bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of Pediatric Cardiac Intensive Care Advanced Practice Provider’s Leadership Education and Experience During Emergencies
Authors: Florez Amy R. , Riley Christine M. , Zender Jill E. , Cooper David S. , Henry Brandon M. , Justice Lindsey B. 
Published: May 2022

Background
The number of advanced practice providers (APPs) in pediatric critical care has increased dramatically over recent years, leading to increased opportunities to lead resuscitation teams during pediatric emergent events.

Objectives
The aim of this study was to better understand the emergency leadership experience, training, and education that pediatric cardiac intensive care unit APPs receive.

Methods
This study was a cross-sectional descriptive studying using survey responses. The self-administered survey was administered to APP and attending physician members of the Pediatric Cardiac Intensive Care Society. Survey results were analyzed.

Results
One hundred seven pediatric cardiac intensive care unit APPs (n = 53) and attending physicians (n = 54) responded to the survey. Half of APPs felt that attendings allowed APPs to lead emergent events, and 50.9% had never functioned in the team leader role. Most respondents (77.5%) rated their comfort functioning in the role during emergent situations as moderate or lower. Increased APP experience level was associated with a higher number of codes led, increased comfort leading codes, and improved mental model sharing (all Ps < .0001). The number of codes an APP had previously led was associated with increased comfort leading codes (P < .0001) and mental model sharing (P = .0002). One-third of attendings said they allow APPs to lead codes in their unit. Half of attendings who do not allow APPs to function as the team leader would follow formal training.

Discussion
Opportunities for APPs to function as team leaders during emergent events continue to increase. A leadership educational program would be beneficial to pediatric critical care APPs. It may also have the additional benefit of improving physician comfort with APPs leading code events and patient outcomes.
One Year Post-Discharge Outcomes After Implementation of an ICU Early Mobility Protocol
Authors: Tymkew Heidi , Sledge Jennifer A. , Vyers Kara , Arroyo Cassandra , Schallom Marilyn 
Published: May 2022

Background
Early mobility benefits include improved strength, decreased length of stay (LOS), and delirium. The impact of an early mobility protocol on return to activities of daily living (ADL) is less studied.

Objective
The aim of this study was to examine 1-year outcomes including ADL performance after the institution of an ICU early mobility protocol.

Methods
One year after the initiation of an early mobility protocol in 7 intensive care units (ICUs) at an academic medical center, patients with an ICU stay of 7 days or more were enrolled in a 1-year follow-up phone call study. Baseline demographic data included the following: average ICU mobility and highest ICU mobility level achieved (4 levels), highest ICU mobility score (10 levels) at ICU admission, ICU discharge (DC), hospital DC, LOS, and delirium positive days. At 4 time points after DC (1, 3, 6, 12 months), patients were contacted regarding current residence, employment, readmissions, and current level of ADL from the Katz ADL (scored 0-6) and Lawton instrumental ADL scales (scored 0-8).

Results
A convenience sample of 106 patients was enrolled with a mean age of 58 ± 15.4 years, ICU LOS of 18 ± 11.5 days, and hospital LOS of 37.5 ± 31 days; 58 (55%) were male; 4 expired before DC. Mobility results included mean mobility level of 1.6 ± 0.8, mean highest mobility level 3.3 ± 0.9; ICU mobility score was 5.9 ± 2.4 at time of ICU DC and 7.3 ± 2.5 at hospital DC. Katz ADL scores improved from 4.8 at 1 month to 5.6 at 12 months (P = .002), and Lawton IADL scores improved from 4.2 to 6.6 (P < .001). Mobility scores were predictors of 1 month Katz (P = .004) and Lawton (P < .001) scores. None of the mobility levels or scores were predictive for readmissions. Most patients were not working before admission, and not all returned to work. Days positive for delirium were predictive of 1 month Katz and Lawton (P = .014, .002) scores. Impact of delirium was gone by 1 year.

