bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development, dissemination and survey evaluation of layered education for healthcare professionals to support implementation of firearm injury and mortality prevention strategies in emergency care settings, New York, USA
Authors: Harrison Laura K , Sathya Chethan , Shekher-Kapoor Monica , Butkus Stephen , Kapoor Sandeep 
Published: October 2024

BackgroundThere is consensus on the need and ability to address firearm injury risk in healthcare settings; however, the lack of education for healthcare professionals hinders the implementation of evidence-based firearm injury and mortality prevention strategies. The objectives of this study are to develop, disseminate and evaluate education for team members to facilitate implementation in emergency departmentsMethodTwo-tiered education was developed in partnership with stakeholders and disseminated to the healthcare team, covering evidence-based screening and interventions for firearm access and violence risk. The implementation, development and dissemination strategies followed the framework used for systemwide Screening, Brief Intervention and Referral to Treatment implementation for substance use. Team members who screened patients for firearm injury risk received screening education and team members meeting with patients who screened positive received intervention education. Participants completed surveys to evaluate the education and learning objectives.ResultsAcross three emergency departments from March 2021 to May 2022, 267 team members completed screening education. Key takeaways reported by 173 participants were how to screen (24.9%), the 5L’s of Firearm Safety (19.7%) and the prevalence of firearm injury (11.0%). Participants still had questions about workflow, resources and safety. 34 of 67 (50.7%) intervention education participants completed the postsurvey. 100% were confident they could screen, 79% were confident they could provide brief interventions and 88% were confident their site could implement firearm injury prevention strategies.ConclusionTiered education for firearm injury prevention screening and intervention achieved learning objectives and facilitated programme implementation. Education increased knowledge and confidence regarding firearm injury risk screening and its importance in healthcare settings.
Characterising fire or burn-related fatalities in the USA using the National Violent Death Reporting System, 2003–2020
Authors: Bista Saroj , Duffy Bridget , Michaels Nichole L. 
Published: October 2024

ObjectivesIntentional fire or burn-related deaths are rare in the USA compared with some countries, but do occur, and our knowledge of their epidemiology is limited. The objective of this study is to epidemiologically describe fire or burn-related deaths resulting from violence, including victim and suspected perpetrator characteristics and incident circumstances.MethodsThis cross-sectional study uses National Violent Death Reporting System data from 2003 to 2020 to examine violent fire or burn-related deaths among individuals of all ages. Analyses include the following case types: (1) fire or burn-related injuries were immediate, underlying or antecedent cause of death; (2) death resulted from arson; or (3) weapon used was categorised as ‘fire or burns’. Precipitating circumstances were examined by manner of death (ie, suicide, homicide or undetermined intent) using χ2tests, with p values of <0.05 indicating statistical significance.ResultsAmong 4395 victims, most were male (64.6%), non-Hispanic white (60.8%) and 20–64 years (72.7%). Deaths by suicide were most common (38.9%), followed by homicides (32.6%) and undetermined deaths (28.5%). Current mental health (53.4%) and substance use problems (15.0%) were common among suicide deaths. One-half (49.8%) of homicide deaths were precipitated by another crime and 19.5% were related to intimate partner violence.ConclusionsThe prevalence of mental health and substance use problems among suicide victims underscores the urgency for targeted prevention strategies and timely interventions. Stressors, such as interpersonal conflicts and financial problems, may contribute to fire or burn-related violent deaths.
Family caregiver narratives of hospice death vigils
Authors: Oliver Debra Parker , Mayahara Masako , Benson Jacquelyn , Donehower Allison K , Washington Karla T , White Patrick Hodge 
Published: October 2024

BackgroundOften, family members and friends gather around a dying hospice patient to say goodbye in what is known as a death vigil. The purpose of this study is to explore the stories and experiences of family caregivers of hospice patients who participated in death vigils.MethodsQualitative analysis of interviews with 50 hospice family caregivers explored the experiences and memories affiliated with death vigils. Grounded in the Hospice Use Model, a Framework Analysis method was used to analyse transcripts and identify themes to answer the research questions.ResultsHospice family caregivers identified community resources, community health resources, hospice agency factors and individual patient and caregiver factors as impacting their participation in the death vigil and their memory of the experience.ConclusionsFamily members perceived and remembered both positive and negative experiences during their death vigil. Their narratives included recommendations for change in the death vigil, including advice for others going through the vigil, changes in operational and clinical care during the vigil and policy changes needed to improve the experience.
Circulating FGF‐23 Is Associated With Increased Risk of Osteoporosis and Fractures in Hemodialysis Patients: A Prospective Observational Study
Authors: Liu Dong , Yang Hongyan , Liao Qirong , Chang Baocao , Zhang Weiwei , Li Xiaoxiong , Li Jinping , Hou Mingliang , Ma Linqiu , Liu Yating , Lu Jing , Zhou Rui 
Published: October 2024

