bluuebunny/crossref_metadata_2025_split huggingface dataset:
Progression of severity in coronavirus disease 2019 patients before treatment and a self-assessment scale to predict disease severity
Authors: Yao Ye , Tian Jie , Meng Xia , Kan Haidong , Zhou Lian , Wang Weibing 
Published: April 2022

Abstract
Objectives
This study aims to further investigate the association of COVID-19 disease severity with numerous patient characteristics, and to develop a convenient severity prediction scale for use in self-assessment at home or in preliminary screening in community healthcare settings.

Setting and participants
Data from 45,450 patients infected with COVID-19 from January 1 to February 27, 2020 were extracted from the municipal Notifiable Disease Report System in Wuhan, China.

Primary and secondary outcome measures
We categorized COVID-19 disease severity, based on The Chinese Diagnosis and Treatment Protocol for COVID-19, as “nonsevere” (which grouped asymptomatic, mild, and ordinary disease) versus “severe” (grouping severe and critical illness).

Results
Twelve scale items—age, gender, illness duration, dyspnea, shortness of breath (clinical evidence of altered breathing), hypertension, pulmonary disease, diabetes, cardio/cerebrovascular disease, number of comorbidities, neutrophil percentage, and lymphocyte percentage—were identified and showed good predictive ability (area under the curve = 0·72). After excluding the community healthcare laboratory parameters, the remaining model (the final self-assessment scale) showed similar area under the curve (= 0·71).

Conclusions
Our COVID-19 severity self-assessment scale can be used by patients in the community to predict their risk of developing severe illness and the need for further medical assistance. The tool is also practical for use in preliminary screening in community healthcare settings.

Summary
Our study constructed a COVID-19 severity self-assessment scale that can be used by patients in the community to predict their risk of developing severe illness and the need for further medical assistance.
Screening for infectious maternal morbidity - knowledge, attitudes and perceptions among healthcare providers and managers in Malawi: a qualitative study
Authors: Slezak Emilia , Unger Holger , Gadama Luis , McCauley Mary 
Published: April 2022

Abstract
Background
Maternal morbidity and mortality related to infection is an international public health concern, but detection and assessment is often difficult as part of routine maternity care in many low- and middle-income countries due to lack of easily accessible diagnostics. Front-line healthcare providers are key for the early identification and management of the unwell woman who may have infection. We sought to investigate the knowledge, attitudes, and perceptions of the use of screening tools to detect infectious maternal morbidity during and after pregnancy as part of routine antenatal and postnatal care. Enabling factors, barriers, and potential management options for the use of early warning scores were explored.

Methods
Key informant interviews (n = 10) and two focus group discussions (n = 14) were conducted with healthcare providers and managers (total = 24) working in one large tertiary public hospital in Blantyre, Malawi. Transcribed interviews were coded by topic and then grouped into categories. Thematic framework analysis was undertaken to identify emerging themes.

Results
Most healthcare providers are aware of the importance of the early detection of infection and would seek to better identify women with infection if resources were available to do so. In current practice, an early warning score was used in the high dependency unit only. Routine screening was not in place in the antenatal or postnatal departments. Barriers to implementing routine screening included lack of trained staff and time, lack of thermometers, and difficulties with the interpretation of the early warning scores. A locally adapted early warning screening tool was considered an enabler to implementing routine screening for infectious morbidity. Local ownership and clinical leadership were considered essential for successful and sustainable implementation for clinical change.

Conclusions
Although healthcare providers considered infection during and after pregnancy and childbirth a danger sign and significant morbidity, standardised screening for infectious maternal morbidity was not part of routine antenatal or postnatal care. The establishment of such a service requires the availability of free and easy to access rapid diagnostic testing, training in interpretation of results, as well as affordable targeted treatment. The implementation of early warning scores and processes developed in high-income countries need careful consideration and validation when applied to women accessing care in low resource settings.
Association between early sonographic findings and acetabular index at the age of 6 months: a prospective observational study
Authors: Chang Wen-Chieh , Hsu Kuei-Hsiang , Su Yu-Ping 
Published: April 2022

Abstract
Background
This study investigated the association between early Graf classification and femoral head coverage (FHC) with the acetabular index (AI) at the age of 6 months.

