bluuebunny/crossref_metadata_2025_split huggingface dataset:
Conceptualizing learning health systems: A mapping review
Authors: de Bruin Josefien , Bos Cheryl , Struijs Jeroen Nathan , Drewes Hanneke Wil‐Trees , Baan Caroline Astrid 
Published: June 2022

AbstractIntroductionHealth systems worldwide face the challenge of increasing population health with high‐quality care and reducing health care expenditure growth. In pursuit for a solution, regional cross‐sectoral partnerships aim to reorganize and integrate services across public health, health care and social care. Although the complexity of regional partnerships demands an incremental strategy, it is yet not known how learning works within these partnerships. To understand learning in regional cross‐sectoral partnerships for health, this study aims to map the concept Learning Health System (LHS).MethodsThis mapping review used a qualitative text analysis approach. A literature search was conducted in Embase and was limited to English‐language papers published in the period 2015‐2020. Title‐abstract screening was performed using established exclusion criteria. During full‐text screening, we combined deductive and inductive coding. The concept LHS was disentangled into aims, design elements, and process of learning. Data extraction and analysis were performed in MAX QDA 2020.ResultsIn total, 155 articles were included. All articles used the LHS definition of the Institute of Medicine. The interpretation of the concept LHS varied widely. The description of LHS contained 25 highly connected aims. In addition, we identified nine design elements. Most elements were described similarly, only the interpretation of stakeholders, data infrastructure and data varied. Furthermore, we identified three types of learning: learning as 1) interaction between clinical practice and research; 2) a circular process of converting routine care data to knowledge, knowledge to performance; and performance to data; and 3) recurrent interaction between stakeholders to identify opportunities for change, to reveal underlying values, and to evaluate processes. Typology 3 was underrepresented, and the three types of learning rarely occurred simultaneously.ConclusionTo understand learning within regional cross‐sectoral partnerships for health, we suggest to specify LHS‐aim(s), operationalize design elements, and choose deliberately appropriate learning type(s).
Effects of Printing Sequence on the Printing Accuracy of Melt Electrowriting Scaffolds
Authors: Zhang Fucheng , Cao Kai , Zaeri Ahmadreza , Zgeib Ralf , Chang Robert C. 
Published: June 2022

AbstractMelt electrowriting (MEW), an emergent additive manufacturing process, shows significant potential in fabricating high‐fidelity fibrous scaffolds for tissue engineering applications. However, fiber deviation can deteriorate the printing accuracy of MEW. To evaluate the printing accuracy, an evaluation protocol along with an index (Ip) is proposed. For the first time, 0–90 patterned and 0–θ patterned scaffolds with varying inter‐fiber distances along different printing directions are fabricated to establish the dependence of Ip on two distinct printing sequences. One sequence is the small–large sequence, which first prints the fibers separated by a small inter‐fiber distance, followed by fibers separated by a large inter‐fiber distance. Alternatively, for the large–small sequence, the fibers separated by a large inter‐fiber distance are printed prior to the fibers separated by a small inter‐fiber distance. The small–large sequence contributes to larger Ip results compared to the large–small sequence. Moreover, the printing sequence has more significant effects on the Ip for the 0–θ pattern compared to the 0–90 pattern. These differences can be attributed to different fiber morphologies at the intersection points, accompanied by resultantly varying charge amounts, which gives an insight into the cause of fiber deviation phenomena.
A 220‐GHz CMOS passive subharmonic downconverter for low‐IF applications
Authors: Fu Haipeng , Huang Puhuan , Ma Kaixue 
Published: June 2022

AbstractThis paper presents a 220‐GHz subharmonic downconverter with high conversion gain (CG) and low noise figure (NF) implemented in 28 nm bulk CMOS, including a core mixer and an intermediate frequency (IF) amplifier. Based on the traditional quasi‐subharmonic mixer, new gate‐shorted technology is presented to improve NF and CG by adding a source inductor to reduce the loss of radiofrequency signals. In addition, the impedance transformation network provides passive voltage gain to suppress the noise of the IF amplifier. The downconverter achieves a minimum single‐sidebandNF of 15.5 dB and a maximum CG of 21.3 dB when the IF frequency is 10 MHz. The 1 dB compression point of the downconverter is −30 dBm and consumes 8 mA current with an operating voltage of 0.9 V. The core area of the chip is 200 × 160 µm2
Clarifying the role of clinical research nurses working in Sweden, using the Clinical Trial Nursing Questionnaire – Swedish version
Authors: Backman Lönn Beatrice , Hajdarevic Senada , Olofsson Niclas , Hörnsten Åsa , Styrke Johan 
Published: June 2022

