bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy and Safety of Clopidogrel Versus Ticagrelor for Stabilized Patients With Acute Coronary Syndromes After Percutaneous Coronary Intervention: Results From a Real-World Registry in China
Authors: Peng Wenxing , Zhang Yunnan , Li Xiaoxi , Lin Yang 
Published: November 2022

Background:
The first 3 months after percutaneous coronary intervention (PCI) in patients with acute coronary syndrome (ACS) is a high-risk period for adverse events, including ischemic and bleeding events, which decrease greatly with time. It is worth investigating whether the use of potent P2Y12 inhibitors is necessary after the early stage. The purpose of this study was to investigate the differences in clinical outcomes between clopidogrel and ticagrelor in stable patients without ischemic or major bleeding events during the first 3 months after PCI.

Methods:
Data for this study were obtained from the PHARM-ACS registry (NCT04184583). Patients who were free from ischemic and major bleeding events in the first 3 months after PCI were enrolled. Inverse probability of treatment weighting (IPTW) and Cox proportional hazards model were applied to compare the differences in clinical outcomes between the 2 groups. Major adverse cardiovascular and cerebrovascular events (MACCE) were considered the primary end point, and major bleeding was considered the secondary end point.

Results:
A total of 6662 patients were included in this study. Of these, 3465 were treated with clopidogrel plus aspirin (clopidogrel group) and 3197 with ticagrelor plus aspirin (ticagrelor group). There were no significant differences in MACCE after IPTW adjustment for baseline variables (IPTW-adjusted HR, 1.06; 95% CI, 0.90–1.25) or major bleeding events (IPTW-adjusted HR, 0.97; 95% CI, 0.67–1.41) between the 2 groups. However, the incidence of minor bleeding in the clopidogrel group was significantly lower than that in the ticagrelor group (IPTW-adjusted HR, 0.65; 95% CI, 0.59–0.71).

Conclusion:
In patients with ACS who were free from ischemic or major bleeding events during the first 3 months after PCI, the subsequent clopidogrel treatment might reduce minor bleeding events without increasing the risk of MACCE compared with ticagrelor. However, the results still need to be confirmed by large randomized controlled studies in the future.
Combination of Long-Acting Injectable Antipsychotics in the Treatment of Psychiatric Disorders—A Systematic Review of the Literature and Case Series
Authors: Youykheang Marina , Al Hallaq Zaki , Menelas Kenny , Biskin Robert S. , Dagenais-Beaulé Vincent 
Published: November 2022

Abstract

Background
The treatment of refractory schizophrenia is complex, and compliance with oral treatment, including clozapine, can be challenging at times. The purpose of this case series and literature review article is to evaluate the efficacy of the combined use of 2 different long-acting injectable antipsychotics (LAIAs) on the number of psychiatric hospitalizations and emergency department visits. There are currently few data to support this treatment option, despite the frequent use of combinations of oral antipsychotics.

Methods
We extracted the data from 8 different patients who received combination LAIAs from 1 hospital setting. We evaluated the frequency of hospitalization and emergency department visits before and after treatment with a mirror-image study design. A systematic review of existing literature was included to find all previously reported cases of combination LAIAs.

Results
The frequency of hospitalizations was greatly reduced after the initiation of combination LAIA treatment in the majority of the cases at study site, as well as in the literature review. The number of ED visits was not as clearly affected. In the literature review, combinations of 2 LAIAs with different mechanisms of action were often documented. Symptom scores were also reduced in most reviewed cases.

Conclusions
Combinations of LAIAs seem to be promising as a treatment option for refractory psychotic disorders. This combination could be a treatment option for patients with limited alternatives, such as clozapine resistant or not eligible. The higher risk of adverse effects and long-term risks are not well documented.
Network Analysis Examining Intrahospital Traffic of Patients With Traumatic Hip Fracture
Authors: Secor Elizabeth A. , Hamilton David , D'Huyvetter Cecile , Salottolo Kristin , Bar-Or David 
Published: November 2022

ABSTRACT

Introduction:
Increased intrahospital traffic (IHT) is associated with adverse events and infections in hospitalized patients. Network science has been used to study patient flow in hospitals but not specifically for patients with traumatic injuries.