Methods
A prospective observational study was conducted between 2017–2018. Patients requiring Pavlik harness treatment and patients with syndromic dislocation or neurogenic dislocation were excluded. In total, 169 newborns with the first ultrasound performed at the mean age of 12.3 (0–15) days, the second ultrasound performed at the mean age of 3.2 (2.5–4.1) months, and the AI measured at the age of 6.6 (4.3–7.1) months were enrolled. The correlation between the AI and first and second alpha angles and FHC measurements, and the correlation of dysplasia in early ultrasound with dysplasia in the AI were analyzed.

Results
At the first ultrasound, only the FHC (P = .02) demonstrated a significant negative correlation with the AI. At the second ultrasound, both the alpha angle (P < .01) and FHC (P < .01) demonstrated a significant negative correlation with the AI. With the AI as a reference, the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were found to be 77%, 7%, 5%, and 81%, respectively, for the first Graf; 91%, 37%, 9%, and 98%, respectively, for the first FHC measurement; 82%, 90%, 35%, and 99%, respectively, for the second Graf; and 95%, 97%, 68% and 99%, respectively, for the second FHC measurement.

Conclusions
FHC and alpha angle exhibited significant negative correlations with the AI at six months, both ultrasound parameters may have the potential to predict AI in DDH screening. Compared to the ultrasound measurements taken at 2 weeks, Graf and FHC at 3 months demonstrated superior sensitivity, specificity, PPV, and NPV to detect abnormal AI. The best timing to perform ultrasound examination may need further research.
Infection control of COVID-19 in pediatric tertiary care hospitals: challenges and implications for future pandemics
Authors: Remppis Jonathan , Hilberath Johannes , Ganzenmüller Tina , Slavetinsky Christoph , Vasconcelos Malte Kohns , Gnädig Marion , Liese Jan , Göpel Siri , Lang Peter , Heinzel Oliver , Renk Hanna 
Published: April 2022

Abstract
Background
More than 2 years into the COVID-19 pandemic, SARS-CoV-2 still impacts children’s health and the management of pediatric hospitals. However, it is unclear which hygiene and infection control measures are effective and useful for pediatric hospitals. Here, we report infection control measures implemented at a tertiary care children’s hospital. We evaluated frequency of SARS-CoV-2 detection in admitted patients, in-hospital transmission and infection related findings. Furthermore, we aimed to capture perspectives of health-care workers and caregivers on effectiveness and burden of infection control measures. Knowledge gained can inform management of the ongoing and future pandemics.

Methods
We designed a retrospective observational study and survey at a pediatric tertiary care referral center. Local infection control measures and respective guidelines regarding COVID-19 were reviewed. Three thousand seven hundred sixteen children under 18 years were tested for SARS-CoV-2 at the University Children’s Hospital Tuebingen and data on SARS-CoV-2 transmission were retrieved from internal records. Two surveys were conducted among 219 staff members and 229 caregivers.

Results
Local infection control measures comprised the formation of a task force, triage, protective hygiene measures and an adaptable SARS-CoV-2 test strategy. Between January 2020 and March 2021, SARS-CoV-2 infection was detected in 37 children presenting to our hospital, 21 of these were admitted. One hospital-acquired infection occurred. About 90% of health-care staff perceived the majority of measures as effective and appropriate. However, visitor restrictions and cancellation of scheduled treatments were perceived least effective by hospital staff and as a particular burden for patients and their caregivers. Visits at the pediatric emergency department significantly decreased during the pandemic. We drafted a pandemic action plan by ranking infection control measures according to local transmission stages.

