bluuebunny/crossref_metadata_2025_split huggingface dataset:
Presence of “One Pill Can Kill” Medications in Medication Organizers: Implications for Child Safety
Authors: Farrell Natalija M. , Hamilton Sebastian , Gendron Bryan J. , Corio Jessica L. , Lookabill Sara K. 
Published: May 2021

Background: Medication organizers increased compliance, but they do not contain child protective packaging. Medications organizers have been involved in some pediatric exposures; however, previous reports do not describe if “one pill can kill” (1PCK) medications were involved in the exposures. 1PCK medications may cause toxicity even with a single tablet. Objective: The purpose of this study is to describe the type and presence of 1PCK medications dispensed in medication organizers at a single center. Methods: Adult patients who received blister packed medications from September 1, 2017 to September 30, 2017 were included in this retrospective review. Medications were excluded if dispensed traditionally during this time. The primary outcome described included 1PCK medications (quantity and type). Secondary outcomes included total number of tablets dispensed, delayed- (DR) and extended-release (ER) formulations, average age of those dispensed 1PCK medications versus those without. Results: A total of 450 patients received 486 blister packs and 75.5% of which found to include 1PCK medications. Most commonly included 1PCK medications were beta-blockers and calcium channel blockers (42.4 and 49.4%, respectively). Patients receiving 1PCK medications were older (69.1 ± 12.6 vs 62.6 ± 16.7 years old, p < 0.0001) and included more medications (8.5 ± 2.9 vs 5.7 ± 2.9 medications, p < 0.0001). DR and ER formulations were in 150 packs. Conclusion: The majority of dispensed medication organizers included 1PCK medications. Upon dispensing, patients should be questioned for possible proximity exposures. Additionally, they should receive education on medication safety for children that may be in proximity of the medications during home, work, or social activities.
Introduction: Configuring the Green New Deal
Authors: Sturman Anna , Heenan Natasha 
Published: May 2021

We introduce a themed collection of articles on approaches to configuring a Green New Deal as a response to the current capitalist crisis marked by ecological breakdown, economic stagnation and growing inequality. The Green New Deal is a contested political project, with pro-market, right-wing nationalist, Keynesian, democratic socialist and ecosocialist variants. Critiques of the Green New Deal include pragmatic queries as the feasibility of implementation, and theoretical challenges from the right regarding reliance on state forms and from the left regarding efforts to ameliorate capitalism. They also include concerns about technocratic bias and complaints about lack of meaningful consultation with Indigenous peoples on proposals for large-scale shifts in land use. Debates over the ideological orientation, political strategy and implementation of the Green New Deal must now account for the economic and employment impacts of COVID. JEL Codes: Q43, Q54, Q56, Q58
Healthcare Provider Perspectives Regarding Use of Medical Interpreters During End-of-Life Conversations With Limited English Proficient Patients
Authors: Silva Milagros D. , Adelman Ronald D. , Singh Vishwas , Gupta Renuka , Moxley Jerad , Sobota Rosanna M. , Tsai Stephanie , Abel Brittany T. , Reid M. Carrington 
Published: May 2021

Background: Healthcare providers increasingly care for patients with Limited English Proficiency (LEP). There is limited research evaluating healthcare provider utilization practices, attitudes, perceived benefits and barriers regarding the use of medical interpreters in end of life (EOL) and goals of care (GOC) conversations. Objectives: To elicit healthcare providers’ opinions of the role, factors that impact decisions to use medical interpreters and perceived utility of using medical interpreters when conducting EOL and GOC conversations with LEP patients and their families. Design: Cross-sectional survey of internal medicine trainees and attending physicians from a U.S. medical center. Results: A total of 117 surveys were collected with a response rate of 51%. In-person medical interpreters received higher ratings with regard to their helpfulness compared to telephone medical interpreters during EOL and GOC conversations. Being an attending physician and having received training in the use of a medical interpreter predicted higher composite scores reflecting greater awareness of the roles of medical interpreters and endorsement of best communication practices. In-person interpreters were viewed by a subset of participants as “standard of care” during EOL and GOC conversations. Conclusion: Having more years in practice and receiving training in the use of medical interpreters correlated with more favorable attitudes toward the role of medical interpreters and positive communication practices. Incorporating early training in the use of medical interpreters could help enhance communication practices and outcomes during EOL and GOC conversations with LEP patients.
Fluctuating Code Status: Strategies to Minimize End-of-Life Conflict in the Neurocritical Care Setting
Authors: Rath Kelly A. , Tucker Kristi L. , Lewis Ariane 
Published: May 2021

