bluuebunny/crossref_metadata_2025_split huggingface dataset:
Smart Scheduling (SMASCH): multi-appointment scheduling system for longitudinal clinical research studies
Authors: Vega Carlos , Gawron Piotr , Lebioda Jacek , Grouès Valentin , Matyjaszczyk Piotr , Pauly Claire , Smula Ewa , Krüger Rejko , Schneider Reinhard , Satagopam Venkata 
Published: May 2022

Abstract

Objective
Facilitate the multi-appointment scheduling problems (MASPs) characteristic of longitudinal clinical research studies. Additional goals include: reducing management time, optimizing clinical resources, and securing personally identifiable information.

Materials and methods
Following a model view controller architecture, we developed a web-based tool written in Python 3.

Results
Smart Scheduling (SMASCH) system facilitates clinical research and integrated care programs in Luxembourg, providing features to better manage MASPs and speed up management tasks. It is available both as a Linux package and Docker image (https://smasch.pages.uni.lu).

Discussion
The long-term requirements of longitudinal clinical research studies justify the employment of flexible and well-maintained frameworks and libraries through an iterative software life-cycle suited to respond to rapidly changing scenarios.

Conclusions
SMASCH is a free and open-source scheduling system for clinical studies able to satisfy recent data regulations providing features for better data accountability. Better scheduling systems can help optimize several metrics that ultimately affect the success of clinical studies.
A machine learning approach to identifying delirium from electronic health records
Authors: Kim Jae Hyun , Hua May , Whittington Robert A , Lee Junghwan , Liu Cong , Ta Casey N , Marcantonio Edward R , Goldberg Terry E , Weng Chunhua 
Published: May 2022

Abstract
The identification of delirium in electronic health records (EHRs) remains difficult due to inadequate assessment or under-documentation. The purpose of this research is to present a classification model that identifies delirium using retrospective EHR data. Delirium was confirmed with the Confusion Assessment Method for the Intensive Care Unit. Age, sex, Elixhauser comorbidity index, drug exposures, and diagnoses were used as features. The model was developed based on the Columbia University Irving Medical Center EHR data and further validated with the Medical Information Mart for Intensive Care III dataset. Seventy-six patients from Surgical/Cardiothoracic ICU were included in the model. The logistic regression model achieved the best performance in identifying delirium; mean AUC of 0.874 ± 0.033. The mean positive predictive value of the logistic regression model was 0.80. The model promises to identify delirium cases with EHR data, thereby enable a sustainable infrastructure to build a retrospective cohort of delirium.
Sporophytic control of pollen meiotic progression is mediated by tapetum expression of ABORTED MICROSPORES
Authors: Tidy Alison C , Ferjentsikova Ivana , Vizcay-Barrena Gema , Liu Bing , Yin Wenzhe , Higgins James D , Xu Jie , Zhang Dabing , Geelen Danny , Wilson Zoe A 
Published: May 2022

Abstract
Pollen development is dependent on the tapetum, a sporophytic anther cell layer surrounding the microspores that functions in pollen wall formation but is also essential for meiosis-associated development. There is clear evidence of crosstalk and co-regulation between the tapetum and microspores, but how this is achieved is currently not characterized. ABORTED MICROSPORES (AMS), a tapetum transcription factor, is important for pollen wall formation, but also has an undefined role in early pollen development. We conducted a detailed investigation of chromosome behaviour, cytokinesis, radial microtubule array (RMA) organization, and callose formation in the ams mutant. Early meiosis initiates normally in ams, shows delayed progression after the pachytene stage, and then fails during late meiosis, with disorganized RMA, defective cytokinesis, abnormal callose formation, and microspore degeneration, alongside abnormal tapetum development. Here, we show that selected meiosis-associated genes are directly repressed by AMS, and that AMS is essential for late meiosis progression. Our findings indicate that AMS has a dual function in tapetum–meiocyte crosstalk by playing an important regulatory role during late meiosis, in addition to its previously characterized role in pollen wall formation. AMS is critical for RMA organization, callose deposition, and therefore cytokinesis, and is involved in the crosstalk between the gametophyte and sporophytic tissues, which enables synchronous development of tapetum and microspores.
A measurement of stellar surface gravity hidden in radial velocity differences of comoving stars
Authors: Moschella Matthew , Slone Oren , Dror Jeff A , Cantiello Matteo , Perets Hagai B 
Published: May 2022

