Improvement methodology were undertaken to achieve the target. Main interventions were: 1) written information of patient being transferred to operation theater for CD sent to the postoperative ward; 2) stationing of a duty doctor in the postoperative ward; and 3) keeping a buffer of 1 vacant bed in the postoperative ward. The data were plotted weekly as a dynamic time series chart and signals of change were observed.

Results:
Eighty-three percent (172 out of 206) of women were shifted in time by 3 weeks. After Plan-Do-Study-Act 4, the percentages kept improving leading to a median shift from 85.6% to 100% after 10 weeks post-initiation of the project. Sustainment was confirmed by continuing observations for 6 more weeks to ensure that the changed protocol was assimilated in the system. We found that all women were shifted within 10 minutes of their arrival in postoperative ward from trolley to bed.

Conclusion:
Providing high-quality care to patients must be a priority for all health care providers. High-quality care is timely, efficient, evidence based, and patient-centric. Delays in transfer of postoperative patients to the monitoring area can be detrimental. The point of Care Quality Improvement methodology is useful and effective in solving complex problems by understanding and fixing the various contributory factors one by one. Reorganization of processes and available manpower without any extra investment in terms of infrastructure and resources is pivotal for long term success of a quality improvement project.
Introduction of a New Method to Monitor Patient-Relevant Outcomes and Costs: Using a Quality Improvement Project in Transcatheter Aortic Valve Implantation Care as an Example
Authors: van Steenbergen Gijs J. , Schulz Daniela N. , Slingerland Stacey R. , Tonino Pim A. , Soliman-Hamad Mohamed A. , Dekker Lukas , van Veghel Dennis 
Published: March 2023

Background and Objective:
Routine outcome monitoring is becoming standard in care evaluations, but costs are still underrepresented in these efforts. The primary aim of this study was therefore to assess if patient-relevant cost drivers can be used alongside clinical outcomes to evaluate an improvement project and to provide insight into (remaining) areas for improvement.

Methods:
Data from patients who underwent transcatheter aortic valve implantation (TAVI) between 2013 and 2018 at a single center in the Netherlands were used. A quality improvement strategy was implemented in October 2015, and pre- (A) and post-quality improvement cohorts (B) were distinguished. For each cohort, clinical outcomes, quality of life (QoL), and cost drivers were collected from the national cardiac registry and hospital registration data. The most appropriate cost drivers in TAVI care were selected from hospital registration data using a novel stepwise approach with an expert panel of physicians, managers, and patient representatives. A radar chart was used to visualize the clinical outcomes, QoL and the selected costs drivers.

Results:
We included 81 patients in cohort A and 136 patients in cohort B. All-cause mortality at 30 days was borderline significantly lower in cohort B than in cohort A (1.5% vs 7.4%, P = .055). QoL improved after TAVI for both cohorts. The stepwise approach resulted in 21 patient-relevant cost drivers. Costs for pre-procedural outpatient clinic visits (€535, interquartile range [IQR] = 321-675, vs €650, IQR = 512-890, P < .001), costs for the procedure (€1354, IQR = 1236-1686, vs €1474, IQR = 1372-1620, P < .001), and imaging during admission (€318, IQR = 174-441, vs €329, IQR = 267-682, P = .002) were significantly lower in cohort B than in cohort A. Possible improvement potential was seen in 30-day pacemaker implantation and 120-day readmission.

Conclusion:
A selection of patient-relevant cost drivers is a valuable addition to clinical outcomes for use in evaluation of improvement projects and identification of room for further improvement.
Fusion of Lateral Calvarial Sutures on Volume-Rendered Computed Tomography Reconstructions in Patients With Known Craniosynostosis
Authors: Wilkinson C Corbett , Belanger Katherine , Elbadry Rasha , Hoffman Jessa , Ryan Megan , Stence Nicholas V. , Graber Sarah J , Ridder Thomas , Batista Ligia , French Brooke M 
Published: March 2023

Introduction:
After treating a child with familial sagittal craniosynostosis, clinocephaly, and bilateral parietomastoid/posterior squamosal suture fusion, the authors wondered if major-suture synostosis and clinocephaly were associated with abnormal fusion of minor lateral calvarial sutures.

Methods:
The authors reviewed all preoperative volume-rendered head computed tomography reconstructions performed for craniosynostosis at their institution from 2010 through 2014 and determined whether the sphenoparietal, squamosal, and parietomastoid sutures were open, partially fused, or fused. The authors determined whether any sutures were abnormally fused based upon a previous study from their center, in which abnormal fusion was defined as either 1 of 3 abnormal fusion patterns or abnormally-early fusion. The authors then determined the rate of abnormal fusion of these sutures and whether abnormal fusion was associated with (1) major-suture craniosynostosis, (2) type of craniosynostosis (sutures involved; single-suture versus multisuture; syndromic versus nonsyndromic), and (3) clinocephaly.