Discussion
In this critically ill patient population followed for 1 year, ICU mobility positively impacted return to ADLs and improved ADLs over time but not readmissions. Delirium positive days decreased ADL scores, but the effect diminished over time.
PrabotulinumtoxinA for Treatment of Millennials With Moderate to Severe Glabellar Lines: Post Hoc Analyses of the Phase III Clinical Study Data
Authors: Ogilvie Patricia , Jones Derek H. , Avelar Rui L. , Jonker Anneke , Monroe Rose , Carruthers Jean 
Published: May 2022

BACKGROUND
The use of esthetic products by millennials is increasing, yet published clinical trial data in this population are limited.

OBJECTIVE
To compare the efficacy and safety of prabotulinumtoxinA for the treatment of moderate to severe glabellar lines in millennial and nonmillennial patients.

METHODS AND MATERIALS:
Post hoc analyses were performed on the pooled population of all patients treated with 20U prabotulinumtoxinA in the 3 single-dose Phase III glabellar line clinical studies. Patients were grouped by age: millennials (born 1982–2000) versus nonmillennials (born ≤1981). One key efficacy end point was the proportion of responders with a ≥1-point improvement from baseline at maximum frown on the 4-point Glabellar Line Scale. Adverse events were also summarized.

RESULTS
Responder rates among millennials (n = 65) were greater than those of nonmillennials (n = 668) by 7.7% on average across all visits; differences were statistically significant at Day 90. Responder rates at Day 90 were 90.2% and 76.1%, respectively (absolute difference of 14.0%, p = .01). Headache was the most common treatment-related adverse event, occurring in 9.0% and 9.4% of millennials and nonmillennials, respectively.

CONCLUSION
A single dose of 20U prabotulinumtoxinA administered for the treatment of glabellar lines was similarly well-tolerated by both millennials and nonmillennials; overall, it was more efficacious in millennials.
Measuring corneal astigmatism using OCT in keratoconus
Authors: Llorens-Quintana Clara , Lee Daniel J. , Pavlatos Elias , Chamberlain Winston , Huang David , Li Yan 
Published: May 2022

Purpose:
To measure net corneal astigmatism using optical coherence tomography (OCT) (Avanti) in individuals with keratoconus and compare the repeatability and accuracy with those obtained using Scheimpflug imaging (Pentacam HR).

Setting:
Casey Eye Institute, Portland, Oregon.

Design:
Prospective cross-sectional observational study.

Methods:
Net corneal astigmatism was calculated in keratoconic and normal eyes using OCT and Scheimpflug imaging with 4 settings—pupil or vertex centration settings with a 3 or 4 mm circular analytical zone. Corneal elevation maps were obtained from OCT images and fitted with the Zernike polynomials to obtain net corneal astigmatism. Manifest refraction astigmatism was used to evaluate the accuracy of net corneal astigmatism measurements. The coefficient of repeatability from 2 repeated measures was calculated.

Results:
46 eyes with manifest or subclinical keratoconus and 52 normal control eyes were analyzed. For OCT measurements in keratoconus, better accuracy was achieved with pupil centration and 3 mm analytical zone; however, better repeatability was achieved with vertex centration and 4 mm analytical zone (coefficient of repeatability = 0.53 diopters, the Fligner-Killeen test with Bonferroni adjustment P < .0017). Agreement with manifest refraction was significantly better with OCT compared with that using Pentacam HR (generalized mixed-effect model with Bonferroni adjustment P < .00625). No statistically significant difference was found between instruments or settings in control eyes.

Conclusions:
OCT was able to measure net corneal astigmatism with better accuracy and precision in keratoconic eyes than the Pentacam HR. Measurements may be more accurate using pupil centration and a smaller analytical zone in patients with keratoconus.
Emerging Lessons and Policy Options for Sexually Transmitted Infection Telehealth Payment: A Narrative Review
Authors: Crowley Jeffrey S. , Hidalgo Julia , McGuire Jean Flatley , Haddad Marwan S. 
Published: May 2022