ABSTRACT
The gravitational redshift induced by stellar surface gravity is notoriously difficult to measure for non-degenerate stars, since its amplitude is small in comparison with the typical Doppler shift induced by stellar radial velocity. In this study, we make use of the large observational data set of the Gaia mission to achieve a significant reduction of noise caused by these random stellar motions. By measuring the differences in velocities between the components of the pairs of comoving stars and wide binaries, we are able to statistically measure the combined effects of gravitational redshift and convective blueshifting of spectral lines, and nullify the effect of the peculiar motions of the stars. For the subset of stars considered in this study, we find a positive correlation between the observed differences in Gaia radial velocities and the differences in surface gravity and convective blueshift inferred from effective temperature and luminosity measurements. The results rule out a null signal at the 5σ level for our full data set. Additionally, we study the subdominant effects of binary motion, and possible systematic errors in radial velocity measurements within Gaia. Results from the technique presented in this study are expected to improve significantly with data from the next Gaia data release. Such improvements could be used to constrain the mass–luminosity relation and stellar models that predict the magnitude of convective blueshift.
Mg ii in the JWST era: a probe of Lyman continuum escape?
Authors: Katz Harley , Garel Thibault , Rosdahl Joakim , Mauerhofer Valentin , Kimm Taysun , Blaizot Jérémy , Michel-Dansac Léo , Devriendt Julien , Slyz Adrianne , Haehnelt Martin 
Published: May 2022

ABSTRACT
Limited constraints on the evolution of the Lyman Continuum (LyC) escape fraction represent one of the primary uncertainties in the theoretical determination of the reionization history. Due to the intervening intergalactic medium, the possibility of observing LyC photons directly in the epoch of reionization is highly unlikely. For this reason, multiple indirect probes of LyC escape have been identified, some of which are used to identify low-redshift LyC leakers (e.g. O32), while others are primarily useful at z &gt; 6 (e.g. [O iii]/[C iii] far-infrared emission). The flux ratio of the resonant Mg ii doublet emission at 2796$\mathring{\rm A}$ and 2803$\mathring{\rm A}$ as well as the Mg ii optical depth have recently been proposed as ideal diagnostics of LyC leakage that can be employed at z &gt; 6 with JWST. Using state-of-the-art cosmological radiation hydrodynamics simulations post-processed with CLOUDY and resonant-line radiative transfer, we test whether Mg ii is indeed a useful probe of LyC leakage. Our simulations indicate that the majority of bright, star-forming galaxies with high LyC escape fractions are expected to be Mg ii emitters rather than absorbers at z = 6. However, we find that the Mg ii doublet flux ratio is a more sensitive indicator of dust rather than neutral hydrogen, limiting its use as a LyC leakage indicator to only galaxies in the optically thin regime. Given its resonant nature, we show that Mg ii will be an exciting probe of the complex kinematics in high-redshift galaxies in upcoming JWST observations.
Do Intrawound Antibiotics Reduce the Incidence of Surgical Site Infections in Pelvic and Lower-Limb Trauma Surgery? A Systematic Review and Meta-analysis
Authors: Ma Norine , Gogos Sophia , Moaveni Ash 
Published: May 2022

Objectives:
To analyze the efficacy of intraoperative topical antibiotics in reducing the incidence of postoperative surgical site infections in pelvic and lower-limb trauma orthopaedic surgery.

Data Sources:
A search of Ovid MEDLINE, PubMed, and Embase was conducted for English language studies published from 1946 through September 3, 2021, using relevant keywords.

Study Selection:
Included studies were randomized controlled trials, cohort studies, or case–control studies reporting on the rate of surgical site infections in adult patients (age 16 and older) who underwent surgical fixation of lower-limb or pelvic traumatic fractures, including both open and closed fractures, with topical intraoperative antibiotics applied to the surgical site before wound closure.