Results:
In 97 included children, minor lateral sutures were abnormally fused in 8, or 8.2%, which was significantly higher than in children without craniosynostosis from our earlier study. Abnormal minor lateral suture fusion was not associated with the type of single-suture synostosis or with multisuture synostosis but was associated with syndromic synostosis. Four of 8 children with abnormal minor lateral suture fusion had multisuture synostosis and 6 had syndromic synostosis. Lateral sutures were abnormally fused in 1 of 4 subjects with clinocephaly, which was not significant.

Conclusion:
Abnormal minor lateral calvarial suture fusion is significantly associated with major-suture craniosynostosis, especially syndromic synostosis.
Application and Accuracy of Craniomaxillofacial Plastic Surgery Robot in Congenital Craniosynostosis Surgery
Authors: Lei Bowen , Sun Tiecheng , Ma Hengyuan , Li Binghang , Yang Bin 
Published: March 2023

Objective:
The objective of this study was to observe the accuracy and security of the craniomaxillofacial plastic surgery robot in congenital craniosynostosis surgery and to enhance and improve its performance.

Materials and Methods:
We performed model surgical experiments on computed tomography data of 5 children with congenital craniosynostosis who were diagnosed and treated in our hospital, and model surgical experiments and animal experiments on the skulls of 3 Bama minipigs.

Results:
There was no statistically significant difference shown either in model experiments or animal experiments in comparing the actual operation with the surgical simulation and inside the groups (P>0.05).

Conclusions:
The craniomaxillofacial plastic surgery robot has achieved good security and accuracy in model surgery and animal experiments. Further studies are needed to be conducted to confirm its security and accuracy and to continuously improve and refine the robot’s performance.
Impact of urbanization on mental health and well being
Authors: Halbreich Uriel 
Published: March 2023

Purpose of review
It is predicted that by mid-21st century, over two-thirds of the world population will be urban. The shift from rural to urban living causes a major shift in priorities of public health. The current article aims at illuminating the urbanization process, its challenges and ramifications for mental health and well being of urban dwellers.

Recent findings
Currently, 55% of world population resides in urban areas. By 2050, that percentage will be at least 68%, mostly in developing and emerging economies. Adequate mental health and socioeconomic support services for the new urban migrants are almost nonexistent.

Summary
Adequate psychosocial clinics are an absolute urgent necessity in the neighborhoods where new migrants reside. Governments‘ policies and funding should be re-prioritized. For effective advocacy, descriptive comprehensive interdisciplinary epidemiological data should be an initial step of research. This should be followed by investigations of the biopsychosocial–economic causes and processes, which would point to adequate culturally sensitive practical solutions.
Benefits of video games for people with schizophrenia: a literature review
Authors: Quiles Clélia , Verdoux Hélène 
Published: March 2023

Purpose of review
In spite of the overwhelming concerns about the deleterious impact of exposure to video games, a growing body of evidence suggests that it may be of potential interest for therapeutic purposes, particularly in schizophrenia. As literature is rapidly evolving, we carried out a systematic review of recent articles on this issue.

Recent findings
We identified seven studies published from 2017 to 2022 exploring the benefits of commercial video games in people with schizophrenia and related disorders regarding symptoms, cognition and functional outcome. Six studies used an RCT design. Associations between gaming and better outcomes were found in three main areas: physical condition (walking speed, aerobic fitness), neurocognition (processing speed, memory and executive functions), and social functioning, self-efficacy in daily life activities and quality of life.

Summary
Active use of video games is associated with better aerobic fitness and cognitive performances. Video gaming may contribute to better functional outcome and quality of life in patients suffering from cognitive impairments and difficulties in social functioning. Persons with schizophrenia may benefit from using commercial video games because of their potential therapeutic impact on functioning and cognition.
Fertility signalling games: should males obey the signal?
Authors: Kovalov Viktor , Kokko Hanna 
Published: March 2023

