bluuebunny/crossref_metadata_2025_split huggingface dataset:
Is Skilled Nursing Facility Financial Status Related to Readmission Rate Improvement?
Authors: Clement Jan P. , MacDonald Kristin M. 
Published: April 2022

SUMMARY

Goal:
We examined whether higher skilled nursing facility (SNF) lagged profitability is associated with a lower 30-day all-cause all-payer risk-adjusted hospital readmission rate. Our aim was to provide insight into whether SNFs with limited financial resources are able to respond to incentives to lower their readmission rates to hospitals.

Methods:
We used data from 2012–2016 to estimate a fixed effects (FE) model with a time trend. Our data included financial data from the Centers for Medicare & Medicaid Services Healthcare Cost Report Information System SNF cost reports, facility characteristics including the all-cause all-payer risk-adjusted unplanned 30-day readmission rate from the LTCFocus (Long-Term Care Focus) project at Brown University, and county-level market variables from the Area Health Resource File. We also examined the relationship for a shorter time frame (2012–2015) after stratifying the sample by system membership or ownership.

Principal Findings:
SNFs with an increase in the lagged operating margin showed a statistically significant, small decrease (<.01 percentage point) in the risk-adjusted readmission rate. The results were robust for different time periods and model specifications. Fixed effects model estimates for SNFs in the highest quartile of percentage of Medicaid patients (≥73.9%) had a lagged operating margin coefficient that is almost four times as large as the coefficient of the FE model with all SNFs.

Application to Practice:
SNFs have an important role in achieving the national priority of reducing hospital readmissions. The study findings suggest that managers of SNFs should not see low profitability as an obstacle to reducing readmission rates, which is good news given the low average profitability of SNFs. Further, reductions in profitability due to penalties incurred from the recently implemented Medicare Skilled Nursing Facility Value-Based Purchasing Program may not limit SNFs’ ability to lower hospital readmission rates, at least initially. However, policymakers may need to determine whether additional resources to high Medicaid SNFs can lower readmission rates for these SNFs.
Participation in Value-Based Payment Programs and U.S. Acute Care Hospital Population Health Partnerships
Authors: Hearld Larry R. , Karabukayeva Aizhan 
Published: April 2022

SUMMARY

Goal:
The goal of this study was to describe the prevalence and pattern of population health partnerships by hospitals and examine whether these partnerships were associated with different types of payment model programs.

Methods:
We conducted a cross-sectional analysis of 3,012 U.S. hospitals using data from the American Hospital Association’s Annual Survey, the Area Health Resources File, and the County Health Rankings & Roadmaps data. We ran a multivariable Poisson regression model to examine the relationship between value-based payment designs and the number of population health partnerships. Binary logistic regression models were used to assess whether participation in value-based payment design programs was associated with specific types of population health partnerships.

Principal Findings:
We found that two thirds or more of hospitals used more informal collaborative partnerships with local or state government, faith-based organizations, and local businesses; formal alliances were most common with health insurance companies and other healthcare providers. Accountable care organizations and bundled payment program participation were associated with greater numbers of population health partnerships, whereas hospital ownership of a health plan was not associated with significantly greater numbers of population health partnerships.

Applications to Practice:
Hospitals were engaged in an intermediate number of partnerships (mean = 3.5, out of 8.0 possible), with opportunities for more partnerships with specific types of organizations (faith-based organizations, health insurance companies). Our findings also suggest that certain types of payment models, particularly those that are less capital intensive and entail less extensive organizational transformation on the part of hospitals, may support hospital engagement in population health partnerships. Hospital leaders need to monitor these partnerships continually to determine if they can capitalize on opportunities to play a more prominent role in population health management in local communities.
Systemic barriers and facilitators to the transition of registered nurse to nurse practitioner in Canada: A scoping review
Authors: El Hussein Mohamed Toufic , Ha Calla 
Published: April 2022

ABSTRACT

Background:
The scope of practice of nurse practitioners (NPs) is expanding, and an increasing number of registered nurses (RNs) are advancing their careers to become NPs. Nurse practitioners are prepared to improve access to high-quality care and enhance care standards. The barriers and facilitators in the transition of RNs to NPs have been seldom studied in the Canadian context.