Background and Objective: It is still controversial whether circulating fibroblast growth factor 23 (FGF‐23) can be used as a biomarker for the diagnosis of osteoporosis and fractures in patients with chronic kidney disease undergoing hemodialysis. We investigated the association of circulating FGF‐23 concentrations with an increased risk of osteoporosis and fractures of hemodialysis patients in the prospective study.Methods: These data were collected in adult patients with hemodialysis in China from January 1 to December 30, 2016, and patients were followed up for 3.5 years. The association of circulating FGF‐23 with the risk of osteoporosis and fractures was analyzed by multivariate analysis.Results: The study included 1788 hemodialysis patients, with a median age of 56 years (50–64 years) and a female population of 54.5%. Of 1788 patients, 389 (21.8%) developed osteoporosis and 207 (11.6%) developed fractures. High concentrations of FGF‐23 were significantly related to osteoporosis and fractures and were significantly related to different types of fractures (vertebral fractures, nonvertebral fractures, and hip fractures). Adjusted for all potential risk factors, high concentrations of FGF‐23 were associated with the risk of osteoporosis or fractures.Conclusion: High concentrations of circulating FGF‐23 were associated with the risk of osteoporosis and fractures, including vertebral fractures and hip fractures. FGF‐23, along with bALP, CTX, and OC, may be used as a serum biomarker for predicting the risk of osteoporosis and fractures in patients with hemodialysis.
Diabetes Mellitus Predicts Severe Respiratory Failure After Aortic Arch Replacement
Authors: Gambardella Ivancarmine , Worku Berhane , Lau Christopher , Tranbaugh Robert , Balaram Sandhya , Girardi Leonard 
Published: October 2024

Objective: The lung is a target organ of diabetes mellitus (DM) via glycation of pulmonary elastin and collagen. In addition, hyperglycemia facilitates hypercapnic respiratory failure, which is instead mitigated by low‐carbohydrate high‐lipid (LC‐HL) nutrition. We sought to determine the association between diabetes and severe respiratory failure (SRF, i.e., need of reintubation\tracheostomy) after open aortic arch replacement (AAR).Methods: Machine learning algorithms were evaluated for precision and recall (F2 score) and for clinical applicability to predict SRF. Conditional regression evaluated independent predictors of SRF after 1:2 propensity‐score matching.Results: Information on diabetic status was available in 1275 patients undergoing AAR (1997–2023). Although support vector machine presented the highest F2 score (F2 = 0.337), conditional inference trees provided the most clinically applicable algorithm: diabetes was the best predictor of SRF, which occurred in 20/150 diabetics (13.3%) vs. 40/1125 nondiabetics (3.6%) (p < 0.01). In diabetics, left ventricular ejection fraction (LVEF) was the next best predictor of SRF, which occurred in 8/20 diabetics with LVEF ≤ 30% (40%) vs. 12/130 diabetics with LVEF >30% (9.2%) (p = 0.02). In nondiabetics, chronic obstructive pulmonary disease (COPD) was the next best predictor of respiratory failure, which occurred in 14/177 nondiabetics with COPD (7.9%) vs. 26/948 nondiabetics without COPD (2.7%) (p = 0.01). In the matched sample, diabetes was independently able to predict SRF (OR 2.20, 95% CI 1.10 | 4.42).Conclusions: DM was the best predictor of SRF after AAR. Strict glycemic control and LC‐HL nutrition should be evaluated as measures to reduce postoperative SRF in diabetic patients.
Relationship of Regular Laxative Use, Genetic Susceptibility of Depression, and Risk of Incident Depression in the General Population
Authors: Zhang Yuanyuan , Gan Xiaoqin , Zhou Chun , Ye Ziliang , He Panpan , Liu Mengyi , Zhang Yanjun , Yang Sisi , Qin Xianhui 
Published: October 2024

