bluuebunny/crossref_metadata_2025_split huggingface dataset:
Use of Hospital Capacity Command Centers to Improve Patient Flow and Safety: A Scoping Review
Authors: Franklin Brian J. , Mueller Stephanie K. , Bates David W. , Gandhi Tejal K. , Morris Charles A. , Goralnick Eric 
Published: February 2022

Objectives
Delayed emergency department (ED) and hospital patient throughput is recognized as a critical threat to patient safety. Increasingly, hospitals are investing significantly in deploying command centers, long used in airlines and the military, to proactively manage hospital-wide patient flow. This scoping review characterizes the evidence related to hospital capacity command centers (CCCs) and synthesizes current data regarding their implementation.

Methods
As no consensus definition exists for CCCs, we characterized them as units (i) involving interdisciplinary, permanently colocated teams, (ii) using real-time data, and (iii) managing 2 or more patient flow functions (e.g., bed management, transfers, discharge planning, etc.), to distinguish CCCs from transfer centers. We undertook a scoping review of the medical and gray literature published through April 2019 related to CCCs meeting these criteria.

Results
We identified 8 eligible articles (including 4 peer-reviewed studies) describing 7 CCCs of varying designs. The most common CCC outcome measures related to transfer volume (n = 5) and ED boarding (n = 4). Several CCCs also monitored patient-level clinical parameters. Although all articles reported performance improvements, heterogeneity in CCC design and evidence quality currently restricts generalizability of findings.

Conclusions
Numerous anecdotal accounts suggest that CCCs are being widely deployed in an effort to improve hospital patient flow and safety, yet peer-reviewed evidence regarding their design and effectiveness is in its earliest stages. The costs, objectives, and growing deployment of CCCs merit an investment in rigorous research to better measure their processes and outcomes. We propose a standard definition, conceptual framework, research priorities, and reporting standards to guide future investigation of CCCs.
Applying Healthcare Failure Mode and Effect Analysis and the Development of a Real-Time Mobile Application for Modified Early Warning Score Notification to Improve Patient Safety During Hemodialysis
Authors: Lin Chang-Hung , Ho Tsing-Fen , Chen Hui-Fen , Chang Hsin-Yi , Chien Ju-Huei 
Published: February 2022

Objective
Patients undergoing hemodialysis are a high-risk population. This study identified possible errors by using a healthcare failure mode and effect analysis system to improve patient safety during hemodialysis.

Methods
A multidisciplinary collaborative team, including physicians, nurses, information technicians, and medical staff members, was assembled. A flow diagram was used to indicate each process of the hemodialysis procedure from evaluating patient condition to transporting the patient back to the ward from the hemodialysis center. We scored all possible failure modes using the hazard scoring method as a combination of the occurrence frequency and severity. These potential failure modes were used to identify and evaluate possible risks by using a risk scoring matrix.

Results
Thirty failure modes were identified across 6 processes, and their potential causes were explored. Four major strategies for addressing most of the failure modes were implemented: establishment of a mobile application that sends real-time automated alerts to the medical team based on the Modified Early Warning Score, design of a modified dialysis Identify-Situation-Background-Assessment-Recommendation checklist for dialysis, technician education and training, and internal auditing and monitoring of the implementation of the entire process. After the implementation of the strategies, the hazard scores of patients during dialysis dropped by 71.2% from 170 points to 49 points.

Conclusions
The healthcare failure mode and effect analysis system was useful for evaluating potential risk during dialysis. Using the mobile application reduced the occurrence of emergency resuscitation during hemodialysis and significantly improved the communication between medical personnel.
Patient Safety Culture in Dentistry Analysis Using the Safety Attitude Questionnaire in DKI Jakarta, Indonesia: A Cross-Cultural Adaptation and Validation Study
Authors: Juliawati Mita , Darwita Risqa R. , Adiatman Melissa , Lestari Fatma 
Published: February 2022

Objectives
This study aimed to analyze a cross-cultural adaptation of the Safety Attitude Questionnaire (SAQ) for Indonesian dentists.

