bluuebunny/crossref_metadata_2025_split huggingface dataset:
Differences in medication reconciliation interventions between six hospitals: a mixed method study
Authors: Stuijt C. C. M. , van den Bemt B. J. F. , Boerlage V. E. , Janssen M. J. A. , Taxis K. , Karapinar-Çarkit F. 
Published: May 2022

Abstract
Background
Although medication reconciliation (MedRec) is mandated and effective in decreasing preventable medication errors during transition of care, hospitals implement MedRec differently.

Objective
Quantitatively compare the number and type of MedRec interventions between hospitals upon admission and discharge, followed by a qualitative analysis on potential reasons for differences.

Methods
This explanatory retrospective mixed-method study consisted of a quantitative and a qualitative part. Patients from six hospitals and six different wards i.e. orthopaedics, surgery, pulmonary diseases, internal medicine, cardiology and gastroenterology were included. At these wards, MedRec was implemented both on hospital admission and discharge. The number of pharmacy interventions was collected and classified in two subcategories. First, the number of interventions to resolve unintended discrepancies (elimination of differences between listed medication and the patient’s actual medication use). And second, the number of medication optimizations (optimization of pharmacotherapy e.g. eliminating double medication). Based on these quantitative results and interviews, a focus group was performed to give insight in local MedRec processes to address differences in context between hospitals. Descriptive analysis (quantitative) and content analysis (qualitative) was used.

Results
On admission 765 (85%) patients from six hospitals, received MedRec by trained nurses, pharmacy technicians, pharmaceutical consultants or pharmacists. Of those, 36–95% (mean per patient 2.2 (SD ± 2.4)) had at least one discrepancy. Upon discharge, these numbers were among 632 (70%) of patients, 5–28% (mean per patient 0.7 (SD 1.2)). Optimizations in pharmacotherapy were implemented for 2% (0.4–3.7 interventions per patient upon admission) to 95% (0.1–1.7 interventions per patient upon discharge) of patients. The main themes explaining differences in numbers of interventions were patient-mix, the type of healthcare professionals involved, where and when patient interviews for MedRec were performed and finally, embedding and extent of medication optimization.

Conclusions
Hospitals differed greatly in the number of interventions performed during MedRec. Differences in execution of MedRec and local context determines the number of interventions. This study can support hospitals who want to optimize MedRec processes.
How does re-classification of variants of unknown significance (VUS) impact the management of patients at risk for hereditary breast cancer?
Authors: Kwong Ava , Ho Cecilia Yuen Sze , Shin Vivian Yvonne , Au Chun Hang , Chan Tsun-Leung , Ma Edmond Shiu Kwan 
Published: May 2022

Abstract
Background
The popularity of multigene testing increases the probability of identifying variants of uncertain significance (VUS). While accurate variant interpretation enables clinicians to be better informed of the genetic risk of their patients, currently, there is a lack of consensus management guidelines for clinicians on VUS.

Methods
Among the BRCA1 and BRCA2 mutations screening in 3,544 subjects, 236 unique variants (BRCA1: 86; BRCA2: 150) identified in 459 patients were being reviewed. These variants consist of 231 VUS and 5 likely benign variants at the initial classification.

Results
The variants in 31.8% (146/459) patients were reclassified during the review, which involved 26 unique variants (11.0%). Also, 31 probands (6.8%) and their family members were offered high-risk surveillance and related management after these variants were reclassified to pathogenic or likely pathogenic. At the same time, 69 probands (15%) had their VUS downgraded to cancer risk equivalent to the general population level.

Conclusion
A review of archival variants from BRCA1 and BRCA2 genetic testing changed the management for 31.8% of the families due to increased or reduced risk. We encourage regular updates of variant databases, reference to normal population and collaboration between research laboratories on functional studies to define the clinical significances of VUS better.
Mechanisms of miR-3189-3p-mediated inhibition of c-MYC translation in triple negative breast cancer
Authors: Vittori Cecilia , Jeansonne Duane , Yousefi Hassan , Faia Celeste , Lin Zhen , Reiss Krzysztof , Peruzzi Francesca 
Published: May 2022

Abstract
Background
Triple negative breast cancer (TNBC) is an aggressive subtype of breast cancer characterized by the lack of estrogen receptor, progesterone receptor, and HER2. Our lab previously characterized miR-3189-3p as a microRNA with potent anti-cancer activity against glioblastoma. Here, we hypothesized a similar activity in TNBC cells. As miR-3189-3p is predicted to target a variety of RNA binding proteins, we further hypothesized an inhibitory effect of this miRNA on protein synthesis.

