bluuebunny/crossref_metadata_2025_split huggingface dataset:
Structured Multidisciplinary Follow-Up After Pediatric Intensive Care: A Model for Continuous Data-Driven Health Care Innovation
Authors: de Sonnaville Eleonore S. V. , van Woensel Job B. M. , van Goudoever Johannes B. , Otten Marieke H. , Teela Lorynn , Aarnoudse-Moens Cornelieke S. H. , Terheggen-Lagro Suzanne W. J. , van der Hulst Annelies E. , Engelen Marc , Kӧnigs Marsh , Oosterlaan Jaap , Knoester Hennie ,   the Emma Children’s Hospital Amsterdam UMC Follow Me Program Consortium
Published: February 2023

OBJECTIVES:
Morbidity after PICU admission for critical illness is a growing concern. Sequelae may occur in various domains of functioning and can only appropriately be determined through structured follow-up. Here, we describe the process of designing and implementing a structured multidisciplinary follow-up program for patients and their parents after PICU admission and show the first results illustrating the significance of our program.

DESIGN:
Prospective observational cohort study.

SETTING:
Outpatient PICU follow-up clinic.

PATIENTS:
Patients 0–18 years old admitted to our PICU.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
In our structured multidisciplinary follow-up program, follow-up care is provided by a pediatric intensivist and psychologist and in addition, depending on patient’s critical illness and received PICU treatment(s), by a pediatric pulmonologist, cardiologist, neurologist, and/or neuropsychologist. All consultations are scheduled consecutively. Collected data are stored in a hospital-wide data warehouse and used for yearly health care evaluation sessions as well as scientific research. Challenges in organizing this follow-up program include technological challenges, providing time-efficient care, participation rate, and completeness of questionnaires. In our experience, a dedicated team is essential to tackle these challenges. Our first results, obtained in 307 of 388 referred patients (79.1%), showed the diversity of problems arising after PICU discharge, including physical, neurocognitive, and psychosocial sequelae. In addition, our data also reflected the risk of psychosocial problems among parents. Within the limited operation time of our follow-up program, the program has evolved based on our experiences and the data collected.

CONCLUSIONS:
We successfully developed and implemented a structured multidisciplinary follow-up program for patients and their parents after PICU admission. This program may help to timely initiate appropriate interventions, improve the standard of care during and after PICU admission, and facilitate scientific research on outcome and prognosis after PICU admission.
Translating evidence: pain treatment in newborns, infants, and toddlers during needle-related procedures
Authors: Harrison Denise , Bueno Mariana 
Published: February 2023

Abstract

Introduction:
Treatment of pain in preterm, sick, and healthy newborns and infants and toddlers (up to 2 years of age) is consistently reported to be inadequate, and effective strategies are poorly implemented.

Objectives:
To present existing evidence of effective pain treatment strategies during needle-related procedures and to highlight initiatives focused on translating evidence into practice.

Methods:
This Clinical Update focuses on the 2022 International Association for the Study of Pain Global Year for Translating Pain Knowledge to Practice in the specific population of newborns, infants, and toddlers. Best evidence is reviewed, and existing knowledge translation strategies and programs available to implement evidence into practice are presented.

Results:
Effective strategies for newborn and young infants during frequently occurring needle procedures include small volumes of sweet solutions, breastfeeding, or skin-to-skin care when feasible and culturally acceptable. In addition, strategies such as nonnutritive sucking, positioning, swaddling, gentle touch, facilitated tucking, and secure holding can be used. For toddlers, the evidence is less robust, and discerning between pain and distress is challenging. However, strategies recommended for needle-related procedures include upright secure comfort holding by parents/caregivers, age-appropriate distraction, and topical anesthetics. Translation of effective pain management needs to involve the family, who need to be supported and empowered to comfort their child during painful procedures. Organizational, nationwide, and global initiatives aimed at improving implementation of effective pain treatments exist.