Abstract
Long before the SARS-CoV-2 (hereafter COVID-19) pandemic, sexually transmitted infection (STI) prevention and control was underresourced in the United States, leading to large and sustained increases in reportable STIs and harmful sequelae of these infections. The abrupt disruption associated with the national shutdown of many public services in early 2020 forced STI clinics and programs to rapidly adopt new models of care, including the greatly increased use of telehealth services. Federal policy makers took actions to relax many requirements in Medicare and other programs that previously impeded the use of telehealth. Numerous states also adopted emergency policies to facilitate the delivery of telehealth services through Medicaid, many of which are related to payment for services. It is unresolved whether and which policies will or should be extended after the public health emergency. How these services are financed and reimbursed underpins the ability to effectively prevent and treat STIs and improve public health. Ultimately, payment systems need to support the solvency and stability of sexual health clinics and other health care services organizations in ways that support providers and that also improve patient satisfaction and retention in care. The Centers for Disease Control and Prevention and state/local health departments have important roles to play in supporting the dialogue needed to create new payment models and facilitate communication and technical assistance across public health and insurance systems. Sexual health providers must be engaged in iterative processes that continue to evolve and can be evaluated over time.
Why Is Patient Safety a Challenge? Insights From the Professionalism Opinions of Medical Students’ Research
Authors: McGurgan Paul M. , Calvert Katrina L. , Nathan Elizabeth A. , Narula Kiran , Celenza Antonio , Jorm Christine 
Published: May 2022

Objectives
Despite increased emphasis on education and training for patient safety in medical schools, there is little known about factors influencing decision making regarding patient safety behaviors. This study examined the nature and magnitude of factors that may influence opinions around patient safety–related behaviors as a means of providing insights into how Australian doctors and medical students view these issues relative to members of the public.

Methods
A national, multicenter, prospective, cross-sectional survey was conducted using responses to hypothetical patient safety scenarios involving the following: fabricating results, personal protective equipment, presenteeism, and reporting concerns.
Australian enrolled medical students, medical doctors, and members of the public were surveyed.
Participant responses were compared for the different contextual variables within the scenarios and the participants’ demographic characteristics.

Results
In total, 2602 medical student, 809 doctors, and 503 members of the Australian public participated. The 3 demographic groups had significantly differing opinions on many of the patient safety dilemmas. Doctors were more tolerant of medical students not reporting concerning behaviors and attending placements despite recent illness. Medical students’ opinions frequently demonstrated a “transition effect,” bridging between the doctors and publics’ attitudes, consistent with professional identity formation.

Conclusions
Opinions on the acceptability of medical students’ patient safety–related behaviors were influenced by the demographics of the cohort and the contextual complexity of the scenario. Although the survey used hypothetical scenarios, doctors and medical students’ opinions seem to be influenced by cognitive dissonances, biases, and heuristics, which may negatively affect patient safety.
Patient Safety and Legal Regulations: A Total-Scale Analysis of the Scientific Literature
Authors: Yeung Andy Wai Kan , Kletecka-Pulker Maria , Klager Elisabeth , Eibensteiner Fabian , Doppler Klara , El-Kerdi Amer , Willschke Harald , Völkl-Kernstock Sabine , Atanasov Atanas G. 
Published: May 2022

Objective
The aim of the study was to quantitatively analyze the scientific literature landscape covering legal regulations of patient safety.

Methods
This retrospective bibliometric analysis queried Web of Science database to identify relevant publications. The identified scientific literature was quantitatively evaluated to reveal prevailing study themes, contributing journals, countries, institutions, and authors, as well as citation patterns.

Results
The identified 1295 publications had a mean of 13.8 citations per publication and an h-index of 57. Approximately 78.8% of them were published since 2010, with the United States being the top contributor and having the greatest publication growth. A total of 79.2% (n = 1025) of the publications were original articles, and 12.5% (n = 162) were reviews. The top authors (by number of publications published on the topic) were based in the United States and Spain and formed 3 collaboration clusters. The top institutions by number of published articles were mainly based in the United States and United Kingdom, with Harvard University being on top. Internal medicine, surgery, and nursing were the most recurring clinical disciplines. Among 4 distinct approaches to improve patient safety, reforms of the liability system (n = 91) were most frequently covered, followed by new forms of regulation (n = 73), increasing transparency (n = 67), and financial incentives (n = 38).