Methods
MDA-MB-231 and MDA-MB-468 cells were used to investigate the effect of miR-3189-3p on cell proliferation, migration, and invasion. TGCA database was used to analyze the expression of miR-3189-3p, c-MYC, 4EPB1, and eIF4E in breast cancer. Western blotting and RT-qPCR assays were used to assess the expression of selected proteins and RNAs after transfections.

Results
Although c-MYC is not a predicted gene target for miR-3189-3p, we discovered that c-MYC protein is downregulated in miRNA-treated TNBC cells. We found that the downregulation of c-MYC by miR-3189-3p occurs in both normal growth conditions and in the absence of serum. The mechanism involved the direct inhibition of eIF4EBP1 by miR-3189-3p. Additionally, we found that miR-3189-3p could negatively affect cap-independent translation mediated by internal ribosome entry sites (IRES) or by m6A. Finally, miR-3189-3p sensitized TNBC cells to doxorubicin.

Conclusion
Overall, results indicated that miR-3189-3p exerts its anti-tumor activity through targeting translational regulatory proteins leading to an impairment in c-MYC translation, and possibly other oncogenic factors, suggesting that miR-3189-3p, alone or in combination, could be a valuable therapeutic approach against a malignancy with few treatment options.
An analysis of how health systems integrated priority-setting in the pandemic planning in a sample of Latin America and the Caribbean countries
Authors: Vélez Claudia-Marcela , Aguilera Bernardo , Kapiriri Lydia , Essue Beverley M. , Nouvet Elysee , Sandman Lars , Williams Iestyn 
Published: May 2022

Abstract
Background
Latin America and the Caribbean (LAC) are among those regions most affected by the COVID-19 pandemic worldwide. The COVID-19 pandemic has strained health systems in the region. In this context of severe healthcare resource constraints, there is a need for systematic priority-setting to support decision-making which ensures the best use of resources while considering the needs of the most vulnerable groups. The aim of this paper was to provide a critical description and analysis of how health systems considered priority-setting in the COVID-19 response and preparedness plans of a sample of 14 LAC countries; and to identify the associated research gaps.

Methods
A documentary analysis of COVID-19 preparedness and response plans was performed in a sample of 14 countries in the LAC region. We assessed the degree to which the documented priority-setting processes adhered to established quality indicators of effective priority-setting included in the Kapiriri and Martin framework. We conducted a descriptive analysis of the degree to which the reports addressed the quality parameters for each individual country, as well as a cross-country comparison to explore whether parameters varied according to independent variables.

Results
While all plans were led and supported by the national governments, most included only a limited number of quality indicators for effective priority-setting. There was no systematic pattern between the number of quality indicators and the country’s health system and political contexts; however, the countries that had the least number of quality indicators tended to be economically disadvantaged.

Conclusion
This study adds to the literature by providing the first descriptive analysis of the inclusion of priority-setting during a pandemic, using the case of COVID-19 response and preparedness plans in the LAC region. The analysis found that despite the strong evidence of political will and stakeholder participation, none of the plans presented a clear priority-setting process, or used a formal priority-setting framework, to define interventions, populations, geographical regions, healthcare setting or resources prioritized. There is need for case studies that analyse how priority-setting actually occurred during the COVID-19 pandemic and the degree to which the implementation reflected the plans and the parameters of effective priority-setting, as well as the impact of the prioritization processes on population health, with a focus on the most vulnerable groups.
The involvement and autonomy of young children undergoing elective paediatric cardiac surgery: a qualitative study
Authors: Alderson Priscilla , Cohen Marc , Davies Ben , Elliott Martin J. , Johnson Mae , Lotteria Alessandra , Mendizabal Rosa , Stockton Emma , Stylianou Michael , Sutcliffe Katy , Wellesley Hugo 
Published: May 2022

Abstract
Background
Standards generally reported in the literature about informing children and respecting their consent or refusal before elective heart surgery may differ from actual practice. This research aims to summarize the main themes in the literature about paediatric anaesthesia and compare these with research findings on how health professionals counsel young children before elective heart surgery, respect their consent or refusal, and maintain patient-centred care.

