bluuebunny/crossref_metadata_2025_split huggingface dataset:
Adding a dose of empathy to healthcare: What can healthcare systems do?
Authors: Kang Esther ShinHyun , Di Genova Tanya , Howick Jeremy , Gottesman Ronald 
Published: February 2022

AbstractRationale, Aims and ObjectivesHealthcare practitioners often note system‐level barriers to empathy between patients and practitioners. These include burnout‐inducing administrative workloads, unfriendly meeting times, burdensome protocols, lack of wellbeing spaces, and undervaluing empathy as a core part of an institution's mission. The need for empathy in healthcare has been magnified with the current SARS‐COV‐2 outbreak which has limited the expression of interpersonal empathy due to rigid isolation protocols and the use of personal protective equipment.MethodThis study—the first of its kind that we are aware of—outlines the details of a facilitated workshop run with the leadership of a tertiary level pediatric center in Canada. The workshop used a modified nominal group technique to discuss and prioritize actions to enhance empathy into the hospital system.ResultsInter‐professional and inter‐disciplinary group of healthcare leader participants agreed on several immediately actionable steps, including embedding patient satisfaction with care measures as standard, and streamlining booking appointments. A roadmap was created to implement the other priorities.ConclusionA systematic approach to infusing empathy into the structure of our healthcare system is much needed. Furthermore, inter‐professional and inter‐disciplinary educational workshops was well‐received as a way to facilitate discussion and drive change.
Predictable digital restorative workflow for minimally invasive esthetic rehabilitation utilizing a virtual patient model with global diagnosis principle
Authors: Li Yiyuan , Yu Yiqiang , Feng Yue , Liu Weicai 
Published: February 2022

AbstractObjectiveThe conventional anterior esthetic treatment protocol is limited as it's time consuming and unreliable. A predictable digital workflow for minimally invasive anterior esthetic tooth rehabilitation with global diagnosis principle has been introduced in this report.Clinical ConsiderationsA 23‐year‐old female patient with the chief complaint of unsatisfied shape and color of her anterior teeth visited our hospital for restorative consultation. Three‐dimensional Digital Smile Design was used to integrate into a virtual patient model to provide rehabilitative esthetic planning with global diagnostic principle. 3D printer was used for communication and guidance preparation. Digital impression and computer‐aided design/computer‐aided manufacturing technologies were adopted for making the morphology of designed restorations that can precisely transfer to definitive prostheses. The esthetics, functional occlusion, and gingival tissues remained stable for over a follow‐up period of 3 years. No signs of fractures within the restorations were observed.ConclusionsMinimally invasive anterior esthetic tooth rehabilitation can be readily achieved using a predictable digital workflow with global diagnosis principle.Clinical SignificanceThis digital approach might promote diagnosis, enhance communication, reduce processing time, and increase the predictability of final outcomes with high comfort and esthetic effect.
Risk from delayed or missed care and non‐COVID‐19 outcomes for older patients with chronic conditions during the pandemic
Authors: Smith Maureen , Vaughan Sarrazin Mary , Wang Xinyi , Nordby Peter , Yu Menggang , DeLonay Allie J. , Jaffery Jonathan 
Published: February 2022

AbstractBackgroundDuring the COVID‐19 pandemic, patients with chronic illnesses avoided regular medical care, raising concerns about long‐term complications. Our objective was to identify a population of older patients with chronic conditions who may be at risk from delayed or missed care (DMC) and follow their non‐COVID outcomes during the pandemic.MethodsWe used a retrospective matched cohort design using Medicare claims and electronic health records at a large health system with community and academic clinics. Participants included 14,406 patients over 65 years old with two or more chronic conditions who had 1 year of baseline data and up to 9 months of postpandemic follow‐up from March 1, 2019 to December 31, 2020; and 14,406 matched comparison patients from 1 year prior. Risk from DMC was defined by 13 indicators, including chronic conditions, frailty, disability affecting the use of telehealth, recent unplanned acute care, prior missed outpatient care, and social determinants of health. Outcomes included mortality, inpatient events, Medicare payments, and primary care and specialty care visits (in‐person and telehealth).ResultsA total of 25% of patients had four or more indicators for risk from DMC. Per 1000 patients annually, those with four or more indicators had increased mortality of 19 patients (95% confidence interval, 4 to 32) and decreased utilization, including unplanned events (−496 events, −611 to −381) and primary care visits (−1578 visits, −1793 to −1401).ConclusionsOlder patients who had four or more indicators for risk from DMC had higher mortality and steep declines in inpatient and outpatient utilization during the pandemic.
Frailty among older surgical patients and risk of hospital acquired adverse events: The South‐Western Sydney frailty and nurse sensitive indicators study
Authors: McEvoy Lynette , Richter Matthew , Chen Tanghua , Le Ann , Wilson Carol , Marov Lynda , Gujraz Poumansing , Gray Leeanne , Mayahi‐Neysi Mandana , Francis Nevenka , Mai Ha Thi , He Steven , Chróinín Danielle Ní , Frost Steven A. 
Published: February 2022

