bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mediators of inflammation resolution and vasoactive eicosanoids in gestational diabetes and preeclampsia
Authors: Barden Anne E. , Shinde Sujata , Phillips Michael , Beilin Lawrence J. , Mori Trevor A. 
Published: August 2022

Objective:
Women with gestational diabetes (GDM) have an increased risk of preeclampsia and postpartum diabetes. Inflammation associates with both GDM and preeclampsia. This study examined specialized proresolving mediators (SPM) that direct inflammation resolution and eicosanoids that are involved in inflammation, in relation to the development of preeclampsia and ongoing postpartum glucose intolerance in GDM.

Methods:
Participants were selected from a prospective study examining the development of preeclampsia in women with GDM. Four groups of age-matched women were studied: GDM (n = 20), GDM who developed preeclampsia (GDM+PE, n = 21), GDM who remained glucose-intolerant postpartum (GDM+PPIGT, n = 20), or pregnancies with glucose tolerance within the normal range (NGT, n = 21). Measurement of SPM (E-series resolvins and D-series resolvins), SPM pathway intermediates (14-HDHA, 18-HEPE and 17-HDHA), 20-hydroxyeicosatetraenoic acid (20-HETE), and the urinary metabolite of the vasodilator prostacyclin 2,3-dinor-6-Keto-PGF1α, were made at 28, 32 and 36 weeks gestation and at 6 months postpartum.

Results:
Compared with GDM, GDM+PE had elevated levels of 20-HETE and the SPM pathway intermediates 14-HDHA, 18-HEPE, 17-HDHA, at 32 weeks, and the SPM RvE1 at 32 and 36 weeks gestation. Compared with NGT and regardless of whether they developed preeclampsia or PPIGT, GDM had lower levels of 2,3-dinor-6-Keto-PGF1α during pregnancy.

Conclusion:
Reduced levels of the prostacyclin metabolite 2,3-dinor-6-Keto-PGF1α may contribute to the increased risk of preeclampsia in women with GDM. The increase in 20-HETE, a vasoconstrictor and mediator of inflammation, and SPM that contribute to inflammation resolution, prior to the onset of preeclampsia require further investigation to clarify their clinical significance.
Effects of Gum Chewing on Recovery From Postoperative Ileus: A Randomized Clinical Trail
Authors: HSU Ya-Chuan , SZU Shu-Ying 
Published: August 2022

ABSTRACT

Background
Sham feeding with products such as chewing gum has been theorized to decrease the incidence and time to resolution of postoperative ileus. The conflicting findings in the literature on this subject are because in part of the use of mixed study populations, which has led to difficulties in assessing the value of sham feeding in ameliorating this condition.

Purpose
The aim of this study was to evaluate the efficacy of postsurgical gum chewing in restoring normal bowel movement in patients with colorectal cancer who had undergone abdominal surgery for colon resection.

Methods
A randomized controlled trial was used to examine the time to first postoperative flatus and defecation. The intervention group (n = 30) received xylitol chewing gum on the first day after colon resection, one piece of gum for 15 minutes, 3 times daily, until the time to first flatus and defecation. Both the intervention and control groups (n = 30) received standard postoperative care and were encouraged to walk as soon as possible after surgery. The time to first flatus was reported by patients.

Results
The time to first flatus and defecation in the intervention group was significantly shorter than that in the control group (39.13 ± 15.66 vs. 52.92 ± 21.97 hours and 54.55 ± 18.90 vs. 77.98 ± 34.59 hours, respectively). However, after controlling for age and surgical duration, only time to first flatus was significantly shorter in the intervention group. Significantly positive correlations were found between time to first flatus and time to first defecation in both groups.

Conclusions/Implications for Practice
In this study, gum chewing was shown to have a positive effect on the time to first postoperative flatus and defecation. This inexpensive and noninvasive intervention may be recommended to decrease the time to resolution of postsurgical ileus in middle-aged and older patients who have undergone open abdominal surgery for colorectal resection.
Acute mesenteric ischaemia
Authors: Reintam Blaser Annika , Forbes Alastair , Björck Martin 
Published: August 2022

Purpose of review
To summarize the recent evidence on acute mesenteric ischaemia (AMI).