Methods
This qualitative research involved: literature reviews about children’s consent to surgery and major interventions; observations of wards, clinics and medical meetings in two paediatric cardiology departments, October 2019 to February 2020; audio-recorded semi-structured interviews with 45 hospital staff, including 5 anaesthetists, and related experts, November 2019 to April 2021; interviews with 16 families, with children aged 6- to 15-years and their parents shortly after elective heart surgery, and some months later (reported in other papers); thematic data analysis; and research reports on how different professions contribute to children’s informed decisions for heart surgery.

Results
The medical, ethics and English legal literature tend to assume legal minors cannot refuse major recommended treatment, and cannot consent until they are 12 years or older. Little is said about informing pre-competent children. If children resist, some anaesthetists rely on sedation and distraction, and avoid much informed discussion, aiming to reduce peri-operative anxiety. However, interviewees reported informing young children, and respecting their consent or refusal before elective surgery. They may delay elective surgery and provide further information and support, aiming to reduce fear and promote trust. Six years of age was commonly cited as the threshold for respecting consent to heart transplantation.

Conclusion
Differing views about younger children’s competence, anxiety and best interests support different reactions to children’s consent and refusal before elective heart surgery. This paper reports the zero-restraint policy followed for over a decade in at least one leading surgery centre. The related law and literature need to be updated, to take more account of evidence of actual practice.
Rapid anticalcification treatment for glutaraldehyde-fixed autologous tissue in cardiovascular surgery
Authors: Kaneko Shotaro , Isoda Susumu , Aoyama Toru , Goda Motohiko , Yasuda Shota , Shibuya Taisuke , Matsumura Mai , Mitsui Hideaki , Okudela Koji , Suzuki Shinichi , Machida Daisuke , Masuda Munetaka 
Published: May 2022

Abstract
Background
Glutaraldehyde (GA)-fixed autologous tissues, including the pericardium, are widely used as patches and valve substitutes in cardiovascular surgery. However, GA treatment causes tissue calcification. No rapid anticalcification method has been established for use during surgery. Here, we aimed to establish a rapid anticalcification method using ethanol, as has already been demonstrated for bioprosthetic valves.

Methods
Thoracic aorta tissues were first fixed with GA for 3 min and then treated with ethanol for 0 (group 2), 10 (group 3), 20 (group 4), and 30 (group 5) min; untreated tissues (group 1) served as the control. The treated tissues were subdermally implanted into 3-week-old male Wistar rats and kept in place for 28 days. The calcification in each explant was semiquantitatively evaluated by annotating and measuring the area using virtual slides, and the data obtained were statistically analyzed.

Results
Semiquantitative analysis revealed that calcification of the implants from the untreated group (group 1; P = 0.0014) and groups 4 (P = 0.0014) and 5 (P = 0.0031) was significantly lower than that of implants from group 2. Moreover, implants from group 3 showed a tendency toward decreased calcification, although it was not significant (P = 0.0503).

Conclusions
A rapid ethanol treatment prevents calcification of GA-fixed tissues in a rat model of subdermal implantation. This method may facilitate effective and rapid anticalcification of autologous tissues for use during cardiovascular surgery.
Reporting quality of sham needles used as controls in acupuncture trials: a methodological evaluation
Authors: Lee Ye-Seul , Kim Song-Yi , Kim Mariah , Kim Minseo , Won Jiyoon , Lee Hyangsook , Lee Myeong Soo , Chae Younbyoung 
Published: May 2022

Abstract
Objective
The description of controls is important in acupuncture clinical trials to interpret its effectiveness without fallacy. This paper aims to evaluate the reporting quality of acupuncture studies on the characteristics of sham needles.