Conclusions
Approximately 78.8% of the publications on patient safety and its legal implications were published since 2010, and the United States was the top contributor. Approximately 79.2% of the publications were original articles, whereas 12.5% were reviews. Healthcare sciences services was the most recurring journal category, with internal medicine, surgery, and nursing being the most recurring clinical disciplines. Key relevant laws around the globe were identified from the literature set, with some examples highlighted from the United States, Germany, Italy, France, Sweden, Poland, and Indonesia. Our findings highlight the evolving nature and the diversity of legislative regulations at international scale and underline the importance of healthcare workers to be aware of the development and latest advancement in this field and to understand that different requirements are established in different jurisdictions so as to safeguard the necessary standards of patient safety.
Implementing Root Cause Analysis and Action: Integrating Human Factors to Create Strong Interventions and Reduce Risk of Patient Harm
Authors: Wolf Laurie , Gorman Kristen , Clark Joshua , Gleason Jonathan , Henrickson Parker Sarah 
Published: May 2022

Objectives
The goal of this study was to develop a systems approach for root cause analysis and action to achieve strong, sustainable interventions. The team integrated human factors principles into the design of interventions to ensure solutions maintain compatibility with human capabilities and limitations resulting in stronger solutions to prevent reoccurrence.

Methods
This study was conducted at a 7-hospital health system located in southwestern Virginia. Including human factors in a new root cause analysis and action process allowed the team to design strong interventions. To assess the results of this process, a team evaluated all interventions over a 4-year period (2.75-y preimplementation and 1.4-y postimplementation). Interventions were initially blind coded and then consensus coding was executed to finalize the strength of each intervention according to the VA National Center for Patient Safety evaluation tool.

Results
The new process resulted in an efficient method to address adverse events with increased staff satisfaction and interventions more resilient to human error. The number of events with strong interventions increased from 43% to 69% after implementation of the new process.

Conclusions
Tailoring an event investigation process to an organizational culture is critical to implementation success. Adding human factors into the design of interventions helped facilitate intervention implementation and sustainability. Blinded ratings showed that with the integration of human factors, there was improved strength of interventions. This indicates that a focus on strong system improvement (rather than weaker individual human-based solutions) will lead to improved staff satisfaction and patient safety.
Time Between Viral Loads for People With HIV During the COVID-19 Pandemic
Authors: El-Nahal Walid G. , Shen Nicola M. , Keruly Jeanne C. , Jones Joyce L. , Fojo Anthony T. , Manabe Yukari C. , Moore Richard D. , Gebo Kelly A. , Chander Geetanjali , Lesko Catherine R. 
Published: May 2022

Background:
During the COVID-19 pandemic, patients experienced significant care disruptions, including laboratory monitoring. We investigated changes in the time between viral load (VL) checks for people with HIV (PWH) associated with the pandemic.

Setting and Methods:
This was an observational analysis of VLs of PWH in routine care at a large subspecialty clinic. At pandemic onset, the clinic temporarily closed its onsite laboratory. The exposure was time period (time varying): prepandemic (January 1, 2019–March 15, 2020); pandemic laboratory closed (March 16–July 12, 2020); and pandemic laboratory open (July 13–December 31, 2020). We estimated time from an index VL to a subsequent VL, stratified by whether the index VL was suppressed (≤200 copies/mL). We also calculated cumulative incidence of a nonsuppressed VL following a suppressed index VL, and of resuppression following a loss of viral suppression.

Results:
Compared with prepandemic, hazard ratios for next VL check were 0.34 (95% CI: 0.30 to 0.37, laboratory-closed) and 0.73 (CI: 0.68 to 0.78, laboratory-open) for suppressed patients, and 0.56 (CI: 0.42 to 0.79, laboratory-closed) and 0.92 (95% CI: 0.76 to 1.10, laboratory-open) for nonsuppressed patients. The 12-month cumulative incidence of loss of suppression was the same in the pandemic laboratory-open (4%) and prepandemic (4%) period. The hazard of resuppression following the loss of suppression was lower during the pandemic laboratory-open versus the prepandemic period (hazard ratio: 0.68, 95% CI: 0.50 to 0.92).