Conclusion:
There is evidence of effective pain management strategies for newborns, infants, and toddlers, and a great deal of effort is being made to translate knowledge into action.
Applicability of Artificial Societies to Evaluate Health Care Policies
Authors: Tolk Andreas , Rouse William B. , Pires Bianica S. , Cline Jon C. , Diallo Saikou Y. , Russell Sybil A. 
Published: February 2023

Summary Statement
We propose the use of artificial societies to support health care policymakers in understanding and forecasting the impact and adverse effects of policies. Artificial societies extend the agent-based modeling paradigm using social science research to allow integrating the human component. We simulate individuals as socially capable software agents with their individual parameters in their situated environment including social networks. We describe the application of our method to better understand policy effects on the opioid crisis in Washington, DC, as an example. We document how to initialize the agent population with a mix of empiric and synthetic data, calibrate the model, and make forecasts of possible developments. The simulation forecasts a rise in opioid-related deaths as they were observed during the pandemic. This article demonstrates how to take human aspects into account when evaluating health care policies.
Risk Models for Developing Pancreatic Fistula After Pancreatoduodenectomy
Authors: Schouten Thijs J. , Henry Anne Claire , Smits Francina J. , Besselink Marc G. , Bonsing Bert A. , Bosscha Koop , Busch Olivier R. , van Dam Ronald M. , van Eijck Casper H. , Festen Sebastiaan , Groot Koerkamp Bas , van der Harst Erwin , de Hingh Ignace H.J.T. , Kazemier Geert , Liem Mike S.L. , de Meijer Vincent E. , Patijn Gijs A. , Roos Daphne , Schreinemakers Jennifer M.J. , Stommel Martijn W.J. , Wit Fennie , Daamen Lois A. , Molenaar Izaak Q. , van Santvoort Hjalmar C. ,   for the Dutch Pancreatic Cancer Group
Published: February 2023

Objective:
To evaluate the performance of published fistula risk models by external validation, and to identify independent risk factors for postoperative pancreatic fistula (POPF).

Background:
Multiple risk models have been developed to predict POPF after pancreatoduodenectomy. External validation in high-quality prospective cohorts is, however, lacking or only performed for individual models.

Methods:
A post hoc analysis of data from the stepped-wedge cluster cluster-randomized Care After Pancreatic Resection According to an Algorithm for Early Detection and Minimally Invasive Management of Pancreatic Fistula versus Current Practice (PORSCH) trial was performed. Included were all patients undergoing pancreatoduodenectomy in the Netherlands (January 2018–November 2019). Risk models on POPF were identified by a systematic literature search. Model performance was evaluated by calculating the area under the receiver operating curves (AUC) and calibration plots. Multivariable logistic regression was performed to identify independent risk factors associated with clinically relevant POPF.

Results:
Overall, 1358 patients undergoing pancreatoduodenectomy were included, of whom 341 patients (25%) developed clinically relevant POPF. Fourteen risk models for POPF were evaluated, with AUCs ranging from 0.62 to 0.70. The updated alternative fistula risk score had an AUC of 0.70 (95% confidence intervals [CI]: 0.69–0.72). The alternative fistula risk score demonstrated an AUC of 0.70 (95% CI: 0.689–0.71), whilst an AUC of 0.70 (95% CI: 0.699–0.71) was also found for the model by Petrova and colleagues. Soft pancreatic texture, pathology other than pancreatic ductal adenocarcinoma or chronic pancreatitis, small pancreatic duct diameter, higher body mass index, minimally invasive resection and male sex were identified as independent predictors of POPF.

Conclusion:
Published risk models predicting clinically relevant POPF after pancreatoduodenectomy have a moderate predictive accuracy. Their clinical applicability to identify high-risk patients and guide treatment strategies is therefore questionable.
The Influence of Patient Preference on Surgeons’ Treatment Recommendations in the Management of Intraductal Papillary Mucinous Neoplasms
Authors: Sacks Greg D. , Shin Paul , Braithwaite R. Scott , Soares Kevin C. , Kingham T. Peter , D’Angelica Michael I. , Drebin Jeffrey A. , Jarnagin William R. , Wei Alice C. 
Published: February 2023

Objective:
We aimed to determine whether surgeon variation in management of intraductal papillary mucinous neoplasms (IPMN) is driven by differences in risk perception and quantify surgeons’ risk threshold for changing their recommendations.

Background:
Surgeons vary widely in management of IPMN.

Methods:
We conducted a survey of members of the Americas HepatoPancreatoBiliary Association, presented participants with 2 detailed clinical vignettes and asked them to choose between surgical resection and surveillance. We also asked them to judge the likelihood that the IPMN harbors cancer and that the patient would have a serious complication if surgery was performed. Finally, we asked surgeons to rate the level of cancer risk at which they would change their treatment recommendation. We examined the association between surgeons’ treatment recommendations and their risk perception and risk threshold.

