bluuebunny/crossref_metadata_2025_split huggingface dataset:
Safety of Intermittent Parenteral Midazolam Injection in Hospitalized Patients Admitted to Non-Intensive Care Nursing Units: A Retrospective Matched-Cohort Study
Authors: Mills Melanie , Torr Haley , Centanni Nicolette , Riker Richard R. , Gagnon David , Gale Ashley 
Published: December 2024

Background: The prescribing information for parenteral midazolam contains a Boxed Warning stating its use may precipitate respiratory arrest, and its safety in non-intensive care unit (ICU) nursing units has been understudied. Objective: To characterize the safety of intermittent midazolam injections in patients admitted to non-ICU nursing units relative to lorazepam injections. Methods: This single-center, retrospective, matched-cohort study included patients ≥18 years of age who received intermittent midazolam in non-ICU nursing units. Midazolam administrations were matched 1:1 to lorazepam administrations. Safety outcomes included hypotension, bradycardia, bradypnea, and escalation in level of nursing unit care or oxygen requirement. Results: A total of 94 midazolam administrations were matched to lorazepam administrations. Demographic data were similar between groups. Midazolam was more commonly given intravenously (95.7% vs 85.1%, P = 0.02) and in an intermediate care nursing unit (31.9% vs 14.9%, P = 0.009). The lorazepam cohort had significantly fewer concomitant respiratory depressants administered, and there were no differences in the use of beta-blockers or antihypertensives. There were no differences in the incidence of hypotension (1.1% vs 2.1%, P = 1), bradycardia (5.3% vs 2.1%, P = 0.44), bradypnea (1.1% vs 0%, P = 1), escalation in level of care (2.1% vs 2.1%, P = 1), or escalation in oxygen requirement (5.3% vs 3.2%, P = 0.72). Conclusion and Relevance: The administration of parenteral midazolam in non-ICU nursing units resulted in a similar incidence of hypotension, bradycardia, bradypnea, escalation in oxygen requirement, and escalation in level of care compared with lorazepam. These results suggest that midazolam may have a similar safety profile to lorazepam, supporting its use in non-ICU nursing units.
Maternal RSVpreF Vaccine: A Novel Agent for Respiratory Syncytial Virus Prevention in Infants
Authors: Fly J. Hunter , Stultz Jeremy S. , Eiland Lea S. 
Published: December 2024

Objective: The objective was to summarize available data regarding the safety and efficacy of RSVpreF in the setting of maternal administration for infant protection against respiratory syncytial virus (RSV) while comparing RSVpreF to other RSV prevention strategies. Data sources: A literature search of PubMed was conducted utilizing the phrases “RSVpreF” and “pregnancy.” Additional references were identified through found sources of information. Organizational guidelines, medication labeling, and regulatory organization presentations were utilized. Study selection and data extraction: Clinical trials investigating RSVpreF administration to pregnant women were included as well as other references on pharmacology, pharmacokinetics, and vaccine uptake. Data synthesis: RSVpreF vaccine, administered once to pregnant women, demonstrated a 69.4% (97.58% confidence interval [CI] = 44.3 to 84.1) lower incidence of severe medically attended RSV lower respiratory tract infection (MA RSV-LRTI) and 51.3% (97.58% CI = 29.4 to 66.8) lower incidence of MA-RSV-LRTI at 180 days post birth in 1 placebo-controlled study. The RSVpreF vaccine administered at 24 to 36 weeks did not have a statistically significant higher rate of preterm births (relative risk = 1.20; 95% CI = 0.99 to 1.46) across two studies and in postmarketing data. Relevance to patient care and clinical practice in comparison with existing agents: The RSVpreF vaccine is the first maternal vaccine approved by the US Food and Drug administration for prevention of RSV in all infants. When compared with other agents, the optimal prophylaxis agent is unclear. Conclusions: Maternal immunization with RSVpreF demonstrated a reduction in MA RSV-LRTI, severe MA RSV-LRTI, and RSV-associated hospitalizations for infants. The vaccine is well tolerated, and adverse events continue to be evaluated.
Recommendations for essential medicines for multiple sclerosis in low-resource settings
Authors: Saylor Deanna , Rijke Nick , McDonell Jennifer , Laurson-Doube Joanna , Avasarala Jagannadha , Baldin Elisa , Banerjee Tapas K , Bogdanovic Ivana , Bove Riley , Chawla DK , Costello Kathleen , Del Giovane Cinzia , Abkari Najoua El , Filippini Graziella , Foschi Matteo , Gonzalez-Lorenzo Marien , Helme Anne , Jacobs Dina , Kalincik Tomas , Mantel-Teeuwisse Aukje , Minozzi Silvia , Navas Carlos , Nonino Francesco , Ojo Oluwadamilola O , Ozcan Bianca , Pasi Elisabetta , Peryer Guy , Prato Chichiraldi Andrea , Ridley Ben , Sokhi Dilraj S , Traboulsee Anthony , Tramacere Irene , Tye Janis SN , Vecchi Simona , Viswanathan Shanthi , Xie Feng , Zeineddine Maya , Schunemann Holger , Piggott Thomas 
Published: December 2024