Conclusions:
Early pandemic restrictions and laboratory closure significantly delayed VL monitoring. Once the laboratory reopened, nonsuppressed patients resumed normal monitoring. Suppressed patients still had a delay but no significant loss of suppression.
Feasibility of Deep Learning–Based Noise and Artifact Reduction in Coronal Reformation of Contrast-Enhanced Chest Computed Tomography
Authors: Kang Eun-Ju , Park Hyoung Suk , Jeon Kiwan , Lee Ji Won , Lim Jae-Kwang 
Published: May 2022

Purpose
This study aimed to evaluate the feasibility of a deep learning method for imaging artifact and noise reduction in coronal reformation of contrast-enhanced chest computed tomography (CT).

Methods
A total of 19,052 coronal reformatted chest CT images of 110 CT image sets (55 pairs of concordant 16- and 320-row CT image sets) were included and used to train a deep learning algorithm for artifact and noise correction. For internal validation, 4093 coronal reformatted CT images of 25 patients from 16-row CT images underwent correction processing. For external validation, chest CT images of 30 patients (1028 coronal reformatted CT images), acquired in other institutions using different scanners, were subjected to correction processing. For both validations, image quality was compared between original (“CTorigin”) and deep learning–based corrected (“CTcorrect”) CT images. Quantitative analysis for stair-step artifact (coefficient of variance of CT density on coronal reformation), image noise, signal-to-noise ratio, and contrast-to-noise ratio were evaluated. Subjective image quality scores were assigned for image contrast, artifact, and conspicuity of major structures.

Results
CTcorrect showed significantly reduced stair-step artifact (mean coefficient of variance: CTorigin 7.35 ± 2.0 vs CTcorrect 5.17 ± 2.4, P < 0.001) and image noise and improved signal-to-noise ratio and contrast-to-noise ratio in the aorta, pulmonary artery, and liver, compared with those of CTorigin (P < 0.01). On subjective analysis, CTcorrect had higher image contrast, lower artifact, and better conspicuity than CTorigin. Most results of the external validation were consistent with those obtained from the internal validation, except for those concerning the pulmonary artery.

Conclusions
Deep learning–based artifact correction significantly improved the image quality of coronal reformation chest CT by reducing image noise and artifacts.
Molecular structures of two copper complexes with the pharmaceuticals norfloxacin and tinidazole, when powder X-ray diffraction assists multi-domain single-crystal X-ray diffraction
Authors: Tobón Zapata Gloria Elena , Martínez Carmona Dina Marcela , Echeverría Gustavo Alberto , Piro Oscar Enrique 
Published: May 2022

The crystal structures of bis[1-ethyl-6-fluoro-4-oxo-7-(piperazin-1-ium-4-yl)-1,4-dihydroquinoline-3-carboxylato]copper(II) sulfate heptahydrate, [Cu(C16H18FN3O3)2]SO4·7H2O or [Cu(nor)2]SO4·7H2O (nor is norfloxacin), and bis{1-[2-(ethylsulfonyl)ethyl]-2-methyl-5-nitroimide}dinitratocopper(II), [Cu(NO3)2(C8H13N3O4S)2] or [Cu(NO3)2(tnz)2] (tnz is tinidazole), were solved by X-ray diffraction. Both complexes crystallize in the space group P21/c, with Z = 4 (for nor) and Z = 2 (for ntz) molecules per unit cell. In [Cu(nor)2]SO4·7H2O, the CuII ion is at the centre of a square-planar environment, trans coordinated to two independent norfloxacin molecules in the zwitterionic form acting as bidentate ligands through one of the carboxyl (cbx) and the carbonyl (cb) O atoms. The solid is further stabilized by an extensive network of N—H...O(sulfate), N—H...O(cbx), N—H...OW, OW—H...O(sulfate) and OW—H...OW hydrogen bonds. The [Cu(NO3)2(tnz)2] complex is centrosymmetric, with the CuII ion in a square planar environment, coordinated to a tinidazole molecule acting as a monodentate ligand through its imidazole N atom and to one nitrate O atom. The vibrational FT–IR absorption spectra and thermal behaviour of the complexes were also studied and are briefly discussed based on the crystal structures.