bluuebunny/crossref_metadata_2025_split huggingface dataset:
Using the Implementation Research Logic Model to Examine High-Intensity Resistance Rehabilitation Implementation in Skilled Nursing Facilities: A Mixed Methods Multi-Site Case Study
Authors: Hinrichs-Kinney Lauren , Derlein Danielle , Pontiff Mattie E , Malone Daniel , Holtrop Jodi Summers , Stevens-Lapsley Jennifer E 
Published: October 2024

Abstract

Background
Implementing evidence-based rehabilitation in skilled nursing facilities (SNFs) is essential for enhancing physical function outcomes and mitigating risk of adverse events. Best implementation approaches in this complex setting are unknown. This study uses the Implementation Research Logic Model (IRLM) to examine the implementation of high-intensity resistance rehabilitation (HIR) in SNFs, aiming to elucidate contextual factors and processes that could enhance future HIR implementation endeavors.
Methods
We conducted a mixed-methods multi-site case study (n = 8 sites) to examine implementation. A standardized implementation strategy was employed, allowing sites to tailor their approaches. Use of HIR was measured using the Provider Report of Sustainment Scale (PRESS). Contextual factors were identified using the Practical Robust Implementation and Sustainability Model (PRISM) through study-specific questionnaires and validated measures (Inner Setting Scale, Provider Perspective of Team Effectiveness, Evidence Based Practice Attitudes Scale, Perceived Characteristics of Intervention Scale, Self-Defined Burnout Measure, and Utrecht Engagement Scale), and analyzed descriptively. Interviews and focus groups with leadership and clinicians revealed contextual factors and processes influencing implementation. Heat maps visualized site trends, while an Implementation Research Logic Model (IRLM) proposed provisional implementation processes.
Results
PRESS scores ranged from 3.75 (0.17) to 2.33 (0.67) indicating all sites implemented HIR to at least a “moderate extent”. Higher-implementing sites demonstrated full-team ability to accommodate HIR to diverse patients. Differentiating factors between higher and lower implementing sites included clinician perspectives, site infrastructure, and satisfaction with leadership. Higher-implementing sites employed a higher volume of site-initiated implementation strategies, notably having a champion and consumer engagement. Processes that appeared to contribute to higher implementation extent included: 1) overcoming inertia of current practice through salience, 2) overcoming clinician concerns of patient compatibility through affirmative experiences, 3) addressing clinician perspective of complexity with session planning, and 4) optimizing patient rehabilitation mindset through encouraging environments.
Conclusion
Improving physical function in older adults necessitates adoption of evidence-based rehabilitation like HIR. Implementation strategies that target infrastructure, including leadership support and communication channels, inertia of current practice, and clinician perspectives of HIR complexity and patient compatibility may facilitate implementation. Identifying a champion and providing guidance for effective patient engagement appear to be key.
Treatment of phase II empyema with intrapleural alteplase vs surgical debridement in children: A retrospective cohort study
Authors: Cuellar Maria Paula Vargas , Reyes Isabel Cristina Cañon , Ramirez Lilian , Romero Maria De Los Angeles , Ucros Carmen , Rueda Sergio , Mogollon German 
Published: October 2024

Abstract

Purpose
Describe a treatment protocol with intrapleural alteplase for phase II empyema in children and compare its efficacy and development of complications with surgical debridement.
Methods
Retrospective cohort design of children with phase II empyema treated with surgical debridement or alteplase through thoracostomy. Clinical outcomes and postoperative complications were analyzed. Efficacy was evaluated by resolution of empyema and need for re- intervention.
Results
38 patients were analyzed. Intrapleural alteplase presented less days of hospitalization (21.79 vs. 22.11 days), less blood transfusion requirement (36.84% vs. 42.11%) and less need (9 vs. 13 patients) and days of invasive mechanical ventilation (4.33 vs. 5.92 days), with no statistical difference (p = 0.68; p = 0.74; p = 0.68 respectively). Treatment failure was present in 4/19 patients treated with alteplase requiring further intervention compared to 6/19 patients treated with surgical debridement.
Conclusions
Intrapleural alteplase is as effective as surgical debridement for the treatment of phase II empyema for disease resolution and need for re-intervention. This study shows its safety and optimal clinical outcomes, minimal adverse events, less morbidity and clear clinical advantages due to its less invasive nature.
Prostate-Specific Antigen (PSA) and Its Association with Cardiovascular Disease Risk in US Men: A Population-Based Study
Authors: Chen Zhi-huang , Liu Yi-jiang , Li Rui , Wang Zhan , Chen Jia-lin , Li Li , Xiao Di , Jiang Shu-yan , Xu Lin-xi , Chen Xin , Zhuang Jia-wei , Xu Jia-cheng , Shan Zhong-gui 
Published: October 2024