Background: Multiple sclerosis (MS) is a demyelinating disease of the central nervous system that, when untreated, can lead to significant disability in young adults. Despite the increase in the number of disease-modifying therapies (DMTs), many people living with MS in low-resource settings do not have access to treatment. Objective: The primary aim was to develop recommendations on the minimum essential DMTs for MS that should be available in low-resource settings. Methods: The Multiple Sclerosis International Federation established an independent, international panel including healthcare professionals and people with MS. This panel, in collaboration with the Cochrane MS Group and McMaster GRADE Centre, reviewed evidence for use of MS DMTs following standardized GRADE protocols including consideration of balance of benefits and harms; certainty of evidence; resources required and cost-effectiveness and values, equity, feasibility and availability in low-resource settings. Results: For active and/or worsening forms of relapsing MS, the panel recommends use of ocrelizumab, cladribine, fingolimod, dimethyl fumarate, interferon beta and glatiramer acetate. For active and/or worsening forms of progressive MS, the panel recommends use of rituximab, ocrelizumab, glatiramer acetate, fingolimod and interferon beta. Conclusions: Recommendations for the minimum essential DMTs for MS in low-resource settings were developed based on robust consideration of evidence and relevant context.
Milling Characteristics and Damage Assessment of Ultrasonic Vibration-Assisted End Milling Cf/SiC Composites
Authors: Wang Zhongwang , Dong Zhigang , Bao Yan , Ran Yichuan , Kang Renke 
Published: December 2024

AbstractCf/SiC composites are characterized as anisotropic, heterogeneous, brittle, and hard materials. The process of manufacturing Cf/SiC composites using traditional machining techniques is prone to edge chipping damage and tool wear, which makes it difficult to meet the machining quality and machining accuracy. The purpose of this paper is to investigate the milling characteristics and damage assessment during ultrasonic vibration-assisted end milling (UVAEM) of Cf/SiC composites. Firstly, UVAEM experiments on Cf/SiC composites were carried out at different ultrasonic amplitudes and comparative experiments with conventional milling (CM). In addition, tool wear, surface roughness, surface micromorphology, milling force and subsurface damage (SSD) were measured and analysed. Finally, the SSD factors of Cf/SiC composites were established to quantify machining damage, and analyzed the effect of ultrasonic amplitude on SSD. Furthermore, the formation mechanism of SSD was investigated and discussed. The findings indicate that appropriate ultrasonic amplitude improves the surface quality by UVAEM, while excessive amplitude deteriorates the surface quality. During the UVAEM, micro/macro brittle fracture of the fibers on the surface occurs, leading to machining defects such as fiber breakage, fiber-interface debonding and pits. The milling force gradually decreases with the increase of ultrasonic amplitude. On the other hand, the forms of SSD in CM and UVAEM are mainly fiber pullout, subsurface crack, crack extension and machining pits. Matrix cracking and fiber pullout in SSD were affected by fiber orientation. Moreover, the introduction of ultrasonic vibration plays a significant contribution in the inhibition of the SSD in Cf/SiC composites.
Telemedicine for HIV care: a cross-sectional survey of people living with HIV receiving care at two federally qualified health centers in Los Angeles during a mature phase of the COVID-19 pandemic
Authors: Walker Daisy , Moucheraud Corrina , Butler Derrick , Takayama Christian , Shoptaw Steven , Currier Judith S. , Gladstein Jay , Hoffman Risa 
Published: December 2024