Methods:
This retrospective analysis included 103 patients with traumatic hip fractures admitted to a level I trauma center between April 2021 and September 2021. Associations with IHTs (moves within the hospital) were analyzed using R (4.1.2) as a weighted directed graph.

Results:
The median (interquartile range) number of moves was 8 (7–9). The network consisted of 16 distinct units and showed mild disassortativity (−0.35), similar to other IHT networks. The floor and intensive care unit (ICU) were central units in the flow of patients, with the highest degree and betweenness. Patients spent a median of 20–28 hours in the ICU, intermediate care unit, or floor. The number of moves per patient was mildly correlated with hospital length of stay (ρ = 0.26, p = .008). Intrahospital traffic volume was higher on weekdays and during daytime hours. Intrahospital traffic volume was highest in patients aged <65 years (p = .04), but there was no difference in IHT volume by dependent status, complications, or readmissions.

Conclusions:
Network science is a useful tool for trauma patients to plan IHT, flow, and staffing.
Accreditation in the Health Professions: Implications for Physician Assistant Education
Authors: Kayingo Gerald , Gordes Karen L. , Kulo Violet , Cawley James F. 
Published: November 2022

Abstract
The accreditation process of health professions educational (HPE) programs is an essential ingredient in preparing a qualified healthcare workforce. Accreditation ensures that minimum standards are met by educational programs and contributes to pedagogical integrity, consistency, and academic policies and practices, leading to the desired quality of graduate outcomes. In this study, we analyzed key characteristics, policies, and practices for accreditation in 5 health professions to highlight emerging trends and discern implications for the physician assistant (PA) profession. There is growing evidence of movement toward outcome-based accreditation versus process-oriented accreditation and collaborative engagements between programs and the accreditors. Agencies are providing online discussion platforms and direct mentorship and, at the height of the coronavirus pandemic, offered virtual site visits. At an institution level, we observed a trend towards structured faculty development on accreditation, implementation of technology infrastructure for data collection, visualization and analysis, and the use of consultants for outsourcing certain elements of the accreditation process. There is a wide spectrum of approaches, from prescriptive to liberal, by the various accrediting agencies in enforcing compliance. A balance is desirable for the institutional–accreditor relationship to work effectively.
Multi-Institutional Physician Assistant Student Perception of Simulated Emergency Room Cases
Authors: Bell Ashley , Salcido Erin , Reichhart Nicole , Moverley Joy 
Published: November 2022

Introduction
During clinical experiences, physician assistant (PA) students are required to participate in the management of multiple patients simultaneously. One method of preparing students for clinical experiences is through the use of simulation. Simulation allows development of decision-making and teamwork skills.
1,2
A previous study of nursing students in a multiple-patient simulation demonstrated improved student readiness to care for multiple patients.
2
The present study evaluated the effect of using simulation on PA student comfort with managing multiple patients in an emergency room setting.

Methods
Four PA programs participated in this quasi-experimental pretest-posttest design. Four simulation days were held, each with 4 standardized cases. Half of the students acted as standardized patients, while the remainder of the students managed patients in small groups. Surveys were administered before and after the emergency medicine course. Descriptive statistics and statistical analysis for significance were performed using Excel and SPSS.

Results
Posttest results indicated significant improvement in student confidence in emergency scenarios, ability to perform a focused medical history, ability to choose and interpret laboratory values, time management, prioritizing patients in a simulated environment, and selecting appropriate treatment. Students reported satisfaction with the experience, feedback, and debriefing. Participation in these simulations increased student interest in pursuing a position in emergency medicine upon graduation.

