bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of a Rapid Response Team on the Incidence of In-Hospital Mortality
Authors: Factora Faith , Maheshwari Kamal , Khanna Sandeep , Chahar Praveen , Ritchey Michael , O’Hara Jerome , Mascha Edward J. , Mi Junhui , Halvorson Sven , Turan Alparslan , Ruetzler Kurt 
Published: April 2022

BACKGROUND:
Approximately half of the life-limiting events, such as cardiopulmonary arrests or cardiac arrhythmias occurring in hospitals, are considered preventable. These critical events are usually preceded by clinical deterioration. Rapid response teams (RRTs) were introduced to intervene early in the course of clinical deterioration and possibly prevent progression to an event. An RRT was introduced at the Cleveland Clinic in 2009 and transitioned to an anesthesiologist-led system in 2012. We evaluated the association between in-hospital mortality and: (1) the introduction of the RRT in 2009 (primary analysis), and (2) introduction of the anesthesiologist-led system in 2012 and other policy changes in 2014 (secondary analyses).

METHODS:
We conducted a single-center, retrospective analysis using the medical records of overnight hospitalizations from March 1, 2005, to December 31, 2018, at the Cleveland Clinic. We assessed the association between the introduction of the RRT in 2009 and in-hospital mortality using segmented regression in a generalized estimating equation model to account for within-subject correlation across repeated visits. Baseline potential confounders (demographic factors and surgery type) were controlled for using inverse probability of treatment weighting on the propensity score. We assessed whether in-hospital mortality changed at the start of the intervention and whether the temporal trend (slope) differed from before to after initiation. Analogous models were used for the secondary outcomes.

RESULTS:
Of 628,533 hospitalizations in our data set, 177,755 occurred before and 450,778 after introduction of our RRT program. Introduction of the RRT was associated with a slight initial increase in in-hospital mortality (odds ratio [95% confidence interval {CI}], 1.17 [1.09–1.25]; P < .001). However, while the pre-RRT slope in in-hospital mortality over time was flat (odds ratio [95% CI] per year, 1.01 [0.98–1.04]; P = .60), the post-RRT slope decreased over time, with an odds ratio per additional year of 0.961 (0.955–0.968). This represented a significant improvement (P < .001) from the pre-RRT slope.

CONCLUSIONS:
We found a gradual decrease in mortality over a 9-year period after introduction of an RRT program. Although mechanisms underlying this decrease are unclear, possibilities include optimization of RRT implementation, anesthesiology department leadership of the RRT program, and overall improvements in health care delivery over the study period. Our findings suggest that improvements in outcome after RRT introduction may take years to manifest. Further work is needed to better understand the effects of RRT implementation on in-hospital mortality.
Spinal Cord Stimulation Alleviates Neuropathic Pain by Attenuating Microglial Activation via Reducing Colony-Stimulating Factor 1 Levels in the Spinal Cord in a Rat Model of Chronic Constriction Injury
Authors: Sun Cong , Tao Xueshu , Wan Chengfu , Zhang Xiaojiao , Zhao Mengnan , Xu Miao , Wang Pinying , Liu Yan , Wang Chenglong , Xi Qi , Song Tao 
Published: April 2022

BACKGROUND:
Spinal cord stimulation (SCS) is an emerging, minimally invasive procedure used to treat patients with intractable chronic pain conditions. Although several signaling pathways have been proposed to account for SCS-mediated pain relief, the precise mechanisms remain poorly understood. Recent evidence reveals that injured sensory neuron-derived colony-stimulating factor 1 (CSF1) induces microglial activation in the spinal cord, contributing to the development of neuropathic pain (NP). Here, we tested the hypothesis that SCS relieves pain in a rat model of chronic constriction injury (CCI) by attenuating microglial activation via blocking CSF1 to the spinal cord.

METHODS:
Sprague-Dawley rats underwent sciatic nerve ligation to induce CCI and were implanted with an epidural SCS lead. SCS was delivered 6 hours per day for 5 days. Some rats received a once-daily intrathecal injection of CSF1 for 3 days during SCS.