Background: There are multiple factors that may cause end-of-life conflict in the critical care setting. These include severe illness, family distress, lack of awareness about a patient’s wishes, prognostic uncertainty, and the participation of multiple providers in goals-of-care discussions. Methods: Case report and discussion of the associated ethical issues. Results: We present a case of a patient with a pontine stroke, in which the family struggled with decision-making about goals-of-care, leading to fluctuation in code status from Full Code to Do Not Resuscitate-Comfort Care, then back to Full Code, and finally to Do Not Resuscitate-Do Not Intubate. We discuss factors that contributed to this situation and methods to avoid conflict. Additionally, we review the effects of discord at the end-of-life on patients, families, and the healthcare team. Conclusion: It is imperative that healthcare teams proactively collaborate with families to minimize end-of-life conflict by emphasizing decision-making that prioritizes the best interest and autonomy of the patient.
A rare presentation of panitumumab-involved interstitial lung disease: Spontaneous pneumomediastinum
Authors: Yakar Nuri , Ergun Bisar , Ugur Levent , Ates Umit Can , Gezer Sinem , Comert Bilgin 
Published: May 2021

Introduction Developments in targeted molecular therapies have considerably improved patient survival in cancer. Panitumumab is a monoclonal antibody against the epidermal growth factor receptor (EGFR). It is used to treat metastatic colorectal carcinoma. Although panitumumab is well tolerated in most patients, pulmonary toxicity, especially interstitial lung disease (ILD), is a life-threatening condition. The presentation of panitumumab-induced ILD with spontaneous pneumomediastinum and subcutaneous emphysema is rarely reported. Case report We describe a 61-year-old male with metastatic colorectal carcinoma treated with FOLFIRI (folinic acid, 5-fluorouracil, irinotecan) and panitumumab. He presented to our hospital with a complaint of severe dyspnea. On the evaluation of dyspnea, the patient was diagnosed with ILD. Management and outcome After exclusion of other common causes of pneumomediastinum and subcutaneous emphysema, panitumumab was attributed as a cause of ILD. Oxygen therapy via high flow nasal cannula and intravenous methylprednisolone regimen was started. After two weeks, the patient became asymptomatic with the radiologic amelioration. Discussion Panitumumab-induced ILD is associated with a poor prognosis and might occur randomly in one year after the drug administration. The possibility of the disease should be considered on every admission. Early recognition, discontinuation of causative medication, and immediate glucocorticoid therapy are essential to reduce mortality.
Long-term outcomes of anterior chest wall arteriovenous graft with polyurethane
Authors: Shimasaki Megumi , Rachi Hiromu , Shiratori Kimitoshi , Takanohashi Seiko , Uyama Satoko , Yamada Kei , Totsuka Yuichi , Takanohasi Akira , Shirota Kazuaki , Nakamura Hajime , Togawa Akashi 
Published: May 2021

Background: Anterior chest wall arteriovenous graft (ACWAVG) is one option for haemodialysis patients when vessels of the upper extremities become exhausted. We report here the long-term outcomes of ACWAVG with polyurethane. Methods: From April 2005 to October 2015, nine ACWAVGs with polyurethane grafts were created. We observed patients until April 2019 and evaluated graft patency, interval from operation to first cannulation, and numbers of interventions and complications. Results: Primary patency rate and secondary patency rate of 6, 12 and 24 months were 55.3%, 33.3%, 33.3% and 77.8%, 55.6%, 55.6% respectively. Mean interval from operation to first cannulation was 3 days. Infection rate and kinking formation rate were slightly higher than previous reports of ACWAVGs with expanded polytetrafluoroethylene (ePTFE). However, one patient was able to keep using a single graft for 166 months with multiple interventions. Conclusions: Slight disadvantage are seen with patency rate and complication rate in polyurethane ACWAVG compare to ePTFE. However, when early cannulation is required, polyurethane is worth to consider for creating ACWAVG.
The effects of emotional context and exposure frequency on L2 contextual word learning
Authors: Hao Sijia , Liang Lijuan , Wang Jue , Liu Huanhuan , Chen Baoguo 
Published: May 2021

