bluuebunny/crossref_metadata_2025_split huggingface dataset:
Implementation of an early attention strategy to reduce emergency room overcrowding in an academic institution in Colombia, a pilot study
Authors: Jaramillo German Devia , Zuluaga Nathalia Esmeral , Avellaneda Viviana Andrea Velandia , Ramirez Salvador Menendez , Neira Fernando Jose Pimienta , Contador Angie Paola Lopez , Gallo Juan Pablo Vargas 
Published: October 2024

AbstractOvercrowding is a worldwide problem, and long waiting times are associated with increased morbidity and even mortality of patients regardless of triage classification. Although there are many tools published in the literature that contribute to the reduction of overcrowding, for the Colombian population there are not many tools evaluated to reduce the length of stay of patients in the emergency department. This is a retrospective analytical study that compared whether there was a difference in patient definition time and ED length of stay between a group attended under an early care protocol (PAT) versus the usual protocol. Of the total of 969 patients included it was found that the group attended under the PAT protocol had a shorter definition time than the usual protocol, also the Emergency department length of stay (EDLOS) was significantly lower in the PAT group compared to the usual protocol. The implementation of the PAT protocol performed by emergency physicians allows a faster contact with the patient by the physician, and leads to a significant reduction of EDLOS, contributing to the reduction of overcrowding in the emergency department.
Lost in space and time: robust demography and enhanced resilience buffer adverse environmental effects in a highly isolated and sedentary pre-pleistocene landscape vertebrate
Authors: Kok Philippe J. R. , Broholm Tessa L. , van Doorn Loïc , Fiorillo Bruno Ferreto , Smith Carl 
Published: October 2024

Abstract
Background
Few animal populations have been studied under the framework of the OCBIL theory, which addresses the ecology and evolution of biodiversity on old climatically buffered infertile landscapes. Available genetic data challenge the low connectivity and high genetic differentiation predicted for isolated tepui-summit vertebrate communities, suggesting potential dispersal among summits. However, the OCBIL theory posits reduced dispersibility, enhanced resilience to habitat fragmentation and inbreeding due to small populations. We tested these hypotheses by conducting the first analytic evaluation of the spatial ecology and population biology of a tepui-summit vertebrate at multiple spatial scales.

Results
We used harmonic radar tracking (100 individuals/448 points of contact) and capture-mark-recapture data (596 individuals captured/52 recaptured) to reveal the temporal niche, microhabitat use, population size, and dispersal abilities of the tepui-summit endemic toad Oreophrynella quelchii on Roraima-tepui. Abundance was determined using a closed population model incorporating sources of variation in capture probability. We tested the relative influence of biotic and abiotic variables on distances moved through model selection. Our data indicate that the population size of O. quelchii is remarkably large (ca. 12 million individuals), with strong seasonal demographic fluctuations. Ecology and observed limited spatial movements challenge the likelihood of active dispersal among tepui tops in this species. Our results are counter to those predicted by the available genetic data but support two hypotheses of the OCBIL theory: reduced dispersibility and enhanced resilience. However, they do not support the expectation of a small refugial population size.

Conclusion
We postulate that the insular, hostile tepui-summit environment tends to produce robust demographic populations, likely to buffer stochastic adverse environmental effects, rather than diversity, as observed in much younger post-Pleistocene Neotropical landscapes. Our results draw attention to the value of faunal studies using an OCBIL framework to better understand the ecology and evolution of this unique biota worldwide.
Strategies for implementation of a transmural fall-prevention care pathway for older adults with fall-related injuries at the emergency department
Authors: Charmant W. M. , Snoeker B. A. M. , van Hout H. P. J. , Geleijn E. , van der Velde N. , Veenhof C. , Nanayakkara P. W. B. 
Published: October 2024

Abstract
Background
Although indicated, referrals for multifactorial fall risk assessments in older adults with fall related injuries presenting at the emergency department (ED) are not standard. The implementation of a transmural fall-prevention care pathway (TFCP) could bridge this gap by guiding patients to multifactorial fall risk assessments and personalised multidomain interventions in primary care. This study aims to develop and evaluate implementation strategies for a TFCP.