AbstractAimTo explore the role of CRNs in Sweden and differences in competences and tasks, using the Clinical Trial Nursing Questionnaire – Swedish version (CTNQ‐SWE).DesignA cross‐sectional survey.MethodsParticipants were identified through strategic sampling. Data were analysed by descriptive and comparative statistics.ResultsThe respondents were experienced nurses who felt proficient in their role, they felt more acceptance by the principal investigators than by nursing colleagues. A majority of CRNs are involved in all procedures specified in the CTNQ‐SWE. The most often performed tasks, also rated as the most important by the CRNs, concerned informed consent and management of investigational products. The education was often informal: with a lack of job descriptions and professional development plans. Need of formal specialist education was expressed.ConclusionsKnowledge about the role description can be used by clinical research enterprise internationally and healthcare organizations aiming to support CRNs in their role.
Baseline risk characterization of early versus later adopters of long‐acting paliperidone palmitate formulations
Authors: Fife Daniel , Fortin Stephen , Qiu Hong , Yamazaki Michiyo , Najarian Dean , Voss Erica A 
Published: June 2022

AbstractEarly Post‐Marketing Phase Vigilance (EPPV) is a unique system that encourages reporting of serious adverse reactions for medications newly introduced to Japan. When a once‐monthly paliperidone palmitate formulation (PP1M) was introduced in Japan in 2013, EPPV detected a signal of increased mortality, but this signal was not subsequently confirmed. To clarify whether that signal reflected increased adverse event reporting or an atypically high baseline mortality risk among early adopters of PP1M, we evaluated the baseline risk characteristics of early, mid, and later adopters of PP1M in a Japanese database and did a similar evaluation of PP1M and the three‐monthly formulation (PP3M) in two US databases. In Japan, early adopters compared with later adopters were older (mean 39.16 vs 33.70 years) but had a lower proportion of male patients (32.0% vs 44.44%), and a lower mean number of antipsychotic medications (distinct active medical substances) other than paliperidone (2.62 vs 2.85). In the United States, the baseline characteristics of early adopters of PP1M and PP3M did not suggest higher mortality risk than later adopters. These results offer no convincing evidence that the unconfirmed early signal of increased mortality with PP1M was due to increased baseline mortality risk among early adopters.
No wrong decisions in an all‐wrong situation. A qualitative study on the lived experiences of families of children with diffuse intrinsic pontine glioma
Authors: De Clercq Eva , Grotzer Michael , Landolt Markus A. , von Helversen Bettina , Flury Maria , Rössler Jochen , Kurzo Andrea , Streuli Jürg 
Published: June 2022

AbstractBackgroundDiffuse intrinsic pontine glioma (DIPG) is a rare, but lethal pediatric brain tumor with a median survival of less than 1 year. Existing treatment may prolong life and control symptoms, but may cause toxicity and side effects. In order to improve child‐ and family‐centered care, we aimed to better understand the treatment decision‐making experiences of parents, as studies on this topic are currently lacking.ProcedureThe data for this study came from 24 semistructured interviews with parents whose children were diagnosed with DIPG in two children's hospitals in Switzerland and died between 2000 and 2016. Analysis of the dataset was done using reflexive thematic analysis.ResultsFor most parents, the decision for or against treatment was relatively straightforward given the fatality of the tumor and the absence of treatment protocols. Most of them had no regrets about their decision for or against treatment. The most distressing factor for them was observing their child's gradual loss of independence and informing them about the inescapability of death. To counter this powerlessness, many parents opted for complementary or alternative medicine in order to “do something.” Many parents reported psychological problems in the aftermath of their child's death and coping strategies between mothers and fathers often differed.ConclusionThe challenges of DIPG are unique and explain why parental and shared decision‐making is different in DIPG compared to other cancer diagnoses. Considering that treatment decisions shape parents’ grief trajectory, clinicians should reassure parents by framing treatment decisions in terms of family's deeply held values and goals.
Rates of metastatic prostate cancer in newly diagnosed patients: Numbers needed to image according to risk level
Authors: Sorce Gabriele , Hoeh Benedikt , Flammia Rocco S. , Chierigo Francesco , Hohenhorst Lukas , Panunzio Andrea , Nimer Nancy , Tian Zhe , Gandaglia Giorgio , Tilki Derya , Terrone Carlo , Gallucci Michele , Chun Felix K. H. , Antonelli Alessandro , Saad Fred , Shariat Shahrokh F. , Montorsi Francesco , Briganti Alberto , Karakiewicz Pierre I. 
Published: June 2022

