bluuebunny/crossref_metadata_2025_split huggingface dataset:
Linking representations and policy adoption: The effect of bureaucratic and political representations on policy outcomes
Authors: Park Sanghee , Vallett Joel D 
Published: November 2024

This study explores the impact of representation in terms of types and loci on the intended outcomes of a child abuse protection policy implemented over 9 years (2011–2019), during which Erin’s Law was introduced in the U.S. states. Using state-level data, we find that gender and minority representation in the political and administrative arena have distinctive effects on policy outcomes and that policy adoption moderates the link between representation and implementation. Our analysis shows that bureaucratic representation significantly decreases child abuse reports per capita and increases investigation rates, with these effects being more pronounced when Erin’s Law is adopted. The marginal effects of bureaucratic representation on reports and investigation rates decrease and indicate non-linear relationships. This study finds that bureaucratic representation provides benefits beyond co-identity groups, but there is little evidence that political representation is moderated by policy adoption when different sources of representation are considered.
Utility of the Oxygen Saturation Index Over the Oxygenation Index in Monitoring Neonates with Respiratory Diseases
Authors: Ashwini KH  , Badiger Shriharsha , Tadakanahalli Satish 
Published: November 2024

Introduction: The Oxygen Saturation Index (OSI) has emerged as a non-invasive monitoring alternative to the traditional Oxygenation Index (OI) in neonates with respiratory diseases requiring mechanical ventilation. This study aims to evaluate the utility of OSI over OI, given the critical need for improved monitoring strategies in neonatal intensive care units (NICUs). Methods: A prospective observational study was conducted in the NICU, Department of Paediatrics, from August 2022 to February 2024. Fifty neonates diagnosed with various respiratory diseases requiring mechanical ventilation were included. OSI and OI were calculated using non-invasive and invasive parameters, respectively. The correlation between OI and OSI was assessed using Pearson’s correlation coefficient, and a regression model was developed to predict OI from OSI measurements. Results: The study found a moderate positive correlation (r = 0.491, p < .001) between OI and OSI, with the correlation strengthening within the oxygen saturation range of 85%–95%. A linear regression model (OSI = 0.391*OI + 4.2341) was developed, facilitating the estimation of OI from OSI measurements. This model underscores the potential utility of OSI in neonatal respiratory monitoring. Conclusion: OSI presents as a viable, non-invasive alternative to OI for monitoring neonates with respiratory failure. The significant correlation and the development of a predictive regression model highlight OSI’s potential to improve clinical monitoring and decision-making in NICUs, potentially reducing the need for invasive procedures.
Unmet Needs of Children and Young Adults With ADHD: Insights From Key Stakeholders on Priorities for Stigma Reduction
Authors: Visser Marlies Jolinde , Peters Ruth Maria Hendrika , Luman Marjolein 
Published: November 2024

Introduction: Individuals with ADHD continue to face stigma, which can negatively impact their access to, adherence to, and quality of mental health services, as well as their overall wellbeing. Perspectives of various stakeholders regarding priorities for stigma reduction remain underexplored. This study explores young adult, parent, teacher, and mental health care professional perspectives on unmet needs of children and young adults with ADHD in the Netherlands, in the context of stigma reduction. Method: A total of 24 respondents participated in seven small focus group discussions (FGDs). The FGDs facilitated in-depth discussions exploring stakeholder group perspectives on unmet needs of children and young adults with ADHD in educational, professional, and social settings. Data was analyzed using thematic content analysis. Results: Three thematic categories of unmet needs were identified: (1) a lack of awareness, knowledge, and understanding of ADHD; (2) insufficient personalized approaches in education and health care; and (3) limited accessibility of information and support services. Within theme 1, respondents primarily highlighted the importance of improving education for primary school teachers and mental health care professionals. Theme 2 underscored the need for increased capacity for personalization and attention to the sociopsychological factors of ADHD, alongside recognizing strengths. Theme 3 emphasized the need for easy access to reliable information and mental health care, including peer networks, as well as proper follow-up and continuity of care. Discussion and Conclusion: Findings highlight the need for improving our understanding of ADHD as a complex biopsychosocial condition, which requires specific adjustments in education and mental health care. Interventions to improve support and disrupt stigmatization should meet diverse needs, incorporate multi-level strategies, and involve key stakeholders.
Comparison of 3-month clinical outcomes between two enhanced monofocal intraocular lenses: A single-center prospective study
Authors: Spagnuolo Vito , Vicini Giulio , Marincolo Ginevra , Franchini Alessandro , Giansanti Fabrizio , Mazzini Cinzia 
Published: November 2024