Background: The relationship between laxative use and the risk of depression remains uncertain. We aimed to assess the prospective association of regular laxative use with the risk of incident depression and to examine whether genetic risk of depression modifies this association.Methods: Four hundred fifty thousand forty‐five participants without depression at baseline and have complete information on laxative use from the UK Biobank were included. The study outcome was incident depression, derived from linkage to primary care records, hospital inpatient data, death register records, or self‐reported medical conditions at follow‐up visits.Results: During a median follow‐up of 12.4 years, 18,651(4.1%) participants have developed depression. Regular laxative use was significantly associated with a higher risk of incident depression (vs. nonregular laxative use; adjusted hazard ratio [HR] = 1.78, 95% confidence interval [CI], 1.68–1.89). Genetic risk of depression did not significantly modify this association. The risk of incident depression increased with increasing types of laxatives used, with a HR of 1.89 (95%CI, 1.73–2.08) for use of single laxative type and 2.32 (95%CI, 1.82–2.96) for combined use of two or more laxative types (P for trend <0.001). The positive association between regular laxative use and incident depression was more pronounced in men (adjusted HR = 2.21, 95%CI, 1.96–2.48) versus women (adjusted HR = 1.67, 95%CI, 1.56–1.79; P interaction <0.001). Compared to those who did not use laxatives regularly and did not have constipation, participants who used laxatives regularly and had constipation had the highest risk of incident depression (adjusted HR = 2.33, 95%CI, 1.94–2.80).Conclusions: Regular laxative use was significantly associated with a higher risk of incident depression, especially in men.
Parliament Hidden in Small Streets and Squares
Authors: Preuss Ondřej 
Published: October 2024

Abstract
Parliament is the space where politics and (constitutional) law literally take shape. Here, collective decisions take form in a specific setting where relationships between various political actors are organized through architecture. The architecture of spaces of political congregation is not only an abstract expression of a political culture – it participates in politics and it is part of the constitutional system.
This paper focuses on the question, whether the location (and architecture) of the seat of the parliament is somehow significant for decision-making practices and for the role of the parliament in the constitutional system and for its values.
This is discussed based on the example of the seat of the Parliament of the Czech Republic. The parliament (and especially the Chamber of Deputies) is one of the key institutions in Czech constitutional system. This is kind of paradox, because unlike other significant parliaments, the buildings of the Parliament of the Czech Republic are not dominant of the city of Prague.
Depressive symptoms and associated socioeconomic and clinic factors: Three different years data from Türkiye
Authors: Özdin Selçuk , Laçiner Kerem , Böke Ömer , Aker Servet 
Published: October 2024

Background: Depression is one of the main diseases that cause disability. It is more common in various sociodemographic situations. Aims: This study investigated the risk factors associated with depressive symptoms and changes over the years based on data from a sample from the Republic of Türkiye. It was also intended to compare depressive symptoms and inflation rates by years. Method: Data for 2016, 2019 and 2022 from the Turkish Health Survey performed by the Turkish Statistical Institute were used in the study. Data for age, sex, marital status, education level, employment status, accompanying chronic health problems, restrictions in daily activities associated with health problems and problems accessing psychological treatment due to difficulty in paying were evaluated in terms of depressive symptoms. Results: Higher depressive symptoms were determined in women, the widowed and divorced, individuals with a low level of education, the unemployed, individuals with chronic health problems, those with restrictions in daily activities associated with chronic health problems and those with problems accessing psychological treatment due to difficulty in paying. Although inflation rates increased over the years, the severity of depressive symptoms decreased. A moderate positive correlation was observed between depressive symptoms and basic activities of daily living. Conclusions: Developing policies aimed at groups with high depressive symptoms may be important in combating depression.
One-Stage Tibiotalocalcaneal Arthrodesis for Severe Septic Destruction of the Ankle Joint Using a Retrograde Intramedullary Nail: A Retrospective Cross-sectional Study
Authors: Boucly Joffrey , Bouché Pierre-Alban , Bermudo Gamboa Maria Dolores , Ménigaux Christophe , Hardy Alexandre , Bauer Thomas , Pioger Charles 
Published: October 2024

Background: Severe septic destruction of the ankle joint poses a therapeutic challenge but lacks a consensus optimal treatment. Tibiotalocalcaneal arthrodesis (TTCA) is considered a valuable salvage procedure, but the literature remains scarce. Conventional treatment approaches, including 2-stage procedures, have been associated with prolonged recovery times and varying success rates. Many authors prefer classical external fixation in these scenarios, citing concerns that internal implants might pose a risk for recurrent infection. To date, no study has investigated the outcomes of 1-stage surgery using a retrograde intramedullary (IM) nail. The main purpose was to assess the rate of recurrent infection at 2 years following 1-stage TTCA using a retrograde IM nail in severe septic destruction of the ankle joint. Fusion rates and functional outcomes were evaluated as secondary purposes. Methods: The clinical and radiologic data of patients who underwent 1-stage TTCA with retrograde IM nail following severe septic destruction of the ankle joint with a minimal follow-up of 2 years were retrospectively analyzed. Reinfection rate, fusion rate, functional outcomes, and complications were evaluated. Results: A total of 25 patients were included with a mean follow-up of 42 months (24-92 months). The mean age was 55 ± 18 years old. At the last follow-up, reinfection occurred in 6 patients (24%) and fusion was obtained in 19 patients (83%). Eight patients (32%) required revision surgery. The mean postoperative modified American Orthopaedic Foot & Ankle Society (AOFAS) score, 12-Item Short Form Health Survey physical and mental component summary scores were respectively 53 ± 19.5, 35.5 ± 11.4, and 46.7 ± 13.5 points. Conclusion: One-stage TTCA with retrograde IM nail appears to be an acceptable alternative in severe septic destruction of the ankle joint, with a high eradication rate of infection and ankle fusion.
Real world comparison of filgrastim to filgrastim-sndz in patients with chemotherapy-induced neutropenia
Authors: Saad Manal , Shadick Kelsey , Prasad Sapna , Amin Kejal , Chaar Randa , Abdelghany Osama 
Published: October 2024

