bluuebunny/crossref_metadata_2025_split huggingface dataset:
Beyond symbolism: the roles of action planning and case-making in immigrant integration policymaking
Authors: Allen William L , Broadhead Jacqueline 
Published: November 2024

Abstract
How do city-level policymakers build support for substantive action in policy domains characterized by low levels of national salience and limited local capacity, and which evidentiary resources support as well as reflect these uses? Despite much attention to policymakers’ engagement with evidence, existing work tends to focus on domains where the issues at stake attract high levels of input and influence from central governments. This limits empirical and theoretical understanding of how local efforts to implement potentially contentious policies arise, and through which means. In response, we examine how municipal actors in 12 cities and regions across the UK have devised and communicated policies on immigrant integration—an area that lacks national policy inputs yet is locally consequential—through the mechanism of “action planning.” Drawing on 6 years’ worth of documentary evidence generated through a university-initiated collaboration with these municipalities, we show how action plans gather attention for objectives and propagate examples of practice to other cities—what we call “case-making.” This serves as a micro-foundation for the action planning mechanism, which links symbolic statements about immigrant integration with substantive intended actions.
“Mission-Aligned Funds Flow”: Effect on Clinical Departments
Authors: Lakshminrusimha Satyan , Murin Susan , Galante Joseph , Mustafa Zishan , Sousa Noel , Chen Stanley , Aizenberg Debbie A. , Morris Elizabeth , Lubarsky David A. 
Published: November 2024

Abstract

Problem
Academic medical centers struggle with the high cost of care, reduced reimbursement, intense competition, and low profit margins. Many factors, including a high proportion of publicly insured patients, a model rewarding procedural specialties, and research and educational support burden, led to faculty salary inequities, physician disengagement, and difficulty recruiting.

Approach
UC Davis Health implemented an aligned funds flow model in July 2021 to create a mission-aligned model in which all departments had financial margins to optimize recruitment, retention, research, and teaching.

Outcomes
The 3-year experience (academic years 2021-2024) with this model at UC Davis Health was characterized by physician compensation, physician recruitment, and profit increases. Total collections for departments increased by 4% in the first year, 0.2% in the second year, and 11.3% in the third year of funds flow. Total productivity increased by 4.9% during the first year, 3.6% during the second year, and 8.4% during the third year. Salaries increased in all departmental categories in year 3. Productivity and collections per faculty member increased during the first year and were stable during the second and third years. Parity among procedural, primary care, and hospital-based service lines was improved because departmental revenue was agnostic to payer mix and hospital agreements were more formulaic. The hospital contribution to funds flow increased from $67 million in 2022 to $101 million in 2024.

Next Steps
Regular communication and transparency are critical to ongoing trust and success with implementation of sustaining funds flow. The new model resulted in improved physician compensation and increased hiring. However, the implementation of funds flow had a negative fiscal effect on the academic medical center, and sustainability may require fine-tuning to balance affordability. The authors plan to convert outpatient primary care to productivity-based models and decrease time-limited support for new faculty from 2 years to 1 year.
Epidemiology of Acute Compartment Syndrome After Pediatric Tibial Tubercle and Tibial Shaft Fractures
Authors: Milner John D. , Bergen Michael A. , Zhang Helen , Callanan Tucker C. , Liu Jonathan , Hall Rigel P. , Daniels Alan H. , Cruz Aristides I. 
Published: November 2024

Background:
While acute compartment syndrome (ACS) is a well-reported complication after pediatric tibial shaft fractures, prior literature has suggested that pediatric patients with tibial tubercle fractures may be at increased risk of ACS due to the proximity of the tibial tubercle to the anterior tibial recurrent artery. However, this theory was largely based on a series of early case reports without substantiation in larger-scale studies.

Hypothesis/Purpose:
The purpose of this study is to conduct a population-level analysis of the incidence and risk factors of acute compartment syndrome following pediatric tibial tubercle and tibial shaft fractures. We hypothesize that the rate of ACS would be lower in patients with tibial tubercle fractures when compared with those with tibial shaft fractures.