RESULTS:
Compared with naive rats, CCI rats had a marked decrease in the mechanical withdrawal threshold of the paw, along with increased microglial activation and augmented CSF1 levels in the spinal dorsal horn and dorsal root ganglion, as measured by immunofluorescence or Western blotting. SCS significantly increased the mechanical withdrawal threshold and attenuated microglial activation in the spinal dorsal horn in CCI rats, which were associated with reductions in CSF1 levels in the spinal dorsal horn and dorsal roots but not dorsal root ganglion. Moreover, intrathecal injection of CSF1 completely abolished SCS-induced changes in the mechanical withdrawal threshold and activation of microglia in the spinal dorsal horn in CCI rats.

CONCLUSIONS:
SCS reduces microglial activation in the spinal cord and alleviates chronic NP, at least in part by inhibiting the release of CSF1 from the dorsal root ganglion ipsilateral to nerve injury.
Incentives for pregnant mothers during antenatal care for better maternal and neonatal health outcomes: A systematic review protocol
Authors: Holla Ramesh , Unnikrishnan Bhaskaran , Vijayamma Ratheebhai , T V Bhumika , Sinha Anju , BB Darshan , T Rekha , Mithra P Prasanna , Kumar Nithin , Kulkarni Vaman , N Ravishankar , Johnson K Rosemol 
Published: April 2022

Background: Universal access to maternal new-born and child healthcare services (MNCH) is detrimental for attainment of Sustainable Development Goal (SDG) three pertaining to promotion of health at all ages. Incentivization in the form of cash, vouchers, and goods have been used as part of strategies to improve maternal and neonatal health outcomes around the world. However, there exists uncertainties regarding the effectiveness of various incentive-based programmes targeted for pregnant mothers in low- and middle-income countries during their antenatal period. Methods: We will search six electronic databases, namely the Medical Literature Analysis and Retrieval System Online (Medline), Cochrane Central Register of Controlled Trials (CENTRAL), the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Scopus, Web of Science, and Embase in addition to Google Scholar. Manual searching of the reference lists of included studies will also be done. The reporting of this protocol will follow the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P) 2015 statement [29]. Only interventional studies that follow randomized, quasi randomized, and cluster randomized controlled study designs will be included. A three-stage screening process will be adopted to select articles. Risk of bias for the included studies will be assessed using the tools and criteria specified in the Cochrane handbook. In addition, the GRADE approach will be used to assess the quality of evidence for the maternal and neonatal health outcomes. Conclusion: This review of trials is essential to inform the effectiveness of incentive-based programmes targeted for pregnant women in low- and middle-income countries. It will help the policy makers to utilise the resources more effectively and to integrate the evidence based public health initiatives into the health system. This can also help build the continuum of care financial packages for all pregnant women.
A systematic review: Male engagement in adolescent and young adults’ sexual and reproductive health in the Americas
Authors: Salinas Ivonne , Freire Erick , Guevara Jane , Herrán Keren , Ortiz Andrea , Palacios Iván 
Published: April 2022

Progress towards sexual and reproductive health (SRH) goals for adolescents across the Americas has stagnated. Of all the regions worldwide, Latin America has experienced the slowest decline in adolescent fertility rates. Reports published by the United Nations and multiple nongovernmental organizations demonstrate a growing consensus for a masculinities framework that engages men and boys in public health and social change. Male engagement acts as a complement - and not a replacement - of current SRH. Emerging evidence indicates that Coronavirus disease in 2019 has worsened SRH outcomes, especially related to gender-based violence; new evidence-based interventions are ever more urgent. This systematic review includes a focus on education-based male engagement, a special consideration of gender equity, and systematic searches by fluent speakers in three most populous languages in the Americas (English, Spanish, and Portuguese). PubMed, EBSCO, SCOPUS, and Google Scholar databases were digitally searched. Publications were excluded if their focus did not align directly with sexual reproductive health, their location was outside the scope of study, its content derived from information collected before 2010, or its study’s population’s age of focus was not between 15-24 years of age. After abstract screening and full-text review, the original 10,721 articles identified were narrowed down to 13 articles whose references were further examined through hand searching, leading us to a total of 32 final articles chosen for analysis. The results were classified by geographic regions of the American continent. The literature emphasized that society often defines masculinity as a hegemonic role grounded in aggressive high-risk sexual behavior. Adolescent males internalize this and hold their peers to these expectations. These beliefs have detrimental SRH consequences that have yet to be fully understood among adolescent boys and males. The efficacy of future interventions will depend on further exploration of these topics, especially among minority populations.
Case Report: Isolated, unilateral oculomotor palsy with anti-GQ1b antibody following COVID-19 vaccination
Authors: Kubota Takafumi , Hasegawa Takafumi , Ikeda Kensuke , Aoki Masashi 
Published: April 2022