Objective:
To conduct a scoping review to identify systemic barriers and facilitators affecting Canadian RN experience in transitioning to independent practice as NPs.

Data Sources:
Four electronic databases were searched for primary studies, and several search engines were used to retrieve gray literature. Keywords included NP, transition, novice, Canada, barriers, obstacles, facilitators, and their variations. Eligible studies are those published from the inception of each respective database to 2021.

Conclusions:
Four research studies and one report in the gray literature were located. Three themes were identified from the literature review, including inconsistencies in education and the need for mentors, need for legislation supportive of NP practice, and inconsistent remuneration structures for NPs.

Implications for Practice:
Addressing systemic barriers and employing systemic facilitators are likely to facilitate the transition of RNs to NPs. The lack of primary evidence to explore the factors that affect the transition process from an RN to an NP in Canada indicates that further research must be done. Findings from the future research are likely to furnish a better understanding of the transition process so that the integration of new NPs into the health care system can be achieved efficiently.
Melanin-Targeted PET Imaging With 18F-PFPN for Identifying Gastric Metastatic Melanoma
Authors: Zhang Xiao , Li Mengting , Lan Xiaoli 
Published: April 2022

Abstract
A 47-year-old man, who had a history of occipital skin dissection for melanoma, underwent 18F-FDG and 18F-PFPN (a specific tracer targeting melanin) PET due to increased stomach discomfort and melena. In 18F-FDG and 18F-PFPN images, strong uptakes were both found in the thickened gastric wall, which was suspected as metastatic melanoma to the stomach. This was further confirmed by pathological biopsy of gastric tissue. Our case illustrated that melanin-targeted PET imaging could provide an effective method for searching the metastases of melanoma.
Radioiodine Uptake in Incidentally Detected Neuroendocrine Tumor
Authors: Hod Nir , Lantsberg Sophie , Levin Daniel 
Published: April 2022

Abstract
Radioiodine whole-body scintigraphy has long been used for detection of differentiated thyroid carcinoma with high avidity in functioning thyroid tissues. However, uptake is not completely specific, and “false-positive” uptake in nonthyroidal tumors have rarely been reported. Herein, we present a case of incidentally detected neuroendocrine tumor showing high radioiodine uptake initially suspected to be thyroid metastasis. Correlative imaging with FDG PET/CT and 68Ga-DOTATATE PET/CT is presented, and literature survey is discussed. We conclude that neuroendocrine tumor should be added to the reported list of neoplasms that can show “false-positive” uptake representing a potential interpretative pitfall.
Machine Learning Approaches for Electronic Health Records Phenotyping: A Methodical Review
Authors: Yang Siyue , Varghese Paul , Stephenson Ellen , Tu Karen , Gronsbell Jessica 
Published: April 2022