Methods:
A retrospective cohort analysis of the PearlDiver Mariner database was performed by querying all patients diagnosed with tibial tubercle and tibial shaft fractures between January 2010 and October 2022. Matched cohorts (n=25,483) of patients with pediatric tibial tubercle and tibial shaft fractures were captured using International Classification of Diseases, Ninth Revision (ICD-9), Tenth Revision (ICD-10) billing codes, and age as inclusion/exclusion criteria. Rates of subsequent compartment syndrome were calculated by querying for insurance claims with associated CPT codes for fasciotomy and/or ICD-9/ICD-10 billing codes for compartment syndrome. Student t test and χ2 analyses were used to compare demographics between the tibial tubercle and tibial shaft cohorts.

Results:
The rate of ACS was significantly lower in the tibial tubercle cohort (0.46%) than in the tibial shaft cohort (0.70%, P<0.001). Male sex and increased age were associated with an increased risk of developing ACS in both cohorts (P<0.001). In addition, polytrauma was found to be a risk factor for ACS among patients with tibial shaft fractures (P<0.001).

Conclusion:
We report a low rate of ACS following both pediatric tibial tubercle fractures and pediatric tibial shaft fractures. Among patients with tibial tubercle fractures, male sex, and increased age were noted to be risk factors for ACS, whereas male sex, older age, and polytrauma were risk factors for ACS among patients with tibial shaft fractures.
Spinal Injuries and Spine Care in the U.S. Military Health System (2001–Present)
Authors: Holly Kaitlyn E. , Hatton Malina O. , Bryan Matthew R. , Freedman Brett A. , Helgeson Melvin D. , Koehlmoos Tracey P. , Schoenfeld Andrew J. 
Published: November 2024

Study Design.
Literature review.

Objective.
The goal of this study was to provide a comprehensive outline of spinal injuries that may transpire over the course of military service from traumatic to repetitive stress injuries and chronic sequelae. We considered studies that assessed spinal injuries in combat and non-combat settings as reported in the literature over the last 15 to 20 years.

Background.
Military service places servicemembers under substantial physical demands, while also exposing them to dangerous, unpredictable environments. As a result, servicemembers are at an increased risk of spinal injuries from combat-related trauma and other causes. They may have different care needs and recovery profiles when compared with civilians with spinal disorders.

Materials and Methods.
We performed a review of the available literature on spinal injuries and spinal care in the Military Health System from 2001 to the present.

Results.
The studies discussed in this review were primarily focused on the conflicts in both Iraq and Afghanistan from over 10 years ago and do not fully capture the present-day advancements in military technology that may have an impact on the potential for spinal injuries. The long-term effects of sustained military service and the relative influence of high demand versus sedentary military occupations on the development of spinal disorders remain poorly understood. Given the changing nature of military service, both with respect to the demographic in uniform and the ever-evolving nature of modern combat, we believe that only a long-term prospective observational study dedicated to the surveillance of spinal problems could effectively answer these questions.

Conclusion.
Further research into the present-day characterization of spinal injuries is warranted given the advancements in both military technology and spine care that have occurred over the last 10 years.
Implementing and Evaluating a Pilot Interprofessional Training Program to Engage Health Care Teams in Cost of Care Conversations
Authors: Edward Jean , Northrip Kimberly D. , Kay Rayens Mary , Costich Julia , Welker Andrea , O'Farrell Rachel , D'Orazio John 
Published: November 2024

Introduction:
This study evaluated the impact of
Financial and Insurance Navigation Assistance-Training – a pilot interprofessional training program to facilitate cost of care (CoC) conversations and address health-harming social determinants of health in a pediatric hematology–oncology clinic.

Methods:
A pre–post study design was used to evaluate the impact of
Financial and Insurance Navigation Assistance-Training on an interprofessional health care team's (clinicians, social workers, financial navigator, and legal advocates) knowledge, attitudes, and behaviors related to CoC conversations and screening, referring, and collaborating with interprofessional team members. Data were collected via surveys administered at baseline/pretraining, immediate post-training, and 12-month post-training.