Methods
In this mixed-methods implementation study, strategies were developed using the Consolidated Framework for Implementation Research Expert Recommendations for Implementing Change Matching Tool. These were evaluated with patients, involved healthcare professionals, and other stakeholders using the Reach, Adoption, Implementation, and Maintenance of the RE-AIM framework in two cycles. Patients of the TFCP consisted of frail community dwelling individuals aged 65 and over presenting at the ED with fall related injuries.

Results
During the first implementation phase, strategies were focussed on assessing readiness, adaptability, local champions, incentives and education for all involved healthcare professions in the TFCP. Only 34.4% of eligible patients were informed of the TFCP at the ED, 30.6% agreed to a fall risk assessment and 8.3% patients received the fall risk assessment. In the second phase, this improved to 67.1%, 64.6%, and 35.4%, respectively. Strategies in this phase focussed on adaptability, obtaining sustainable financial resources, local champions, assessing readiness, and education. The implementation was facilitated by strategies related to awareness, champion recruitment, educational meetings, adaptability of TFCP elements and evaluations of facilitators and barriers.

Conclusion
The study outlined strategies for implementing TFCPs in EDs. Strategies included increasing awareness, utilising local champions, educational initiatives, adaptability of the TFCP, and continuous monitoring of facilitators and barriers. These insights can serve as a blueprint for enhancing fall prevention efforts for older adults in emergency department settings.
A model of prevention of mother-to-child transmission and health management team for improving adverse outcomes of pregnancy syphilis in Ningxia, China
Authors: Zhang Chenglei , Yue Jinwei , Ji Liying , Huang Yongxiang , Shi Qingmei , Yang Xiulian , Wang Jingjiao 
Published: October 2024

AbstractRegional variations exist in the implementation of Syphilis Mother-to-Child Transmission Prevention (PMTCT). Thus, it is crucial to assess the effectiveness of this model in the Ningxia region and explore the supplementary role of Health Management Teams (HMT). This study established the PMTCT + HMT model and examined its impact on adverse outcomes in pregnant women with syphilis infection. The majority of participants were urban residents, married, had a minimum high school education, and held public positions; 36.7% and 26.7% were from minority ethnic groups. The PMTCT + HMT model enhanced participants’ knowledge, rates of voluntary counseling, and testing. The incidence of adverse pregnancy outcomes (miscarriages, preterm births, stillbirths) significantly decreased, and adverse neonatal outcomes (low birth weight, neonatal mortality, congenital syphilis) were notably reduced. Simultaneously, we identified factors associated with adverse outcomes, including non-residency, unmarried status, lower educational attainment, minority ethnicity, primary syphilis, and positive titers. Thus, HMT may be an effective intervention to enhance the effect of PMTCT for syphilis. The unique population structure in Ningxia is closely linked to adverse outcomes, highlighting the significance of providing equitable treatment for vulnerable populations.
A rare cause of echogenic kidneys with oligohydramnios in the fetus: report of two different cases
Authors: Phetthong Tim , Achaloetvaranon Krit , Diawtipsukon Sanpon 
Published: October 2024

Abstract
Background
Prenatal ultrasound findings of fetal bilateral echogenic kidneys accompanied by oligohydramnios can be highly stressful for both pregnant women and physicians. The diversity of underlying causes makes it challenging to confirm a prenatal diagnosis, predict postnatal outcomes, and counsel regarding recurrence risks in future pregnancies.

Case Presentation
We report two cases of abnormal fetal echogenic kidneys with oligohydramnios detected in the early third trimester. Autosomal recessive polycystic kidney disease (ARPKD), a rare genetic syndrome, was initially suspected in both cases. However, postnatal diagnoses differed: the first case was confirmed as glomerulocystic kidney disease (GCKD) through renal pathology, while the second case was diagnosed as ARPKD with a compound heterozygous likely pathogenic PKHD1 mutation.