Data Extraction:
Studies were evaluated using the Joanna Briggs Institute Critical Appraisal Checklist for analytical cross-sectional studies. The risk of bias was assessed using the ROBINS-I and Cochrane risk-of-bias tools.

Data Synthesis:
A meta-analysis was conducted using the inverse variance method and random-effects model to assess effect significance and study heterogeneity.

Conclusions:
Seven studies were included in the systematic review. Results of the meta-analysis suggested a potential 23% reduction in the odds of developing a deep surgical site infection in patients treated with intraoperative antibiotic powder compared with those managed with intravenous antibiotics alone (odds ratio 0.77, 95% confidence interval 0.52–1.13), although the results did not reach statistical significance. Further powered studies including randomized controlled trials would be of great value to validate the results suggested in this study and inform best practice intraoperative antibiotic prophylaxis in pelvic and lower-limb trauma surgery.

Level of Evidence:
Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Association of Frailty, Organ Support, and Long-Term Survival in Critically Ill Patients With COVID-19
Authors: Taniguchi Leandro Utino , Avelino-Silva Thiago Junqueira , Dias Murilo Bacchini , Jacob-Filho Wilson , Aliberti Márlon Juliano Romero ,   on behalf of CO-FRAIL Study Group and EPICCoV Study Group, for COVID HCFMUSP Study Group
Published: May 2022

OBJECTIVES:
Few studies have explored the effect of frailty on the long-term survival of COVID-19 patients after ICU admission. Furthermore, the Clinical Frailty Scale (CFS) validity in critical care patients remains debated. We investigated the association between frailty and 6-month survival in critically ill COVID-19 patients. We also explored whether ICU resource utilization varied according to frailty status and examined the concurrent validity of the CFS in this setting.

DESIGN:
Ancillary study of a longitudinal prospective cohort.

SETTING:
University hospital in São Paulo.

PATIENTS:
Patients with severe COVID-19 admitted to ICU.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
We assessed baseline frailty using the CFS (1–9; frail ≥ 5) and used validated procedures to compute a Frailty Index (0–1; frail > 0.25). We used Cox models to estimate associations of frailty status with 6-month survival after ICU admission and area under the receiver operating characteristic curves (AUCs) to estimate CFS’s accuracy in identifying frailty according to Frailty Index. We included 1,028 patients (mean age, 66 yr; male, 61%). Overall, 224 (22%) patients were frail (CFS ≥ 5), and 608 (59%) died over the 6-month follow-up. Frailty was independently associated with lower 6-month survival and further stratified mortality in patients with similar age and Sequential Organ Failure Assessment scores. We additionally verified that the CFS was highly accurate in identifying frailty as defined by the Frailty Index (AUC, 0.91; 95% CI, 0.89–0.93). Although treatment modalities did not diverge according to frailty status, higher CFS scores were associated with withholding organ support due to refractory organ failure.

CONCLUSIONS:
One in five COVID-19 patients admitted to the ICU was frail. CFS scores greater than or equal to 5 were associated with lower long-term survival and decisions on withholding further escalation of invasive support for multiple organ failure in the ICU. Clinicians should consider frailty alongside sociodemographic and clinical measures to have a fuller picture of COVID-19 prognosis in critical care.
Effect of Somatosensory Interaction Transcutaneous Electrical Acupoint Stimulation on Cancer-related Fatigue and Immunity
Authors: Shu Jianfeng , Ren Wei , Chen Shu , Li Lin , Zhu Hui , Jin Aixiang 
Published: May 2022

Background:
This study was intended to evaluate the clinical effect of somatosensory interaction transcutaneous electrical acupoint stimulation (SI-TEAS) on cancer-related fatigue (CRF) and its safety.

Methods:
The study protocol had been registered in China Clinical Trial Registration Center with registration number: ChiCTR2100045655. CRF patients were equally divided into SI-TEAS Group, Acupressure Group and Sham Acupressure Group to receive SI-TEAS, acupressure and sham acupressure treatments 5 times a week. The fatigue levels of patients in the 3 groups were measured by the Piper Fatigue Scale during the baseline period and after 4 and 8 weeks (of treatment). The cell immunity of these patients was determined by detecting the T-lymphocyte subsets and NK cells.