Recent findings
The overall incidence of AMI is below 10/100 000 person years but increases exponentially with age. The overall mortality of AMI remains high, exceeding 50%, despite continuing progress and increasing availability of imaging and endovascular interventions. However, patients with (early) revascularization have significantly better outcomes. The majority of patients surviving the acute event are still alive at 1 year, but evidence on quality of life is scarce.
Clinical suspicion of AMI is the key to timely diagnosis, with biphasic computed tomography-angiography the diagnostic method of choice. Currently, no biomarker has sufficient specificity to diagnose AMI.

Summary
Improved awareness and knowledge of AMI are needed to raise the suspicion of AMI in relevant patients and thereby to achieve better outcomes.
COVID-19-associated pulmonary aspergillosis: an underdiagnosed or overtreated infection?
Authors: Rouzé Anahita , Martin-Loeches Ignacio , Nseir Saad 
Published: August 2022

Purpose of review
Coronavirus disease (COVID-19)-associated pulmonary aspergillosis (CAPA) may concern up to one third of intensive care unit (ICU) patients. The purpose of this review is to discuss the diagnostic criteria, the pathogenesis, the risk factors, the incidence, the impact on outcome, and the diagnostic and therapeutic management of CAPA in critically ill patients.

Recent findings
The incidence of CAPA ranges 3--28% of critically ill patients, depending on the definition used, study design, and systematic or triggered screening. COVID-19 is associated with direct damage of the respiratory epithelium, immune dysregulation, and common use of immunosuppressive drugs which might promote Aspergillus respiratory tract colonization and invasion. Positive Aspergillus tests among COVID-19 critically patients might reflect colonization rather than invasive disease. CAPA usually appears during the second week after starting invasive mechanical ventilation and is independently associated with ICU mortality.

Summary
Further studies are needed to validate CAPA case definitions, to determine the accurate incidence of CAPA in comparison to adequate controls, and its evolution during the pandemic. A pro-active diagnostic strategy, based on risk stratification, clinical assessment, and bronchoalveolar lavage could be recommended to provide early antifungal treatment in patients with high probability of CAPA and clinical deterioration.
Hospital Price Transparency in the United States
Authors: Linde Sebastian , Egede Leonard E. 
Published: August 2022

Background:
Effective January 1, 2021, US hospitals were required to upload information on their chargemaster prices (database of list prices), discounted cash prices (commonly charged to self-pay patients), and payer-specific negotiated prices.

Objective:
Examine how prices vary and are associated with hospital characteristics, market competition, and hospital quality.

Design Setting and Participants:
This observational study used data on 14 common medical services across 1599 hospitals in 2021. Descriptive and regression analyses were used to study price variation. Analyses adjust for hospital characteristics, market competition and state fixed effects.

Results:
Ninetieth -to-10th-percentile price markups factors (ratios) range between 3.2 and 11.5 for chargemaster; 6.1 and 19.7 for cash; and 6.6 and 30.0 for negotiated prices. Adjusted regression results indicate that hospitals’ cash prices are on average 60% (P<0.01) higher, and list prices are on average 164% (P<0.01) higher, than negotiated prices. Systematic pricing differences across hospitals were noted, with urban hospitals having 14% (P<0.01) lower prices than rural hospitals, teaching hospitals having 3% (P<0.01) higher prices than nonteaching hospitals, and nonprofit hospitals pricing 9% (P<0.01), and for-profit hospitals 39% (P<0.01), higher than government owned hospitals. In addition, hospitals that contract with more insurance plans have higher prices, hospitals in more competitive markets have lower prices, and higher quality hospitals have on average 5% (P<0.01) lower prices than lower quality hospitals.