Study design and setting
Using a checklist developed from previously published reporting guidelines, the distribution of reported items and changes of reporting rates over time were investigated. Two-way ANOVA and linear regression were conducted.

Results
Original articles of RCTs of any design involving sham needles as controls were eligible for assessment. 117 trials from three 2-year time periods between 2009 and 2018 were included. Seven items out of 25 were reported in more than 50% of the studies. While significant differences of reporting scores among categories were observed, there were no significant differences among time periods; no significant improvement was observed over time.

Conclusions
Low reporting qualities of sham needles used in acupuncture studies may influence how researchers understand the effectiveness of acupuncture. This study evaluated previous publications from 2009 to 2018 and found that reporting qualities on sham needles did not improve over time. Further studies are required to validate the items used in this study to endorse better reporting of controls in acupuncture trials.
A novel extracorporeal cardiopulmonary resuscitation strategy using a hybrid emergency room for patients with pulseless electrical activity
Authors: Ijuin Shinichi , Inoue Akihiko , Ishihara Satoshi , Suga Masafumi , Nishimura Takeshi , Kikuta Shota , Nakayama Haruki , Igarashi Nobuaki , Matsuyama Shigenari , Doi Tomofumi , Nakayama Shinichi 
Published: May 2022

Abstract
Background
Whether extracorporeal cardiopulmonary resuscitation (ECPR) is indicated for patients with pulseless electrical activity (PEA) remains unclear. Pulmonary embolism with PEA is a good candidate for ECPR; however, PEA can sometimes include an aortic disease and intracranial haemorrhage, with extremely poor neurological outcomes, and can thus not be used as a suitable candidate. We began employing an ECPR strategy that utilised a hybrid emergency room (ER) to perform computed tomography (CT) before extracorporeal membrane oxygenation (ECMO) induction from January 2020. Therefore, the present study aimed to evaluate the effectiveness of this ECPR strategy.

Methods
Medical records of patients who transferred to our hybrid ER and required ECPR for PEA between January 2020 and November 2021 were reviewed.

Results
Twelve consecutive patients (median age, 67 [range, 57–73] years) with PEA requiring ECPR were identified in our hybrid ER. Among these patients, nine were diagnosed using an initial CT scan (intracranial haemorrhage (3); cardiac tamponade due to aortic dissection (3); aortic rupture (2); and cardiac rupture (1)), and unnecessary ECMO was avoided. The remaining three patients underwent ECPR, and two of them survived with favourable neurological outcomes. Patients not indicated for ECPR were excluded before ECMO induction.

Conclusion
Our ECPR strategy that involved the utilisation of a hybrid ER may be useful for the exclusion of patients with PEA not indicated for ECPR and decision making.
A new ichnotaxonomic name for burrows in vertebrate coprolites from the Miocene Chesapeake Group of Maryland, U.S.A
Authors: Godfrey Stephen J. , Collareta Alberto 
Published: May 2022

AbstractA new ichnotaxonomic name, Transexcrementum cuniculus, is applied to tubular (cylindrical) tunnelings in coprolites. The type series of T. cuniculus consists of burrowed vertebrate (probably crocodilian) coprolites that originate from the Miocene Chesapeake Group of Maryland, U.S.A. These complex trace fossils exhibit the following combination of characters: burrows not lined nor backfilled; opening and transverse sections sub-circular; diameter supra-millimetric, up to ca. 20 mm, rather constant throughout; inner termination(s) rounded/conical; tunnel morphology straight or gently curved, sometimes branching; internal sculpturing sometimes present in form of short and irregularly oriented scratches and gouges. Clusters of the same kinds of gouges may also mark the outer surface of the coprolite. The tunneling tracemaker likely engaged in coprophagy; however, it is unclear what kind of organisms could have produced these burrows. Judging from the overall rarity of Transexcrementum cuniculus occurrences in the fossil record, the tracemaker responsible for the burrows might also have been rare, or fed on faeces only occasionally.ZooBank LSID: urn:lsid:zoobank.org:pub:DE755233-4F0E-48D1-A667-7AAD96B56B60
Current knowledge on epidemiology and evolution of novel porcine circovirus 4
Authors: Wang Dongliang , Mai Jinhui , Yang Yi , Xiao Chao-Ting , Wang Naidong 
Published: May 2022