Conclusion
Prenatal diagnosis of fetal echogenic kidneys with oligohydramnios should prioritize accurate diagnosis. Given the differences in the clinical spectrum, GCKD should be considered a differential diagnosis for this condition, particularly ARPKD. This study highlights the importance and benefits of molecular diagnosis and postnatal renal pathology for precise diagnosis and effective counseling.
Development of graded prognostic assessment for breast Cancer brain metastasis incorporating extracranial metastatic features: a retrospective analysis of 284 patients
Authors: Wang Yan , Xu Hangcheng , Sa Qiang , Li Li , Han Yiqun , Wu Yun , Zhou Yiran , Xu Binghe , Wang Jiayu 
Published: October 2024

Abstract
Background
Breast cancer brain metastasis (BCBM) is associated with poor survival outcomes and reduced quality of life. The Graded Prognostic Assessment (GPA) score model serves as a well-established tool for predicting the prognosis of BCBM. Notably, the presence of extracranial metastasis (ECM) is considered as a significant prognostic factor in the breast GPA model. This study aims to further refine other features of ECM to enhance the prognostic prediction for BCBM.

Methods
This study included all inpatients diagnosed with BCBM at the Cancer Hospital, Chinese Academy of Medical Sciences, from January 2010 to July 2021. Baseline characteristics of patients were compared based on features of ECM, including the presence, number, location, and control status of metastases. Overall survival (OS) were compared using the Kaplan–Meier method with log-rank tests. Cox regression analyses were conducted to identify significant prognostic factors. The aforementioned ECM features were incorporated into the original Breast-GPA model to enhance its prognostic accuracy. The concordance index (C-index) and restricted mean survival time (RMST) were utilized to evaluate and compare the predictive accuracy of the updated and original survival models.

Results
284 patients with BCBM were included in the study. Kaplan–Meier survival curves suggested that patients without ECM when diagnosed with BCBM showed better survival (p = 0.007). In the subgroups with ECM, more than 3 organs involved, both bone and visceral metastasis and progressive ECM portended dismal OS (p = 0.003, 0.001 and <0.001). Multivariate analysis demonstrated that molecular subtype, presence of ECM, and number of brain metastasis significantly influenced OS after BCBM. By modifying the current GPA model to include more precise characteristics of ECM, the predictive accuracy was further enhanced as indicated by the C-index and RMST curve.

Conclusions
More ECM sites, both bone and visceral invasion and uncontrolled ECM were dismal prognostic factors for survival outcomes of BCBM patients. A new Breast-GPA model with better predictive effect was constructed.
Children’s self-reported exposure to sugary beverage advertisements and association with intake across six countries before and during the COVID-19 pandemic: a repeat cross-sectional study
Authors: Demers-Potvin Élisabeth , Lemieux Simone , Acton Rachel B. , Penney Tarra L. , Sacks Gary , White Christine M. , White Martin , Hammond David , Vanderlee Lana 
Published: October 2024

Abstract
Background
Children’s exposure to sugary beverage advertising may have changed during the COVID-19 pandemic due to shifts in media habits, which could subsequently have influenced intake. This study aimed to examine: 1) children’s frequency and setting of exposure to advertisements of sugary beverages in six countries before and during the COVID-19 pandemic; 2) the association between exposure to sugary beverage advertisements and intake.

Methods
Children aged 10–17 years (n = 28,908) in Australia, Canada, Chile, Mexico, the United Kingdom (UK) and the United States (US) completed online surveys in 2019, 2020 and 2021 as part of the International Food Policy Study using a repeat cross-sectional study design. Respondents self-reported frequency and setting of exposure to sugary beverage advertisements, location of school classes (in-person/online, 2020–2021 only), screen time, and sugary beverage intake. Adjusted weighted logistic and negative binomial regression models stratified by country examined associations between year and reported sugary beverage advertising exposure, and associations between sugary beverage advertising exposure and intake. Differences in reported advertising exposure between students taking online or in-person school classes were explored.

Results
Self-reported exposure to advertisements for sugary beverages at least weekly was relatively stable across years within countries, with differences in settings of exposure. Exposure to sugary beverage advertisements increased on digital media independently of screen time from 2019 to 2021 in Australia, Canada, the UK and US, with a concomitant decrease in exposure in retail settings in all countries except the UK. In Australia and the UK, children attending all classes online were more likely to report at least weekly (vs less than once a week) exposure to sugary beverage advertisements, and children attending all classes online were more likely to report exposure to advertisements on digital media and in other settings (e.g., billboard, magazines) compared to children attending in-person classes in Australia, Canada and the UK. Exposure to sugary beverage advertisements at least weekly (IRR = 1.12,99%CI:1.09–1.15) and in each of the settings was associated with sugary beverage intake.