Conclusions:
Prices all vary considerably across US hospitals. High quality hospitals are associated with lower pricing across all three sets of prices examined. Hospital price transparency may help consumers better identify hospitals that provide both high quality, and low cost, care.
Mitochondria and ischemia reperfusion injury
Authors: Panconesi Rebecca , Widmer Jeannette , Carvalho Mauricio Flores , Eden Janina , Dondossola Daniele , Dutkowski Philipp , Schlegel Andrea 
Published: August 2022

Purpose of review
This review describes the role of mitochondria in ischemia-reperfusion-injury (IRI).

Recent findings
Mitochondria are the power-house of our cells and play a key role for the success of organ transplantation. With their respiratory chain, mitochondria are the main energy producers, to fuel metabolic processes, control cellular signalling and provide electrochemical integrity. The mitochondrial metabolism is however severely disturbed when ischemia occurs. Cellular energy depletes rapidly and various metabolites, including Succinate accumulate. At reperfusion, reactive oxygen species are immediately released from complex-I and initiate the IRI-cascade of inflammation. Prior to the development of novel therapies, the underlying mechanisms should be explored to target the best possible mitochondrial compound. A clinically relevant treatment should recharge energy and reduce Succinate accumulation before organ implantation. While many interventions focus instead on a specific molecule, which may inhibit downstream IRI-inflammation, mitochondrial protection can be directly achieved through hypothermic oxygenated perfusion (HOPE) before transplantation.

Summary
Mitochondria are attractive targets for novel molecules to limit IRI-associated inflammation. Although dynamic preservation techniques could serve as delivery tool for new therapeutic interventions, their own inherent mechanism should not only be studied, but considered as key treatment to reduce mitochondrial injury, as seen with the HOPE-approach.
A Protocol to Assess Adult Outcomes at 30 Years Following Preterm Birth
Authors: Sullivan Mary C , D’Agata Amy L. , Stanley Zachary , Brewer Pamela , Kelly Michelle M. 
Published: August 2022

Abstract

Background
Among the most intense adversity experiences for infants is premature birth. Early birth marks the beginning of a life course that broadly affects families, health care, education, social systems, and the survivors themselves. For many, the transition to adulthood is challenging and often hampered by cognitive, physical and mental health, and motor and independence difficulties.

Objectives
To share a comprehensive protocol of a 10th follow-up study of premature infants in their 30s. The protocol accounts for stress during the neonatal period, the cumulative context (risk, protection) of development, biological and epigenetic mechanisms, and individual resilience.

Methods
The prospective 5-group longitudinal design includes 215 term-born and preterm-born individuals with various neonatal morbidities at ages 30–35. Adult outcomes include health, adaptive, executive, and work and social competence. Novel measures are four system indicators of allostatic load (AL) and epigenetics. Contextual measures include socioeconomic risk and individual resilience. All measures were selected based on coherence with constructs of the scientific aims, strong psychometrics, continuity for repeated measures, and minimal subject burden. Objective assessments include body composition imaging, exercise testing, blood and saliva collection, and actigraphy. The 2-phase protocol takes approximately 8 hr.

Discussion
After an 11-month COVID-19 pause, participant response has been strong. As of May 2022, 75 participants have completed the full protocol, and 99 have consented to participate. When socioeconomic risk is controlled, we hypothesize that life course trajectories in physical and psychological health, adaptive function, and executive function will differ between term and preterm neonatal morbidity groups. AL will vary across groups and contribute to outcomes. We expect proximal protection and resilience to mediate the cumulative medical and socioeconomic risk and AL. Epigenome-wide DNA methylation, with estimates of age acceleration, will be examined across groups and explored in longitudinal associations with medical risk, socioeconomic status, and protection. To our knowledge, this is the only U.S. study of premature infants aged 30–35 years. With millions of preterm-born individuals reaching adulthood, the protocol incorporates molecular and genetic biomarkers in a life course developmental examination to inform the timing and content of interventions.
The Cost of Operating Sexual Health Clinics During the Ending the (HIV) Epidemic Initiative in New York City
Authors: Williams Austin M. , Jamison Kelly , Eppink Samuel T. , Pathela Preeti , Blank Susan , Peters Dana , Gift Thomas L. , Berruti Andrés A. 
Published: August 2022