AbstractBackgroundThe numbers needed to image to identify pelvic lymph node and/or distant metastases in newly diagnosed prostate cancer (PCa) patients according to risk level are unknown.MethodsRelying on Surveillance, Epidemiology, and End Results (2010–2016), we tabulated rates and proportions of patients with (a) lymph node or (b) distant metastases according to National Comprehensive Cancer Network (NCCN) risk level and calculated the number needed to image (NNI) for both endpoints. Multivariable logistic regression analyses were performed.ResultsOf 145,939 newly diagnosed PCa patients assessable for analyses of pelvic lymph node metastases (cN1), 4559 (3.1%) harbored cN1 stage: 13 (0.02%), 18 (0.08%), 63 (0.3%), 512 (2.8%), and 3954 (14.9%) in low, intermediate favorable, intermediate unfavorable, high, and very high‐risk levels. These resulted in NNI of 4619, 1182, 319, 35, and 7, respectively. Of 181,109 newly diagnosed PCa patients assessable for analyses of distant metastases (M1a–c), 8920 (4.9%) harbored M1a–c stage: 50 (0.07%), 45 (0.1%), 161 (0.5%), 1290 (5.1%), and 7374 (22.0%) in low, intermediate favorable, intermediate unfavorable, high, and very high‐risk. These resulted in NNI of 1347, 602, 174, 20, and 5, respectively.ConclusionsOur observations perfectly validated the NCCN recommendations for imaging in newly diagnosed high and very high‐risk PCa patients. However, in unfavorable intermediate‐risk PCa patients, in whom bone and soft tissue imaging is recommended, the NNI might be somewhat elevated to support routine imaging in clinical practice.
Caring in a crisis: Understanding the stressors and uplifts for National Health Service frontline staff through the lens of clinical psychologists
Authors: Sattar Raabia , Heyhoe Jane , O’Hara Daniel , Wijeratne Dileep , Lawton Rebecca 
Published: June 2022

AbstractThe unprecedented public health crisis of the Covid‐19 pandemic resulted in a significant challenge to the delivery of healthcare that has rarely been experienced before. The stress already faced by healthcare staff working in the National Health Service (NHS) has been further exacerbated during Covid‐19, putting them at risk of adverse mental health outcomes. Through the lens of clinical psychologists who had provided support to frontline healthcare staff during the Covid‐19 pandemic, this study aimed to better understand the stressors and uplifts healthcare staff experienced during Covid‐19, the impact of these on the wellbeing of staff and patient care, and to examine the support needed to deal with the impact of a crisis. A qualitative study design using a combination of diaries followed by semi‐structured interviews was utilised. Data was analysed using thematic analysis. The following five themes represented the stressors and uplifts experienced by NHS frontline healthcare staff during Covid‐19, the impact on staff wellbeing and patient care: facing change; risks of working in the NHS environment; transcending the negatives; challenging professional values and haunted by patient deaths. The findings also highlight the importance of providing psychological support and suggest the need to continue to provide this support service to help NHS staff manage through subsequent waves of the pandemic. These findings can contribute towards both the management of the current Covid‐19 pandemic and other similar crises in the future.
SAMBA: A Multicolor Digital Melting PCR Platform for Rapid Microbiome Profiling
Authors: Luo Yongqiang , Cui Xu , Cheruba Elsie , Chua Yong Kang , Ng Charmaine , Tan Rui Zhen , Tan Ker‐Kan , Cheow Lih Feng 
Published: June 2022

AbstractDuring the past decade, breakthroughs in sequencing technology have provided the basis for studies of the myriad ways in which microbial communities in and on the human body influence human health and disease. In almost every medical specialty, there is now a growing interest in accurate and quantitative profiling of the microbiota for use in diagnostic and therapeutic applications. However, the current next‐generation sequencing approach for microbiome profiling is costly, requires laborious library preparation, and is challenging to scale up for routine diagnostics. Split, Amplify, and Melt analysis of BActeria‐community (SAMBA), a novel multicolor digital melting polymerase chain reaction platform with unprecedented multiplexing capability is presented, and the capability to distinguish and quantify 16 bacteria species in mixtures is demonstrated. Subsequently, SAMBA is applied to measure the compositions of bacteria in the gut microbiome to identify microbial dysbiosis related to colorectal cancer. This rapid, low cost, and high‐throughput approach will enable the implementation of microbiome diagnostics in clinical laboratories and routine medical practice.
Model‐based risk assessment evaluation
Authors: Germanos Vasileios , Zeng Wen 
Published: June 2022