Neurological complications following vaccinations are extremely rare, but cannot be eliminated. Here, we report the first case of unilateral oculomotor nerve palsy (ONP) with anti-GQ1b antibody after receiving the Pfizer-BioNTech COVID-19 (BNT162b2) mRNA vaccine. A 65-year-old man developed diplopia and ptosis in the right eye 17 days after vaccination, without preceding infection. Neurological examination revealed mild blepharoptosis, limitation of adduction, and vertical gaze on the right side. Increased levels of anti-GQ1b ganglioside antibody in the serum and albuminocytologic dissociation in the cerebrospinal fluid were detected. Cranial magnetic resonance imaging showed swelling and enhancement of the right oculomotor nerve. The patient was diagnosed with right ONP accompanied with anti-GQ1b antibody, and intravenous immunoglobulin (IVIG) therapy for 5 days was administered. The limitation of adduction and vertical gaze improved, and ptosis markedly resolved after IVIG treatment. Given the temporal sequence of disease progression, laboratory findings, and a favorable response to IVIG, a causal relationship cannot be ruled out between the occurrence of ONP and COVID-19 immunization. Since immunomodulatory treatments significantly hasten the recovery and minimize the residual symptoms in anti-GQ1b antibody syndrome, clinicians should be aware of this clinical condition following COVID-19 vaccination.
Dynamic Pricing with Online Reviews
Authors: Shin Dongwook , Vaccari Stefano , Zeevi Assaf 
Published: April 2022

This paper investigates how the pricing policy of a revenue-maximizing monopolist is influenced by the social learning dynamics of customers who use online reviews to estimate the quality of the product. A salient feature of our problem is that the customers’ willingness to pay, and hence the demand function, evolves over time in conjunction with the online reviews. The monopolist strives to maximize its total expected revenue over a finite horizon by adjusting prices in response to these dynamics. The revenue maximization problem is studied using two different review models: a quality-based review model, where customers report their experienced quality, and a value-based review model, where reviews internalize experienced quality as well as the purchase price. To formulate the problem in tractable form, we derive a fluid model that provides a good approximation of the system dynamics when the volume of sales is large. This formulation lends itself to key structural insights into the interactions between optimal pricing policies and review dynamics. In particular, we identify critical time scales and social learning regimes that sharply separate the efficacy of dynamic pricing vis-à-vis fixed-price strategies. Furthermore, we demonstrate the impact of the quality-based and value-based review models on key structural properties of the optimal pricing policies. These structural insights are also elucidated in an illustrative simulation study based on data from an online marketplace. This paper was accepted by Gabriel Weintraub, revenue management and market analytics. Supplemental Material: Data and the e-companion are available at https://doi.org/10.1287/mnsc.2022.4387 .
Dipole-spread-function engineering for simultaneously measuring the 3D orientations and 3D positions of fluorescent molecules
Authors: Wu Tingting , Lu Jin , Lew Matthew D. 
Published: April 2022

Interactions between biomolecules are characterized by where they occur and how they are organized, e.g., the alignment of lipid molecules to form a membrane. However, spatial and angular information are mixed within the image of a fluorescent molecule–the microscope’s dipole-spread function (DSF). We demonstrate the pixOL algorithm to simultaneously optimize all pixels within a phase mask to produce an engineered Green’s tensor–the dipole extension of point-spread function engineering. The pixOL DSF achieves optimal precision to simultaneously measure the 3D orientation and 3D location of a single molecule, i.e., 4.1° orientation, 0.44 sr wobble angle, 23.2 nm lateral localization, and 19.5 nm axial localization precisions in simulations over a 700 nm depth range using 2500 detected photons. The pixOL microscope accurately and precisely resolves the 3D positions and 3D orientations of Nile red within a spherical supported lipid bilayer, resolving both membrane defects and differences in cholesterol concentration in six dimensions.
Reproductive factors and the risk of incident dementia: A cohort study of UK Biobank participants
Authors: Gong Jessica , Harris Katie , Peters Sanne A. E. , Woodward Mark 
Published: April 2022