Abstract
Background
The COVID-19 pandemic resulted in the rapid implementation of telemedicine for HIV care at federally qualified health centers (FQHCs) in the United States. We sought to understand use of telemedicine (telephone and video) at two FQHCs in Los Angeles, and the client attitudes towards and experiences with telemedicine as part of future HIV care.

Methods
We conducted surveys with 271 people living with HIV (PLHIV), with questions covering sociodemographic factors, telemedicine attitudes and experiences, technological literacy, and access to technological resources and privacy. Survey data were analyzed utilizing summary statistics, chi-square analyses, and Fisher’s exact test to understand associations between sociodemographic factors and telemedicine attitudes and experiences.

Results
Sixty percent of the sample had used any telemedicine and, of these, 93% utilized only telephone visits. Almost all respondents (95%, n = 257) had access to a functioning smartphone and self-rated their technological literacy as high. Most had consistent access to privacy (88%, n = 239), and those without privacy noted this as a barrier to the use of telemedicine. The main benefits of telemedicine (compared to in person) were savings of time and money, convenience, and ability to complete appointments as scheduled. Just over half of PLHIV said they would feel more comfortable discussing sensitive topics (e.g., substance use, relationship issues) in person than over telephone (60%, n = 164) or video (55%, n = 151). Despite limited experience with video telemedicine, half of all participants desired a mix of telephone and video visits as part of their future HIV care.

Conclusions
During a mature phase of the COVID-19 pandemic, PLHIV in our study showed high satisfaction with telemedicine, largely conducted as telephone visits, and high interest in telemedicine visits as a component of their future HIV care. Future studies should explore barriers to implementing video telemedicine in FQHCs and determine telemedicine’s impact on clinical outcomes, including engagement and viral suppression.
Treatment and counselling preferences of postpartum women with and without symptoms of (childbirth-related) PTSD: findings of the cross-sectional study INVITE
Authors: Horstmann Rosa Hannele , Seefeld Lara , Schellong Julia , Garthus-Niegel Susan 
Published: December 2024

Abstract
Background
Post-traumatic stress disorder (PTSD) in the postpartum period is a prevalent yet under-researched mental health condition. To date, many women who suffer from postpartum PTSD remain unrecognized and untreated. To enhance the accessibility of help for these women, it is crucial to offer tailored treatment and counselling services that align with their needs. This study aimed to understand how support preferences differ between women with and without postpartum PTSD, considering the two subgroups of postpartum PTSD: childbirth-related PTSD (CB-PTSD) and general PTSD (gPTSD).

Methods
This study used data from the cross-sectional INVITE study, comprising telephone interviews with N = 3,874 women conducted six weeks to six months after childbirth. The City Birth Trauma Scale (City BiTS) was used to assess CB-PTSD, while the Primary Care Posttraumatic Stress Disorder Screen for DSM-5 (PC-PTSD-5) was used to assess gPTSD. Service preferences and preferred modes of service provision were measured with self-developed questionnaires. Analyses of variance were used to identify differences between groups.