Conclusions
Exposure to digital advertisements for sugary beverages increased from 2019 to 2021 in most countries, and exposure was associated with sugary beverage intake. Reducing children’s exposure to advertising of less healthy foods, including on digital media, may reduce sugary beverage intake.
A descriptive epidemiological study of the prevalence of self-reported sensory difficulties by age group, sex, education, disability, and migration status in Sweden in 2020
Authors: Badache Andreea-Corina , Mäki-Torkko Elina , Widen Stephen , Fors Stefan 
Published: October 2024

Abstract
Background
The objective of this study is to estimate the prevalence of self-reported hearing difficulties, vision difficulties and combined vision and hearing difficulties in a Swedish adult population that varies according to migration status, sex, age, disability measured by ADL and IADL and educational attainment level.

Methods
The study utilised data from the Survey of Health, Ageing and Retirement in Europe, which consisted of 2257 individuals aged 60 and above that were interviewed in Sweden in the 2019/2020, SHARE wave 8. To determine the prevalence of sensory difficulties (hearing, vision and dual-sensory difficulties) among various subgroups of the population, a multinomial logistic regression was used. The results of these analyses are presented in terms of predicted probabilities.

Results
The study findings indicate that foreign-born older adults experience a lower prevalence of visual difficulties (6.2% [3.3–11.5] in comparison to their Swedish-born counterparts. Moreover, older adults with higher levels of education tend to report a lower prevalence of sensory difficulties overall. Furthermore, sex differences are apparent, with males reporting a higher prevalence of hearing difficulties (18.9% [15.5–22.8] vs. 12.8% [10.7–15.3]) and females reporting a higher prevalence of vision difficulties (12.7% [10.7–15.1] vs. 8.5%[6.8–10.5]).

Conclusion
The findings highlight disparities in the prevalence and type of perceived sensory difficulties experienced by older adults, by factors such as age, sex, education and migration status. It is important to consider these demographic factors in healthcare planning and interventions aimed at mitigating sensory difficulties in the older population.
Exploration of the triceps surae muscle in ambulatory children with cerebral palsy using instrumented measurements of stiffness and diffusion tensor magnetic resonance imaging for muscle architecture
Authors: Åhblom Alexandra , Pontén Eva , Destro Antea , Petersson Sven , von Walden Ferdinand , Wang Ruoli , Lidbeck Cecilia 
Published: October 2024

Abstract
Background
Musculoskeletal alterations causing reduced range of motion of the ankle joint are common in children with cerebral palsy (CP). Objective measurements of passive joint resistance and three-dimensional skeletal muscle volume and muscle architecture can lead to a comprehensive understanding of which factors influence joint range of motion.

Research question
To investigate the relation between the passive dorsiflexion of the ankle joint, biomechanical contributing factors to the passive joint resistance, and muscular architectural properties of the triceps surae muscle in children with CP.

Methods
In this cross-sectional observational study, 14 children with spastic CP (bilateral: 5, unilateral: 9, Gross Motor Function Classification System (GMFCS) level I:11, II:3) naïve to intramuscular tone reducing treatment, and 14 TD children were included. The passive dorsiflexion of the ankle was measured with a goniometer. Passive joint resistance and related parameters were estimated based on a biomechanical model and measurements using a motorized device, the Neuroflexor. Three-dimensional muscle architecture was quantified with diffusion tensor magnetic resonance imaging (DT-MRI).