Background
As part of New York State's Ending the Epidemic (EtE) initiative, sexual health clinics (SHCs) in New York City invested in clinic enhancements and expanded their HIV-related services to increase access to HIV prevention interventions and treatment. The objective of this study was to estimate and describe the change in SHC operating costs related to clinic enhancements and expanded patient services implemented as part of the EtE initiative.

Methods
A comprehensive microcosting approach was used to collect retrospective cost information from SHCs, broken down by category and programmatic activity. Cost information was collected from 8 clinics across New York City during two 6-month time periods before (2015) and during (2018–2019) EtE.

Results
Eight SHCs reported comprehensive cost data. Costs increased by $800,000 on average per clinic during the 6-month EtE period. The cost per visit at an SHC increased by $120 on average to $381 (ranging from $302 to $464) during the EtE period. Personnel costs accounted for 69.9% of EtE costs, and HIV-related medications accounted for 8.9% of costs. Employment of social workers and patient navigators increased costs by approximately $150,000 on average per clinic. Postexposure prophylaxis was the costliest medication with average expenditures of $103,800 per clinic.

Conclusions
This study demonstrates the key drivers of cost increases when offering enhanced HIV services in SHCs. Documenting the changes in resources necessary to implement these services and their costs can inform other health departments on the viability of offering enhanced HIV services within their own clinics.
Observation and Patients’ Perceptions of Incorporating Their Photograph Into the Electronic Health Record
Authors: Reuland Brian D. , Redman Chelsea T. , Kneifati-Hayek Jerard Z. , Fernandes Yelstin , Kosber Rashid , Ortuno-Garcia Claudia , Crossman Daniel J. , Salmasian Hojjat , Chen Allen R. , Barchi Daniel J. , Applebaum Jo R. , Green Robert A. , Adelman Jason S. 
Published: August 2022

Objectives
Wrong-patient errors are common and have the potential to cause serious harm. The Office of the National Coordinator for Health Information Technology Patient Identification SAFER Guide recommends displaying patient photographs in electronic health record (EHR) systems to facilitate patient identification and reduce wrong-patient errors. A potential barrier to implementation is patient refusal; however, patients’ perceptions about having their photograph captured during registration and integrated into the EHR are unknown.

Methods
The study was conducted in an emergency department (ED) and primary care outpatient clinic within a large integrated health system in New York City. The study consisted of 2 components: (1) direct observation of the registration process to quantify the frequency of patient refusals and (2) semistructured interviews to elicit patients’ feedback on perceived benefits and barriers to integrating their photograph into the EHR.

Results
Of 172 registrations where patients were asked to take a photograph for patient identification, 0 refusals were observed (ED, 0 of 87; primary care outpatient clinic, 0 of 85). A convenience sample of 30 patients were interviewed (female, 70%; age ≥55 years, 43%; Hispanic/Latino, 67%; Black, 23%). Perceived benefits of integrating patient photographs into the EHR included improved security (40%), improved patient identification (23%), and ease of registration (17%). A small proportion of patients raised privacy concerns.

Conclusions
Patient refusal was not found to be a barrier to implementation of patient photographs in the EHR. Efforts to identify and address other potential barriers would help ensure that the highest proportion of patients has photographs in their medical record.
Interventions Into Reliability-Seeking Health Care Organizations: A Systematic Review of Their Goals and Measuring Methods
Authors: Auschra Carolin , Asaad Eleonora , Sydow Jörg , Hinkelmann Jürgen 
Published: August 2022

Objectives
Within the last 2 decades, numerous interventions making use of high-reliability theory have been implemented to increase reliability in healthcare organizations. This systematic literature review first explores the concrete goals on which such interventions focus. Second, the review captures how the achievement of these goals, or alternatively a change, generally an increase in organizational reliability, is measured across different contexts.