Background
Women’s reproductive factors have been associated with the risk of dementia; however, these findings remain uncertain. This study aimed to examine the risk of incident all-cause dementia associated with reproductive factors in women and the number of children in both sexes and whether the associations vary by age, socioeconomic status (SES), smoking status, and body mass index (BMI) in the UK Biobank.

Methods and findings
A total of 273,240 women and 228,957 men without prevalent dementia from the UK Biobank were included in the analyses. Cox proportional hazard regressions estimated hazard ratios (HRs) for reproductive factors with incident all-cause dementia. Multiple adjusted models included age at study entry, SES, ethnicity, smoking status, systolic blood pressure, BMI, history of diabetes mellitus, total cholesterol, antihypertensive drugs, and lipid-lowering drugs. Over a median of 11.8 years follow-up, 1,866 dementia cases were recorded in women and 2,202 in men. Multiple adjusted HRs ((95% confidence intervals (CIs)), p-value) for dementia were 1.20 (1.08, 1.34) (p = 0.016) for menarche <12 years and 1.19 (1.07, 1.34) (p = 0.024) for menarche >14 years compared to 13 years; 0.85 (0.74, 0.98) (p = 0.026) for ever been pregnant; 1.43 (1.26, 1.62) (p < 0.001) for age at first live birth <21 compared to 25 to 26 years; 0.82 (0.71, 0.94) (p = 0.006) for each abortion; 1.32 (1.15, 1.51) (p = 0.008) for natural menopause at <47 compared to 50 years; 1.12 (1.01, 1.25) (p = 0.039) for hysterectomy; 2.35 (1.06, 5.23) (p = 0.037) for hysterectomy with previous oophorectomy; and 0.80 (0.72, 0.88) (p < 0.001) for oral contraceptive pills use. The U-shaped associations between the number of children and the risk of dementia were similar for both sexes: Compared with those with 2 children, for those without children, the multiple adjusted HR ((95% CIs), p-value) was 1.18 (1.04, 1.33) (p = 0.027) for women and 1.10 (0.98, 1.23) (p = 0.164) for men, and the women-to-men ratio of HRs was 1.09 (0.92, 1.28) (p = 0.403); for those with 4 or more children, the HR was 1.14 (0.98, 1.33) (p = 0.132) for women and 1.26 (1.10, 1.45) (p = 0.003) for men, and the women-to-men ratio of HRs was 0.93 (0.76, 1.14) (p = 0.530). There was evidence that hysterectomy (HR, 1.31 (1.09, 1.59), p = 0.013) and oophorectomy (HR, 1.39 (1.08, 1.78), p = 0.002) were associated with a higher risk of dementia among women of relatively lower SES only. Limitations of the study include potential residual confounding and self-reported measures of reproductive factors, as well as the limited representativeness of the UK Biobank population.

Conclusions
In this study, we observed that some reproductive events related to shorter cumulative endogenous estrogen exposure in women were associated with higher dementia risk, and there was a similar association between the number of children and dementia risk between women and men.
What is the subtype of dementia in patients with fragility hip fracture?
Authors: Uchiyama Shigeharu , Kamoi Fumiki , Tanaka Manabu , Joko Itsuo , Kasuga Kazuo , Suzuki Kenta , Tachibana Naoko , Kaneko Tomoki , Amano Naoji 
Published: April 2022

Introduction
Cognitive function is an important factor that affects functional recovery after hip fracture (HipFx) surgery. The literature on the pathophysiology of dementia in HipFx patients is scarce. We performed a differential diagnosis of dementia in HipFx patients using clinical and brain MRI findings.