Results:
One hundred and fifty surgeons participated in the study. Surgeons varied in their recommendations for surgery [19% for vignette 1 (V1) and 12% for V2] and in their perception of the cancer risk (interquartile range: 2%–10% for V1 and V2) and risk of surgical complications (V1 interquartile range: 10%–20%, V2 20%–30%). After adjusting for surgeon characteristics, surgeons who were above the median in cancer risk perception were 22 percentage points (27% vs. 5%) more likely to recommend resection than those who were below the median (95% CI: 11.34%; P<0.001). The median risk threshold at which surgeons would change their recommendation was 15% (V1 and V2). Surgeons who recommended surgery had a lower risk threshold for changing their recommendation than those who recommended surveillance (V1: 10.0 vs. 15.0, P=0.06; V2: 7.0 vs. 15.0, P=0.05).

Conclusions:
The treatment that patients receive for IPMNs depends greatly on how their surgeons perceive the risk of cancer in the lesion. Efforts to improve cancer risk prediction for IPMNs may lead to decreased variations in care.
Primary Graft Dysfunction Is Associated With Development of Early Cardiac Allograft Vasculopathy, but Not Other Immune-mediated Complications, After Heart Transplantation
Authors: Han Jiho , Moayedi Yasbanoo , Henricksen Erik J. , Waddell Kian , Valverde-Twiggs Julien , Kim Daniel , Luikart Helen , Zhang Bing M. , Teuteberg Jeffrey , Khush Kiran K. 
Published: February 2023

Background.
We investigated associations between primary graft dysfunction (PGD) and development of acute cellular rejection (ACR), de novo donor-specific antibodies (DSAs), and cardiac allograft vasculopathy (CAV) after heart transplantation (HT).

Methods.
A total of 381 consecutive adult HT patients from January 2015 to July 2020 at a single center were retrospectively analyzed. The primary outcome was incidence of treated ACR (International Society for Heart and Lung Transplantation grade 2R or 3R) and de novo DSA (mean fluorescence intensity >500) within 1 y post-HT. Secondary outcomes included median gene expression profiling score and donor-derived cell-free DNA level within 1 y and incidence of cardiac allograft vasculopathy (CAV) within 3 y post-HT.

Results.
When adjusted for death as a competing risk, the estimated cumulative incidence of ACR (PGD 0.13 versus no PGD 0.21; P = 0.28), median gene expression profiling score (30 [interquartile range, 25–32] versus 30 [interquartile range, 25–33]; P = 0.34), and median donor-derived cell-free DNA levels was similar in patients with and without PGD. After adjusting for death as a competing risk, estimated cumulative incidence of de novo DSA within 1 y post-HT in patients with PGD was similar to those without PGD (0.29 versus 0.26; P = 0.10) with a similar DSA profile based on HLA loci. There was increased incidence of CAV in patients with PGD compared with patients without PGD (52.6% versus 24.8%; P = 0.01) within the first 3 y post-HT.

Conclusions.
During the first year after HT, patients with PGD had a similar incidence of ACR and development of de novo DSA, but a higher incidence of CAV when compared with patients without PGD.
Effectiveness of a Smart Urinary Continence Care Assessment System for Nursing Home Residents
Authors: Rajabali Saima N. , Hunter Kathleen F. , Asaana Prosper , McCreary Megan L. , Nazari Sahar , Wagg Adrian S. 
Published: February 2023

PURPOSE:
The purpose of this study was to compare the effect of use of an electronic urinary continence assessment system versus usual care on construction of care plans, resource use, and continence care for nursing home (NH) residents.

DESIGN:
Convergent mixed-methods study comprising a prospective, parallel arm–controlled phase, and concurrent qualitative component.

SUBJECTS AND SETTING:
The study setting was Alberta, a province in Western Canada. Residents requiring a continence assessment or reassessment in an NH with 2 units assigned to intervention (I) and 2 units to usual care (UC). One hundred one residents (I: n = 49; UC: n = 52) participated; 89 (I: n = 43; UC: n = 46) completed the study. The mean age of the UC group was 88.5 (SD = 6.9) years, whereas the mean age of the intervention group was 85.6 (SD = 7.5) years.

METHODS:
Quantitative data on assessment, resource use, resident quality of life, and continence care outcomes were collected at weeks 0, 2, and 8; plan adherence was assessed at week 16. Qualitative data were collected via interviews.