Discussion
In clinical rotations, PA students are expected to manage multiple patients with a variety of conditions. In this study, students were initially uncomfortable managing multiple patients. Student comfort increased after a simulation experience. Increased opportunities for students to select appropriate diagnostics and treatment may increase their overall comfort in management of patients during rotations.
Methodology Applied by a Physician Assistant Program to Evaluate the New ARC-PA 5th Edition Diversity and Inclusion Standard
Authors: Rolfs Jenna , Nicholas Joyce , Archambault Mark E. , Schmidt Eric 
Published: November 2022

Abstract
Diversity and inclusion in higher education are a top priority for institutions. In 2020, the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA), in its 5th edition of the Accreditation Standards for Physician Assistant Education, implemented a standard specifically designed to require programs to demonstrate their commitment to diversity and inclusion. Through a protocol-driven methodology, consistent with the ARC-PA’s 4 key elements of analysis, one PA program demonstrates and explains how it examines ongoing compliance with diversity and inclusion within their program.
Factors Influencing Physician Assistant Student Attrition Rates
Authors: Kilstrom Jonathan , Neary Stephanie , Roman Chris , Garrubba Carl , LeLacheur Susan , Van Rhee James 
Published: November 2022

Introduction
The aim of this study was to assess factors that influence student well-being and attrition and to compare faculty perceptions to the realities of student experience.

Methods
Three anonymous online surveys were distributed, one for each group of currently enrolled students, faculty/staff, and attritted students.

Results
Faculty estimated that an average of 12.8% of PA students in their program have considered dropping out in the past 6 months, while 22.9% of students self-reported considering dropping out in the past 6 months. The most frequently cited factors for considering dropping out were mental health and lack of connection to the program. Mental health was the highest cited reason for having taken or having considered taking a leave of absence.

Discussion
Faculty perceptions in this study were incongruent with the actual situations of their students. Mental health issues and a lack of connection to programs were the largest influencers of attrition.
Physician Assistant Program Perseveres Through COVID-19 Pandemic
Authors: Saunders Abby , McWeeney Michelle , Fernandez Christine 
Published: November 2022

Abstract
The COVID-19 pandemic has disrupted almost every aspect of life globally, with higher education one of many direct targets. Institutions and educators have been faced with urgent crises of how to conduct business as usual while maintaining expectations of high standards and uncompromised goals. As physician assistant (PA) educators at Seton Hall University, we rallied and brainstormed approaches to daily instruction to keep students on track and faculty both effective and sane. We tapped technological resources offered by our university, learned countless new skills, and adapted classroom activities to online virtual platforms. Creativity and flexibility became the norm as we modified the way we did everything while remaining laser focused on the ultimate objectives. Our intention was to provide insight, motivation, and, at a minimum, an example of how to do things differently when faced with roadblocks. We were inspired by an editorial by Mary Jo Bondy, DHEd, MHS, PA-C, former CEO of the Physician Assistant Education Association, in which she called for collective innovation, collaboration, publication, and circulation of stories. With that charge, we assembled a detailed account of how a didactic team within our faculty maneuvered the challenges created by COVID-19, in hopes of adding to the arsenal of small triumphs in this uncharted territory.
How Does Workplace Violence–Reporting Culture Affect Workplace Violence, Nurse Burnout, and Patient Safety?
Authors: Kim Sinhye , Lynn Mary R. , Baernholdt Marianne , Kitzmiller Rebecca , Jones Cheryl B. 
Published: November 2022

Background:
Workplace violence (WPV) against nurses has a negative impact on the nurses and the care they provide. Formal reporting of WPV is necessary to understand the nature of violent incidents, develop proactive coping strategies, and provide support for nurses affected by WPV.

Purpose:
This study explored the relationships among nurses' WPV experiences, burnout, patient safety, and the moderating effect of WPV-reporting culture on these relationships.

Methods:
This descriptive cross-sectional study used secondary data collected from 1781 nurses at a large academic medical center.

Results:
Workplace violence increased nurse burnout, which in turn negatively affected patient safety. A strong WPV-reporting culture increased the negative effect of WPV on burnout but mitigated the negative effect of burnout on patient safety.

Conclusions:
The findings indicate that nurses may perceive WPV-reporting behavior as a stressor. Violence-reporting systems and procedures need to be improved to reduce the burden of reporting.
Delegation of Work Within a Patient-Centered Medical Home
Authors: Wakefield Bonnie J. , Lampman Michelle A. , Paez Monica B. , Farag Amany , Ferguson Heidi , Stewart Greg L. 
Published: November 2022

OBJECTIVE
The aim of this study was to analyze the perceptions of core team members implementing patient-centered medical home (PCMH) within the Veterans Health Administration regarding delegation of work.