Objectives: An experiment was conducted to explore how emotional valence of contexts and exposure frequency of novel words affect second language (L2) contextual word learning. Methodology: Chinese native speakers who learned English in a formal classroom setting were asked to read English paragraphs with different emotional valence (positive, negative or neutral) across five different days. These paragraphs were embedded with pseudowords. During this learning process, form recognition test and meaning recall test were carried out for these pseudowords. Data and analysis: Data were analyzed using mixed-model ANOVA. Accuracy for each task was compared among the three kinds of emotional contexts. Findings/Conclusions: In the form recognition test, the accuracy in the negative context was higher than in the positive and neutral contexts, and the pseudowords were acquired much earlier. In the meaning recall test, the accuracy in the positive and negative contexts was higher than that in the neutral context. Accuracy increased gradually with the increase of exposure frequency of the pseudowords. More importantly, we found that less exposure times were needed for emotional context relative to neutral context in contextual word learning. Originality: This may be the first study to explore the influence of emotional valence and exposure frequency on L2 contextual word learning. Significance/Implications: This study underlined the importance of emotional information in L2 contextual word learning and contributed to the understanding of how emotional information and exposure frequency functions in this learning process.
The Impacts of Working With Victims of Sexual Violence: A Rapid Evidence Assessment
Authors: Crivatu Ioana M. , Horvath Miranda A. H. , Massey Kristina 
Published: May 2021

Aim: Supporting clients who have experienced trauma can lead to trauma symptoms in those working with them; workers in the sexual violence field are at heightened risks of these. This article collated and critically appraised papers, published from 2017 onward, in the area of people assisting victims of sexual violence. It explores the impacts and effects the work has on them, their coping and self-care mechanisms, and organizational support offered to them. Design: A question-based rapid evidence assessment with a triangulated weight of evidence approach was used. Academic and nonacademic databases were searched. Twenty-five papers were included for analysis based on the inclusion/exclusion criteria. Results: Most studies were of medium to high methodological quality. Negative impacts included trauma symptoms, disrupted social relationships, behavioral changes, and emotional and psychological distress. Ability to manage negative impacts was influenced by overall organizational support, availability of training, supervision and guidance, workloads and caseload characteristics, individual characteristics, and their coping and self-care mechanisms. Positive impacts included empowering feelings, improved relationships, compassion satisfaction, and posttraumatic growth. Conclusions: Impacts are significant. Support at work and in personal life increases staff’s ability to cope and find meaning in their role. Implications for research and practice are discussed.
Transition practice before entering primary school: A longitudinal study of children with and without special needs across a year
Authors: Lim Sok M , Nyoman Leanna , Tan Ying J , Yin Yun Y 
Published: May 2021

Introduction The transition to primary school is a significant milestone for children. Transition periods can offer new opportunities to build skills, relationships, and experiences that strengthen self-efficacy. In Singapore, parents play an important role in supporting transition as preschools and primary schools operate independently. Occupational therapists are involved in supporting children with special needs in transitions. Objective Focusing on the transition period of getting children ready for primary school, the objectives are (i) to learn about the strategies that parents used for the purpose of transition and understand the intentions behind what they do and (ii) to compare the transition practices and perceived school readiness between parents of children with and without special needs. Method A longitudinal study involving 48 parents was conducted over 12 months. Parents completed a survey at the start and end of the year to detect changes from baseline, and semi-structured interviews every two months to gather their subjective experiences and track their child’s readiness for transition. The surveys and interviews were conducted on a mobile instant messaging platform. Coding of responses was guided by school readiness domains identified in earlier studies and Occupational Therapy Practice Framework’s approaches to intervention. Results Most parents focused on establishing and maintaining new self-help and academic skills across the year while few were “modifying” or “preventing”. Increasing trends in child readiness were noted for both children with and without special needs. Conclusion In family-centred practice, it is important to recognise parents’ expertise and resources.
Direct mechanical thrombectomy without intravenous thrombolysis versus bridging therapy for acute ischemic stroke: A meta-analysis of randomized controlled trials
Authors: Podlasek Anna , Dhillon Permesh Singh , Butt Waleed , Grunwald Iris Q , England Timothy J 
Published: May 2021