RESULTS:
Analysis revealed a significant change in the proportion of residents achieving a reduction in 24-hour pad absorbency (50.6% vs 39.1%, P = .034) at week 8. There were significant differences in between-group changes (total absorbency of pads used in 24 hours and total cost of night pads used). Both groups reported improved health-related quality of life. Analysis of qualitative data revealed 3 themes: resource use; quality of continence care; and system utility and limitations.

CONCLUSIONS:
A technological solution offering a standardized system of continence assessment provided benefit in terms of quality of care for residents and use of continence containment products; utility was validated by staff.
Effectiveness of Single Chest Tube vs Double Chest Tube Application Post Decortication: Prospective Randomized Controlled Study
Authors: Hart Jonathan Minagogo , Mohammed Anwar Hussien , Tesfaye Samuel , Nadamo Siyasebew Mamo , Feyissa Mekonnen Senbu , Fekadu Desalegn Wadaja , Tadesse Isreal Bacha , Gebeyehu Hiwot Tebeje 
Published: February 2023

Background:
Draining the chest cavity with two tubes is a common practice amongst thoracic surgeons. This research was conducted in Addis Ababa from March 2021 to May 2022. A total of 62 patients were included.

Study Design:
This study was conducted to investigate the superiority of either single tube or double tubes insertion following decortication. Patients were randomized in a ratio of 1:1. In Group A two tubes were inserted; in Group B, single tube 32F tubes was inserted. Statistical analyses were performed using SPSS V.27, student’s t-test and Pearson chi-square test.

Results:
The age range 18 to 70 years; the mean of 44 ± 14.4434; male to female ratio of 2.9:1. The dominant underlying pathologies were TB and trauma (45.2% vs 35.5%); right side was more involved (62.3%). Drain output was 1465ml ± 1887.9751 in Group A vs 1018ml ± 802.5662 in Group B (p-value .00001); the duration of drains was 7.5498 ± 11.3137 days in Group A versus 3.8730 ± 1.4142 days in Group B [p-value .000042]. The degree of pain was 2.6458 ± 4.2426 vs 2.000 ± 2.1213 in Group A and Group B respectively (p-value 0.326757); The length of hospital stay was 21.5818 ± 11.9791 days in Group A vs 13.6091 ± 6.2048 days in Group B (p-value .00001). Group A had air leak of 90.3% vs 74.2% in Group B; subcutaneous emphysema was 9.7% in Group A and 12.9% in Group B. No fluid recollection and no patients required reinsertion tube.

Conclusions:
The placement of single tube following decortication is effective in reducing drain output; shorter time of drain; shorter hospital stay. There was no association of pain. No effect on other endpoints.
A multi-scale review of the dynamics of collective behaviour: from rapid responses to ontogeny and evolution
Authors: Ioannou Christos C. , Laskowski Kate L. 
Published: February 2023

Collective behaviours, such as flocking in birds or decision making by bee colonies, are some of the most intriguing behavioural phenomena in the animal kingdom. The study of collective behaviour focuses on the interactions between individuals within groups, which typically occur over close ranges and short timescales, and how these interactions drive larger scale properties such as group size, information transfer within groups and group-level decision making. To date, however, most studies have focused on snapshots, typically studying collective behaviour over short timescales up to minutes or hours. However, being a biological trait, much longer timescales are important in animal collective behaviour, particularly how individuals change over their lifetime (the domain of developmental biology) and how individuals change from one generation to the next (the domain of evolutionary biology). Here, we give an overview of collective behaviour across timescales from the short to the long, illustrating how a full understanding of this behaviour in animals requires much more research attention on its developmental and evolutionary biology. Our review forms the prologue of this special issue, which addresses and pushes forward understanding the development and evolution of collective behaviour, encouraging a new direction for collective behaviour research.
This article is part of a discussion meeting issue ‘Collective behaviour through time’.
Towards an integrative approach to understanding collective behaviour in caterpillars
Authors: McLellan Callum F. , Montgomery Stephen H. 
Published: February 2023