Results:
Most health care team members (n= 21) reported improvement in their knowledge of available financial (66.7%) and legal resources (86.7%) and ability to address social needs (93.3%), financial needs (93.3%), and facilitate CoC conversations with patients and caregivers (66.7%).

Discussion:
Improvements in attitudes and behaviors toward engaging in CoC conversations, screenings, and referrals were relatively improved as a result of the training. However, there was a lower positive rate for actual behaviors around routine screening and initiating discussions on out-of-pocket costs, suggesting a need to address barriers. Study findings highlight the importance of interprofessional education in helping health care teams address social determinants of health through effective CoC conversations.
Effect of remimazolam on intra-operative hypotension
Authors: He Ting-Yu , Zhong Rui-Peng , Zhong Wei-Bo , Huang Gui-Ming , Liu Xiao-Cheng 
Published: November 2024

BACKGROUND
Hypotension is common during anaesthesia. Increasing number of studies have reported that remimazolam may be associated with lower incidence of intra-operative hypotension compared with other anaesthetics. However, the results remain controversial.

OBJECTIVE
This study aimed to evaluate the influence of remimazolam on intra-operative hypotension and its related outcomes (hypoxaemia, bradycardia and time to awake).

DESIGN
A systematic review of randomised controlled trials (RCTs) with meta-analyses

DATA SOURCES
PubMed, Cocharane and Embase databases were searched to identify eligible RCTs published up to June 2024.

ELIGIBILITY CRITERIA
RCTs published in English were eligible for inclusion. The study patients were 18 years or older who were administered with remimazolam and other positive control agents in either the pre-operative or intra-operative period. The incidence of intra-operative hypotension was identified in these studies.

RESULTS
This study evaluated 34 trials including 4847 individuals. Basing on moderate-certainty evidence, we found that remimazolam administration reduced the incidence of intra-operative hypotension [risk ratio (RR) = 0.48, 95% confidence interval (95% CI): 0.41 to 0.57] and bradycardia (16 studies, n = 2869, RR = 0.40, 95% CI: 0.29 to 0.54). No difference was observed in the incidence of hypoxaemia (RR = 0.70, 95% CI: 0.48 to 1.01) and time to awake (MD = −0.91, 95% CI: −2.42 to 0.60). The remarkable association between remimazolam and hypotension remained robust and significant, regardless of general anaesthesia or procedural sedation (P < 0.01, I

2
= 82%). No significant difference was found between different control drugs (P = 0.97, I

2
= 82%).

CONCLUSION
Moderate-quality evidence shows that remimazolam administration to patients undergoing general anaesthesia or procedural sedation decreases the incidence of intra-operative hypotension and bradycardia.
Coccidioidal Endophthalmitis Secondary to Coccidoides Posadasii: A Rare Infection in Humans
Authors: Muste Justin , Baynes Kimberly , Srivastava Sunil K 
Published: November 2024

Purpose:
To describe the first case of Coccidioides posadasii endophthalmitis.

Methods:
A 41-year-old man referred for acute retinal necrosis (ARN) failing 3 months of outpatient treatment was referred for further management. Three consecutive pars plana vitrectomies were required to identify C. posadasii as the source of the endophthalmitis. Two amphotericin intravitreal injections were delivered in addition to three foscarnet injections, two clindamycin, and one ceftazidime. Therapeutic intervention was complicated by patient compliance.

Results:
Despite repeated surgical and medical intervention, vision was lost. The patient later developed fungal meningitis.

Conclusions:
Given parallels between C. posadasii and C. immitis endogenous endophthalmitis, a combined medical and surgical approach can combat C. posadasii in cases of good patient compliance with therapy.
No Increased Injury Risk on Artificial Turf in Finnish Premier Division Football
Authors: Immonen Ville , Kurittu Einari , Kuitunen Ilari , Vasankari Tommi , Leppänen Mari 
Published: November 2024

Objective:
To compare the injury risk between natural grass and artificial turf in the male Finnish premier division (Veikkausliiga) matches during the 2019 league season.