Background Direct mechanical thrombectomy may result in similar outcomes compared to a bridging approach with intravenous thrombolysis (IVT + MT) in acute ischemic stroke. Recent randomized controlled trials have varied in their design and noninferiority margin. Aim We sought to meta-analyze accumulated trial data to assess the difference and non-inferiority in clinical and procedural outcomes between direct mechanical thrombectomy and bridging therapy. Summary of review We conducted a systematic review of electronic databases following the preferred reporting items for systematic reviews and meta-analyses guidelines. Random effects meta-analyses were conducted for the pooled data. The primary outcome was good functional outcome at 90 days (modified Rankin scale (mRS) ≤ 2). Secondary outcomes included excellent functional outcome (mRS ≤ 1), mortality, any intracranial hemorrhage, symptomatic intracranial hemorrhage, successful reperfusion (thrombolysis in cerebral infarction ≥ 2 b), and procedure-related complications. Four randomized controlled trials comprising 1633 patients (817 direct mechanical thrombectomy, 816 bridging therapy) were included. There were no statistical differences for the 90-day good functional outcome (OR = 1.02, 95% CI 0.84–1.25, p = 0.54, I2 = 0%), and the absolute risk difference was 1% (95% CI: −4% to 5%). The lower 95% CI falls within the strictest noninferiority margin of −10% among included randomized control trials. Direct mechanical thrombectomy reduced the odds of successful reperfusion (OR = 0.76, 95% CI: 0.60–0.97, p = 0.03, I2 = 0%) and any intracranial hemorrhage (OR = 0.65, 95% CI: 0.49–0.86, p = 0.003, I2 = 38%). There was no difference in the remaining secondary outcomes. The risk of bias for all studies was low. Conclusion The combined trial data assessing direct mechanical thrombectomy versus bridging therapy showed no difference in improving good functional outcome. The wide noninferiority thresholds set by individual trials are in contrast with the clinical consensus on minimally important differences. However, our pooled analysis indicates noninferiority of direct mechanical thrombectomy with a 4% margin of confidence. The application of these findings is limited to patients presenting directly to mechanical thrombectomy-capable centers and real-world workflow times may differ against those achieved in a trial setting.
Identification of the Ingredients and Mechanisms of Curcumae Radix for Depression Based on Network Pharmacology and Molecular Docking
Authors: Wang Xiaotong , Lin Qiaoru , Shen Meiqing , Lin Haixiong , Feng Junjie , Peng Lulu , Huang Minling , Zhan Xiaoxuan , Chen Ziyin , Ma Tengfei 
Published: May 2021