AbstractBackgroundWhile advances in healthcare mean people are living longer, increasing frailty is a potential consequence of this. The relationship between frailty among older surgical patients and hospital acquired adverse events has not been extensively explored. We sought to describe the relationship between increasing frailty among older surgical patients and the risk of hospital acquired adverse events.MethodsWe included consecutive surgical admissions among patients aged 70 years or more across the SWSLHD between January 2010 and December 2020. This study used routinely collected ICD‐10‐AM data, obtained from the government maintained Admitted Patient Data Collection. The relationships between cumulative frailty deficit items and risk of hospital acquired adverse events were assessed using Poisson regression modelling. This study followed the RECORD/STROBE guidelines.ResultsDuring the study period, 44,721 (57% women) older adults were admitted, and 41% (25,306) were planned surgical admissions. The risk of all adverse events increased with increasing number of frailty deficit items, the highest deficit items group (4–12 deficit items) compared with the lowest deficit items group (0 or 1 deficit item): falls adjusted rate ratio (adj RR) = 15.3, (95% confidence interval (CI) 12.1, 19.42); pressure injury adj RR = 21.3 (95% CI 12.53, 36.16); delirium adj RR = 40.9 (95% CI 31.21, 53.55); pneumonia adj RR = 16.5 (95% CI 12.74, 21.27); thromboembolism adj RR = 17.3 (95% CI 4.4, 11.92); and hospital mortality adj RR = 6.2 (95% CI 5.18, 7.37).ConclusionThe increase in number of cumulative frailty deficit items among older surgical patients was associated with a higher risk of adverse hospital events. The link offers an opportunity to clinical nursing professionals in the surgical setting, to develop and implement targeted models of care and ensure the best outcomes for frail older adults and their families.
Effects of thalassemia on pregnancy outcomes of women with gestational diabetes mellitus
Authors: Wu Yinyin , Han Lu , Chen Xiangxu , He Jing , Fan Xiaoxiao , Dai Jiamiao , Liu Yanqun , Bai Jinbing 
Published: February 2022

AbstractAimTo explore the effect of thalassemia on pregnancy outcomes of women with gestational diabetes mellitus (GDM).MethodsThis retrospective study reviewed the medical records of women with GDM delivered at the Chongqing Maternal and Child Health Hospital in China between July 2017 and December 2020. The live singleton pregnancies with α or β‐thalassemia were identified as the thalassemia group, included α‐thalassemia subgroup and β‐thalassemia subgroup, whereas pregnant women without thalassemia were randomly selected as the non‐thalassemia group according to a control‐to‐case ratio of 10:1 by computerized randomization. Logistic regression analyses were used to explore the potential association between thalassemia and pregnancy outcomes.ResultsA total of 223 pregnant women with GDM and thalassemia were analyzed, including women with α‐thalassemia (n = 143) and β‐thalassemia (n = 80). There were no significant differences in the incidence of adverse neonatal outcomes such as preterm birth and low‐birth weight among groups. However, among pregnancy complications, significant differences were detected in the incidence of placenta increta, polyhydramnios, and postpartum anemia between the thalassemia group and the non‐thalassemia group. Logistic regression results indicated that β‐thalassemia increased the risk of polyhydramnios (odds ratio [OR] = 3.95, 95% confidence interval [CI]: 1.14–13.65, p = 0.030) and chorioamnionitis (OR = 3.61, 95%CI: 1.04–12.49, p = 0.043) compared with the non‐thalassemia group.ConclusionIn our study, thalassemia did not increase adverse neonatal outcomes, but β‐thalassemia increased the risk of pregnancy complications, including polyhydramnios and chorioamnionitis.
When More is Less: Quality and Variety Trade‐off in Sharing Economy Platforms
Authors: Skiti Tedi , Luo Xueming , Lin Zhijie 
Published: February 2022