Methods
Searches were conducted in PubMed, Academic Search Ultimate, Business SourcePremier, CINAHL, Communication Source, EconLit, ERIC, Medline, Political Science Complete, PsycArticles, APA PsycInfo, PSYNDEX, SocINDEX (via the resource hosterEbscoHost), and Web of Science (through November 22, 2021). Peer-reviewed, English language studies were included, reporting on the implementation of a concrete intervention to increase reliability in a medical context and referring to high-reliability theory.

Results
The search first yielded 8896 references, from which 75 studies were included in the final sample. Important healthcare goals stated by the seminal report “Crossing the Quality Chasm” guided the analysis of the included studies. Most of the studies originated from the United States and report on interventions to increase reliability of either organizational units or whole organizations when aiming for safety (n = 65). Other goals reported on include effectiveness, and much less frequently timeliness, patient centeredness, and efficiency. Fifty-eight studies use quantitative measurement exclusively to account for the achievement of these goals; 7 studies use qualitative measurement exclusively, and 10 studies use a mixed-method approach. The operationalization of goals, including the operationalization of organizational reliability, and measurement methods do not follow a unified approach, despite claiming to be informed by a coherent theory. Instead, such operationalizations strongly depend on the overall objective of the study and the respective context.

Conclusions
Measuring the outcomes of high-reliability interventions into healthcare organizations is challenging for different reasons, including the difficult operationalization of partly overlapping goals, the complex, processual nature of achieving reliability, and the limited ability of organizations striving for more reliability if they are already performing on a high level. This review critically assesses the adoption of the goals stated in the seminal report “Crossing the Quality Chasm” and provides insights for organizations and funding providers that strive to evaluate more reliable service provision.
Multi-Institutional Stereotactic Body Radiation Therapy Incident Learning: Evaluation of Safety Barriers Using a Human Factors Analysis and Classification System
Authors: McGurk Ross , Woch Naheedy Katherine , Kosak Tara , Hobbs Amy , Mullins Brandon T. , Paradis Kelly C. , Kearney Meghan , Roback Donald , Durney Jeffrey , Adapa Karthik , Chera Bhishamjit S. , Marks Lawrence B. , Moran Jean M. , Mak Raymond H. , Mazur Lukasz M. 
Published: August 2022

Objectives
Stereotactic body radiation therapy (SBRT) can improve therapeutic ratios and patient convenience, but delivering higher doses per fraction increases the potential for patient harm. Incident learning systems (ILSs) are being increasingly adopted in radiation oncology to analyze reported events. This study used an ILS coupled with a Human Factor Analysis and Classification System (HFACS) and barriers management to investigate the origin and detection of SBRT events and to elucidate how safeguards can fail allowing errors to propagate through the treatment process.

Methods
Reported SBRT events were reviewed using an in-house ILS at 4 institutions over 2014–2019. Each institution used a customized care path describing their SBRT processes, including designated safeguards to prevent error propagation. Incidents were assigned a severity score based on the American Association of Physicists in Medicine Task Group Report 275. An HFACS system analyzed failing safeguards.

Results
One hundred sixty events were analyzed with 106 near misses (66.2%) and 54 incidents (33.8%). Fifty incidents were designated as low severity, with 4 considered medium severity. Incidents most often originated in the treatment planning stage (38.1%) and were caught during the pretreatment review and verification stage (37.5%) and treatment delivery stage (31.2%). An HFACS revealed that safeguard failures were attributed to human error (95.2%), routine violation (4.2%), and exceptional violation (0.5%) and driven by personnel factors 32.1% of the time, and operator condition also 32.1% of the time.

Conclusions
Improving communication and documentation, reducing time pressures, distractions, and high workload should guide proposed improvements to safeguards in radiation oncology.