Background Curcumae Radix (CR), derived from the dry roots of Curcuma longa L., family Zingiberaceae, is widely used to treat depression. However, the ingredients and mechanisms of CR are still unclear. The purpose of this study was to solve this problem using network pharmacology and molecular docking. Methods The active ingredients of CR were screened through TCMSP, and the depression-related genes were obtained through the Genetic Association, GeneCards, and OMIM databases. Then, DisGeNET score was performed to evaluate the correlation between co-genes and depression. Topological analysis was conducted to screen hub genes and proteins, molecular docking was performed to evaluate the binding ability of the hub protein with active ingredients, and gene ontology (Go) function analysis, gene tissue localization, and KEGG pathway analysis were conducted to explore the function and location of genes, as well as the mechanism of CR for treating depression. Results Eight ingredients of CR were screened based on pharmacokinetic properties, five of which are closely related to depression, including (E)−5-hydroxy-7-(4-hydroxyphenyl)−1-phenyl-1-heptene, (E)−1,7-diphenyl-3-hydroxy-1-hepten-5-one, oxycurcumenol, β-sitosterol, and sitosterol. They interacted with 45 co-genes and co-proteins with a DisGeNET score ≥0.3. AR, NOS2, PTGS2, and TYK2 were pivot genes. EGFR, PTGS2, HSP90AA1, MAPK8, and ESR1 were hub proteins. PTGS2 was found to have good binding potential with oxycurcumenol, (E)−1,7-diphenyl-3-hydroxy-1-hepten-5-one and (E)−5-hydroxy-7-(4-hydroxyphenyl)−1-phenyl-1-heptene. Go functional analysis indicated that co-genes involved complex biological processes, cellular components and molecular functions. PER2, P2RX7, GRM1, TACR1, MAPK8, HCRTR1, EGFR, and TYK2 were highly expressed in the prefrontal cortex. The potential pathways for CR to exert antidepressant effects were calcium, estrogen, PI3K-Akt and ErbB signaling pathways. Conclusions This study revealed the ingredients, effective targets and mechanisms of CR in the treatment of depression, which provides a new perspective for the development of new antidepressants.
Intensive Care Unit Built Environments: A Comprehensive Literature Review (2005–2020)
Authors: Verderber Stephen , Gray Seth , Suresh-Kumar Shivathmikha , Kercz Damian , Parshuram Christopher 
Published: May 2021

Background: The intensive care environment in hospitals has been the subject of significant empirical and qualitative research in the 2005–2020 period. Particular attention has been devoted to the role of infection control, family engagement, staff performance, and the built environment ramifications of the recent COVID-19 global pandemic. A comprehensive review of this literature is reported summarizing recent advancements in this rapidly expanding body of knowledge. Purpose and Aim: This comprehensive review conceptually structures the recent medical intensive care literature to provide conceptual clarity and identify current priorities and future evidence-based research and design priorities. Method and Result: Each source reviewed was classified as one of the five types—opinion pieces/essays, cross-sectional empirical investigations, nonrandomized comparative investigations, randomized studies, and policy review essays—and into nine content categories: nature engagement and outdoor views; family accommodations; intensive care unit (ICU), neonatal ICU, and pediatric ICU spatial configuration and amenity; noise considerations; artificial and natural lighting; patient safety and infection control; portable critical care field hospitals and disaster mitigation facilities including COVID-19; ecological sustainability; and recent planning and design trends and prognostications. Conclusions: Among the findings embodied in the 135 literature sources reviewed, single-bed ICU rooms have increasingly become the norm; family engagement in the ICU experience has increased; acknowledgment of the therapeutic role of staff amenities; exposure to nature, view, and natural daylight has increased; the importance of ecological sustainability; and pandemic concerns have increased significantly in the wake of the coronavirus pandemic. Discussion of the results of this comprehensive review includes topics noticeably overlooked or underinvestigated in the 2005–2020 period and priorities for future research.
Overweight/Obesity and Associated Factors Among Second Cycle Primary School Children in Kirkos Sub-City, Addis Ababa, Ethiopia
Authors: Fitsum Kidus , Egata Gudina , Demena Melake , Gebremichael Berhe 
Published: May 2021

Background Although overweight/obesity is becoming a public health issue in low income countries, there is a paucity of evidence concerning overweight/obesity in Ethiopia. The aim of the study was to assess the magnitude of overweight/obesity and associated factors among second cycle primary school children in Kirkos Sub-City, Addis Ababa, Ethiopia. Methods A school based cross-sectional study was conducted among 482 children from May to June, 2019. Data were collected using a questionnaire and checklist. Data were entered using EpiData version 3.1 and exported into SPSS version 22.0. Bivariable and multivariable logistic regression analyses were done to identify factors associated with overweight/obesity. Level of statistical significance was declared at p ≤ 0.05. Results The overall magnitude of overweight/obesity was 21.2%. The magnitude of overweight was 13.7% while obesity was 7.5%. Vehicle availability, being from private school, not having friend(s), preferring sweet foods, eating breakfast irregularly, watching movies/Television while eating and physical inactivity were the factors significantly associated with overweight/obesity among second cycle primary school children. Conclusions The magnitude of overweight/obesity was high in the study area. Therefore, health and education sectors should promote healthy lifestyle to curb child overweight/obesity.