Design:
A retrospective reanalysis of prospectively collected season-long injury surveillance cohort study.

Setting:
Finnish elite-level male football.

Participants:
All 12 teams of Veikkausliiga participated in the study. All players were eligible to participate. Two hundred thirty-six players took part in the follow-up between February and November 2019.

Interventions:
Matches were played between April and November 2019. Injury data were collected using standard injury reports from the team medicals and weekly player questionnaires. Individual player exposure in matches was collected. Artificial turf was classified as exposure and natural grass as control in the analyses.

Main Outcome Measures:
Match-related injury incidence and incidence rate ratios (IRR) with 95% confidence intervals (CI) on natural grass and artificial turf.

Results:
A total of 113 injuries (65 on artificial turf, 48 on natural grass) in 167 matches (90 on artificial turf, 77 on natural grass) were included. Injury incidence was 27.2/1000 hours on artificial turf and 23.9/1000 hours on natural grass and (IRR, 1.1; 95% CI, 0.8–1.7). There was no difference in injury types, anatomical regions, injury recurrence, injury severity, or injury contact. Forwards may have had an increased injury incidence on artificial turf compared with natural grass (IRR, 3.4; 95% CI, 1.0–11.8).

Conclusions:
This study supports previous reports that there is no significant increase in the overall risk of injury in professional football played on artificial turf compared with that on natural grass.
Amino acids and the kidney; friends or foes?
Authors: Baiardo Redaelli Martina , Landoni Giovanni , Monti Giacomo , Bellomo Rinaldo 
Published: November 2024

Purpose of review
Acute kidney injury (AKI) is common in hospitalized patients and is independently associated with morbidity and mortality. Moreover, AKI increases the risk of chronic kidney disease, which is a major healthcare problem. Currently, no single therapy has been proven to be effective in preventing AKI. The role of amino acids in the context of kidney function and AKI prevention has been controversial and most of the evidence is available from nutritional studies. However, knowledge of amino acids in recruiting renal functional reserve and their potential role to protect renal function under stress has recently expanded.

Recent findings
The nephroprotective effects of amino acids were first postulated in 1973. Recently, this strategy gained renewed interest and has been more extensively studied, reintroducing their use in clinical situations characterized by a high incidence of AKI. Intravenous amino acids administration for kidney protection is now supported by a large multinational randomized double-blind controlled trial in cardiac surgery and by experimental and observational data. All such data support the rationale for a biologically and clinically important nephroprotective effect.

Summary
The infusion of amino acids was recently found to reduce the incidence of AKI in cardiac surgery patients and surgical patients. This strategy for the protection of renal function is supported by a multicenter, international, double-blind randomized trial, with a huge potential for additional application in several clinical fields. Several mechanisms of action support the robustness of these findings and are summarized in this manuscript.
Is biomechanical loading reduced in individuals with unilateral transtibial amputation during fast-paced walking when using different ankle/foot prostheses? A pragmatic randomized controlled trial
Authors: Andrag Lizanne , Derman Wayne , Cockcroft John , Runciman Phoebe 
Published: November 2024

Introduction:
Sound side loading is a risk factor for osteoarthritis development, which has been noted to reduce when using advanced prostheses during normal-paced walking in individuals with unilateral transtibial amputation (UTTA). However, descriptions of loading during fast-paced walking remain relatively unreported. Therefore, the aim of this study was to describe the biomechanical loading of individuals with UTTA while using different ankle/foot prostheses during fast-paced walking.

Methods:
A blinded, randomized control trial was conducted in a group of K3–K4 ambulators, who used 3 different prosthetic feet (1. a solid ankle cushioned heel foot prosthesis [SACH], 2. a standard energy storage and return foot prosthesis [ESAR], and 3. a novel ESAR foot prosthesis [N-ESAR]) in a 2-week randomized crossover design. The spatiotemporal and kinetic data of the participants' fast walking pace were collected. Data were analyzed using a mixed model and one-way analysis of variances (p < 0.05) and Cohen d.