AbstractRisk assessment (RA) belongs to the core parts of an organizational risk management process. The primary goals of a RA are the identification, estimation and prioritization of risk(s) to organizational operations. The existing quantitative analysis of RA is focusing on the risk factors, that is, threat or vulnerability. However, the quantitative metrics of the assessment have not been formally defined and modeled yet. Consequently, it is essential to define a formal model and relevant security metrics for RA within an organization. In this study, we will use a complete lattice to analyze risk factors. Moreover, a formal model will be defined to describe the RA process. The reachability of the model will be discussed. Quantitative metrics will be defined to provide insight on the risk estimation. The model can be expressed using colored Petri nets. This study can assist chief information security officers analyze security risks in their organizations and help them balance the security budget in their organizations.
Mesenteric lymph node abscesses due to Escherichia coli in a cat
Authors: Sakai Kosei , Kanegi Ryoji , Nabetani Tomoyo , Tanaka Toshiyuki , Shimamura Shunsuke , Shimada Terumasa , Sugiura Kikuya , Hatoya Shingo 
Published: June 2022

AbstractA 3‐year‐old, castrated male mixed‐breed cat presented with an almost 2‐year history of chronic loose stools. On radiography and ultrasound examination, there were two masses in the centre of the abdomen. Contrast‐enhanced computed tomography revealed that the masses were enlarged mesenteric lymph nodes with fluid accumulation. Percutaneous lesion drainage yielded pus‐like fluid. Fluid cytology revealed numerous neutrophils and Gram‐negative rods. Pus culture identified Escherichia coli as the causative organism. Consequently, mesenteric lymph node abscesses were definitively diagnosed. Since computed tomography showed that the abscesses adhered to the surrounding tissues, it was difficult to remove them surgically. With drainage and antimicrobial therapy, the mesenteric lymph nodes gradually decreased in size. However, loose stools persisted. The cat's diet was changed to a hydrolysed diet, and the clinical symptoms improved, suggesting food‐responsive enteropathy. This may be an underlying disease of lymph node abscesses. Lymph node abscesses limited to the mesenteric lymph nodes rarely occur in veterinary medicine, and this is the first report in cats.
Investigating the use of anaerobically stored carbon in post‐anoxic denitrification
Authors: Bauhs Kayla T. , Gagnon Alexandria A. , Bott Charles B. 
Published: June 2022

AbstractSignificant methanol savings are hypothesized to result from anaerobic storage of internal carbon that is used for post‐anoxic denitrification. An investigation into this internal carbon‐driven denitrification was performed via a series of batch tests using biomass from Hampton Roads Sanitation District's (HRSD's) water resource recovery facilities (WRRFs): the Virginia Initiative Plant (VIP), Nansemond Plant (NP), and Army Base (AB) Treatment Plant. Internal carbon specific denitrification rates (SDNRs) increased during winter, by as much as 1 mg N/g MLVSS/h for VIP. Increasing the aeration time by 2–4 h lowered the SDNR by an average of 0.21–0.35 mg N/g MLVSS/h. No internal carbon denitrification was observed for biomass from non‐nitrifying/denitrifying, biological phosphorus removal (bio‐P) WRRFs. The increase in internal carbon SDNRs when the anaerobic acetate dose increased from 20 to 100 mg COD/L ranged from 0.06 to 0.28 mg N/g MLVSS/h. Higher phosphorus uptake rates were found to correlate to higher internal carbon SDNRs, but no significant post‐anoxic P uptake was observed. The first steps are taken towards developing a strategy for full‐scale implementation of this relatively novel type of denitrification by evaluating how some factors affect its occurrence.Practitioner Points

Significant methanol savings at a full‐scale facility may result from use of internally stored carbon for post‐anoxic denitrification.
Short aerobic HRTs and high anaerobic zone VFA loading increase the post‐anoxic internal carbon‐driven denitrification.
Non‐nitrifying, bio‐P biomass is not capable of internal carbon‐driven denitrification.
Internal carbon‐driven denitrification is correlated with the activity of polyphosphate accumulating organisms.
Characterization of antibiotic resistance genes and bacteria in a municipal water resource recovery facility
Authors: Rajabi Akbar , Farajzadeh Davoud , Dehghanzadeh Reza , Aslani Hassan , Mousavi Saeid , Mosaferi Mohammad , Dehghani Mohammad Hadi , Asghari Farzaneh Baghal 
Published: June 2022