Result:
Of the 300 participants, 279 have gone through the independent rehabilitation intervention study, including 94 in the SI-TEAS Group, 92 in the Acupressure Group, and 93 in the Sham Acupressure Group. Intergroup comparisons of fatigue degree and cell immunity, namely SI-TEAS Group versus Acupressure Group, Acupressure Group versus Sham Acupressure Group, and SI-TEAS Group versus Sham Acupressure Group, showed that group changes observed during the baseline period and different time points after Week 4 and 8 were statistically different (P<0.05). The SI-TEAS Group had the sharpest decreases in the behavioral, sensory, emotional and cognitive dimensions of fatigue, and the total score, followed by the Acupressure Group, while the Sham Acupressure Group did not show significant changes; the SI-TEAS Group experienced the sharpest increases in the absolute counts of CD3+ T cells, CD4+ T cells, CD8+ T cells, CD4+/CD8+ T cells, and NK cells, followed by the Acupressure Group, while the Sham Acupressure Group did not show significant changes.

Conclusion:
SI-TEAS could significantly relieve the fatigue of CRF patients and improve their cell immunity, which maybe a useful and effective option for reducing CRF in clinical practice.
Menopausal Hormone Therapy and the Mind: The Role of Hormone Replacement in the Prevention and Treatment of Cognitive Decline, Dementia, and Cognitive Dysfunction of Depression
Authors: Koire Amanda , Joffe Hadine , Buckley Rachel 
Published: May 2022

Learning objectives
After participating in this activity, learners should be better able to:
• Outline the clinical recommendations for menopausal hormone treatment related to cognitive concerns
• Debate and discuss the various research pieces on the use of menopausal hormone therapy cognitive decline, dysfunction, and dementia

Abstract
Menopause has been associated with subjective cognitive dysfunction and elevated rates of depression. While menopausal hormone therapy (MHT) is Food and Drug Administration–approved for the treatment of vasomotor symptoms related to menopause, a potential role for MHT in treating and preventing cognitive decline, dysfunction, and dementia has remained unclear and a topic of continued interest and debate across decades of research. Increasing numbers of patients are seeking help for subjective cognitive decline, and those with poorer mental health are substantially more likely to perceive themselves to be at high risk of developing dementia; thus, mental health professionals are likely to encounter such patients and may be asked to provide advice concerning MHT, cognition, and indications for MHT use. Here, we synthesize the neurobiological effects of MHT, make recommendations for its use in current clinical practice in the contexts of cognitive dysfunction associated with major depressive disorder, cognitive decline, and Alzheimer’s disease, and discuss the frontiers being explored by ongoing research on this topic. We conclude that MHT to improve cognitive functioning has only a few scenarios where it would be recommended and that particular caution may be warranted for carriers of the APOE ε4 allele.
Initial Impact of the COVID-19 Pandemic on Physician Assistant Education
Authors: Valentin Virginia , Najmabadi Shahpar , Warner Mary , White Ryan , Dehn Richard 
Published: May 2022

Purpose:
The COVID-19 pandemic significantly impacted United States (US) health professions educational programs. Physician assistant (PA) programs were forced to respond to rapidly changing circumstances early in the pandemic. This study describes the impact that the early phase of the COVID-19 pandemic had on PA programs in the United States.

Methods:
This cross-sectional study is based on data from the COVID-19 Rapid Response Report 1, conducted by the Physician Assistant Education Association in April 2020. The survey sample included 254 US PA program directors with a response rate of 64.2%. Our outcome measures included temporary changes to PA program operations and clinical training, and current and upcoming budget and tuition changes, as well as the impact of the pandemic on faculty and staff employment. We used descriptive statistics to summarize these outcomes, stratified by 4 categories characterizing features of PA programs, including geographical location, academic housing, funding model, and academic health center status.

Results:
The COVID-19 pandemic impact on programs varied geographically. A majority of programs reported making numerous temporary changes to their operations. Most programs moved both didactic and clinical education to an online format. Clinical training was temporarily suspended at almost all programs.