Introduction There exists some apprehension by prescribers, healthcare providers, and other stakeholders regarding the real-world safety and effectiveness of biosimilars. While some of the apprehension is likely due to clinician knowledge gaps in the biosimilarity exercise, additional data (including those generated from the real-world) regarding safety and efficacy could reduce a clinician's perception of biosimilar uncertainty and can potentially increase biosimilar acceptance and uptake. The published literature is lacking regarding the real-world impact on healthcare costs and clinical outcomes when a single healthcare institution converts from filgrastim to filgrastim-sndz as its short-acting Granulocyte Colony Stimulating Factor (GCSF), especially within diverse populations and indications not explicitly studied through the registration trials. Specifically, both filgrastim and filgrastim-sndz possess FDA-approved indications within patients with hematologic malignancies receiving high-dose chemotherapy and in those undergoing bone marrow transplantation. As a biosimilar to filgrastim, the FDA did not require prospective, randomized controlled trials to obtain these indications for filgrastim-sndz. The purpose of this study is to describe real-world healthcare resource costs, utilization patterns, and clinical outcomes in patients with hematologic malignancies who received filgrastim-sndz or filgrastim to support neutrophil recovery following chemotherapy (i.e., induction or consolidation) or a bone marrow transplant (BMT) at Yale New Haven Hospital (YNHH). Methods A total of 148 patients were identified and met the following criteria: at least 18 years old, Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 2, absence of fever or infection, newly diagnosed acute myeloid leukemia or newly post-bone marrow transplant and received filgrastim-sndz (Zarxio®) or reference filgrastim (Neupogen®). Results Healthcare resource utilization outcomes were compared between biosimilar and reference filgrastim using descriptive statistics. There were no major differences between either cohort, including duration of hospitalization, the number of overall emergency room visits and additional hospital admissions with a primary diagnosis of febrile neutropenia or neutropenia within 30 days post-discharge from initial hospital admission, time to neutrophil recovery following GCSF support, and the incidence and duration of both fever and febrile neutropenia. The total cost based on treatment of all patients in each arm differed significantly with filgrastim-sndz being the most cost-effective choice. Conclusion filgrastim-sndz significantly reduced healthcare utilization costs compared to reference filgrastim with similar effect on absolute neutrophil count, incidence of fever, and febrile neutropenia.
Exploring the Impact of Social Media on Attaining HbA1c Targets in Individuals with Type 2 Diabetes Mellitus in Iraq: A Cross-Sectional Study
Authors: Atia Jabbar J. , Dheyaa Al-Obaidi Ahmed , Sermed Al Sakini Ahmed , Ali Al-Saady Yousif , Othman Assalah , Talib Hashim Hashim , Najah Al-Obaidi Mustafa , Al-Obaidi Hasan , Merza Nooraldin 
Published: October 2024

Objectives: Type 2 diabetes mellitus (T2DM) is a persistent metabolic illness causing elevated glucose levels due to insulin resistance. Social media has been found to positively impact diabetes management by boosting motivation, adherence, emotional support, and sharing evidence-based information, thereby enhancing patients’ glycemic control efforts and achieving HbA1c targets. Primarily to examine the influence of social media within a random sample Iraqi population of T2DM patients on the control of diabetes, as measured by HbA1c levels. Methods: A multicentric cross-sectional study involves patients diagnosed with T2DM recruited between December 30, 2019 and November 8, 2023. Patients diagnosed with T2DM, who visited the outpatient clinic at least twice during the study period, were included. The sample size comprised 2921 patients. Various social media platforms available including, Facebook, WhatsApp, Instagram, Telegram, X (formerly known as Twitter), and Viber, were reported. Results: The study involves 2921 participants with a mean age of 53.3 years, 56% of them successfully reached their HbA1c target within a mean of 18.17 months. A significant correlation was found between achieving the target and using social media ( P = .0001), with a shorter average duration among social media users compared to non-users. A family history of diabetes also significantly correlated with achieving the desired outcome, suggesting a probable positive correlation ( P = .019). Conclusion: The study reveals a significant association between social media usage and glycemic control, introducing the importance of technology-based interventions in enhancing diabetes self-management, highlighting the relationships between social media engagement and HbA1c target achievement.