Conclusions
SARS-CoV-2 infection control measures implemented in our tertiary care children’s hospital were evaluated by health-care workers as mostly effective and appropriate. In particular, good communication, transparency of decision-making as well as universal masking and infection screening were assessed as successful measures of infection control management. Visitor restrictions and cancellation of routine appointments, in contrast, were perceived as a particular burden on patient care and should be avoided. An established pandemic action plan may guide children’s hospitals in the future.
Cross-sectional association of light sensor-measured time outdoors with physical activity and gross motor competency among U.S. preschool-aged children: the 2012 NHANES National Youth Fitness Survey
Authors: Kwon Soyang , Tandon Pooja S. , O’Neill Meghan E. , Becker Adam B. 
Published: April 2022

Abstract
Background
Time spent outdoors (outdoor time) has been suggested to be beneficial for physical activity (PA) and healthy development among preschool-aged children. The aim of this study was to quantify PA level and gross motor competency associated with light sensor-measured daily outdoor time in a representative sample of U.S. children aged 3 to 5 years.

Methods
The study sample included 301 participants (149 girls) aged 3 to 5 years from the 2012 U.S. National Health and Examination Survey National Youth Fitness Survey. ActiGraph GT3X+ accelerometers with a built-in ambient light sensor were used to measure PA (expressed in monitor-independent movement summary [MIMS]) and outdoor time. The Test of Gross Motor Development-Second Edition (TGMD-2) was used to assess gross motor skills. Multivariable linear regression models were fit to predict daily and gross motor scores by daily outdoor time.

Results
Average daily outdoor time was 95 min (median of 84 min; interquartile range of 52 to 123 min). Means of daily outdoor time and daily MIMS were not significantly different between boys and girls. Among girls, every additional 10 min of daily outdoor time was associated with an additional 540 daily total MIMS (95% CI = 372, 708). Among boys, every additional 10 min of daily outdoor time was associated with an additional 296 daily total MIMS (95% CI = 131, 460). Every additional 10 min of daily outdoor time was associated with a 0.1-point (95% CI = 0.001, 0.130) higher object control standard score. Daily outdoor time was not associated with a locomotor standard score.

Conclusions
In a representative sample of U.S. preschool-aged children, daily outdoor time was positively associated with daily PA. The contribution of outdoor time to PA was greater among girls than boys, suggesting that providing outdoor opportunities is critical for promoting PA, particularly among girls.
Radiographic measurement of the posterior tibial slope in normal Chinese adults: a retrospective cohort study
Authors: Chen Yong , Ding Jianping , Dai Siyu , Yang Jiao , Wang Mengke , Tian Tian , Deng Xiaolong , Li Boyi , Cheng Guohua , Liu Jie 
Published: April 2022

Abstract
Background
Measurement of the posterior tibial slope (PTS) angle has important applications in total knee replacement surgery, high tibial osteotomy, and anterior cruciate ligament reconstruction. This study aimed to determine the mean PTS of knee joints in healthy Chinese adults, and provide data to guide knee surgery in China.

Methods
A retrospective analysis of 1257 (n = 1233, 50.4% male) plain X-ray films of participants aged 25–59 years was performed. The picture archiving and communication system was used for PTS measurement. The PTS was defined as the angle between the vertical line of the tangent of the anterior tibial cortex of the proximal tibia, and the tangent line of the tibial cortex. Two imaging physicians conducted the PTS measurements independently, and both the inter- and intraclass correlation coefficients (ICCs) were calculated.

Results
The mean PTS value was 7.68 ± 3.84° (range: 0–21°). The left PTS was significantly smaller in males than in females (7.22 ± 3.89 vs 8.05 ± 3.60; P = 0.005). Additionally, the PTS in participants aged 25–29 years was significantly larger than that in the other age groups (Left side: 8.64 ± 3.73 vs 6.92 ± 3.42, 7.42 ± 3.75, 7.53 ± 3.98; P <  0.001 and Right side: 8.68 ± 3.84 vs 7.48 ± 4.21, 7.13 ± 3.64, 7.66 ± 3.80; P = 0.004). There were no significant differences in PTS between the left and right sides. Two-way analysis of variance suggested that the differences in PTS between age groups were not affected by sex. The interobserver ICC was 0.91 (95% confidence interval [CI]: 0.85–0.94), and the intraobserver ICC was 0.90 (95% CI: 0.82–0.94).