Abstract

Background
This study aims to examine the associations of total PSA (tPSA), free PSA (fPSA), and PSA ratio with CVD risk in the adult male population of the United States.
Methods
In this study, we utilized data from the National Health and Nutrition Examination Survey (NHANES) database with cardiovascular condition,PSA levels and confounding factor information spanning 2001 to 2010. We tabulated the selected data to compare the baseline characteristics of participants.Using a multivariate logistic regression model, we calculated odds ratios (OR) and 95% confidence intervals (95% CI) to assess the potential correlation between total PSA (tPSA), free PSA (fPSA), and the PSA ratio with the odds of CVD and revealed that fPSA was the most significantly related. Subsequently, we divided fPSA into quartiles to further explore the differences in risk association among the different intervals. Additionally we applied forest plots to display the effects of covariates in this risk relation. Two-sided p-tests derived from Wald tests were applied to verify the significance of the results.
Results
Higher fPSA levels were significantly associated with an elevated risk of CVD in each model(Model1: OR:1.90;95%CI: 1.48–2.46; P < 0.001 ;Model2: OR:1.89;95%CI: 1.47–2.42; P < 0.001 ;Model3:OR:1.71;95%CI: 1.33–2.20; P < 0.001). The multivariable OR for the highest versus lowest quartile of fPSA after fully adjusted was 2.55 (95% CI: 1.98–3.29; P-trend < 0.001). Similar but weaker associations were observed for tPSA and PSA ratio. In the fully adjusted model of tPSA, the OR was 1.08 (95% CI: 1.03–1.12; P < 0.001), and for PSA ratio, the OR was 1.01 (95% CI: 1.00-1.01; P = 0.11).
Conclusions
Our study suggests that elevated fPSA levels may be associated with a higher prevalence of CVD. This analysis offers a novel perspective on the complex relationship between PSA and CVD. Further research is warranted to elucidate the potential mechanisms underlying this association in this filed.
Combating Deepfakes Using an Integrated Framework forAudio and Video Deepfake Detection
Authors: Sharma Vishal Kumar , Singh Shailendra Narayan , Caudron Quentin 
Published: October 2024

Abstract

The creation and accessibility of synthetic audio-visual media which is commonly known as deepfakes has been into an alarming situation with the rapid advancement of generative AI techniques. This media is fabricated or sometimes manipulated and it can serve threats to individuals’ privacy, security and integrity of information. This situation makes it crucial to develop robust and reliable deepfake detection methods to mitigate these risks. We present a multimodal approach to deepfake detection leveraging both audio and visual signals. By harnessing the power of deep learning, our proposed framework extracts discriminative audio and visual features which are then fused to classify the synthetic media effectively. For audio analysis, we employ mel-spectrogram representations and convolutional neural networks (CNNs) to capture spectral patterns indicative of deepfakes. On the front of video, we utilize facial landmark detection, alignment, and deep CNNs to model facial cues and inconsistencies associated with deepfakes. The fusion of these audio and video modalities enables our model to capitalize on complementary information, enhancing its ability to detect deepfakes accurately. Extensive experiments on benchmark datasets, including DeepFakeTIMIT and DFDC, demonstrate the efficacy of our approach, achieving a precision of 0.78, an accuracy of 0.93, and an F1 score of 0.82, outperforming several state-of-the-art monomodal methods. Our findings underscore the importance of multimodal analysis for robust deepfake detection and pave the way for developing more sophisticated techniques to safeguard media authenticity in an increasingly synthetic world.
The Effect of Empowerment Based on 5A Model on Fall Self-Efficacy, Self-Care and Quality of Life in Older Adults: A Parallel Randomized Clinical Trial
Authors: Maghsoodloo Ermia , Ebrahimi Hossein , Goli Shahrbanoo , Khoddam Homeira , Dadgari Ali 
Published: October 2024