Methods
This is a prospective study in which brain MRI was evaluated for patients with HipFx for research purposes. One-hundred-and-five HipFx patients (85 females and 20 males) who underwent surgery and were subsequently able to undergo brain MRI at our hospital were evaluated. The mean age was 84 years. The presence of dementia was determined based on clinical findings and whether the patient meets its diagnostic criteria according to the International Classification of Diseases 10th Edition (ICD-10). The differential diagnosis of dementia was made based on brain MRI findings and the dementia diagnostic flow chart published in the Clinical Practice Guideline for Dementia 2017 (Japanese Society of Neurology). The Voxel-based Specific Regional Analysis System for Alzheimer’s Disease (VSRAD) advance 2 diagnostic software was used to evaluate atrophy of the para-hippocampal gyrus.

Results
Fifty-six (53%) patients were clinically diagnosed with dementia according to the ICD-10 criteria. The MRI findings were diverse: Alzheimer’s disease (AD)-type, asymptomatic multiple ischemic cerebral lesions, past symptomatic cerebral infarction or cerebral hemorrhage, Binswanger’s disease (BW)-type, chronic subdural hematoma, disproportionately enlarged subarachnoidal hydrocephalus (DESH), and their combinations thereof. A combination of MRI and clinical findings of dementia patients demonstrated the following distribution of dementia subtypes: AD (n = 20), vascular dementia (n = 33), AD and BW vascular dementia (n = 3).

Conclusion
This study revealed that the brain MRI findings of HipFx patients were diverse. Although vascular dementia is found to be common in this particular population, this could be an incidental finding. Further study is warranted to clarify the specificity of our findings by increasing the number of patients, setting the control, and investigating whether dementia subtypes affect postoperative gait acquisition and fall risk.
Lessons learned from academic medical centers’ response to the COVID-19 pandemic in partnership with the Navajo Nation
Authors: Bongiovanni Tasce , Shamasunder Sriram , Brown William , Rivera Carpenter Cristina , Pantell Matthew , Ghali Bassem , Harrison James D. 
Published: April 2022

Introduction
Structural forces that drive health inequalities are magnified in crises. This was especially true during the COVID-19 pandemic, and minority communities were particularly affected. The University of California San Francisco and Health, Equity, Action, Leadership Initiative jointly sent volunteer teams of nurses and doctors to work in the Navajo Nation during the COVID-19 pandemic. This presented an opportunity to explore how academic medical centers (AMCs) could effectively partner with vulnerable communities to provide support during healthcare crises. Therefore, the aims of this study were to describe volunteers’ perspectives of academic-community partnerships by exploring their personal, professional and societal insights and lessons learned based on their time in the Navajo Nation during COVID-19.

Methods
We recruited key informants using purposeful sampling of physicians and nurses who volunteered to go to the Navajo Nation during the spring 2020 COVID-19 surge, as well as hospital administrators and leaders involved in organizing the COVID-19 efforts. We used in-depth qualitative interviews to explore key informants’ experiences pre-departure, during their stay, and after their return, as well as perspectives of the partnership between an AMC and the Navajo Nation. We used thematic analysis to systematically identify, analyze and report patterns (themes) within the data.

Results
In total, 37 clinicians and hospital administrators were interviewed including 14 physicians, 16 nurses, and 7 health system leaders. Overall, we found 4 main themes each with several subthemes that defined the partnership between the AMC and the Navajo Nation. Mission and values incorporated civic duty, community engagement, leadership commitment and employee dedication. Solidarity, trust and humility encompassed pre-existing trust, workforce sustainability, humility and erasure of ‘savior narratives.’ Coordination included logistical coordination, flexibility, selectivity of who and what traveled to the response and coordination around media response. Workforce preparation and support encompassed understanding of historical context and providing healthcare in limited settings, dangers of inadequate preparation and the need for emotional support.

Conclusion
This study provides guidelines which AMCs might use to develop and improve partnerships they have or would like to develop with vulnerable communities. These guidelines may even be broadly applied to partnerships outside of a pandemic response. Importantly, such partnerships need to be built with trust and with an eye towards sustainability and long-term relationships as opposed to ‘medical missions’.