Results:
Twenty individuals with UTTA (age: 40 ± 16 years; height: 1.76 ± 0.09 m; and BMI: 24.72 ± 3.63 kg/m2) participated in this study. There were minimal changes in the spatiotemporal data between the different prosthetic feet. When the participants used the N-ESAR feet, they had a lower peak vertical ground reaction force (p = 0.02) and external knee adduction moment (p = 0.02) on the sound side, as well as a higher distal shank power on the prosthetic side (p < 0.01).

Conclusion:
Overall fast-paced walking resulted in higher sound side loading forces compared with normal-paced walking. However, use of the N-ESAR prosthesis reduced the biomechanical loading on the sound side in individuals with UTTA while walking at a fast pace compared with the ESAR and SACH prostheses. The percentage change in the biomechanical loading from normal- to fast-paced walking of the N-ESAR foot was also larger compared with the other prostheses, perhaps because of the individuals’ ability to achieve a faster walking pace when using the N-ESAR prosthesis. Longitudinal intervention studies should be performed to further investigate the possible benefits of using advanced prostheses.
68Ga-Prostate-Specific Membrane Antigen PET/CT in Endometrial Cancer: A Preliminary Report
Authors: Kunikowska Jolanta , Pełka Kacper , Bizoń Magdalena , Olszewski Maciej 
Published: November 2024

Purpose of the Report
Endometrial cancer is the most common gynecological cancer. Prostate-specific membrane antigen (PSMA) is expressed in prostate cancer cells but can be found in other cancers, such as endometrial cancer, during angiogenesis.
The aim of this prospective pilot study was to evaluate the feasibility of using 68Ga-PSMA-11 PET/CT in endometrial cancer patients before surgical treatment.

Patients and Methods
Seven women with a mean age of 58 ± 7.9 years were included in the study. All patients underwent standard imaging studies involving transvaginal ultrasound, ceCT scans of the chest and abdomen, and MRI as qualified for surgery. Additionally, PET/CT was performed on a Siemens Biograph scanner 60 minutes after the injection of 2 MBq/kg 68Ga-PSMA-11.

Results
Six of 7 patients had positive 68Ga-PSMA-11 PET/CT images, and histopathology confirmed endometrial cancer. One patient also exhibited uptake in the left ovary, and final histopathology revealed a hemorrhagic cyst. Lymph node involvement was further confirmed after ceCT fusion with 68Ga-PSMA-11. The consensus of histopathological staging of endometrial cancer and ceCT was 4/7, that of MR was 6/7, and that of 68Ga-PSMA-11 PET/CT was 5/7. All methods were consistent in terms of staging in 3/7 patients.

Conclusions
The initial experience showed the possibility of using 68Ga-PSMA-11 in endometrial cancer patients. However, prospective large studies are needed to explore the real diagnostic role of radiolabelled PSMA in this field.
This study was approved by the Ethical Committee of the Medical University of Warsaw (KB/2/A/2018).
Wild-Type Transthyretin Amyloidosis With 99mTc-PYP Uptake in the Extracardiac Soft Tissues But Not in the Myocardium
Authors: Takahashi Koji , Iwamura Takaaki , Sasaki Daisuke , Ueda Mitsuharu , Okura Takafumi 
Published: November 2024

Abstract
Wild-type transthyretin amyloid (ATTRwt) deposits in most organs, mainly the heart, ligaments, and tenosynovium. Orthopedic diseases due to ATTRwt deposits often precede overt ATTRwt cardiomyopathy. 99mTc-PYP scintigraphy is highly sensitive in detecting myocardial and extracardiac ATTRwt deposits. However, there are few reports of extracardiac ATTRwt deposits before myocardial deposits confirmed by imaging modalities. We report a case of atrial fibrillation-related heart failure in which 99mTc-PYP scintigraphy showed tracer uptake in extracardiac soft tissues but not in the myocardium, and a biopsy of soft tissues with tracer uptake confirmed ATTRwt deposits. 99mTc-PYP scintigraphy can image extracardiac ATTRwt deposits before myocardial deposits.