AbstractPorcine circovirus type 4 (PCV4) is a newly emerging virus, with both PCV4 genomic DNA and specific antibodies detected in swine herds in several provinces in China and South Korea. Although the virus was first identified in 2019 in Hunan, China, retrospective research suggests that serum samples collected as early as 2008 were positive for PCV4 antibody. Infections with only PCV4 or co-infections with other pathogens have been associated with several clinical manifestations, but its pathogenesis remains to be determined. The purpose of this review was the following: (1) to characterize PCV4 epidemiology by assessing evolutionary dynamics and genetic diversity of PCV4 strains circulating in swine herds; (2) to reconstruct a computerized 3D model to analyze PCV4 Cap properties; (3) and to summarize the current evidence of PCV4-associated clinical-pathological manifestations. The origin of PCV4 is apparently distinct from other PCV, based on analysis of phylogenetic trees. Of note, PCV4 shares an ancient common ancestor with mink circoviruses. Furthermore, the amino acid residue at position 27 of the PCV4 Cap is a key benchmark to distinguish PCV4a (27S) from PCV4b (27 N), based on PCV4 strains currently available, and variation of this residue may alter Cap antigenicity. In addition, the capsid surface of PCV4 has characteristics of increased polar residues, compared to PCV2, which raises the possibility that PCV4 may target negatively charged host receptors to promote virus infection. Further studies are required, including virus isolation and culture, and more detailed characterization of molecular epidemiology and genetic diversity of PCV4 in swine herds.
A case study addressing trauma needs during COVID-19 remote learning from an ecological systems theory framework
Authors: Mahmud Sharmeen 
Published: May 2022

AbstractMental health conditions related to trauma among American children are a concern, particularly because of the impacts of the COVID-19 pandemic. Children, as students, carry the trauma they encounter with them into the classroom. Students impacted by trauma learn differently due to effects on the brain that relate to several impairments, causing them to perform poorly in school. However, teachers may not always understand this issue. This case study shows how certain dynamics within the EST layers impacted one school during the pandemic. The purpose of this study was to examine how teachers at the school experienced a trauma-informed online PD and SEL program intended to improve student outcomes, teacher perceptions, and teacher–student relationships. The six participants included teachers in a K-8 low-income, minority population charter school. The assessment tools used were the Teacher–Student Relationship Scale, Teacher Perception Scale, and Student Outcomes Survey. The teachers’ outlook on SEL improved, particularly online. This improvement helped the teachers implement community circles and SEL infused with mindfulness in their online classrooms, which may have helped them maintain their relationships with the students and may have helped the students with academic and stress outcomes. During unprecedented times, the maintenance, rather than the deterioration, of student outcomes and teacher–student relationships is an accomplishment and an area that necessitates further research.
High room temperature mobility in Al2O3/SrTiO3 heterostructures
Authors: Gao K. H. , Ma X. R. , Li Q. L. , Zhang X. H. , Xu J. P. , Sun Y. , Yu G. 
Published: May 2022

Abstract
Al2O3/SrTiO3 heterostructures have attracted wide attention because of high electron mobility at cryogenic temperatures. But very low room temperature mobility (typically less than 12 cm2V−1s−1) limits its potential application. Here, the Al2O3/SrTiO3 heterostructures are successfully prepared by the low-cost magnetron sputtering. We observed that room temperature mobility is gradually enhanced on increasing electron concentration, and a maximum of 41.1 cm2V−1s−1 is obtained. This can be attributed to the high electron concentration due to the longitudinal optical phonon scattering. Our findings not only offer a route to improve room temperature mobility of the SrTiO3-based heterostructures but also provide a new experimental method for fabricating Al2O3/SrTiO3 heterostructures.