Abstract

Background: With aging and declining functional abilities in older adults, the fear of falling increases, leading to decrease in quality of life. Self-care is an important factor in maintaining older adults' overall health and quality of life. This study aimed to determine the effect of empowerment via the 5A model on fall self-efficacy, self-care, and quality of life in older adults.
Methods: This clinical trial study was conducted with 110 elderly individuals residing in the community. The participants were selected via a sequential sampling method and were allocated to the control and intervention groups viablock randomization in sets of four. The control group received routine care from comprehensive health service centers, whereas the intervention group received 5A model-based empowerment over a 12-week program. The data collection instruments included a demographic characteristics form and questionnaires such as the Activities-Specific Balance Confidence Scale, the WHO-5 Well-Being, and the Elderly Self-Care, which were completed before random allocation and after the twelfth week. The data were analyzed using chi-square tests, Fisher's exact tests, independent t-tests, and analysis of covariance.
Results: The mean and standard deviation (SD) of the participants' age were 68.28±3.14. The mean differences in the scores of fall self-efficacy (p<0.001), self-care (p<0.001), and quality of life (p<0.001) before and after the intervention were significantly different between the control and intervention groups.
Conclusion: Empowerment based on the 5A model led to improvements in fall self-efficacy, self-care, and quality of life among older adults. Health caregivers and nurses can utilize this model to increase fall self-efficacy, reduce fear of falling, improve self-care, and improve quality of life among older adults, as well as to design care programs.
Trial registration:Iranian Registry of Clinical Trials (IRCT20221231057000N2; 11/12/2023)
When should on-scene CPR be terminated in OHCA patients?: Prognostic Models for Outcomes Based on Duration of On-Scene CPR in OHCA
Authors: Chun Soh Yeon , Kim Gi Woon , Kim Han Bit 
Published: October 2024

Abstract

Background
Out-of-Hospital Cardiac Arrest (OHCA) is a leading cause of mortality worldwide, with approximately 30,000 cases managed annually by Emergency Medical Services (EMS) in South Korea. Prolonged on-scene Advanced Life Support (ALS) in OHCA patients has demonstrated potential for prehospital return of spontaneous circulation (ROSC) and neurological improvement. However, the optimal timing for terminating on-scene CPR in patients who do not achieve ROSC remains challenging. This study aims to develop and validate a predictive model for patient outcomes based on the duration of on-scene CPR in OHCA patients using data from the Smart ALS (SALS) protocol in South Korea.
Methods
A multi-regional observational study was conducted from August 2015 to December 2022, involving 19 fire stations and nine academic tertiary hospitals across seven provinces. Data were sourced from the SALS database, including EMS prehospital care reports, SALS intervention logs, and hospital patient records. The study focused on non-traumatic OHCA patients who underwent SALS, excluding those with obvious signs of death, those under 18 years old, those who refused on-scene CPR, or those with a DNR status. Statistical analyses were performed using R software, employing logistic regression models to predict prehospital ROSC, survival to discharge, and favorable neurological outcomes.
Results
Out of 98,569 OHCA patients evaluated, 34,989 were eligible for SALS, and 16,052 received SALS. Significant predictors of prehospital ROSC included younger age, male gender, arrest occurring in public places, witnessed arrest, bystander CPR, and initial shockable rhythm. Logistic regression models for patients who did not achieve prehospital ROSC showed that longer on-scene CPR duration negatively impacted the probability of ROSC, survival to discharge, and neurological outcomes. The predictive model for ROSC had an AUC of 0.730, for survival to discharge AUC of 0.838, and for favorable neurological outcome AUC of 0.917.
Conclusions
This study emphasizes the critical role of prehospital ROSC in improving survival and neurological outcomes in OHCA patients. The predictive models can aid in making informed decisions about the cessation of on-scene CPR. Further research is needed to validate these models and explore their application in different EMS settings.
Trial registration
Retrospectively registered.
Determinants of locally acquired malaria infections in Zanzibar: a cross-sectional study
Authors: Fakih Bakar Shariff , Seidahmed Osama , Holzschuh Aurel , Abdul Ramadhan , Irema Imani , Shija Shija J. , Aliy Safia M. , Ali Abdullah , Fink Günther , Yukich Joshua , Hetzel Manuel W. 
Published: October 2024