ABSTRACTObjectiveAccurate and rapid phenotyping is a prerequisite to leveraging electronic health records (EHRs) for biomedical research. While early phenotyping relied on rule-based algorithms curated by experts, machine learning (ML) approaches have emerged as an alternative to improve scalability across phenotypes and healthcare settings. This study evaluates ML-based phenotyping with respect to (i) the data sources used, (ii) the phenotypes considered, (iii) the methods applied, and (iv) the reporting and evaluation methods used.Materials and MethodsWe searched PubMed and Web of Science for articles published between 2018 and 2022. After screening 850 articles, we recorded 37 variables on 100 studies.ResultsMost studies utilized data from a single institution and included information in clinical notes. Although chronic conditions were most commonly considered, ML also enabled characterization of nuanced phenotypes such as social determinants of health. Supervised deep learning was the most popular ML paradigm, while semi-supervised and weakly-supervised learning were applied to expedite algorithm development and unsupervised learning to facilitate phenotype discovery. ML approaches did not uniformly outperform rule-based algorithms, but deep learning offered marginal improvement over traditional ML for many conditions.DiscussionDespite the progress in ML-based phenotyping, most articles focused on binary phenotypes and few articles evaluated external validity or used multi-institution data. Study settings were infrequently reported and analytic code was rarely released.ConclusionContinued research in ML-based phenotyping is warranted, with emphasis on characterizing nuanced phenotypes, establishing reporting and evaluation standards, and developing methods to accommodate misclassified phenotypes due to algorithm errors in downstream applications.
Barriers and facilitators to the implementation of cell phone interventions to improve the use of family planning services among women in Sub-Saharan Africa: a systematic review
Authors: Barro Abibata , Ngangue Patrice , Bationo Nestor , Soubeiga Dieudonné , Pafadnam Yacouba , Kaboré Safiata S. , Pilabré Hermann , Traoré Doulaye 
Published: April 2022

AbstractBackgroundMobile health (mHealth) interventions are being tested to improve contraceptive uptake in SubSaharan Africa (SSA). However, few attempts have systematically reviewed the mHealth programs aiming to improve family planning (FP) services among women in SSA. This review identifies and highlights facilitators and barriers to implementing cell phone interventions designed to target women FP services.MethodsDatabases including PubMed, CINAHL, Epistemonikos, Embase, and Global Health were systematically searched for studies from January 01, 2010, to December 31, 2020, to identify various mHealth interventions used to improve the use of FP services among women in SSA. Two authors independently selected eligible publications based on inclusion/exclusion criteria, assessed study quality and extracted data using a pre-defined data extraction sheet. In addition, a content analysis was conducted using a validated extraction grid with a pre-established categorization of barriers and facilitators.ResultsThe search strategy led to a total of 8,188 potentially relevant papers, of which 16 met the inclusion criteria. The majority of included studies evaluated the impact of mHealth interventions on FP services; access (n = 9) and use of FP outcomes (n = 6). The most-reported cell phone use was for women reproductive health education, contraceptive knowledge and use. Barriers and facilitators of the use of mhealth were categorized into three main outcomes: behavioral outcomes, data collection and reporting, and health outcomes. mHealth interventions addressed barriers related to provider prejudice, stigmatization, discrimination, lack of privacy, and confidentiality. The studies also identified barriers to uptake of mHealth interventions for FP services, including decreased technological literacy and lower linguistic competency.ConclusionThe review provides detailed information about the implementation of mobile phones at different healthcare system levels to improve FP services; outcomes. Barriers to uptake mHealth interventions must be adequately addressed to increase the potential use of mobile phones to improve access to sexual reproductive health awareness and family planning services.Systematic review registrationPROSPERO CRD42020220669 (December 14, 2020)
Impact of HIV and recreational drugs on cognitive functions in young men having sex with men
Authors: Henrard Sophie , Trotta Nicola , Rovai Antonin , Coolen Tim , Slama Hichem , Bertels Julie , Puttaert Delphine , Goffard Jean-Christophe , Van Vooren Jean-Paul , Goldman Serge , De Tiège Xavier 
Published: April 2022