Conclusions
This study demonstrated that there were significant differences in PTS based on sex and age, highlighting the need to provide individualized treatment for knee surgery. It provided valuable information regarding the normal PTS values in Chinese adults and presented regionalised data to guide knee surgery.
Types of therapeutic errors in the management of osteoporosis made by physicians and medical students
Authors: Tausendfreund Olivia , Braun Leah T. , Schmidmaier Ralf 
Published: April 2022

Abstract
Background
Clinical reasoning is of high importance in clinical practice and thus in medical education research. Regarding the clinical reasoning process, the focus has primarily been on diagnostic reasoning and diagnostic errors, but little research has been done on the subsequent management reasoning process, although the therapeutic decision-making process is at least equally important. The aim of this study was to investigate the frequency of therapeutic decision errors and the cognitive factors leading to these errors in the context of osteoporosis, as it is known to be frequently associated with inadequate treatment decisions in clinical practice worldwide.

Methods
In 2019, 19 medical students and—for comparison—23 physicians worked on ten patient cases with the medical encounter of osteoporosis. A total of 254 cases were processed. The therapeutic decision errors were quantitatively measured, and the participants’ cognitive contributions to therapeutic errors and their clinical consequences were qualitatively analysed.

Results
In 26% of the cases, all treatment decisions were correct. In the remaining 74% cases, multiple errors occurred; on average, 3 errors occurred per case. These 644 errors were further classified regarding the cognitive contributions to the error. The most common cognitive contributions that led to errors were faulty context generation and interpretation (57% of students, 57% of physicians) and faulty knowledge (38% of students, 35% of physicians). Errors made due to faulty metacognition (5% of students, 8% of physicians) were less common. Consequences of these errors were false therapy (37% of cases), undertreatment (30% of cases) or overtreatment (2.5% of cases).

Conclusion
The study is the first to show that errors in therapy decisions can be distinguished and classified, similar to the already known classification for errors in diagnostic reasoning. Not only the correct diagnosis, but particularly the correct therapy, is critical for the outcome of a patient.
Psychological first aid for workers in care and nursing homes: systematic review
Authors: Schoultz Mariyana , McGrogan Claire , Beattie Michelle , Macaden Leah , Carolan Clare , Polson Rob , Dickens Geoffrey 
Published: April 2022

Abstract
Background
The Covid-19 pandemic has produced unprecedented challenges across all aspects of health and social care sectors globally. Nurses and healthcare workers in care homes have been particularly impacted due to rapid and dramatic changes to their job roles, workloads, and working environments, and residents’ multimorbidity. Developed by the World Health Organisation, Psychological First Aid (PFA) is a brief training course delivering social, emotional, supportive, and pragmatic support that can reduce the initial distress after disaster and foster future adaptive functioning.

Objectives
This review aimed to synthesise findings from studies exploring the usefulness of PFA for the well-being of nursing and residential care home staff.

Methods
A systematic search was conducted across 15 databases (Social Care Online, Kings Fund Library, Prospero, Dynamed, BMJ Best Practice, SIGN, NICE, Ovid, Proquest, Campbell Library, Clinical Trials, Web of Knowledge, Scopus, Ebsco CINAHL, and Cochrane Library), identifying peer-reviewed articles published in English language from database inception to 20th June 2021.

Results
Of the 1,159 articles screened, 1,146 were excluded at title and abstract; the remaining 13 articles were screened at full text, all of which were then excluded.