Abstract

Background
Zanzibar has made significant progress in malaria control reaching a population prevalence of around 1% with program-led interventions. Nevertheless, malaria infections persist in people with no recent travel history implying locally acquired infections. Understanding risk factors of local transmission is crucial to refine elimination strategies.
Methods
From May 2017 to October 2019, a rolling cross-sectional survey was conducted in five Zanzibar districts, linked to routine malaria surveillance procedures. The study involved testing all individuals living in households of clinical malaria cases (index cases) routinely detected at a health facility, and a sample of neighboring households using malaria rapid diagnostic tests and qPCR. Information on socio-demographic and household characteristics, recent travel and bed net use were collected during interviews.
Results
Among 17,891 surveyed individuals, 15,151 (85%) had not travelled outside Zanzibar in the last sixty days. Of these, 7286 were tested for malaria by qPCR and 2.6% [95% confidence interval (CI): 2–3%] tested positive. Members of index households were more likely to be infected (adjusted odds ratio [aOR ] = 14.9, 95% CI 9.7–23.0) than neighbours, as were individuals aged 5–15 and 16–25 years compared to older age groups (aOR = 4.0, 95% CI 2.5–6.5 and aOR = 2.0, 95% CI 1.3–3.1, respectively). Infections were more likely in Unguja residents (aOR = 1.3 95% CI 0.9–2.0), in people living in houses with no windows (aOR = 2.1, 95% CI 1.4–3.1), in those with no bed net (aOR = 2.3, 95% CI 1.4–3.1), those going to sleep early and in people living in areas with a higher local index of wetness.
Conclusion
Combatting locally acquired malaria in Zanzibar requires interventions and strategies that promote uptake of existing interventions such as bed nets, housing improvements, and the identification and targeting of individuals at higher risk of infection.
Evaluation of Keratinized Tissue Augmentation Using Amnion/Chorion Allograft vs. Autogenous Connective Tissue in Implant Therapy: A Retrospective Study
Authors: De Angelis Nicola , Pesce Paolo , Kassim Zethy Hanum , Yumang Catherine , Baldi Domenico , Menini Maria 
Published: October 2024

Abstract

Objectives: Successful implant therapy must also ensure the integration of the soft tissues around the crown/abutment emergence profile. The existing literature does not consistently agree on the necessity of a minimal amount of keratinized tissue (KT), though it appears advantageous for the long-term stability and aesthetics of implants. The purpose of this clinical retrospective study is to compare the effectiveness of amnion/chorion membrane and autogenous subepithelial connective tissue in increasing the keratinized mucosa and maintaining it over a 5-year follow-up.
Methods: Twenty patients who had previously undergone implant surgery were included in the study. Ten patients had received the allograft (Group 1) and ten had received autogenous connective tissue (Group 2).An independent examiner retrospectively analyzed the patient records at 7, 15, and 60 days, and five years post-procedure. Data from these observations were collected and analyzed using SPSS Statistics, version 25. Descriptive statistical analysis was conducted.
Results: All patients exhibited an increase in KT. For Group 1, the mean KT width measurements were 1.27 ± 0.46 mm at the initial evaluation, increasing to 2.00 ± 0.38 mm, 2.80 ± 0.78 mm, 3.27 ± 0.80 mm, and 3.01 ± 0.68 mm at 7, 15, and 60 days post-surgery (with prosthesis delivery on day 60), and five years after prosthetic rehabilitation, respectively.
Conclusions: Within the limitations of this retrospective clinical study, both amnion/chorion and connective tissue show significant potential for KT expansion when used in conjunction with implant surgery. Considering the minimally invasive approach, focusing future research on the use of allografts or xenografts appears justified. Clinical Relevance: the use of allografts , due their low morbidity, and acceptable results should be considered as a viable option for soft tissues augmentations.
Characteristics of and risk factors for early migration of biliary plastic stents after stone removal with endoscopic retrograde cholangiopancreatography
Authors: Chen Longping , Lin Yanfang , Zheng Linfu , Jiang Chuanshen , Chen Zhiping , Li Dazhou , Wang Wen 
Published: October 2024