AbstractObjectivesThis study characterizes the structural and metabolic cerebral correlates of human immunodeficiency virus (HIV)-associated neurocognitive disorders (HAND) in a preclinical setting that considers the lifestyle of young European men exposed to HIV, including recreational drugs.DesignProspective inclusion of participants.MethodsSimultaneous structural brain magnetic resonance imaging (MRI) and positron emission tomography using [18F]-fluorodeoxyglucose (FDG-PET) were acquired on a hybrid PET-MRI system in 23 asymptomatic young men with HIV+ (mean age: 33.6 years, age range: 23-60 years; normal CD4+ cell count, undetectable viral load). Neuroimaging data were compared with that of a group of 26 young HIV-men, highly well matched for what concerns age, lifestyle, named pre-exposure prophylaxis users (HIV-PrEP), and to a group of 23 undifferentiated matched young men (i.e., healthy controls). A comprehensive neuropsychological assessment was also administered to the HIV+ and HIV-PrEP subjects.ResultsHIV+ subjects had lower performances in executive, attentional and working memory functions compared to HIV-PrEP subjects. No structural or metabolic differences were found between those two groups. Compared to healthy controls, HIV+ and HIV-PrEP exhibited a common frontal hypometabolism in the right prefrontal cortex that correlated with the level of recreational drug use. No structural brain abnormality was found.ConclusionA dynamic prevention of recreational drugs use in HIV+ and HIV-PrEP subjects is mandatory to cope with their negative impact on brain function and their neurocognitive consequences. A complex interplay between recreational drugs and HIV might be involved in the development of neurocognitive disorders in young men with HIV.
Implementation of a pediatric telemedicine and medication delivery service in a resource-limited setting: A pilot study for clinical safety and feasibility
Authors: Klarman Molly B. , Flaherty Katelyn E. , Chi Xiaofei , Cajusma Youseline , Exantus Lerby , Friesen Jason , Beau de Rochars Valery M , Baril Chantale , Gurka Matthew J. , Becker Torben K. , Nelson Eric J 
Published: April 2022

ABSTRACTObjectiveDetermine the clinical safety and feasibility of implementing a telemedicine and medication delivery service (TMDS) to address gaps in nighttime healthcare access for children in low-resource settings.MethodsWe implemented a TMDS in Haiti called ‘MotoMeds’: (i) A parent/guardian of a child ≤10 years contacted the call center (6pm-5am). (ii) A provider used paper clinical decision support tools to triage the case as mild, moderate, or severe. Severe cases were referred to emergency care. For non-severe cases, call center providers gathered clinical findings to generate an assessment and plan. (iii) For households within the delivery zone, a provider and driver were dispatched with medications/fluids; the provider performed a paired in-person exam. For households outside the delivery zone, the family received phone consult alone. All families received a follow-up call at 10-days. Data were analyzed for clinical safety and feasibility.ResultsA total of 391 cases were enrolled from September 9th, 2019 to January 19th, 2021; 89% (347) received a household visit. Most cases were triaged as mild or moderate (92%; 361). Among the severe cases, 83% (20) sought subsequent referred care. The most common complaint was a respiratory problem (63%; 246). At 10-days, 95% (329) of parents reported their child’s condition as “improved” or “recovered”. Ninety-nine percent (344) rated the TMDS as “good” or “great”. The median phone consultation was 20 minutes, time to arrival at the household was 73 minutes and total workflow per case was 114 minutes.ConclusionThe TMDS was a feasible healthcare delivery model with high rates of improved clinical status at 10-days.Study registration (clinicaltrials.gov)NCT03943654
Structural insights into the high selectivity of the anti-diabetic drug mitiglinide
Authors: Wang Mengmeng , Wu Jing-Xiang , Chen Lei 
Published: April 2022

AbstractMitiglinide is a highly selective fast-acting anti-diabetic drug that inhibits pancreatic KATP channels to induce insulin secretion. However, how mitiglinide binds KATP channels remains unknown. Here, we show the cryo-EM structure of the SUR1 subunit in complex with mitiglinide. The structure reveals that mitiglinide binds inside the common insulin secretagogue-binding site in the transmembrane domain of SUR1, locking SUR1 in a NBD-separated inward-facing conformation. The detailed structural analysis uncovers the molecular basis of the high selectivity of mitiglinide.
GM-CSF-activated human dendritic cells promote type1 T follicular helper cells (Tfh1) polarization in a CD40-dependent manner
Authors: Korniotis Sarantis , Saichi Melissa , Trichot Coline , Hoffmann Caroline , Amblard Elise , Viguier Annick , Grondin Sophie , Noel Floriane , Mattoo Hamid , Soumelis Vassili 
Published: April 2022