Purpose This study aims to compare the 3-month clinical outcomes between two enhanced monofocal intraocular lenses (IOLs) following cataract surgery. Setting: Eye Clinic of Careggi University Hospital, Florence, Italy. Design Single-center prospective study. Methods We included patients with cataract and corneal astigmatism less than 0.75 D, with no ocular comorbidities, who underwent unilateral cataract surgery with implantation of either the Tecnis Eyhance ICB00 ( N = 25) or Evolux ( N = 25) IOLs. Standard cataract procedures were performed without complications. The main outcome measures included uncorrected and corrected visual acuity at distance (4 m), intermediate (60 cm) and near (40 cm) at 3-month follow-up. Additionally, monocular defocus curves, aberrometric profiles, and perceptions of halo and glare were evaluated. Results The study involved 50 patients (26 male, 24 female) with a mean age of 68 ± 8 years. Preoperative characteristics were similar between the groups, and no intraoperative or postoperative complications were reported. Statistically significant differences were observed between the groups, with the Evolux IOL showing superior results ( p < 0.05) in terms of uncorrected and corrected visual acuity at near, intermediate, and distance, as well as in aberrometric profiles (lower-order aberration root-mean-square [RMS], higher-order aberration RMS, spherical equivalent RMS, and point spread function) and defocus curves. Conclusions Based on our experience, while both IOLs offer substantial visual performance for intermediate and distance vision, the Evolux IOL demonstrated superior mean visual outcomes and objective parameters at the 3-month follow-up compared to the Tecnis Eyhance IOL. This indicates a potential advantage of the Evolux IOL in providing better visual performance.
Unveiling the Digital Landscape of E-Cigarette Marketing in India: Evidence From Mixed Method Study
Authors: Bahl Deepika , Bassi Shalini , Thapliyal Nishibha , Aneja Kashish , Sinha Praveen , Arora Monika 
Published: November 2024

Introduction: India is one of the few countries to have banned production, manufacture, import, export, transport, sale, distribution, storage and advertisement of electronic cigarettes (e-cigarettes). With the advent of technology, these product are being marketed extensively on internet despite the ban. Objective: To assess promotion and sales of e-cigarettes on the internet, and social networking sites (SNS); and to assess the levels of awareness regarding e-cigarettes among youth participants and the source of receiving information on e-cigarettes. Methodology: In 2022, a survey was conducted with youth (18-24 years), along with a desk review to identify influencers promoting, and e-stores selling e-cigarettes in India. Further, a content analysis was conducted on the identified influencers and online stores. Results: 370 youth with a mean age of 21.1 ± 1.7 years participated in the survey. 66.6% of participants reported being aware of e-cigarettes through social media. Instagram (46%) was identified as the most popular social networking platform for promoting e-cigarettes. 189 influencers promoting e-cigarettes on Instagram were identified and their posts positively portrayed e-cigarettes (trendy/cool, flavours, hedonic value, features cessation aid and cost-effective). Additionally, 83 e-stores (49 Indian and 34 international) were identified as selling e-cigarettes in India. Findings from content analysis of both influencers and e-stores highlighted issue of international cross-border marketing. Conclusion: To safeguard youth and achieve a path to Tobacco-free generation; there is a dire need for strengthening the monitoring and enforcement of PECA 2019, especially to address international cross-border advertisements and sales of e-cigarettes. Additionally establishing strong reporting violation mechanisms is also needed. Furthermore, educating youth, retailers, policy makers and community via sensitization programs on detrimental effects of e-cigarette use and existing policies related to e-cigarettes in India is crucial.
Health care utilization and costs among coordinated care patients in Southeastern Ontario: A difference-in-differences study of a double propensity score-matched cohort
Authors: Johnson Ana P , Hore Elizabeth , Wodchis Walter P , Bai Yu Qing , Mondor Luke , Tenbensel Tim , Donnelly Catherine , Green Michael , Spinks Michael , Swedak Julia , McIntyre Dianne , Wolfe Ashleigh 
Published: November 2024