To evolve, and remain adaptive, collective behaviours must have a positive impact on overall individual fitness. However, these adaptive benefits may not be immediately apparent owing to an array of interactions with other ecological traits, which can depend on a lineage's evolutionary past and the mechanisms controlling group behaviour. A coherent understanding of how these behaviours evolve, are exhibited, and are coordinated across individuals, therefore requires an integrative approach spanning traditional disciplines in behavioural biology. Here, we argue that lepidopteran larvae are well placed to serve as study systems for investigating the integrative biology of collective behaviour. Lepidopteran larvae display a striking diversity in social behaviour, which illustrates critical interactions between ecological, morphological and behavioural traits. While previous, often classic, work has provided an understanding of how and why collective behaviours evolve in Lepidoptera, much less is known about the developmental and mechanistic basis of these traits. Recent advances in the quantification of behaviour, and the availability of genomic resources and manipulative tools, allied with the exploitation of the behavioural diversity of tractable lepidopteran clades, will change this. In doing so, we will be able to address previously intractable questions that can reveal the interplay between levels of biological variation.
This article is part of a discussion meeting issue ‘Collective behaviour through time’.
A study of transfer of information in animal collectives using deep learning tools
Authors: Romero-Ferrero Francisco , Heras Francisco J. H. , Rance Dean , de Polavieja Gonzalo G. 
Published: February 2023

We studied how the interactions among animals in a collective allow for the transfer of information. We performed laboratory experiments to study how zebrafish in a collective follow a subset of trained animals that move towards a light when it turns on because they expect food at that location. We built some deep learning tools to distinguish from video which are the trained and the naïve animals and to detect when each animal reacts to the light turning on. These tools gave us the data to build a model of interactions that we designed to have a balance between transparency and accuracy. The model finds a low-dimensional function that describes how a naïve animal weights neighbours depending on focal and neighbour variables. According to this low-dimensional function, neighbour speed plays an important role in the interactions. Specifically, a naïve animal weights more a neighbour in front than to the sides or behind, and more so the faster the neighbour is moving; and if the neighbour moves fast enough, the differences coming from the neighbour’s relative position largely disappear. From the lens of decision-making, neighbour speed acts as confidence measure about where to go.
This article is part of a discussion meeting issue ‘Collective behaviour through time’.
Lower risks of sodium glucose cotransporter 2 (SGLT2) inhibitors compared to dipeptidyl peptidase-4 (DPP4) inhibitors for new-onset hip fracture risks in patients with type-2 diabetes: A propensity score-matched study with competing risk analysis
Authors: In Chou Oscar Hou , Zhou Jiandong , Satti Danish Iltaf , Mui Jonathan V , Lin Karen , Lee Sharen , Wong Wing Tak , Chung Wai Abraham Ka , Liu Tong , Yung Cheung Bernard Man , Jing Fengshi , Tse Gary 
Published: February 2023

AbstractPurposeThis study aimed to compare the effects of sodium glucose cotransporter 2 inhibitors (SGLT2I) and dipeptidyl peptidase-4 inhibitors (DPP4I) on new-onset hip fractures.MethodsThis was a retrospective population-based cohort study including type-2 diabetes mellitus patients treated with either SGLT2I or DPP4I between January 1st2015 and December 31st2020 in Hong Kong. The primary outcome was new-onset hip fracture and the secondary outcome was all-cause mortality. Propensity score matching (1:1 ratio) using the nearest neighbour search was performed. Univariable and multivariable Cox regression were applied to identify significant predictors. Competing risks models and multiple approaches using the propensity score were performed.ResultsThis cohort included 56393 patients with type-2 diabetes mellitus (median age: 62.1 years old [interquantile range, IQR]: 54.2-71.1; 57.45% males), of which 20432 patients ([incidence rate, IR]: 36.23%) used SGLT2I and 35961 patients (IR: 63.77%) used DPP4I. After the 1:1 propensity score matching, 449 (IR: 1.09%) patients had hip fractures, and 2012 patients (IR: 4.92%) died. SGLT2I was associated with significantly lower risks of hip fractures after adjusting for the demographics, past comorbidities, non-SGLT2I/DPP4I medications and laboratory results (hazard ratio: 0.55; 95% confidence interval: 0.42-0.89; P=0.0036). The results were consistent in the competing risk models and the different propensity matching approaches.ConclusionsSGLT2I was associated with lower risks of new-onset hip fractures after propensity score matching and adjustments.SummaryThis study compared the risks of hip fractures in between users of sodium glucose cotransporter 2 inhibitors (SGLT2I) and dipeptidyl peptidase-4 inhibitors in type-2 diabetes mellitus. After propensity score matching, SGLT2I was associated with lower risks of hip fractures adjusting for confounders (hazard ratio: 0.55; 95% confidence interval: 0.42-0.89; P=0.0036).