Methods
A cross-sectional study was conducted on 250 general dentists in health services in Jakarta, Indonesia. The first step included cultural adaptation and translation, which was followed by the development of the tested questionnaire through expert agreement and by validity and reliability analysis using Spearman correlation coefficient, Cronbach α, and interclass correlation coefficient. The SAQ consisted of 30 items and 6 dimensions (safety climate, teamwork climate, job satisfaction, stress recognition, perception of management, and working conditions).
Respondents were members of the Indonesian Dental Association who voluntarily filled out a Google-based questionnaire from September to October 2020.

Results
A total of 250 respondents with a response rate of 16.4% demonstrated a total Cronbach α value of 0.897, whereas the value per item ranged from 0.890 to 0.905, which suggested an acceptable and good to very good internal consistency. The interclass correlation coefficient value varied from 0.840 to 1.000, which meant almost perfect agreement. The correlation coefficient of 30 questions items resulted in a total SAQ score ranging from 0.422 to 0.699 (moderate to strong correlation) and between 6 dimensions to total SAQ score ranging from 0.648 to 0.772 (strong correlation).

Conclusions
The Indonesian version of the SAQ exhibited good validity and very good reliability and potential to be used for evaluating dentists’ patient safety culture in Indonesia.
Assessment of Culture and Laboratory Practices Related to Patient Safety in Brazilian Laboratories
Authors: Shcolnik Wilson , da Silva Duarte Alberto Jose 
Published: February 2022

Objectives
This study aimed at the simultaneous assessment of culture and laboratory practices related to patient safety in Brazilian laboratories, and validation of the proposed questionnaire.

Methods
The questionnaire was based on the Hospital Survey on Patient Safety Culture, used by the 1.0 version of the Agency of Healthcare Research and Quality and other bibliographical references. The sample consisted of 1414 professionals from 51 different Brazilian clinical laboratories. Agency of Healthcare Research and Quality criteria were used to define “strengths and weaknesses” related to patient safety. The psychometric evaluation of the questionnaire included the analysis of reliability and validity.

Results
Patient safety in the laboratories was considered “excellent” (35.22%), “very good” (53.14%), “regular” (10.11%), “bad” (0.92%), and “very bad” (0.61%). The only dimension of culture with positivity less than 50% was “nonpunitive responses to errors” (30.74%). The dimensions on laboratory practices related to patient safety revealed positivity greater than 60%, with the “analytical” dimension (76.47%) being the highest. The psychometric evaluation revealed the reliability of the questionnaire, the applicability of 12 dimensions to assess culture, and 4 or 5 dimensions to assess laboratory practices related to patient safety.

Conclusions
The culture and practices related to patient safety in Brazilian laboratories were evaluated as good, although a punitive culture against the occurrence of errors was identified. The psychometric evaluation of the questionnaire confirmed its reliability and validity. Studies performed in a larger and more diverse sample of clinical laboratories are needed to confirm the results obtained.
Report of a Multimodal Strategy for Improvement of Hand Hygiene Compliance in a Latin American Hospital. How Far From Excellence?
Authors: González-González Ricardo , Huertas-Jiménez Martha Asunción , Ochoa-Hein Eric , Galindo-Fraga Arturo , Macías-Hernández Alejandro E. , De la Torre-Rosas Alethse 
Published: February 2022

Objective
The aim of the study was to report the results of a multimodal strategy for improvement of hand hygiene (HH) compliance in a third-level hospital in Mexico.

Methods
This is an epidemiological study in a public, acute care, academic, tertiary referral center from 2009 to 2019. Healthcare worker (HCW) compliance with HH was assessed after implementation of the World Health Organization multimodal strategy that included permanent and widespread access to alcohol-based hand rubs; educational activities for staff, students, patients, and relatives; reminders in healthcare areas; patient empowerment; water quality surveillance; frequent evaluation of compliance; and feedback. The primary outcome was HH compliance rate (measured by direct observation). The association of HH with healthcare-associated infections was the secondary outcome.

Results
A total of 60,685 HH opportunities were evaluated. The HH compliance rate increased significantly from 39.83% (95% confidence interval [CI] = 38.83%–40.84%) to 64.81% (95% CI = 64.08%–65.54%), mostly due to HH compliance in World Health Organization moments 3 to 5 (r = 0.86, P = 0.001). A statistically significant inverse association was found between HH compliance rates and surgical site infection rates (incidence rate ratio = 0.9977, 95% CI = 0.9957–0.9997, P = 0.029).