Game theory is frequently used to study conflicting interests between the two sexes. Males often benefit from a higher mating rate than females do. A temporal component of this conflict has rarely been modelled: females' interest in mating may depend on when females become fertile. This sets conditions for male–female coevolution, where females may develop fertility signals, and males may obey the signal, such that they only target signalling females. Modelling this temporal aspect to sexual conflict yields two equilibria: (i) a trivial equilibrium without signals and with males targeting all females, and (ii) a signalling equilibrium where all females signal before ovulation, and where either some, or all, males obey the signal. The ‘all males obey the signal’ equilibrium is more likely if we assume that discriminating males have an advantage in postcopulatory sperm competition, while in the absence of this benefit, we find the ‘some males obey the signal’ equilibrium. The history of game-theoretic models of sex differences often portrays one sex as the 'winner' and the opposite sex as the ‘loser’. From early models emphasizing ‘battle of the sexes’-style terminology, we recommend moving on to describe the situation as non-signalling equilibria having stronger unresolved sexual conflict than signalling equilibria.This article is part of the theme issue ‘Half a century of evolutionary games: a synthesis of theory, application and future directions’.
A marine cleaning mutualism provides new insights in biological market dynamics
Authors: Bshary Redouan , Noë Ronald 
Published: March 2023

Most mutually beneficial social interactions (cooperation within species, mutualism between species) involve some degree of partner choice. In an analogy to economic theory as applied to human trading practices, biological market theory (BMT) focuses on how partner choice affects payoff distributions among non-human traders. BMT has inspired a great diversity of research, including research on the mutualism between cleaner fishLabroides dimidiatusand other marine fish, their ‘clients’. In this mutualism, clients have ectoparasites removed and cleaners obtain food in return. We use the available data onL. dimidiatuscleaner–client interactions to identify avenues for future expansion of BMT. We focus on three main topics, namely how partner quality interacts with supply-to-demand ratios to affect service quality, the role of threats and forms of forceful intervention, and the potential role of cognition. We consider it essential to identify the specifics of each biological market as a basis for the development of more sophisticated BMT models.This article is part of the theme issue ‘Half a century of evolutionary games: a synthesis of theory, application and future directions’.
Evolutionary game theory of continuous traits from a causal perspective
Authors: Lehtonen Jussi , Otsuka Jun 
Published: March 2023

Modern evolutionary game theory typically deals with the evolution of continuous, quantitative traits under weak selection, allowing the incorporation of rich biological detail and complicated nonlinear interactions. While these models are commonly used to find candidates for evolutionary endpoints and to approximate evolutionary trajectories, a less appreciated property is their potential to expose and clarify the causal structure of evolutionary processes. The mathematical step of differentiation breaks a nonlinear model into additive components which are more intuitive to interpret, and when combined with a proper causal hypothesis, partial derivatives in such models have a causal meaning. Such an approach has been used in the causal analysis of game-theoretical models in an informal manner. Here we formalize this approach by linking evolutionary game theory to concepts developed in causal modelling over the past century, from path coefficients to the recently proposed causal derivative. There is a direct correspondence between the causal derivative and the derivative used in evolutionary game theory. Some game theoretical models (e.g. kin selection) consist of multiple causal derivatives. Components of these derivatives correspond to components of the causal derivative, to path coefficients, and to edges on a causal graph, formally linking evolutionary game theory to causal modelling.This article is part of the theme issue ‘Half a century of evolutionary games: a synthesis of theory, application and future directions’.
Multivariate brain-based dimensions of child psychiatric problems: degrees of generalizability
Authors: Xu Bing , Dall’Aglio Lorenza , Flournoy John , Bortsova Gerda , Tervo-Clemmens Brenden , Collins Paul , de Bruijne Marleen , Luciana Monica , Marquand Andre , Wang Hao , Tiemeier Henning , Muetzel Ryan L. 
Published: March 2023

AbstractMultivariate machine learning techniques are a promising set of tools for identifying complex brain-behavior associations. However, failure to replicate results from these methods across samples has hampered their clinical relevance. This study aimed to delineate dimensions of brain functional connectivity that are associated with child psychiatric symptoms in two large and independent cohorts: the Adolescent Brain Cognitive Development (ABCD) Study and the Generation R Study (totaln=8,605). Using sparse canonical correlations analysis, we identified three brain-behavior dimensions in ABCD: attention problems, aggression and rule-breaking behaviors, and withdrawn behaviors. Importantly,out-of-samplegeneralizability of these dimensions was consistently observed in ABCD, suggesting robust multivariate brain-behavior associations. Despite this,out-of-studygeneralizability in Generation R was limited. These results highlight that thedegreeof generalizability can vary depending on the external validation methods employed as well as the datasets used, emphasizing that biomarkers will remain elusive until models generalize better in true external settings.
Poisoned in Their Homes- Red Blood Cell Abnormalities in Lead-Exposed Residents of a Pakistani Industrial Zone
Authors: Shah Farhad Ali , Shoaib Naila , Iqbal Asim , Jamil Nazia , Batool Rida , Munir Rimsha , Lutfi Ameem , Zaidi Nousheen 
Published: March 2023

