bluuebunny/crossref_metadata_2025_split huggingface dataset:
Leflunomide-Associated Wound Complication After Cochlear Implantation: A Case Report
Authors: Munjal Vikas , Macielak Robert J. , Kaul Vivian F. , Dodson Edward E. , Ren Yin 
Published: July 2024

Introduction: Cochlear implantation has become an increasingly common strategy for aural rehabilitation in patients with severe to profound hearing loss who no longer benefit from conventional amplification. In conjunction, immunosuppressive therapies (e.g. disease-modifying anti rheumatic drugs (DMARDs) have become the keystone of management in numerous autoimmune conditions. Given the increasing prevalence of both, a greater proportion of patients will undergo cochlear implantation while on immune-modulating medications. While these medications are usually well tolerated, immunosuppression may put patients a higher risk for device infections. At present, this is not extensively studied within the cochlear implant literature. Methods: We conducted a retrospective chart review and review of the literature. Results: We present the case of an 81-year-old male who experienced wound dehiscence and infection secondary to leflunomide use for treatment of rheumatoid arthritis. Resolution of these issues was noted with a therapeutic drug holiday, and the patient has subsequently undergone re-implantation without issue. Conclusions: The case highlights a potential CI-associated wound complication in the setting of DMARD therapy. Given the increasing prevalence of both CIs and immunosuppressive therapy, future study on the potential for interaction is warranted to identify the best management strategy in the perioperative setting.
Distribution of biochemical and haematological parameters in an aging population from southern India: A cross-sectional analysis
Authors: Mallikarjun Divya N , Jain Shubham , Malo Palash Kumar , Kahali Bratati , Sundarakumar Jonas S. , Diwakar Latha , Ravindranath Vijayalakshmi ,   SANSCOG study team
Published: July 2024

Background Examining the distribution of biochemical and haematological tests in different age groups of rural population is necessary to ensure that health care facilities are equipped to address the prevalent health conditions and manage age-related illness effectively. Hence, this study is aimed at seeing the distributions of blood biochemical and haematological parameters in rural population. Methods This cross-sectional study investigated the distribution of 26 different haematological and biochemical parameters in longitudinal cohort study (Srinivaspura Aging, NeuoSenescence and COGnition - SANSCOG), from the villages of Srinivaspura, Kolar district, India. A total of 2592 participants (1240 males and 1352 females), aged ≥45 years who are cognitively healthy were included for the analysis. Mean, 2.5th, 5th, 25th, 50th, 75th, 95th and 97.5th percentiles were calculated for the entire sample. Additionally, median and percentiles were determined for both gender and age categories (45-54, 55-64, 65-74, and ≥75 years). Results We observed the distinct distributions of various haematological and biochemical parameters, with elevated levels of glycaemic, lipid, liver, and thyroid parameters. Conclusion Findings revealed the notable variations from the established reference ranges, indicating the potential undiagnosed cases and highlighting the gaps in health awareness and health seeking behaviour.
Factors Influencing Maternal Substance Use and Recovery in the Perinatal Period
Authors: Renbarger Kalyn M. 
Published: July 2024

Background: Substance use disorders (SUD) in the perinatal period have risen dramatically over the past 2 decades. Substance use disorders can have deleterious effects on maternal-infant health. Recovery can improve quality of life but can be challenging for women with SUD in the perinatal period. It is important for health care providers to have an understanding of factors associated with maternal substance use and recovery. Objective: The purpose of this qualitative review was to identify factors influencing substance use and recovery in women with SUD in the perinatal period. Methods: A systematic search was conducted using the databases of CINAHL, PsycINFO, and PubMed along with a manual search of Google Scholar. The studies were assessed using criteria from the Joanna Briggs Institute’s critical appraisal checklist for qualitative research. Results: Findings from 16 qualitative studies were synthesized. Six descriptive subthemes identifying factors influencing substance use and recovery were revealed: (1) Infant Care, (2) Stigma, (3) Social Settings Involving Substance Use, (4) Internalized Stigma and Mental Health Symptoms, (5) Addiction Concerns, and (6) Coping Abilities. Conclusions: Participants described external and internal factors that influenced their substance use and recovery. The findings suggest health care providers refer women to residential addiction treatment, use destigmatizing language, promote access to peer services, and provide trauma-informed care.
Icon Arrays for Medical Risk Communication: Do Icon Type and Color Influence Cardiovascular Risk Perception and Recall?
Authors: Blase Rebecca , Meis-Harris Julia , Weltermann Birgitta , Dohle Simone 
Published: July 2024