Conclusions
A multimodal strategy in a Latin American setting showed an increase in HH compliance over 10 years of follow-up that should nonetheless be improved. An association between HH compliance and surgical site infection rates was noticed, but this did not occur with other healthcare-associated infections; this underscores the need for a comprehensive bundled approach in their prevention.
Standardization of Pediatric Noncardiac Operating Room to Intensive Care Unit Handoffs Improves Communication and Patient Care
Authors: Hebballi Nutan B. , Gupta Vikas S. , Sheppard Kyle , Kubanda Ann , Salley Danielle , Ostovar-Kermani Tiffany , Bryndzia Christina , Khan Amir M. , Wadhwa Nitin , Tsao KuoJen , Jain Ranu , Kawaguchi Akemi L. 
Published: February 2022

Objectives
Handoffs are critical points in transitioning care between multidisciplinary teams, yet data regarding intensive care unit (ICU) handoffs in pediatric noncardiac surgical patients are lacking. We hypothesized that standardized handoffs from the pediatric operating room (OR) to the ICU would improve physician presence, communication, and patient care parameters.

Methods
This quality improvement initiative was performed at a tertiary children’s hospital. Stakeholders (anesthesiologists, nurses, intensivists, and surgeons) developed a standardized OR to pediatric and neonatal ICU handoff process based on common goals and outcomes of interest. Baseline data were collected before intervention. Implementation was carried out in 2 phases, phase 1 with a written handoff and Phase 2 with a scripted handoff process. Data collected by trained observers included handoff attendance, distractions, and transfer of essential patient information. As a surrogate for outcomes, patient care parameter data were collected for 6 hours after transfer.

Results
After phase 1, surgery and ICU physician attendance increased significantly, distractions decreased, and communication of essential patient data improved. In phase 2 (scripted handoff), attendance continued to rise, distractions remained decreased, and transfer of essential information was still improved compared with baseline. Mean handoff duration did not significantly change throughout the study. Certain patient care parameters (escalation of respiratory support, additional laboratory studies, vasopressor administration, antibiotic administration and timing) remained unchanged compared with baseline. However, the need for resuscitative fluid bolus or blood products significantly decreased after implementation phase 2.

Conclusions
Standardized handoffs for pediatric noncardiac surgical patients from the OR to the ICU can improve provider attendance and communication.
Survey of physical activity in persons with limb loss during the COVID-19 pandemic in the United States
Authors: Lee Daniel Joseph , Miller Carol A , Gambale Albert , Nisani Maya , Marra Matthew , Leung Elizabeth R , Chillianis Daniel , Rodgers Madeline 
Published: February 2022

Background:
Physical activity has been shown to be fundamental in the prevention of numerous diseases and disorders. Achieving and maintaining physical activity levels can be particularly challenging in those with impairments, such as those experiencing a lower limb amputation. To slow the spread of the virus, COVID-19 lockdown mandates imposed by the US state governments may have inadvertent consequences on physical activity levels of those dependent on specific forms of exercise. Understanding how physical activity levels may have affected persons with limb loss can inform intervention strategies for this vulnerable population.

Objectives:
Examine the effects of the COVID-19 pandemic on physical activity levels in persons with limb loss.

Study design:
Mixed-method design.

Methods:
A 20-item logic web-based survey and semistructured interviews were administered to individuals who were 18 years or older, spoke English, and had a history of lower limb loss. Quantitative data were analyzed using SPSS v25, whereas qualitative data were analyzed using constant comparison to formulate themes.

Results:
There were a significant effect on the amount of physical activity minutes performed per day, a negative effect on the ability to exercise and participate in societal engagements, and a series of barriers to performing physical activity because of the pandemic.