AbstractPlatform owners often attempt to reduce information asymmetry between sellers and buyers by redesigning how users interact. One widely used platform design is to sort (i.e., rank) incumbent sellers based on their buyer‐generated ratings within a geographical area. We theorize that this mechanism may indirectly limit the entry of low‐quality sellers to the platform and therefore increase overall platform quality, but it may also reduce variety. As incumbents adjust their strategies to gain a display advantage, the competition effect functions as an additional barrier to sellers who would otherwise enter the platform. We use an extensive dataset from a sharing economy platform to identify sellers’ heterogeneous strategic responses at the market level. Our results highlight that platform owners may face an unintended trade‐off between product quality and variety at the local level when they design their rating systems.
The effects of maternal supplementation of rumen‐protected lysine during the close‐up dry period on newborn metabolism and growth in Holstein calves
Authors: Kawashima Chiho , Oie Hako , Mashimo Riku , Goto Akira , Kusaba Nobuyuki , Yamagishi Norio 
Published: February 2022

AbstractThis study aimed to evaluate the effects of rumen‐protected lysine (RPL) supplementation during the close‐up period on blood metabolites and calf growth. Forty multiparous Holstein dams were selected based on parity, body condition score, and expected calving date, and randomly assigned to a group: with RPL (n = 22) or without (control [CON], n = 18). RPL dams were supplied daily with 80 g of RPL from Day 21 before the expected calving date to parturition. Blood samples were obtained from the dams before the start of supplementation, 1 week before calving, and immediately after calving, and from calves immediately after birth and weekly until 8 weeks of age. Body weight measurements were performed immediately after birth in all calves and at weekly intervals until 8 weeks of age in female calves. No significant difference was observed in serum metabolite levels and plasma amino acid concentrations between the RPL and CON dams before supplementation, whereas plasma lysine concentrations tended to be higher in RPL dams immediately after calving (p = 0.07). Serum total protein levels (p < 0.05) were higher, whereas plasma total amino acid, total essential amino acid, total non‐essential amino acid, and other amino acid concentrations were lower in the calves of RPL dams than those of CON dams (p < 0.05). There were no significant differences in calf birth weight between the two groups, although female calves of RPL dams (n = 7) had higher serum total protein (p < 0.05) and tended to have greater body weight (p = 0.09) from 1 to 8 weeks of age than those of CON dams (n = 11). Overall, RPL supplementation during the close‐up period may increase placenta‐mediated amino acid transfer to the foetus and enhance protein synthesis in the calf, leading to improved weight gain during the suckling period.
Polarization of human gingival fibroblasts by Th1‐, Th2‐, Th17‐, and Treg‐derived cytokines
Authors: Ha Da Young , Jung Jae‐Suk , Choi Geum Hee , Ji Suk 
Published: February 2022

