bluuebunny/crossref_metadata_2025_split huggingface dataset:
THREE-YEAR TREATMENT OUTCOMES OF AFLIBERCEPT VERSUS RANIBIZUMAB FOR DIABETIC MACULAR EDEMA
Authors: Gabrielle Pierre-Henry , Nguyen Vuong , Creuzot-Garcher Catherine , Arnold Jennifer J. , Mehta Hemal , Duran Mónica Asencio , Bougamha Walid , Carreño Ester , Viola Francesco , Squirrell David , Barthelmes Daniel , Gillies Mark 
Published: February 2022

Purpose:
Compare the 3-year outcomes of ranibizumab versus aflibercept in eyes with diabetic macular edema in daily practice.

Methods:
This was a retrospective analysis of naive diabetic macular edema eyes starting intravitreal injections of ranibizumab (0.5 mg) or aflibercept (2 mg) from January 1, 2013 to December 31, 2017 that were collected in the Fight Retinal Blindness! Registry.

Results:
We identified 534 eyes (ranibizumab—267 and aflibercept—267) of 402 patients. The adjusted mean (95% confidence interval) visual acuity change of +1.3 (−0.1 to 4.2) letters in the ranibizumab group and +2.4 (−0.2 to 5.1) letters (P = 0.001) in the aflibercept group at 3 years was not clinically different. However, the adjusted mean CST change seemed to remain significantly different throughout the 3-year period with higher reductions in favor of aflibercept (−87.8 [−108.3 to −67.4] µm for ranibizumab vs. −114.4 [−134.4 to −94.3] for aflibercept; P < 0.01). When baseline visual impairment was moderate (visual acuity ≤68 Early Treatment Diabetic Retinopathy Study letters), we found a faster improvement in visual acuity in eyes treated with aflibercept up until 18 months of treatment than eyes treated with ranibizumab, which then stayed similar until 36 months of treatment, whereas there was no apparent difference when baseline visual impairment was mild (visual acuity ≥69 Early Treatment Diabetic Retinopathy Study letters). The rate of serious adverse events was low.

Conclusion:
Aflibercept and ranibizumab were both effective and safe for diabetic macular edema over 3 years.
VALIDATION OF A DEEP LEARNING-BASED ALGORITHM FOR SEGMENTATION OF THE ELLIPSOID ZONE ON OPTICAL COHERENCE TOMOGRAPHY IMAGES OF AN USH2A-RELATED RETINAL DEGENERATION CLINICAL TRIAL
Authors: Loo Jessica , Jaffe Glenn J. , Duncan Jacque L. , Birch David G. , Farsiu Sina 
Published: February 2022

Purpose:
To assess the generalizability of a deep learning-based algorithm to segment the ellipsoid zone (EZ).

Methods:
The dataset consisted of 127 spectral-domain optical coherence tomography volumes from eyes of participants with USH2A-related retinal degeneration enrolled in the RUSH2A clinical trial (NCT03146078). The EZ was segmented manually by trained readers and automatically by deep OCT atrophy detection, a deep learning-based algorithm originally developed for macular telangiectasia Type 2. Performance was evaluated using the Dice similarity coefficient between the segmentations, and the absolute difference and Pearson's correlation of measurements of interest obtained from the segmentations.

Results:
With deep OCT atrophy detection, the average (mean ± SD, median) Dice similarity coefficient was 0.79 ± 0.27, 0.90. The average absolute difference in total EZ area was 0.62 ± 1.41, 0.22 mm2 with a correlation of 0.97. The average absolute difference in the maximum EZ length was 222 ± 288, 126 µm with a correlation of 0.97.

Conclusion:
Deep OCT atrophy detection segmented EZ in USH2A-related retinal degeneration with good performance. The algorithm is potentially generalizable to other diseases and other biomarkers of interest as well, which is an important aspect of clinical applicability.
Examining the Implementation of the National Protocol for Sexual Assault Medical Forensic Examinations
Authors: Langness Mel , Zweig Janine M. , Tiry Emily , Henderson Erica , Stahlmann Nicole , Bastomski Sara 
Published: February 2022