AbstractThe present study investigated the clinical and hematological effects of chronic lead exposure in the population residing inShadi Pura, a small industrial zone in Lahore, Pakistan. A cross-sectional analysis of 149 participants recruited through health camps was conducted to explore the hematological manifestations of environmental lead exposure, focusing on various red blood cell (RBC) indices and morphology. Moreover, the study examined the differences in the impact of lead exposure on RBC indices and morphology between men, women, and children. Participants exhibited symptoms of lead poisoning, including fatigue, muscle pain, and headache, with a significant percentage of women (44%) reporting miscarriages. Iron deficiency anemia was highly prevalent among all sub-groups of the study population, with adult females showing a significantly higher prevalence than adult males. Male children were the most affected subgroup, with 93% displaying anemia. The RBC count in children remained unchanged, while 31% of male and 7% of female participants displayed elevated RBC counts. RBC indices, mainly mean corpuscular volume (MCV) and mean corpuscular hemoglobin (MCH), were below normal levels, with children being more affected than adults and adult males being the least affected group. Furthermore, RBC morphology was severely affected, with a considerable proportion of females and children displaying hypochromic microcytic morphology. Our results highlight variations in the hematological impacts of lead exposure in different gender and age cohorts. Overall our findings underscore the urgency of addressing the issue of environmental lead exposure in similar industrial zones. It is critical to implement appropriate measures to reduce lead exposure and enhance the infrastructure for safe drinking water and waste disposal to protect the health of populations in such areas.
Stabilizing the return to normal behavior in an epidemic
Authors: Berry Tyrus , Ferrari Matthew , Sauer Timothy , Greybush Steven J. , Ebeigbe Donald , Whalen Andrew J. , Schiff Steven J. 
Published: March 2023

Predicting the interplay between infectious disease and behavior has been an intractable problem because behavioral response is so varied. We introduce a general framework for feedback between incidence and behavior for an infectious disease. By identifying stable equilibria, we provide policy end-states that are self-managing and self-maintaining. We prove mathematically the existence of two new endemic equilibria depending on the vaccination rate: one in the presence of low vaccination but with reduced societal activity (the “new normal”), and one with return to normal activity but with vaccination rate below that required for disease elimination. This framework allows us to anticipate the long-term consequence of an emerging disease and design a vaccination response that optimizes public health and limits societal consequences.Significance StatementThe experience of the COVID-19 pandemic has revealed that behavior can change dramatically in response to the spread of a disease. This behavioral response impacts disease transmission. Predicting future outcomes requires accounting for the feedback between behavior and transmission. We show that accounting for these feedbacks generates long-term predictions about disease burden and behavior that can guide policy.
RNA-seq analysis of skeletal muscle in motor neurone disease cases and controls
Authors: Freydenzon Anna , Wani Shivangi , Bharti Vanda , Wallace Leanne M. , Henders Anjali K. , McCombe Pamela A. , Henderson Robert D. , Steyn Frederik J. , Wray Naomi R. , Ngo Shyuan T. , McRae Allan F. 
Published: March 2023

AbstractBackgroundAmyotrophic lateral sclerosis (ALS), the most predominant form of Motor Neuron Disease (MND), is a progressive and fatal neurodegenerative condition that spreads throughout the neuromotor system by afflicting upper and lower motor neurons. Lower motor neurons project from the central nervous system and innervate muscle fibres at motor endplates, which degrade over the course of the disease leading to muscle weakness. The direction of neurodegeration from or to the point of neuromuscular junctions and the role of muscle itself in pathogenesis has continued to be a topic of debate in ALS research.MethodsTo assess the variation in gene expression between affected and nonaffected muscle tissue that might lead to this local degeneration of motor units, we generated RNA-seq skeletal muscle transcriptomes from 28 MND cases and 18 healthy controls and conducted differential expression analyses on gene-level counts, as well as an isoform switching analysis on isoform-level counts.ResultsWe identified 52 differentially-expressed genes (Benjamini-Hochberg-adjustedp< 0.05) within this comparison, including 38 protein coding, 9 long non-coding RNA, and 5 pseudogenes. Of protein-coding genes, 31 were upregulated in cases including with notable genes including the collagenicCOL25A1(p= 3.1 × 10−10),SAA1which is released in response to tissue injury (p= 3.6 × 10−5) as well as others of the SAA family, and the actin-encodingACTC1(p= 2.3 × 10−5). Additionally, we identified 17 genes which exhibited a functional isoform switch with likely functional consequences between cases and controls.ConclusionsOur analyses provide evidence of increased tissue generation in MND cases, which likely serve to compensate for the degeneration of motor units and skeletal muscle.