AbstractBackground and objectiveThe purpose of this study was to evaluate whether gingival fibroblasts (GFs) can be differently activated and polarized into distinct functional subtypes by T‐helper (Th) cytokines.MethodsGingival fibroblasts were stimulated with interferon (IFN)‐γ, interleukin (IL)‐4, IL‐17, and transforming growth factor (TGF)‐β, representative cytokines of Th1, Th2, Th17, and regulatory T cells, respectively, and the gene expression profiles were analyzed by microarray. Differentially expressed genes (DEGs) in GFs stimulated by 4 cytokines were screened, and a gene ontology (GO) analysis of the DEGs was conducted. To confirm the reliability of the microarray results, the DEGs that showed the largest differences compared with non‐stimulated GFs were further analyzed by RT‐PCR. To evaluate the effect of polarization on GFs responses to lipopolysaccharide (LPS), GFs stimulated by 4 cytokines were further stimulated with Escherichia coli LPS and mRNA levels of several genes were analyzed using RT‐PCR.ResultsDifferentially expressed genes by 4 Th cytokines were enriched in different GO terms, and the patterns of gene expression on GFs were shown functionally different. GFs stimulated with IFN‐γ (GF(IFN‐γ)) up‐regulated the expression of chemokines (chemokine (C‐X‐C motif) ligand (CXCL)9, −10, −11, chemokine (C‐C motif) ligand (CCL)8), molecules involved in antigen presentation, complement component 3 (C3), and other immune response–related molecules, whereas they down‐regulated the expression of several types of collagen, extracellular matrix (ECM) components, and DNA replication and nuclear protein–related molecules. By contrast, GF(IL‐4) up‐regulated the expression of ECM components, cell adhesion molecules, and tissue development–related molecules and down‐regulated the expression of chemokines (CXCL10 and CXCL8) and adaptive immune response–related molecules. GF(IL‐17) up‐regulated the expression of chemokines and other molecules for neutrophil infiltration and activation, the pro‐inflammatory cytokine IL‐6, and C3. GF(TGF‐β) up‐regulated the expression of cell growth–related molecules, ECM components, several types of collagen, and cell adhesion molecules and down‐regulated the expression of molecules related to complement activation and bacterial recognition. GFs stimulated by 4 cytokines responded differently to LPS.ConclusionThese results show that Th cytokines can polarize GFs into cells with functionally distinct features: immune‐activating but tissue‐destructive GF(IFN‐γ), tissue‐reparative, and immune‐inhibiting GF(IL‐4), highly pro‐inflammatory GF(IL‐17), and potent tissue‐reparative GF(TGF‐β).
A strategy to improve the efficiency of spermatogenesis during the breeding seasons of Pelodiscus sinensis
Authors: Yang Yu‐Fei , Xing Lu , Wang Xin‐Yi , Yao Jia , Yin Shang‐Jun , Qian Guo‐Ying , Wang Wei , Park Yong‐Doo 
Published: February 2022

AbstractThe Chinese soft‐shelled turtle (Pelodiscus sinensis) is a reptile that undergoes seasonal reproduction. To produce enough spermatozoa during the mating season, immature spermatozoa can be quickly released from the testis. Cell morphological changes related to the maturation process are then completed in the epididymis. In this way, spermatozoa develop simultaneously in the epithelium and lumen of the seminiferous tubules, making sperm production much more efficient, which is a strategy to boost the efficiency of spermatogenesis. Morphological changes of spermatozoa can also occur in vitro. We found that when P. sinensis spermatozoa were maintained in vitro, the head could be transformed into an expanded shape with nucleolus‐like structures appearing inside. The results suggest that the process of morphological changes of P. sinensis sperm is a response to the seasonal reproduction and environmental changes. For most species, spermatogenesis and morphological maturation occur at the epithelium of the seminiferous tubule, but our results offer a new perspective in spermatogenesis of P. sinensis, and explain why spermatozoa can be produced so quickly during the breeding seasons.
Automated capillary flow segmentation and mapping for nailfold video capillaroscopy
Authors: Niizawa Tomoya , Yokemura Kota , Kusaka Tomoya , Sugashi Takuma , Miura Ichiro , Kawagoe Keiji , Masamoto Kazuto 
Published: February 2022

AbstractObjectiveThis study aimed to develop an automated image analysis method for segmentation and mapping of capillary flow dynamics captured using nailfold video capillaroscopy (NVC). Methods were applied to compare capillary flow structures and dynamics between young and middle‐aged healthy controls.MethodsNVC images were obtained in a resting state, and a region of the vessel in the image was extracted using a conventional U‐Net neural network. The approximate length, diameter, and radius of the curvature were calculated automatically. Flow speed and its fluctuation over time were mapped using the Radon transform and frequency spectrum analysis from the kymograph image created along the vessel's centerline.ResultsThe diameter of the curve segment (14.4 μm and 13.0 μm) and the interval of two straight segments (13.7 μm and 32.1 μm) of young and middle‐aged subjects, respectively, were significantly different. Faster flow was observed in older subjects (0.48 mm/s) than in younger subjects (0.26 mm/s). The power spectral analysis revealed a significant correlation between the high‐frequency power spectrum and the flow speed.ConclusionsThe present method allows a spatiotemporal characterization of capillary morphology and flow dynamics with NVC, allowing a wide application such as large‐scale health assessment.
A deep reinforcement learning‐based distributed connected automated vehicle control under communication failure
Authors: Shi Haotian , Zhou Yang , Wang Xin , Fu Sicheng , Gong Siyuan , Ran Bin 
Published: February 2022