BACKGROUND
Significant overlap exists in the performance of work tasks among PCMH team members (primary care providers, RNs, clinical associates, clerks), and scant literature exists on appropriate delegation within PCMH teams.

METHODS
This study conducted used a quantitative and qualitative analysis of 4254 respondents to a 2018 survey.

RESULTS
Primary care providers rely heavily on team members, and nurses report being relied upon at high levels. Lack of role clarity and a perceived need for a team leader were concerns voiced by participants.

CONCLUSIONS
Findings indicated a need for clear guidance on roles and responsibilities within the team. Patient-centered medical home team members need information about the scope of practice of each professional group to allow providers to function at the top of their scope of practice and ensure effective delegation.
A peridynamic approach to simulating fatigue crack propagation in composite materials
Authors: Ni Tao , Zaccariotto Mirco , Galvanetto Ugo 
Published: November 2022

In this article, a numerical tool is proposed in the framework of bond-based peridynamics to simulate fatigue crack propagation in composite materials and structures. The cycle-dependent damage-cumulative model derived from Peerlings' law and applied to a bilinear constitutive law is used to evaluate the fatigue degradation of the bond stiffness. Several benchmark cases are studied to validate the proposed approach. Finally, static and fatigue crack propagations in composite systems with single or multi-inclusions are simulated to illustrate the capabilities and characteristics of the developed approach.
This article is part of the theme issue ‘Ageing and durability of composite materials’.
Characterizing and predicting the relationship between translaminar fracture toughness and pull-out length distributions under distinct temperatures
Authors: Yu B. , Katafiasz T. J. , Nguyen S. , Allegri G. , Finlayson J. , Greenhalgh E. S. , Pinho S. T. , Pimenta S. 
Published: November 2022

The translaminar fracture toughness reflects the damage tolerance of a fibre-reinforced composite under longitudinal tension, which often governs the final failure of structures. One of the main energy-dissipation mechanisms that contributes to the translaminar toughness of composites is the fibre pull-out process. The present study aims to quantify and model the statistical distribution of fibre pull-out lengths formed on the translaminar fracture surface of composites, for the first time in the literature; this is done under different temperatures, so that the relationship between pull-out length distributions, micromechanical properties and the translaminar fracture toughness can be established. The fracture surfaces of cross-ply compact tension specimens tested under three different temperatures have been scanned through X-ray computed tomography to quantify the extent of fibre pull-out on the fracture surfaces; the distribution of pull-out lengths showed alarger average and larger variability with an increase in temperature, which also lead to an increase in translaminar fracture toughness. A similar trend has been captured by the proposed analytical model, which predicts the pull-out length distribution based on the analysis of quasi-fractal idealizations of the fracture surface, yielding an overall accuracy of more than 85%.
This article is part of the theme issue 'Ageing and durability of composite materials'.
Characterization and modelling of the hygro-viscoelastic behaviour of polymer-based composites used in marine environment
Authors: Dezulier Quentin , Clement Alexandre , Davies Peter , Jacquemin Frédéric , Arhant Mael , Flageul Benjamin 
Published: November 2022

This paper presents results from a study of the long-term behaviour of carbon/epoxy composites. The interactions between ageing in water and constant mechanical loads are described, first experimentally then using a simple modelling approach. An identification procedure for the model is carried out and test/model comparisons are discussed. The results show that a four-parameter Burgers model can provide a good fit of the experimental data. The analysis of the results indicates the impact of water diffusion on the viscoelastic behaviour with larger strains for both creep and recovery phases. Those changes tend to appear at the early stage of the moisture diffusion process and stabilize quite quickly.
This article is part of the theme issue 'Ageing and durability of composite materials'.
The Oncogenic Role of Human Microcephalin Gene Revealed by Pan-Cancer Analysis
Authors: Wang Zerui , Li Mian , Liu Zhen , Kang Weiming , Cui Yazhou , Han Jinxiang , Du Wenbin 
Published: November 2022