ABSTRACT
The National Protocol for Sexual Assault Medical Forensic Examinations, Adult/Adolescent, 2nd edition, or SAFE Protocol, is a voluntary guide that assists local and state jurisdictions with their responses to sexual assault by institutionalizing best practices around survivor care and evidence collection, particularly for sexual assault nurse examiners (SANEs) completing medical forensic examinations. We examined the uptake of the SAFE Protocol in communities across the United States by analyzing data from a set of national surveys of forensic nursing programs and victim advocates within the same communities. We studied four implementation outcomes: the acceptability, adoption, reach, and sustainability of the SAFE Protocol. SANEs and advocates reported that stakeholders responding to sexual assault—including forensic nurses, advocates, law enforcement, and prosecutors—have high implementation of the Protocol, which indicates how important individual stakeholder engagement is in actively facilitating the adoption of it. However, when information from SANEs and advocates from the same community are compared, the extent to which the SAFE Protocol is reported to be implemented with fidelity across U.S. jurisdictions is mixed.
Time-Varying Risk Factors Associated With the Progress of Functional Recovery and Psychological Distress in First-Ever Stroke Patients
Authors: Liu Kuei Fen , Lin Hung Ru , Lee Tzu-Ying , Lin Kuan Chia 
Published: February 2022

ABSTRACT

BACKGROUND: Evaluation of stroke recovery outcome is crucial and a major goal of clinical practice. A recovery trajectory model serves as a prognostic tool that enables development of effective intervention and long-term management to improve poststroke recovery outcomes. This study explored time-varying risk factors associated with the progression of functional recovery and psychological distress poststroke. METHODS: Participants were patients with first-ever stroke who underwent assessment for activities of daily living, psychological distress, and social support at the onset (within 72 hours) and at 1, 3, and 6 months. A generalized estimation equation was used to account for the correlation between the repeated measurements. RESULTS: Of the 101 patients, 60.4% were men, and the mean (SD) age was 63.06 (13.12) years. Over time, the physical functions of patients after stroke significantly increased, and anxiety and depression significantly decreased. Approximately 50% of patients achieved full functional recovery after 6 months. The time-varying risk factors for National Institutes of Health Stroke Scale scores and depression levels affected the trajectory of functional recovery during follow-up. Factors associated with patient anxiety levels were National Institutes of Health Stroke Scale scores and depression levels. Factors associated with patient depression levels included education, anxiety, and social support levels. CONCLUSION: This study demonstrates the progression of time-varying risk factors for functional recovery and psychological distress in patients with first-ever stroke. We recommend that nurses work with patients and their families in the early poststroke stages to identify comprehensive goals based on individual needs and related factors at different stages and that they educate patients on what is required for them to regain independence.
Outcome of Total Colonic Aganglionosis Involving the Small Bowel Depends on Bowel Length, Liver Disease, and Enterocolitis
Authors: Payen Elise , Talbotec Cécile , Chardot Christophe , Capito Carmen , Khen‐Dunlop Naziha , Sarnacki Sabine , Lacaille Florence , Lambe Cecile , Goulet Olivier 
Published: February 2022

ABSTRACTObjectives:Total colonic aganglionosis involving the small bowel is a rare form of Hirschsprung disease. We aim to analyse the long‐term outcomes, digestive autonomy, and complications, to suggest recommendations for prevention and treatment.Methods:All patients born between 2000 and 2015 followed in our centre were retrospectively included. We analysed the length of aganglionosis, surgical procedures, growth, duration of parenteral nutrition (PN), enterocolitis, liver disease, intestinal transplantation.Results:Twenty‐five patients were followed for a median of 10.9 years. Fifteen patients had less than 80 cm of ganglionic small bowel (SB) with a median of 20 cm. Ten patients had more than 80 cm of ganglionic sB with a median of 115 cm. The median PN duration was significantly shorter for patients with more than 80 cm: 0.9 versus 7.5 years in those with less than 80 cm (P < 0.001). No patient with less than 80 cm was weaned off PN, except 1 who underwent intestinal transplantation. Ten patients with less than 80 cm develop enterocolitis on the excluded segment, leading to emergency entero‐colectomy in 5. Liver disease was more frequent in patients with less than 80 cm (11 vs 0). Three patients required combined liver‐intestine transplantation; 2 underwent an isolated intestinal transplantation.Conclusions:Digestive autonomy was possible in most patients with more than 80 cm of ganglionic SB. The more severe complication was enterocolitis. Liver disease compromised long‐term survival without transplantation. Both complications should be prevented by early diversion and enterectomy of the whole aganglionic segment. Follow‐up in or together with a multidisciplinary intestinal rehabilitation centre is suggested.
Patterns of Healthcare Services Among Children With Advanced Cancer in Concurrent Hospice Care
Authors: Svynarenko Radion , Lindley Lisa C. , Mooney-Doyle Kim , Mendola Annette , Naumann Wendy C. , Mack Jennifer W. 
Published: February 2022

Background
Children with advanced cancer have access to comprehensive cancer care and hospice care if they enroll in concurrent hospice care. However, little is known about the patterns of nonhospice healthcare services used by these children.