AbstractThis paper proposes a deep reinforcement learning (DRL)‐based distributed longitudinal control strategy for connected and automated vehicles (CAVs) under communication failure to stabilize traffic oscillations. Specifically, the signal‐interference‐plus‐noise ratio‐based vehicle‐to‐vehicle communication is incorporated into the DRL training environment to reproduce the realistic communication and time–space varying information flow topologies (IFTs). A dynamic information fusion mechanism is designed to smooth the high‐jerk control signal caused by the dynamic IFTs. Based on that, each CAV controlled by the DRL‐based agent was developed to receive the real‐time downstream CAVs’ state information and take longitudinal actions to achieve the equilibrium consensus in the multi‐agent system. Simulated experiments are conducted to tune the communication adjustment mechanism and further validate the control performance, oscillation dampening performance and generalization capability of our proposed algorithm.
Why Did the Origenist Controversy Begin? Re‐thinking the Standard Narratives
Authors: Rubenson Samuel 
Published: February 2022

AbstractThe Origenist controversy at the end of the fourth century was largely played out within a monastic context, and had, moreover, an immediate and extensive impact on the movement. In spite of this, studies of the controversy and its causes have mainly focused on the dogmatic issues foregrounded in the controversy, neglecting the more fundamental issues about why the legacy of Origen was important, but also considered dangerous, to the monastic tradition. In my contribution I draw on suggestions by Rowan Williams and Sarah Coakley on a growing tension between the monastic tradition with its emphasis on individual spiritual growth, and the gradually institutionalized church under the bishops with an emphasis on the society. I question previous approaches and propose an analysis of how the work of Origen related to the early monastic movement. Instead of a presumed inner‐monastic conflict between ‘Origenists’ and ‘non‐Origenists’, for which there is little evidence, I suggest that the legacy of Origen, being an essential element in the Christian transformation of classical paideia, was fundamental to the making of monasticism. Based on recent work on early Egyptian monasticism as basically an educational movement in its broadest sense, I argue that Origen’s views on how and why to read the Scriptures, and how reading relates to prayer and the work of the Holy Spirit, were crucial in early monastic tradition and clearly mirrored in our fourth‐century monastic sources.
COVID‐19‐associated pulmonary aspergillosis (CAPA): Risk factors and development of a predictive score for critically ill COVID‐19 patients
Authors: Calderón‐Parra Jorge , Mills‐Sanchez Patricia , Moreno‐Torres Victor , Tejado‐Bravo Sandra , Romero‐Sánchez Isabel , Balandin‐Moreno Bárbara , Calvo‐Salvador Marina , Portero‐Azorín Francisca , García‐Masedo Sarela , Muñez‐Rubio Elena , Ramos‐Martinez Antonio , Fernández‐Cruz Ana ,   the HUPH IFI Study Group
Published: February 2022

AbstractBackgroundCOVID‐19‐associated pulmonary aspergillosis (CAPA) is a major complication of critically ill COVID‐19 patients, with a high mortality rate and potentially preventable. Thus, identifying patients at high risk of CAPA would be of great interest. We intended to develop a clinical prediction score capable of stratifying patients according to the risk for CAPA at ICU admission.MethodsSingle centre retrospective case–control study. A case was defined as a patient diagnosed with CAPA according to 2020 ECMM/ISHAM consensus criteria. 2 controls were selected for each case among critically ill COVID‐19 patients.Results28 CAPA patients and 56‐matched controls were included. Factors associated with CAPA included old age (68 years vs. 62, p = .033), active smoking (17.9% vs. 1.8%, p = .014), chronic respiratory diseases (48.1% vs. 26.3%, p = .043), chronic renal failure (25.0% vs. 3.6%, p = .005), chronic corticosteroid treatment (28.6% vs. 1.8%, p < .001), tocilizumab therapy (92.9% vs. 66.1%, p = .008) and high APACHE II at ICU admission (median 13 vs. 10 points, p = .026). A score was created including these variables, which showed an area under the receiver operator curve of 0.854 (95% CI 0.77‐0.92). A punctuation below 6 had a negative predictive value of 99.6%. A punctuation of 10 or higher had a positive predictive value of 27.9%.ConclusionWe present a clinical prediction score that allowed to stratify critically ill COVID‐19 patients according to the risk for developing CAPA. This CAPA score would allow to target preventive measures. Further evaluation of the score, as well as the utility of these targeted preventive measures, is needed.