Results
In the CP group, the median [min, max] passive dorsiflexion was decreased in the most affected leg (MAL) compared to the less affected leg (LAL) (2.5° [-25°, 20°] vs. 12.5° [5°, 30°], p = 0.001). The stiffness coefficient (Nm/rad) in the MAL was significantly higher in children with CP compared to TD children (7.10 [3.39, 62.00] vs. 2.82 [1.24, 10.46], p = 0.015). Muscle architecture properties did not differ between CP and TD, except for pennation angle in the medial gastrocnemius (MG) of the MAL (CP 17.64° (2.29) vs. TD 21.46° (3.20), p = 0.017). The stiffness coefficient, in the MAL, correlated negatively to passive dorsiflexion (rs=-0.638) and pennation angle in medial gastrocnemius (rs=-0.964), and the non-linear coefficient (Non-linear 1) correlated negatively to the fascicle length of the medial gastrocnemius (rs=-0.857).

Conclusion
This study shows that stiffness of the plantarflexors is related to decreased passive dorsiflexion of the ankle and muscle structure of the MG in high-functioning children with spastic CP. Assessments of how dynamic components as well as microscopic muscle alterations contribute to joint stiffness in the plantarflexors in individuals with CP are warranted.

Trial registration
Retrospectively registered in ClinicalTrials.gov, NCT05447299. Observational study. Study start: 2019-01-15, register date: 2022-07-01.
Strategy for scheduled downtime of hospital information system utilizing third-party applications
Authors: Jo Inhae , Kim Woojin , Lim Younghee , Kang Eunjeong , Kim Jinung , Chung Hyekyung , Kim Jihae , Kang Eunhye , Jung Yoon Bin 
Published: October 2024

Abstract
Background
The widespread adoption of Hospital Information Systems (HIS) has brought significant benefits in healthcare quality and workflow efficiency. However, downtimes for system maintenance are inevitable and pose a considerable challenge to continuous patient care. Existing strategies, including manual prescription methods, are no longer effective due to increasing reliance on digital systems.

Method
This study implemented two main strategies to mitigate the impact of scheduled downtimes. First, we created an “Emergency query program” that switches to a read-only backup server during downtimes, allowing clinicians to view essential patient data. Second, an “Emergency prescription system” was developed based on the Microsoft Power Platform and integrated into Microsoft Teams. This allows clinicians to perform digital prescriptions even during downtimes.

Results
During a planned 90-minute downtime, 282 users accessed the Emergency Prescription System, resulting in 22 prescriptions from various departments. Average times for prescription confirmation and completion were 8 min and 3 s, and 18 min and 40 s, respectively. A post-downtime evaluation revealed high user satisfaction.

Conclusion
Essential maintenance-induced HIS downtimes are inherently disruptive to patient care process. Our deployment of an emergency query program and a Microsoft Teams-integrated emergency prescription system demonstrated robust care continuity during HIS downtime.
Database of twitter influencers in cryptocurrency (2021–2023) with sentiments
Authors: Jahanbin Kia , Chahooki Mohammed Ali Zare 
Published: October 2024

Abstract
Objectives
With the expansion of social networks such as Twitter, many experts share their opinions on various topics. The opinions of experts, who are also known as influencers, can be very influential. Combining these tweets and the historical prices of cryptocurrencies makes it possible to predict their price trends accurately. A Hybrid of RoBERTa deep neural network and BiGRU has been used for Sentiment Analysis (SA). Sentiments of tweets can be of great help to investors to understand the future behavior of the market and manage the stock portfolio. Unlike the tweets that are only extracted using the cryptocurrency name hashtag, the tweets of this dataset have specialized opinions and can determine the market trend.

Data description
The dataset created in this research concerns the opinions of more than 52 influencers (persons or companies) regarding eight cryptocurrencies. This dataset was collected through the Apify Twitter API for eight months, from February 2021 to June 2023. This dataset contains five Excel files and tweets, compound score, importance coefficient of each tweet, sentiment polarity, and historical prices of four cryptocurrencies: Bitcoin, Ethereum, Binance, and other information. These tweets cover the opinions of 52 influencers on more than 300 cryptocurrencies, although most comments are related to Bitcoin, Ethereum, and Binance. For this reason, three Excel files containing the historical prices of polarity and compound sentiment related to Bitcoin, Ethereum, and Binance cryptocurrencies have been placed separately in the dataset. The polarity of sentiment in these Excel shows the maximum number of polarities by applying the importance coefficient, which determines the dominant polarity of sentiment related to a particular day for the cryptocurrency.