AbstractThe human gene microcephalin (MCPH1) plays a key role in DNA damage-induced cellular responses and chromosome condensation. Recent clinical studies proposedMCPH1as a tumor suppressor gene in lung cancer, pancreatic cancer, and breast cancer, yet its roles remain poorly understood in other types of tumors. Pan-cancer analyses ofMCPH1are urgently required to help us understand the potential molecular functions ofMCPH1in other types of tumors. Here, we used several bioinformatic database and tools, including TCGA, GEO, ONCOMINE, and Human Protein Atlas to investigate the role ofMCPH1in 33 tumor types. We found that the expression ofMCPH1in tumor cases and normal cases were significantly different, and the higher expression ofMCPH1generally predicted poor overall survival for tumor patients, such as acute myeloid leukemia, liver hepatocellular carcinoma, and pancreatic adenocarcinoma. Meanwhile, lower expression of theMCPH1gene was related to poor OS prognosis for KIRC and gastric cancer. Moreover, the expression level ofMCPH1was highly associated with the immune microenvironment. Our result provides some fresh light into the oncogenic roles ofMCPH1in various human cancers and revealed thatMCPH1may be a potential diagnostic and prognostic marker in LAML, PAAD, and gastric cancer.
Multi-site assessment of reproducibility in high-content live cell imaging data
Authors: Hu Jianjiang , Serra-Picamal Xavier , Bakker Gert-Jan , Van Troys Marleen , Winograd-katz Sabina , Ege Nil , Gong Xiaowei , Didan Yuliia , Grosheva Inna , Polansky Omer , Bakkali Karima , Van Hamme Evelien , Van Erp Merijn , Vullings Manon , Weiss Felix , Clucas Jarama , Dowbaj Anna M. , Sahai Erik , Ampe Christophe , Geiger Benjamin , Friedl Peter , Bottai Matteo , Strömblad Staffan 
Published: November 2022

AbstractHigh-content image-based cell phenotyping provides fundamental insights in a broad variety of life science areas. Striving for accurate conclusions and meaningful impact demands high reproducibility standards, even more importantly with the advent of data sharing initiatives. However, the sources and degree of biological and technical variability, and thus the reproducibility and usefulness of meta-analysis of results from live-cell microscopy have not been systematically investigated. Here, using high content data describing features of cell migration and morphology, we determine the sources of variability across different scales, including between laboratories, persons, experiments, technical repeats, cells and time points. Significant technical variability occurred between laboratories, providing low value to direct meta-analysis on the data from different laboratories. However, batch effect removal markedly improved the possibility to combine image-based datasets of perturbation experiments. Thus, reproducible quantitative high-content cell image data and meta-analysis depend on standardized procedures and batch correction applied to studies of perturbation effects.
Phase-specific signatures of wound fibroblasts and matrix patterns define cancer-associated fibroblast subtypes
Authors: Wietecha Mateusz S. , Lauenstein David , Cangkrama Michael , Seiler Sybille , Jin Juyoung , Goppelt Andreas , Claassen Manfred , Levesque Mitchell P. , Dummer Reinhard , Werner Sabine 
Published: November 2022

ABSTRACTHealing wounds and cancers present remarkable cellular and molecular parallels, but the specific roles of the healing phases are largely unknown. We developed a bioinformatics pipeline to identify genes and pathways that define distinct phases across the time course of healing. Their comparison to cancer transcriptomes revealed that a resolution-phase wound signature is associated with increased severity in skin cancer and enriches for extracellular matrix-related pathways. Comparisons of transcriptomes of early- and late-phase wound fibroblasts vs skin cancer-associated fibroblasts (CAFs) identified an “early-wound” CAF subtype, which localizes to the inner tumor stroma and expresses collagen-related genes that are controlled by the RUNX2 transcription factor. A “late-wound” CAF subtype localizes to the outer tumor stroma and expresses elastin-related genes. Matrix imaging of primary melanoma tissue microarrays validated these matrix signatures and identified collagen- vs elastin-rich niches within the tumor microenvironment, whose spatial organization predicts survival and recurrence. These results identify wound-regulated genes and matrix patterns with prognostic potential in skin cancer.