Results
The support services (family-)midwives and family, friends, or colleagues and the service provision mode as in person communication were preferred most by women across groups. The analyses revealed that women with CB-PTSD had lower overall preferences for services compared to women without postpartum PTSD. Women with CB-PTSD also showed less preference for psychotherapeutic services (e.g. outpatient treatment, inpatient clinics) compared to women without postpartum PTSD. Regarding modes of service provision, women with gPTSD had a higher preference for all service modes compared to women with CB-PTSD and those without postpartum PTSD, with a stronger preference for both direct (e.g. in person, video conference) and delayed communication (e.g. chat, e-mail).

Conclusion
This study was the first to explore the support preferences of women experiencing symptoms of postpartum PTSD. Findings suggest that women differ in their preferences, contingent upon the subgroup of postpartum PTSD. According to women's overall preferences, the expansion and further training of (family-)midwife services is recommended. By tailoring support services accordingly to women’s preferences, it may be possible to bridge the treatment gap for postpartum PTSD and to improve the well-being of affected women and their families.
Assessment of the efficacy of palliative sedation in advanced cancer patients by evaluating discomfort levels: a prospective, international, multicenter observational study
Authors: Rijpstra Maaike , Vissers Kris , Belar Alazne , Van der Elst Michael , Surges Séverine Marie , Adile Claudio , Rojí Rocío , Grassi Yasmine , Bronkhorst Ewald , Mercadante Sebastiano , Radbruch Lukas , Menten Johan , Centeno Carlos , Kuip Evelien , Hasselaar Jeroen 
Published: December 2024

Abstract
Background
Palliative sedation involves the intentional proportional lowering of the level of consciousness in patients with life-limiting disease who are experiencing refractory suffering. The efficacy of palliative sedation needs to be monitored to ensure patient comfort. The aim of this study was to evaluate the efficacy using discomfort levels combined with sedation/agitation levels.

Methods
In this prospective observational study, adult patients with advanced malignancies were recruited from hospice units, palliative care units, and hospital wards in five European countries. Health care professionals used proxy observations of discomfort levels (Discomfort Scale-Dementia of Alzheimer Type, range 0–27) and sedation/agitation levels (Richmond Agitation-Sedation Scale modified for palliative care inpatients), range − 5 to + 4) to evaluate the efficacy of palliative sedation.

Results
In 78 participants, discomfort levels were monitored during palliative sedation. The mean discomfort score before start was 9.4 points (95% CI 8.3–10.5), which showed a significant decrease of 6.0 points (95% CI 4.8–7.1) after start of sedation for the total sedation period. In the multivariable analysis, no significant factors influencing baseline discomfort levels were identified. The discomfort and depth of sedation scores were found to be positively correlated, with an r of 0.72 (95% CI 0.61–0.82). The internal consistency of the discomfort scale was good (0.83), but the “Noisy breathing” item was less informative of the total discomfort score.

Conclusions
The efficacy of palliative sedation can be evaluated by measuring discomfort levels combined with sedation/agitation levels. The measurement of discomfort levels might provide a more specific and detailed evaluation of adequate sedation.

Trial registration
This study is registered at ClinicalTrials.gov since January 22, 2021, registration number: NCT04719702.
Occurrence of Taenia species and Toxoplasma gondii in pigs slaughtered in Bujumbura city, Kayanza and Ngozi provinces, Burundi
Authors: Minani Salvator , Spiessens Emma , Labarrière Alyssa , Niyokwizera Pascal , Gasogo Anastasie , Ntirandekura Jean-Bosco , Trevisan Chiara , Gabriël Sarah 
Published: December 2024

Abstract
Background
Taenia spp. and Toxoplasma gondii are foodborne parasites affecting humans and pigs. The magnitude of the burden of these parasites in pigs in Burundi is not known. Therefore, this study aimed to estimate the prevalence of Taenia spp. infections in pigs by meat inspection, partial carcass dissection and molecular confirmation and estimate the prevalence of Toxoplasma gondii infection in pigs by serology. A cross-sectional study was conducted in pig slaughter slabs located in Bujumbura city, Kayanza and Ngozi provinces. Multisampling strategies were used to sample 576 pigs. Upon pig slaughter, blood samples were collected to perform indirect ELISA for detecting antibodies against the T. gondii P30 protein in the serum. Routine meat inspection was carried out to detect T. solium and T. hydatigena cysticerci. The tongue, heart and masseter muscles were dissected by making slices less than 5 mm thick to estimate the intensity and stages of T. solium cysticerci. A subset of cysticerci and suspected lesions per infected pig were examined using PCR-RFLP to differentiate Taenia spp.