Conclusion
This review highlights that empirical evidence of the impact of PFA on the well-being of nursing and residential care home staff is absent. PFA has likely been recommended to healthcare staff during the Covid-19 pandemic. The lack of evidence found here reinforces the urgent need to conduct studies which evaluates the outcomes of PFA particularly in the care home staff population.
Electronic transfusion consent and blood delivering pattern improve the management of blood bank in China
Authors: Jiang Luxi , Zhang Guobing , Hao Ke , Xiang Weiling , Zhang Qin , Xie Yiwei , Wang Zhen , Chen Bingyu , Du Yaoqiang 
Published: April 2022

Abstract
Background
The aim of this study was to improve the blood transfusion treatment consent accuracy, simplify the verification process, prolong the temperature control time before the blood transfusion, and save the blood transportation labor cost.

Methods
We designed the blood transfusion consent electronic signing process, which can generate personalized the text content and can automatically check the filling accuracy. The signal can be transmitted to the blood transfusion management system (TMS) to relieving the blood distribution. For blood delivering pattern, we established the blood transport center, recruited full-time nurses and used temperature-controlled blood transfer boxes to deliver blood in batches on a regular basis.

Results
A quarterly data analysis of blood transfusion quality showed a 100% blood transfusion consent accuracy after an electronic signing process was implemented. The average confirmation time savings between the electronic content and paper content was 26 min for the Department of Emergency (estimated difference 95% CI = 26 (20 to 36), p < 0.05). The blood delivering pattern reduced the time for each unit by leaving the average temperature control by 7.24 min (estimated difference 95% CI = 7.24 (6.92 to 7.56), p < 0.05). Furthermore, $3.67 was saved for the blood transportation labor cost for each unit as well.

Conclusion
Blood transfusion consent electronic signing process not only ensures the accuracy, but also saves the verification time. Moreover, the blood delivering pattern prolongs the blood temperature control time and saves blood transportation labor costs. Thus, these two improvements could enhance transfusion management.
Ontology-aware deep learning enables ultrafast and interpretable source tracking among sub-million microbial community samples from hundreds of niches
Authors: Zha Yuguo , Chong Hui , Qiu Hao , Kang Kai , Dun Yuzheng , Chen Zhixue , Cui Xuefeng , Ning Kang 
Published: April 2022

AbstractThe taxonomic structure of microbial community sample is highly habitat-specific, making source tracking possible, allowing identification of the niches where samples originate. However, current methods face challenges when source tracking is scaled up. Here, we introduce a deep learning method based on the Ontology-aware Neural Network approach, ONN4MST, for large-scale source tracking. ONN4MST outperformed other methods with near-optimal accuracy when source tracking among 125,823 samples from 114 niches. ONN4MST also has a broad spectrum of applications. Overall, this study represents the first model-based method for source tracking among sub-million microbial community samples from hundreds of niches, with superior speed, accuracy, and interpretability. ONN4MST is available at https://github.com/HUST-NingKang-Lab/ONN4MST.
The resilient intensive care unit
Authors: Salluh Jorge I. F. , Kurtz Pedro , Bastos Leonardo S. L. , Quintairos Amanda , Zampieri Fernando G. , Bozza Fernando A. 
Published: April 2022

Abstract
Background
The COVID-19 pandemic tested the capacity of intensive care units (ICU) to respond to a crisis and demonstrated their fragility. Unsurprisingly, higher than usual mortality rates, lengths of stay (LOS), and ICU-acquired complications occurred during the pandemic. However, worse outcomes were not universal nor constant across ICUs and significant variation in outcomes was reported, demonstrating that some ICUs could adequately manage the surge of COVID-19.

Methods
In the present editorial, we discuss the concept of a resilient Intensive Care Unit, including which metrics can be used to address the capacity to respond, sustain results and incorporate new practices that lead to improvement.

Results
We believe that a resiliency analysis adds a component of preparedness to the usual ICU performance evaluation and outcomes metrics to be used during the crisis and in regular times.

Conclusions
The COVID-19 pandemic demonstrated the need for a resilient health system. Although this concept has been discussed for health systems, it was not tested in intensive care. Future studies should evaluate this concept to improve ICU organization for standard and pandemic times.