Objective
The aim of this study was to examine the patterns of nonhospice healthcare services among children with cancer in concurrent hospice care.

Methods
This study was a retrospective cohort analysis of 2011-2013 Medicaid claims data from 862 pediatric cancer patients. Data were analyzed using descriptive statistics and latent class analysis (LCA).

Results
Children used 120 388 healthcare services, including inpatient and outpatient hospital services, laboratories and x-rays, durable medical equipment, medications, and others. These services clustered into 2 classes with moderate-intensity (57.49%) and high-intensity (42.50%) healthcare service use. Children in the high-intensity cluster were more likely to reside in the South with comorbidities, mental/behavioral health conditions, and technology dependence and were less likely to have solid tumors, compared with the moderate-intensity group.

Conclusions
Nonhospice healthcare services clustered together in 2 distinct classes, providing critical insight into the complexity of the healthcare use among children with cancer in concurrent hospice care.

Implications for Practice
Understanding that pediatric patients in concurrent care may have different healthcare service patterns may assist oncology nurses caring for children with advanced cancer. These findings also have policy implications.
Overview of Patient Safety Culture in Bosnia and Herzegovina With Improvement Recommendations for Hospitals
Authors: Draganović Šehad , Offermanns Guido 
Published: February 2022

Objectives
This study investigates the patient safety culture (PSC) in Bosnia and Herzegovina (BiH). We identify factors that contribute to higher patient safety and improved reporting of adverse events, thereby developing recommendations to improve PSC.

Methods
The study used a correlation design based on cross-sectional surveys in the healthcare sector of BiH (N = 2617). We analyzed the correlation between 9 PSC factors, 4 background characteristics (explanatory variables), and 2 outcome variables (patient safety grade and number of events reported). We also analyzed the variance to determine perceived differences in PSC across the various staff roles in hospitals.

Results
The highest rated PSC factors were Hospital handoffs and transitions and Hospital management support for patient safety and the lowest rated factor was Nonpunitive response to error. Each of the 9 factors showed considerable potential to improve from a hospital, department, and outcome perspective. A comparison of the various employee positions shows significant differences in the PSC perceptions of managers versus nurses and doctors as well as nurses versus doctors.

Conclusions
We found average scores for most PSC factors, leaving the considerable potential for improvement. Compared with the number of events reported and background characteristics, it is evident that PSC factors contribute significantly to patient safety. These factors are essential for the targeted development of PSC. We propose evidence-based practices as recommendations for improving patients’ safety factors.
Lean Management Systems in Health Care: A Review of the Literature
Authors: Winner Laura E. , Reinhardt Erica , Benishek Lauren , Marsteller Jill A. 
Published: February 2022

Background and Objectives:
Many health care organizations now employ Lean tools to improve value in health care, yet reports of their effectiveness vary. This variation may be explained by the context in which Lean is implemented, whether as a tool or as a management system. This article reports on a structured literature review conducted to understand the evidence base for the impact of Lean Management System implementation in health care.

Methods:
A search of PubMed, Scopus, Emerald, EMBASE, CINAHL, and Business Source Complete databases was conducted in November 2017 and repeated in July 2020 to assess the evidence for the impact of Lean Management Systems in health care from 2000 to July 2020. Articles were included if they (1) reported on a Lean Management System or (2) reported on Lean Management System components as described by Mann1 (ie, leader standard work, visual controls, daily accountability process, and discipline).