Abstract

Background and Aims: Biliary plastic stents often fall off prematurely or shift from the duodenal papilla can cause recurrent biliary tract infection or intestinal perforation. We aimed to investigate the incidence of and risk factors for early migration of biliary plastic stents after ERCP.
Methods: The study population underwent ERCP for bile duct stone removal and placement of biliary plastic stents were analyzed from March 2018 to December 2022. Patient data was obtained through the electronic medical records.
Results: A total of 836 patients (60.40±15.58 years, 511 males) were included. 105 patients showed early stent migration, of which 91 (10.9%) patients showed early stent shedding, and 14 (1.7%) patients showed displacement of stent. Multivariate logistic regression analysis showed that the risk of early stent migration was significantly higher in patients with a duodenal diverticula (OR = 2.367, P= 0.005), duodenal sphincter incision (OR = 3.638, P = 0.007), and longer stents (OR = 0.423, P＜0.001). The Christmas tree plastic stent was significantly less prone to early migration than the conventional biliary plastic stent (OR = 2.654, P = 0.034). The risk of stent displacement significantly increased with the degree of balloon dilatation (OR = 2.708, P= 0.043) and with the presence of diverticula in the descending part of the duodenum (OR = 6.412, P = 0.002).
Conclusion: Early stent migration often occurs after ERCP. Therefore, patients with risk factors for early stent migration should be followed up carefully.
Artificial Photosynthesis Directed toward Organic Synthesis
Authors: Saito Susumu , Mori Shogo , Hashimoto Riku , Hisatomi Takashi , Domen Kazunari 
Published: October 2024

Abstract

In nature, plants convert solar energy into chemical energy via water oxidation.1,2 Inspired by natural photosynthesis, artificial photosynthesis has been gaining increasing interest in the field of sustainability/green science and technology as a non-natural and thermodynamically endergonic (ΔG° > 0, uphill) solar-energy-driven reaction that uses water as an electron donor and source material.3,4 Among the artificial-photosynthesis processes, inorganic-synthesis reactions via water oxidation, including water splitting and CO2-to-fuel conversion, have been attracting much attention.5,6 In contrast, the synthesis of high-value functionalized organic compounds via artificial photosynthesis, which we have termed “artificial photosynthesis directed toward organic synthesis” (APOS),7 remains a great challenge. Herein, we report a pioneering example of APOS. The carbohydroxylation of C=C double bonds is accomplished via a three-component coupling with H2 evolution, where carbon groups activated via C–H bond scission and a hydroxy group derived from water are incorporated into the products. In these reactions, water also provides the hydroxyl radical for oxidation and electrons for the H2 evolution reaction. This uphill transformation is induced by dual functions of semiconductor photocatalysts, i.e., silver-loaded titanium dioxide (Ag/TiO2)8 and rhodium–chromium–cobalt-loaded aluminum-doped strontium titanate (RhCrCo/SrTiO3:Al),9–11 under simulated solar light. The present APOS protocol enables the rapid and creative construction of useful organic frameworks for drug synthesis.
IoT-Enabled Smart Glove for Enhanced Elderly Care: A Health Monitoring Solution
Authors: Ahmed Mohammad Faisal , Hasan Nowshad 
Published: October 2024

Abstract

With the growing elderly population, ensuring consistent and reliable healthcare monitoring has become increasingly important. This research introduces an innovative solution in the form of a smart glove designed specifically for elderly care. The glove is equipped with advanced features such as fall detection, emergency messaging via hand gestures, and vital signs monitoring, including oxygen saturation (SpO2) and heart rate.The smart glove integrates the MPU6050 and MAX30100 sensors with Arduino and ESP8266 modules to achieve these functionalities. Fall detection is accurately identified by the MPU6050 sensor, while the MAX30100 sensor monitors SpO2 and heart rate. Hand gestures are recognized and interpreted for sending emergency messages. Data from these sensors are transmitted through IFTTT, enabling alerts and notifications via SMS, email, and a secured website, thus facilitating real-time remote monitoring and communication.This setup provides a comprehensive and reliable method for monitoring the health and safety of elderly individuals, ensuring prompt response and care in emergencies. The proposed system demonstrates significant potential in enhancing the quality of life for elderly individuals by offering a smart, integrated, and user-friendly healthcare solution.