Objectives Coordinated care plans (CCPs) for high-cost health care system users aim to improve system-level performance. We evaluated health care resource use and costs among CCP patients (enrollees) versus a control group that did not receive coordinated care (comparators) in Southeastern Ontario. Methods A difference-in-differences analysis of a quasi-experimental, double propensity score-matched and adjusted cohort was conducted. Linked population-based administrative data were used to measure health care utilization and costs and to identify comparators for two enrollee groups who began CCPs between April 1, 2013, and March 31, 2019. Enrollees were recruited from hospitals in Quinte or community care centres in Rural Hastings/Thousand Islands, and were 1:1 propensity score matched to comparators. Difference-in-differences estimates were calculated using generalized estimating equations for hospitalization rates, homecare visits, primary care visits, other health care resources and total costs. Results A total of 558 enrollees in Quinte and 538 in Rural Hastings/Thousand Islands were identified and matched to comparators. Difference-in-differences estimates were significant in both enrollee groups for number of homecare visits ([IRR 1.72; 95% CI (1.44, 2.06)] and [IRR 1.73; 95% CI (1.45, 2.06)], respectively). Number of primary care visits were 1.76 times greater for Rural Hastings/Thousand Islands enrollees versus comparators [IRR 1.76; 95% CI (1.32, 2.35)]; total costs increased by 23% ([IRR 1.23; 95% CI (1.09,1.39)]. Conclusions Homecare use significantly increased for enrollees versus comparators, indicating specific priority areas of Ontario CCPs were met. However, no reductions were shown for other health system performance indicators. We also showed increased 7-day primary care follow-up visits for community care centre-recruited patients, but not for hospital-recruited patients. Decision-makers may wish to target patients who are less advanced in their chronic disease trajectory.
Hepatobiliary-Phase Hypointense Nodules Without Arterial-Phase Hyperenhancement: Developing a Risk Stratification for Hypervascular Transformation Based on a Real-World Observational Cohort Study
Authors: Li Na , Wang Yi , Yang Li , Yang Chun , Zeng Mengsu 
Published: November 2024

Purpose To develop a risk stratification based on MRI features to predict hypervascular transformation for hepatobiliary-phase (HBP) hypointense nodules without arterial-phase hyperenhancement (APHE). Materials and methods This retrospective observational cohort study included 55 HBP hypointense nodules without APHE in 35 patients with chronic liver disease, cirrhosis, or current hepatocellular carcinoma (HCC) who underwent gadoxetic acid-enhanced MRI. The hypervascular transformation during the follow-up MRI(s) was the primary endpoint analyzed for the nodules. Univariable and multivariable Cox proportional hazard regression analyses were performed to identify risk features predicting transformation and assess their predictive value. Results Among the 55 nodules, 27 developed hypervascular transformation, while 28 did not. Diffusion-weighted imaging (DWI) hyperintensity (hazard ratio [HR], 4.98; 95% confidence interval [CI]: 1.60, 15.54; p = 0.006) and portal venous phase (PVP) hypointensity (HR, 4.08; 95% CI: 1.43, 11.64; p = 0.009) were associated with hypervascular transformation. DWI hyperintensity and PVP hypointensity had 44.4% (95% CI: 26.0%, 64.4%) and 81.9% (95% CI: 61.3%, 93.0%) sensitivity, while their specificity was 78.2% (95% CI: 64.6%, 87.8%) and 67.9 (95% CI: 47.6%, 83.4%), respectively. The specificity of the combination of two features was 100% (95% CI: 85.0%, 100%). The hypervascular transformation rates for nodules with both, either and neither of the risk MRI findings were 100% (10/10), 60.9% (14/23), and 13.6% (3/22), respectively; the median intervals for transformation were 312 (range: 73–838), 409 (range: 50–1643) and 555 (range: 423–968) days, respectively. Conclusion The combination of DWI hyperintensity and PVP hypointensity may be used as a high-risk indicator for the hypervascular transformation of HBP hypointense nodules without APHE; nodules without either feature may be treated as low-risk nodules and could adopt an extended interval follow-up schedule.
Balloon angioplasty for cerebral vasospasm in preschool children
Authors: Demartini Zeferino , Requejo Flavio , Beraldo Renato Fedato , Maeda Adriano Keijiro , Savoldi Alexandre Mello , Cardoso-Demartini Adriane 
Published: November 2024