Conclusion:
Physical activity was reduced significantly in persons with limb loss during the COVID-19 pandemic. A combination of health concerns, fitness center closures, and social distancing mandates were the primary drivers behind the decrease in activity.
Single Cell Characterization of Myeloma and its Precursor Conditions Reveals Transcriptional Signatures of Early Tumorigenesis
Authors: Boiarsky Rebecca , Haradhvala Nicholas J. , Alberge Jean-Baptiste , Sklavenitis-Pistofidis Romanos , Mouhieddine Tarek H , Zavidij Oksana , Shih Ming-Chieh , Firer Danielle , Miller Mendy , El-Khoury Habib , Anand Shankara K. , Aguet François , Sontag David , Ghobrial Irene M. , Getz Gad 
Published: February 2022

AbstractMultiple myeloma is a plasma cell malignancy almost always preceded by precursor conditions, but low tumor burden of these early stages has hindered the study of their molecular programs through bulk sequencing technologies. Here, we generated and analyzed single cell RNA-sequencing of plasma cells from 26 patients at varying disease stages and 9 healthy donors. In silico dissection and comparison of normal and transformed plasma cells from the same bone marrow biopsy enabled discovery of novel, patient-specific transcriptional changes. Using Bayesian Non-Negative Matrix Factorization, we discovered 15 gene expression signatures which represent transcriptional modules relevant to myeloma biology, and identified a signature that is uniformly lost in neoplastic cells across disease stages. Finally, we demonstrated that tumors contain heterogeneous subpopulations expressing distinct transcriptional patterns. Our findings characterize transcriptomic alterations present at the earliest stages of myeloma, paving the way for exploration of personalized treatment approaches prior to malignant disease.
Using the Dynamic Forward Scattering Signal for Optical Coherence Tomography based Blood Flow Quantification
Authors: Nam Ahhyun Stephanie , Braaf Boy , Vakoc Benjamin J. 
Published: February 2022

ABSTRACTTo our knowledge, all existing optical coherence tomography approaches for quantifying blood flow, whether Doppler-based or decorrelation-based, analyze light that is back-scattered by moving red blood cells (RBCs). This work investigates the potential advantages of basing these measurements on light that is forward-scattered by RBCs, i.e., by looking at the signals back-scattered from below the vessel. We show experimentally that this results in a flowmetry measure that is insensitive to vessel orientation for vessels that are approximately orthogonal to the imaging beam. We further provide proof-of-principle demonstrations that DFS can be used to measure flow in human retinal and choroidal vessels.
An interpretable and versatile machine learning approach for oocyte phenotyping
Authors: Letort Gaelle , Eichmuller Adrien , Silva Christelle Da , Nikalayevich Elvira , Labrune Elsa , Wolf Jean-Philippe , Terret Marie-Emilie , Verlhac Marie-Hélène 
Published: February 2022

AbstractMeiotic maturation is a crucial step of oocyte development allowing its potential fertilization and embryo development. Elucidating this process is important both for fundamental research and assisted reproductive technology. However, only few computational tools, based on non-invasive measurements, are currently available to characterize oocyte meiotic maturation. Here, we develop a computational framework to phenotype oocytes based on images or movies acquired exclusively in transmitted light. We first trained neural networks to segment the contours of oocytes and their zona pellucida using a diverse cohort of both mouse and human oocytes. We then defined a comprehensive set of morphological features to describe a single oocyte. We have implemented these steps in a versatile and user-friendly open source Fiji plugin available to the mouse and human oocyte community. Then, we present a machine learning pipeline based on selected features to automatically recognize oocyte populations and determine their morphological differences. Its first application is a novel approach to screen oocyte strains and automatically identify their morphological characteristics. We demonstrate its potential by phenotyping a well characterized genetically modified mouse oocyte strain. Its second application is to predict and characterize the maturation potential of oocytes. Importantly, we identify two new features to assess mouse oocyte maturation potential, consisting in the texture of the zona pellucida and the cytoplasmic particles size. Eventually, we tested whether these mouse oocyte quality features were applicable to human oocyte’s developmental potential.
Tandem Walk in Simulated Martian Gravity and Visual Environment
Authors: Rosenberg Marissa J. , Koslovsky Matthew , Noyes Matthew , Reschke Millard F. , Clément Gilles 
Published: February 2022