Conclusions:
PA programs continued training despite the pandemic. The long-term impact of the pandemic may be the instability of the PA education workforce.
Caregiver Inclusion in IDEAL Discharge Teaching
Authors: Topham Emily Wahlquist , Bristol Alycia , Luther Brenda , Elmore Catherine E. , Johnson Erin , Wallace Andrea S. 
Published: May 2022

Purpose:
Despite recognition that unpaid (e.g., family, friends) caregivers (caregivers) play an important role in successful transitions home after hospitalization, limited information is available about whether and how caregiver experiences of discharge align with current strategies for providing high-quality discharge processes, and how these experiences at discharge impact successful transitions home. The purpose of this study was to explore perceptions of caregivers regarding their discharge preparation, focusing particular attention on whether and how they believed discharge preparation impacted postdischarge patient outcomes.

Methods:
We conducted in-depth, case interviews with four English-speaking caregivers (61–75 years of age). Content analysis was framed by the nature of caregiver involvement proposed by the Agency for Healthcare Research and Quality's (AHRQ's) IDEAL (Include, Discuss, Educate, Assess, Listen) discharge planning strategy.

Results:
Caregivers reported receiving clear discharge instructions, or basic education, and yet felt only passively included in discharge teaching. Once home, the caregivers reported gaps in their knowledge of how to care for the patient, suggesting key gaps related to knowledge of warning signs and problems. Two of the four caregiver participants attributed a hospital readmission to postdischarge knowledge gaps.

Conclusion:
The experiences of these caregivers demonstrate how their limited, passive involvement in discharge education may result in suboptimal patient outcomes after hospitalization. Our findings suggest that structured programs aimed at increasing caregiver involvement in discharge, particularly related to assessment of caregiver problem solving, planning, and postdischarge support, are important in efforts seeking to improve care transitions and postdischarge outcomes.

Implications for Case Management:
This study assesses caregivers' experience with discharge planning and problems they encounter post-discharge, providing case managers with important information regarding the effectiveness of discharge processes. This study of caregiver experiences suggests that the IDEAL discharge planning strategy remains a useful and important framework for case managers to follow when providing discharge services.
The Fate of the Cervical Collar
Authors: Hewes Hilary A. , Ravindra Vijay M. , Ryan Sydney , Russell Katie W. , Soisson Sean , Brockmeyer Douglas L. 
Published: May 2022

Objectives
After evaluation and treatment of minor traumatic cervical spine injury (CSI), many children are discharged home in a rigid cervical orthosis (RCO). This study investigated their adherence to RCO treatment recommendations. The feasibility of telehealth cervical spine clearance was also explored.

Methods
This was a prospective observational study of children 3 to 18 years old with mild CSI evaluated at a level I pediatric trauma center from December 1, 2019, through July 31, 2021. Before emergency department discharge, patients received RCO use instructions and recommendation for follow-up with in-person neurosurgery clinic visit, neurosurgery telehealth visit, or in-person primary care provider visit. The family was responsible for arranging follow-up. Primary outcomes included compliance with follow-up and collar use.

Results
Ninety-eight children (mean age, 11.3 ± 4.1 years) were included. Overall, follow-up contact was available for 51 patients (52%). At 1-week follow-up with 36 children, 64% were collar compliant, 13 had no pain (38% remained in RCO), 14 had mild pain without limitations, 8 had pain with some limitations, and 1 had significant pain. At 2-week follow-up with 31 children, 9 (29%) were collar compliant, 23 had no pain, 7 had mild pain without limitations, and 1 with significant persistent pain was found to have an odontoid fracture requiring C1–2 fusion. Patients/families often discontinued the use of the collar without follow-up (47%). Approximately half utilized a recommended clinical follow-up option for clearance, most often in neurosurgery clinic or using a neurosurgery telehealth visit. The mean time to follow-up was 11.34 ± 4.9 days (range, 3–25 days), and mean collar compliance lasted 9.8 ± 5.7 days (range, 1–25 days). No child experienced any short-term complications related to RCO use.

Conclusions
In this pilot study, a substantial portion of children with mild CSIs discharged from the emergency department with an RCO did not adhere to compliance or follow-up recommendations. Persistent pain requires further evaluation.