Results:
A total of 52 articles met the inclusion criteria. Although all articles described some combination of leader standard work, visual management, and daily accountability as part of their Lean Management System, only a handful described use of all 3 components together. Only one explicitly mentioned the fourth component, discipline, required to consistently apply the first 3. The majority reported on single-unit or department implementations and most described daily huddles at the unit level that included review of key performance indicators, identification of improvement opportunities, and problem solving. The role of the leader in a Lean Management System was described a coach and a mentor. Barriers to adoption such as insufficient training and increased workload for nurses were noted along with the importance of relevance to the local context for unit teams to find value in huddle boards and huddles. As yet, evidence of Lean Management System effectiveness in driving health care improvement is absent due to weak study designs and lack of statistical rigor.

Conclusion:
Well-designed research on Lean Management Systems in health care is lacking. Despite increasing adoption of Lean Management Systems over the past 10 years and anecdotal reports of its effectiveness, very few articles provide quantitative data. Those that do report unit-level implementation only, little use of a comprehensive package of Lean Management Systems elements, and weaker study designs and statistical methods. More rigorous study designs and robust statistical analysis are needed to evaluate effectiveness of Lean Management Systems in health care. This represents a rich area for future health care management research.
Steatotic Hepatitis Presenting as a Huge Hypermetabolic Liver Mass
Authors: Doroudinia Abtin , Karam Mehrdad Bakhshayesh , Ghadimi Niloufar , Yousefi Farhad 
Published: February 2022

Abstract
FDG PET/CT scan is a diagnostic imaging modality for oncologic patients, but with false-positive findings in inflammatory diseases. In this interesting case, we present a 24-year-old woman with history of giant cell tumor of the bone (lumbar vertebrae) who underwent whole-body FDG PET/CT scan for treatment response evaluation. FDG PET/CT scan demonstrated a large hypermetabolic tumoral mass lesion in segment VI/VII of the right hepatic lobe. A range of malignant versus benign lesions should be considered as differential diagnoses, including metastasis, primary cholangiocarcinoma, hepatocellular carcinoma, focal nodular hyperplasia, and infection. Final diagnosis of “steatotic hepatitis” after CT-guided biopsy was established.
Evaluation of Variability in Operative Efficiency in Plastic Surgery Procedures
Authors: Boson Alexis L. , Ross Evan , Popp Daniel , Tapking Christian , Ramirez Arianna , Branski Ludwik , Phillips Linda G. , Wolf Steven E. 
Published: February 2022

Background
As the cost of healthcare rises, it is imperative to assess value delivered to patients and impact on the economic viability of institutions. We aimed to characterize plastic surgery operative time management and identified areas for efficiency improvement.

Methods
Procedures from a US academic plastic surgery division from September 2017 to August 2018 were reviewed. Times were categorized into preparation (patient in room to incision), procedure (incision to closure), exit (closure to patient exiting room), and turnover (patient out of room to next patient in room). Median and interquartile ranges were calculated. Procedures were classified by relative value units (RVUs) for comparison of procedure complexities and resources. Components were plotted against RVUs; r
2 values were calculated.

Results
We analyzed 522 cases; 69 were excluded for missing data, primary surgeon not a plastic surgeon, emergent cases, or burn procedures; a total of 453 cases were analyzed. Median and interquartile range (in minutes) for preparation was (34, 18 minutes; 23% of total), procedure (53, 75 minutes; 36% of total), exit (30, 27 minutes; 20% of total), and turnover (30, 26 minutes; 20% of total). Normalized to RVUs, preparation demonstrated the most variability (r
2 = 0.19), followed by exit (r
2 = 0.38), and procedure (r
2 = 0.57). Average work RVUs per month was 678.1 ± 158.7. Average work RVUs per OR hour was 7.2.

Conclusions
The largest component with greatest variability was preparation for surgery in the OR. Improved efficiency by decreasing variability increases the value of healthcare delivered to patients and OR throughput.
Effect of a single dose of oral iron on pancreatic beta-cell function in healthy individuals: a before-and-after (pre-post) study
Authors: Venkatesan Padmanaban , Ramaswamy Jagadish , Vanitha S , Jacob Molly , Varghese Joe 
Published: February 2022