AbstractMunicipal water resource recovery facilities (WRRFs) are important sources of antibiotic‐resistant bacteria and genes (ARB and ARGs). In this study, antibiotic‐resistant total heterotrophic bacteria (THBR) counts (CFU/ml) cultivated from influent, effluent of activated sludge process, and outflow of disinfection unit of an urban WRRF were investigated for the presence of 16, 32, 64, and 128 μg/ml of nine antibiotics. The isolates of Pseudomonas spp., Acinetobacter spp., and Escherichia coli obtained from effluent of activated sludge process were subjected for molecular identification by detecting the 16S rRNA gene sequences. Additionally, using the polymerase chain reaction method (PCR), the isolates were investigated for the presence of blaSHV, blaTEM, blaCTX‐M, blaVIM, sul1, and qnrS genes. According to the results, the abundance of THBR counts was not significantly reduced by the biological treatment except for cefixime and sulfamethoxazole; it also increased for some antibiotics after disinfection unit. The average removal efficiency of THBR resistant to ciprofloxacin, sulfamethoxazole, and ceftazidime were 7.9 ± 1.7%, 41.8 ± 2.1%, and 14.4 ± 6.2%, respectively. Also, all the tested isolates were resistant to at least four antibiotics. For all antibiotics, the resistance ratio (THBR/THB) significantly increased in the effluent and after chlorination unit. Among 12 resistant isolates, blaTEM and sul1 genes were the most frequently detected ones involved in 92% and 83% of the isolates, respectively. Both blaTEM and sul1 genes were found in 100% of E. coli, and 83% and 67% of Pseudomonas spp. isolates, respectively. Further efforts are necessary to limit the transmission of ARB and ARGs from WRRFs into the environment and prevent human health threats.Practitioner Points

The ratio of resistance significantly increased after biological treatment.
Up to 40% of heterotrophic bacteria in the effluent was antibiotic resistant.
blaTEM and sul1 genes were more prevalent (92%) in all isolates of bacteria.
Both blaTEM and sul1 genes were found in 100% of E. coli isolates.
Pseudomonas spp. holds blaTEM and sul1 genes in 83% and 67% of isolates, respectively.
Prostatic Artery Embolization (PAE) Using Polyethylene Glycol Microspheres: Safety and Efficacy in 81 Patients
Authors: Insausti Iñigo , Galbete Arkaitz , Lucas-Cava Vanesa , de Ocáriz Ana Sáez , Solchaga Saioa , Monreal Raquel , de la Cuesta Antonio Martínez , Alfaro Raquel , Sun Fei , Montesino Manuel , Urtasun Fermin , Bilbao Jaureguízar José Ignacio 
Published: June 2022

Abstract
Purpose
To evaluate the safety and efficacy of prostatic artery embolization (PAE) using polyethylene glycol microspheres (PEGM) in patients with lower urinary tract symptoms secondary to benign prostatic hyperplasia (BPH).

Materials and methods
This multicentric prospective study enrolled 81 patients who underwent PAE with 400 ± 75 µm PEGM (HydroPearl®, Terumo, Japan). Results from baseline and 1-, 3-, 6-, and 12-month follow-ups were assessed for subjective outcomes including International Prostate Symptoms Score (IPSS), Quality of life (QoL), and International Index of Erectile Function, and objective outcomes such as peak urinary flow (Qmax) and post-void residual volume (PVR). The visual analogue scale, satisfaction questionnaire, prostatic volume, and prostatic specific antigen levels were also evaluated. Complications were documented using the modified Clavien–Dindo classification.

Results
Technical success was obtained in all patients. Clinical success was achieved in 78.5% of patients. Before PAE, 54.3% of patients had an indwelling catheter which was removed in 75% of them after procedure. A statistically significant decrease was observed in IPSS and QoL from baseline to 12 months (20.14 vs 5.89; 4.8 vs 0.63, P < .01), respectively. Objective outcomes also showed a statistically significant improvement in Qmax (+ 114.9%; P < .01), achieving a maximum urinary flow of 14.2 mL/sec, and PVR (decrease 58%; P < .05) at 12 months. Minor complications (Clavien–Dindo grades I–II) occurred in 13.6% of patients, without major complications observed.

Conclusion
PAE with PEGM is safe and effective treatment in patients with symptomatic BPH, with a significant improvement in both subjective and objective outcomes.