BackgroundSubarachnoid hemorrhage evolving with cerebral vasospasm and delayed cerebral ischemia may increase morbidity and mortality. Treating vasospasm with balloon percutaneous angioplasty (PTA) in adults is well known, but data in preschool children are scarce. In addition, the smaller diameters and fragility of the vessels in childhood might lead to serious complications. This study presents two cases of cerebral vasospasm in preschool children treated with balloon PTA. Therefore, it may contribute to a better understanding of the role of that technique as an effective treatment modality in this population.MethodsBalloon PTA was performed in two children (3 and 4 year-old) with aneurysmal subarachnoid hemorrhage and delayed cerebral ischemia.ResultsThe procedures were uneventful, and both patients survived without complications or new infarction.ConclusionsBalloon PTA for proximal vasospasm may improve clinical outcomes in selected pediatric patients. Further studies are needed to clarify the best candidates, materials, and techniques.
Enhancing systematic review efficiency in hand surgery using artificial intelligence (natural language processing) for abstract screening
Authors: Wong Gordon C. , Kane Robert L. , Chu Cheng-C.J. , Lin Ching-Heng , Kuo Chang-Fu , Chung Kevin C. 
Published: November 2024

The aim of the present study was to train a natural language processing model to recognize key text elements from research abstracts related to hand surgery, enhancing the efficiency of systematic review screening. A sample of 1600 abstracts from a systematic review of distal radial fracture treatment outcomes was annotated to train the natural language processing model. To assess time-saving potential, 200 abstracts were processed by the trained models in two experiments, where reviewers accessed natural language processing predictions to include or exclude articles. The natural language processing model achieved an overall accuracy of 0.91 in recognizing key text elements, excelling in identifying study interventions. Use of the natural language processing reduced mean screening time by 31% without compromising accuracy. Precision varied, improving in the second experiment, indicating context-dependent performance. These findings suggest that natural language processing models can streamline abstract screening in systematic reviews by effectively identifying original research and extracting relevant text elements. Level of evidence: IV
Artificial intelligence in rheumatology: status quo and quo vadis—results of a national survey among German rheumatologists
Authors: Holzer Marie-Therese , Meinecke Anna , Müller Felix , Haase Isabell , Morf Harriet , Witte Thorben , Labinsky Hannah , Klemm Philipp , Knitza Johannes , Krusche Martin 
Published: November 2024

Background:The development and potential of artificial intelligence (AI) is remarkable. Its application in all medical disciplines, including rheumatology, is attracting attention. To what extent AI is already used in clinical routine in rheumatology is unknown. In addition, the perceived barriers, potentials, and expectations regarding AI by rheumatologists have not yet been studied.Objectives:To examine the current usage and perceived barriers and facilitators of AI, including large language models (LLMs), among rheumatologists.Design:National, observational, non-interventional, and cross-sectional web-based study.Methods:A web-based survey was developed by the Working Group Young Rheumatology (AGJR) of the German Society for Rheumatology. The survey was distributed at the Congress of the German Society for Rheumatology and via social media, QR code, and email from August 30 until November 4, 2023.Results:Responses from 172 rheumatologists (55% female; mean age 43 years) were analyzed. The majority stated that they did not previously use AI (73%) in their daily practice. Eighty-eight percent of rheumatologists rated their AI knowledge as low to intermediate and 84% would welcome dedicated training on LLMs. The majority of rheumatologists anticipated AI implementation to improve patient care (60%) and reduce daily workload (62%). Especially for diagnosis (73%), writing medical reports (70%), and data analysis (70%), rheumatologists reported a potential positive benefit of AI. Main AI concerns addressed the responsibility for medical decisions (64%) and data security (58%).Conclusion:Overall, the results indicate that rheumatologists currently have little AI knowledge and make very little use of AI in clinical routine. However, the majority of rheumatologists anticipate positive AI effects and would welcome increased AI implementation and dedicated training programs.
Investigating the impact of a pharmacist intervention on inappropriate prescribing practices at hospital admission and discharge in older patients: a secondary outcome analysis from a randomized controlled trial
Authors: Garcia Beate Hennie , Omma Katharina Kaino , Småbrekke Lars , Johansen Jeanette Schultz , Skjold Frode , Halvorsen Kjell Hermann 
Published: November 2024