AbstractIntroductionAlthoughin vitroand animal studies have shown that iron loading in pancreatic beta-cells impaired insulin secretion, no human studies have documented the acute effects of oral iron on beta-cell insulin secretory capacity. In this study, we determined beta-cell insulin secretory capacity at baseline and after a single oral dose of iron (ferrous sulphate, 120 mg elemental iron) in healthy male individuals.MethodsFifteen healthy male volunteers underwent an oral glucose tolerance test (OGTT) to document baseline glucose tolerance and insulin secretion kinetics (baseline OGTT). One week later, the same subjects underwent a second OGTT, two hours after an oral dose of ferrous sulfate (120 mg of elemental iron) (post-iron OGTT). Changes in disposition index, insulin secretion kinetics, glucose tolerance, insulin clearance, and iron-related parameters in serum were determined.ResultsCompared to baseline OGTT, the areas under the curve (AUC) for serum iron and transferrin saturation increased by 125% and 118% respectively, in the post-iron OGTT. The disposition index decreased by 20% (p=0.009) and the AUC for glucose concentrations increased by 5.7% (p<0.001) during the post-iron OGTT. The insulin secretion rate was marginally lower during the first hour (−3.5%, p=0.63), but became significantly higher during the second hour (22%, p=0.005) of the post-iron OGTT. Concentrations of glucose, insulin and C-peptide in blood were significantly higher at 120 min of the post-iron OGTT.ConclusionThe decrease in disposition index and glucose tolerance observed after the oral dose of iron points to an acute iron-induced impairment in pancreatic beta-cell insulin secretory capacity.
SpecDB: A Relational Database for Archiving Biomolecular NMR Spectra Data
Authors: Fraga Keith J. , Huang Yuanpeng J. , Ramelot Theresa A. , Swapna G.V.T. , Anak Kendary Arwin Lashawn , Li Ethan , Korf Ian , Montelione Gaetano T. 
Published: February 2022

AbstractNMR is a valuable experimental tool in the structural biologist’s toolkit to elucidate the structures, functions, and motions of biomolecules. The progress of machine learning, particularly in structural biology, reveals the critical importance of large, diverse, and reliable datasets in developing new methods and understanding in structural biology and science more broadly. Protein NMR research groups produce large amounts of data, and there is renewed interest in organizing this data to train new, sophisticated machine learning architectures to improve biomolecular NMR analysis pipelines. The foundational data type in NMR is the free-induction decay (FID). There are opportunities to build sophisticated machine learning methods to tackle long-standing problems in NMR data processing, resonance assignment, dynamics analysis, and structure determination using NMR FIDs. Our goal in this study is to provide a lightweight, broadly available tool for archiving FID data as it is generated at the spectrometer, and grow a new resource of FID data and associated metadata. This study presents a relational schema for storing and organizing the metadata items that describe an NMR sample and FID data, which we call Spectra Database (SpecDB). SpecDB is implemented in SQLite and includes a Python software library providing a command-line application to create, organize, query, backup, share, and maintain the database. This set of software tools and database schema allow users to store, organize, share, and learn from NMR time domain data. SpecDB is freely available under an open source license at https://github.rpi.edu/RPIBioinformatics/SpecDB.Abstract Figure
Time-dependent Role of Bisphosphonates on Atherosclerotic Plaque Calcification
Authors: Nik Amirala Bakhshian , Ng Hooi Hooi , Russo Manuel Garcia , Iacoviello Francesco , Shearing Paul R. , Bertazzo Sergio , Hutcheson Joshua D. 
Published: February 2022

AbstractAtherosclerotic plaque calcification directly contributes to the leading cause of morbidity and mortality by affecting the plaque vulnerability and rupture risk. Small microcalcifications can increase plaque stress and promote rupture, whereas large calcifications can stabilize plaques. Drugs that target bone mineralization may lead to unintended consequences on ectopic plaque calcification and cardiovascular outcomes. Bisphosphonates, common anti-osteoporotic agents, elicited unexpected cardiovascular events in clinical trials. Here, we investigated the role of bisphosphonates treatment and timing on the disruption or promotion of vascular calcification and bone mineral in a mouse model of atherosclerosis. We started the bisphosphonate treatment either before plaque formation, at early plaque formation times associated with the onset of calcification, or at late stages of plaque development. Our data indicate that long term bisphosphonate treatment (beginning prior to plaque development) leads to higher levels of plaque calcification, with a narrower mineral size distribution. When given later in plaque development, we measured a wider distribution of mineral size. These morphological alterations may associate with higher risk of plaque rupture by creating stress foci. Yet, bone mineral density positively correlated with the duration of bisphosphonate treatment.