AbstractT follicular helper (Tfh) cells are specialized CD4+T cells that regulate humoral immunity by providing B cell help. Tfh1 sub-population was recently identified and associated with severity in infection and autoimmune diseases. The cellular and molecular requirements to induce human Tfh1 differentiation are unknown. Our work investigated the role of human dendritic cells (DC) in promoting Tfh1 differentiation and their physiopathological implication in mycobacterium tuberculosis and mild COVID-19 infection.Activated human blood CD1c+DC were cocultured with allogeneic naive CD4+T cells. Single-cell RNA sequencing was then used alongside protein validation to define the induced Tfh lineage. DC signature and correlation with Tfh1 cells in infected patients was established through bioinformatic analysis.Our results show that GM-CSF-activated DC drove the differentiation of Tfh1 cells, displaying typical Tfh molecular features, including 1) high levels of PD-1, CXCR5, and ICOS expression; 2) BCL6 and TBET co-expression; 3) IL-21 and IFN-γ secretion. Mechanistically, GM-CSF triggered the emergence of two distinct DC sub-populations defined by their differential expression of CD40 and ICOS-ligand (ICOS-L), and distinct phenotype, morphology, transcriptomic signature, and function. We showed that Tfh1 differentiation was efficiently and specifically induced by CD40highICOS-LlowDC in a CD40-dependent manner. Tfh1 cells were positively associated with a CD40highICOS-LLowDC signature in patients with latent mycobacterium tuberculosis and mild COVID-19 infection.Our study uncovers a novel CD40-dependent human Tfh1 axis. Immunotherapy modulation of Tfh1 activity might contribute to control diseases where Tfh1 are known to play a key role, such as infections.Significance StatementDendritic cells (DC) play a central role in triggering the adaptive immune response due to their T cell priming functions. Among different T cell subsets, it is still not clear how human type1 T follicular helper cells (Tfh1) differentiate. Tfh1 cells are implicated in several physiopathological conditions, including infections. Here we show that GM-CSF induces diversification of human DC. Only CD40highICOS-LLowDC were able to drive Tfh1 cell differentiation. We found that CD40highICOS-LLowDC signature was associated to Tfh1 cells in mycobacterium tuberculosis and COVID-19 patients. Our data reveal a previously undescribed pathway leading to human Tfh1 cell differentiation and highlight the importance of GM-CSF and CD40 as potential targets for the design of anti-infective therapies.
Architecture and the imaginary: text stimulus to improve students' creativity with nonlinear design process
Authors: Park Eun Joo , Kim Dong-Hyun , Kim Mi Jeong 
Published: April 2022

PurposeThis study aims to examine whether a text stimulus could enhance students' imagination and thus enhance their creativity in the architectural design studio. The assumption is that adopting the text stimulus in the conceptual design stage would support students' imagination through a nonlinear design process, and ultimately produce the creative values of design outcomes.Design/methodology/approachA curriculum that adopts a text stimulus was developed and used for first-year university students. The aim was to implement an architectural setting to stimulate students' imagination with a framework for creativity evaluation. The study focused not only on the design process that characterizes the generation of concepts and ideas, but also on the processes related to the creative practices that students need for developing their own expression methods to solve problems they encounter.FindingsThe results show that design education that emphasizes the imaginary could enhance students' creative thinking, thus leading to creative design. As a training tool in the design studio, the diversity of interpretation following the text stimulus was revealed to provoke a nonlinear design process and to eventually enhance students' originality, differential and inventiveness, which are associated with the creativity criteria for evaluation.Originality/valueThe study explores the translation of imaginary spaces from text into spatial design as a conceptual tool in order to characterize and support creativity throughout design education in the architectural design studio.