Background: Inappropriate medication prescribing in older patients increases the risk of poorer health outcomes and increased costs. The IMMENSE trial, integrated a clinical pharmacist into the health care team, to improve medication therapy among older patients, and to investigate the impact on acute revisits to hospital. Objectives: This study investigated the prevalence of potentially inappropriate medications (PIMs) and prescribing omissions (PPOs) at hospital admission and discharge. It also explored the impact of the pharmacist intervention on PIMs and PPOs, and other factors associated with PIMs and PPOs at discharge. Design: The STOPP/START criteria version 2 were retrospectively applied at admission and discharge. PIM and PPO changes were compared, and Poisson regression was used to assess factors influencing prevalence at discharge. Results: At hospital admission, PIM prevalence was 58.6% among intervention patients and 64.8% among control patients. PPO prevalence was 55.3% and 55.5%, respectively. A larger proportion of PIMs identified at admission were resolved by discharge in the intervention group (42.9%) compared to the control group (27.4%). No difference was seen for PPOs. Poisson regression identified a significantly higher risk for PIMs at discharge in the control group compared to the intervention group (IRR 1.255; 95% CI 1.063–1.480, p = 0.007), but no effect for PPOs. Patients living in a nursing home, a home care facility, or an institution showed a higher risk of PPOs at discharge compared to patients living at home (IRR 1.378; 95% CI 1.156–1.644, p < 0.001). Conclusion: The IMMENSE intervention significantly reduced the risk of PIMs at discharge, with no effect on PPOs. Living in nursing homes, home care facilities, or institutions prior to hospitalization increased the risk of PPOs at discharge. Pharmacists may contribute to improved medication appropriateness in older hospitalized patients.
Evaluation of Post-Operative Outcomes of Femoral Neck Fracture Interventions: A Systematic Review
Authors: Sheffels Erin , Khalil Mariam , Hutchison Kristen , Hardy Nicole J. , Tarchand Ranita , Pederson John M. , Parikh Anjani , Blauth Michael 
Published: November 2024

Introduction Femoral neck fractures (FNF) represent a significant challenge in orthopedic practice, demanding prompt intervention to restore function and mobility in affected individuals. Numerous surgical interventions have been developed to address these fractures, including internal fixation with devices such as the Femoral Neck System (FNS, DePuy Synthes, Inc., West Chester, PA, USA). However, the optimal fixation system remains unclear. Understanding the postoperative outcomes associated with these interventions is crucial for optimizing patient care and informing treatment decisions. Significance This PRISMA-compliant systematic literature review evaluates the efficacy and safety of the Femoral Neck System relative to other operative treatment options. Clinical and safety outcomes included mortality, perioperative complications, postoperative complications at 1 year, and reoperation. Results A total of 117 studies with 68,567 patients with FNF treated with internal fixation were identified. Of these, thirteen included FNS as a treatment arm (1078 patients). Due to heterogeneity in study designs and populations, only the eleven studies that directly compared FNS to other operative treatments, and 2 non-comparative studies that treated with FNS were included in the systematic review. Seven of the eleven included studies had high risk of bias, 2 had moderate risk of bias, and 2 had low risk of bias. FNS groups had similar or significantly lower incidences of postoperative complications, reoperations, and mortality compared to cannulated screw, cancellous screw, or dynamic or sliding hip screw groups in all studies. Conclusion FNS can be a safe and effective operative treatment option for FNF. Safety outcomes and reoperation rates are comparable between patients treated with FNS and patients treated with cannulated screws, cancellous screws, and dynamic or sliding hips screws. Future prospective, controlled studies are needed to confirm the safety and efficacy of FNS relative to other operative treatment options.