Results
Of the 576 pigs, 14 (2.4%) were positive for T. solium cysticercosis by meat inspection and 67 (11.6%) by partial carcass dissection. After molecular analysis, 66 (11.5%) samples were confirmed to be T. solium infections. The average of T. solium cysticerci in the dissected organs was estimated at 80 cysticerci. Most cysticerci (76.1%) were counted in the masseter muscles, followed by the tongue (18.8%) and the heart (5.1%). The majority of cysticerci (88.3%) were viable, 6.4% were calcified and 5.3% were degenerated. Approximately 69% of the pigs infected with T. solium had light infections, 13.4% had moderate infections and 17.9% had heavy infections. Thirty-two out of 576 pigs (5.5%) were suspected of being infected with T. hydatigena by meat inspection, but 24 pigs (4.2%) were confirmed molecularly to be positive for T. hydatigena infection. The seroprevalence of T. gondii infection in pigs was 17.7%.

Conclusions
This study indicates that T. solium and T. gondii parasites are endemic in Burundi and provides evidence of potential public health risks for the local population. Effective control strategies, including improved pig farming practices, better hygiene and sanitation, increased meat inspection, monitoring of infected pigs, risk-free culinary practices, and treatment of tapeworm carriers, should be implemented to avoid the perpetual contamination of pigs and humans with these zoonotic parasites.
“It’s a delicate balance”: clinicians’ experiences of providing heroin-assisted treatment
Authors: Ellefsen Rune , De Pirro Silvana , Haukland Vegard , Wüsthoff Linda Elise Couëssurel , Arnevik Espen Ajo 
Published: December 2024

Abstract
Background
Little attention has been paid to the experiences of clinicians and health personnel who provide heroin-assisted treatment (HAT). This study provides the first empirical findings about the clinicians’ experiences of providing HAT in the Norwegian context.

Methods
23 qualitative interviews were conducted with 31 clinicians shortly after HAT clinics opened in Norway’s two largest cities: Oslo and Bergen. By inductive thematic analysis of interview transcripts, we identified what research participants experienced and viewed as the chief rewards and challenges of providing HAT. The study aimed to offer an overview of these key rewards and challenges, with insights potentially transferable to HAT programs internationally.

Results
Participants experienced three aspects of providing HAT as particularly rewarding, and three as most challenging. The rewarding aspects were observing harm reduction outcomes; providing holistic care; and having a positive clinic milieu and patient–clinician relationships. The challenging aspects were dosing and overdose risk; rule enforcement and aggression management; and the difficulty of initiating treatments beyond medication and harm reduction. The rewarding and challenging aspects of providing HAT overlapped and were at times contradictory, thus reflecting the duality and tensions in clinicians’ work to provide HAT. The challenges were reported to vary between patient subgroups, according to their degree of instability. The most unstable patients were seen as involving more difficulties as regards the challenging aspects of HAT. Participants expressed uncertainty about HAT’s utility for a small group of the most unstable patients.

Conclusion
While studies about clinical experiences of HAT have usually examined individual or limited aspects of treatment provision, this study provided an overview of the main aspects of the rewards and challenges of providing HAT. Importantly, it also showed the tensions between these overlapping and sometimes contradictory aspects of HAT provision. Because a positive patient–clinician relationship is crucial to patient satisfaction and treatment outcomes in HAT, the provision of training for clinicians on navigating the inherent tensions of HAT provision, nurturing therapeutic alliances with patients, and managing their role as gatekeepers to medical heroin and valuable services, seem particularly important for ensuring that care is patient-centered and staff are adequately supported.