AbstractAstronauts returning from long-duration spaceflights experience visual-vestibular conflicts that causes motion sickness, perceptions that the environment is moving when it is not, problems with walking, and other functional tasks. To evaluate whether astronauts will have similar decrements associated with visual-vestibular conflicts after they land on Mars following exposure to weightlessness, participants were held by a device that offloads their weight; first entirely (0 G) for 10 minutes, and then partially (0.38 G) or not at all (1 G) for 15 minutes. Tandem (heel-to-toe) walk was used to assess the subjects walking performance. Ten subjects performed 2 trials of 10 steps on a medium-density foam surface. Four conditions were investigated: (a) 1 G in virtual reality (VR); (b) 1 G in VR with a superimposed disorienting optokinetic simulation (VR+DOS); (c) 0.38 G in VR; and (d) 0.38 G in VR+DOS. Tandem walk performance decreased in VR+DOS compared to VR in both 1 G and simulated 0.38 G. Tandem walking performance in VR+DOS was better in 0.38 G compared to 1 G. Tandem walking performance in VR+DOS in 1 G was not significantly different from tandem walking performance after spaceflight or bed rest. The increased tandem walking performance in 0.38 G compared to 1 G was presumably due to an increased cone of stability, allowing larger amplitude of body sway without resulting in a fall. Tandem walking on a compliant foam surface in VR+DOS is a potential analog for simulating postflight dynamic balance deficits in astronauts.
Joint coding of visual input and eye/head position in V1 of freely moving mice
Authors: Parker Philip R. L. , Abe Elliott T. T. , Leonard Emmalyn S. P. , Martins Dylan M. , Niell Cristopher M. 
Published: February 2022

SUMMARYVisual input to the brain during natural behavior is highly dependent on movements of the eyes, head, and body. Neurons in mouse primary visual cortex (V1) respond to eye and head movements, but how information about eye and head position is integrated with visual processing during free movement is unknown, since visual physiology is generally performed under head-fixation. To address this, we performed single-unit electrophysiology in V1 of freely moving mice while simultaneously measuring the mouse’s eye position, head orientation, and the visual scene from the mouse’s perspective. Based on these measures we were able to map spatiotemporal receptive fields during free movement, using a generalized linear model (GLM) that predicted the activity of V1 neurons based on gaze-corrected visual input. Furthermore, we found that a significant fraction of visually-responsive neurons showed tuning for eye position and head orientation. Incorporating these variables into the GLM revealed that visual and positional signals are integrated through a multiplicative mechanism in the majority of modulated neurons, consistent with computation via gain fields and nonlinear mixed selectivity. These results provide new insight into coding in mouse V1, and more generally provide a paradigm for performing visual physiology under natural conditions, including active sensing and ethological behavior.HIGHLIGHTSNeurons in mouse V1 respond to both vision and self-motion, but it is unclear how these are combined.We record neural activity in V1 concurrent with measurement of the visual input from the mouse’s perspective during free movement.These data provide the first measurement of visual receptive fields in freely moving animals.We show that many V1 neurons are tuned to eye position and head orientation, and these contribute a multiplicative gain on visual responses in the majority of modulated neurons.
How exposure to land use impacts and climate change may prune the tetrapod tree of life
Authors: Beaumont Linda J , Nipperess David A , Wilson Peter D , Baumgartner John B , Esperon-Rodriguez Manuel 
Published: February 2022

AbstractHuman domination of landscapes is a key driver of biodiversity loss, with the fingerprint of climate change becoming increasingly pronounced. Frameworks and tools for identifying threats to biodiversity are required to meet Post-2020 Global Biodiversity Framework targets for 2030 that call for, among other things, reducing or halting species extinction rates (1). Hence, we compiled a phylogenetic tree for terrestrial tetrapods, mapped hotspots of geographically restricted and evolutionarily distinct lineages, and identified which hotspots may simultaneously face the highest magnitudes of land use impacts and climate change. Across a quarter of Earth’s surface, hotspots contain the entire ranges of 45% of tetrapods, representing 39% of terrestrial tetrapod evolutionary heritage. By 2070, we estimate 8–13% of this heritage to occur entirely within hotspots highly exposed to climate change, with 13–29% of hotspots projected to experience high exposure to both stressors simultaneously. Most hotspots at highest risk occur in countries least able to take action. Our analysis highlights the need for global ambition and coordination to avoid catastrophic loss of tetrapod evolutionary heritage.