Background Icon arrays have been shown to be an effective method for communicating medical risk information. However, in practice, icon arrays used to visualize personal risks often differ in the type and color of the icons. The aim of this study was to examine the influence of icon type and color on the perception and recall of cardiovascular risk, as little is known about how color affects the perception of icon arrays. Methods A total of 866 participants aged 40 to 90 years representative of the German population in terms of gender and age completed an online experiment. Using a 2 × 2 between-subjects design, participants were randomly assigned to 1 of 4 experimental groups. They received their hypothetical 10-year cardiovascular risk using an icon array that varied by icon type (smiley v. person) and color (black/white v. red/yellow). We measured risk perception, emotional response, intentions of taking action to reduce the risk (e.g., increasing one’s physical activity), risk recall, and graph evaluation/trustworthiness, as well as numeracy and graphical literacy. Results Icon arrays using person icons were evaluated more positively. There was no effect of icons or color on risk perception, emotional response, intentions of taking action to reduce the risk, or trustworthiness of the graph. While more numerate/graphical literate participants were more likely to correctly recall the presented risk estimate, icon type and color did not influence the probability of correct recall. Conclusions Differences in the perception of the tested icon arrays were rather small, suggesting that they may be equally suitable for communicating medical risks. Further research on the robustness of these results across other colors, icons, and risk domains could add to guidelines on the design of visual aids. Highlights The use of different icons and colors did not influence the perception and the probability of recalling the 10-year cardiovascular risk, the emotional response, or the intentions to reduce the presented risk. Icon arrays with person icons were evaluated more positively. There was no evidence to suggest that the effectiveness of the studied icon arrays varied based on individuals’ levels of numerical or graphical literacy, nor did it differ between people with or without a history of CVD or on medication for an increased CVD risk.
Machine Learning Methods to Estimate Individualized Treatment Effects for Use in Health Technology Assessment
Authors: Zhang Yingying , Kreif Noemi , GC Vijay S. , Manca Andrea 
Published: July 2024

Background Recent developments in causal inference and machine learning (ML) allow for the estimation of individualized treatment effects (ITEs), which reveal whether treatment effectiveness varies according to patients’ observed covariates. ITEs can be used to stratify health policy decisions according to individual characteristics and potentially achieve greater population health. Little is known about the appropriateness of available ML methods for use in health technology assessment. Methods In this scoping review, we evaluate ML methods available for estimating ITEs, aiming to help practitioners assess their suitability in health technology assessment. We present a taxonomy of ML approaches, categorized by key challenges in health technology assessment using observational data, including handling time-varying confounding and time-to event data and quantifying uncertainty. Results We found a wide range of algorithms for simpler settings with baseline confounding and continuous or binary outcomes. Not many ML algorithms can handle time-varying or unobserved confounding, and at the time of writing, no ML algorithm was capable of estimating ITEs for time-to-event outcomes while accounting for time-varying confounding. Many of the ML algorithms that estimate ITEs in longitudinal settings do not formally quantify uncertainty around the point estimates. Limitations This scoping review may not cover all relevant ML methods and algorithms as they are continuously evolving. Conclusions Existing ML methods available for ITE estimation are limited in handling important challenges posed by observational data when used for cost-effectiveness analysis, such as time-to-event outcomes, time-varying and hidden confounding, or the need to estimate sampling uncertainty around the estimates. Implications ML methods are promising but need further development before they can be used to estimate ITEs for health technology assessments. Highlights Estimating individualized treatment effects (ITEs) using observational data and machine learning (ML) can support personalized treatment advice and help deliver more customized information on the effectiveness and cost-effectiveness of health technologies. ML methods for ITE estimation are mostly designed for handling confounding at baseline but not time-varying or unobserved confounding. The few models that account for time-varying confounding are designed for continuous or binary outcomes, not time-to-event outcomes. Not all ML methods for estimating ITEs can quantify the uncertainty of their predictions. Future work on developing ML that addresses the concerns summarized in this review is needed before these methods can be widely used in clinical and health technology assessment–like decision making.
Setting Regional Priorities for Palliative and End-of-Life Care Research Using a Delphi Technique Approach
Authors: Efstathiou Nikolaos , Guo Ping , Walker Wendy , MacArtney John I. , Bailey Cara 
Published: July 2024

Objective Identifying research priorities is very important for palliative and end-of-life care to ensure research is focused on evidence gaps. This project aimed to identify and prioritise palliative and end-of-life care research areas within the West Midlands region in United Kingdom (UK). Methods A modified Delphi technique approach was used with palliative care stakeholders. The first round was item generation via rapid interviews. Data were analysed using content analysis and all the items were grouped into main categories. For round two, an online survey was conducted to present all the items from round one, and stakeholders were asked to rate the priority of items on a Likert-type scale (1 = not a priority to 7 = essential priority). Items that achieved consensus in round two were presented to the third round, where stakeholders ranked them in descending order. Results We completed and analysed 56 rapid interviews which resulted in 158 research items under 15 categories. The research items were rated by 30 stakeholders and seven items which reached consensus were subsequently ranked in order by 45 stakeholders. The highest ranked item was ‘Integrated care systems to prevent crisis’, followed by three research items related to ‘equity’ in palliative care. Conclusions Our research priorities, although unique for our region, mirror previously research priorities from other regions and countries. This suggests issues of integration and equity in palliative and end-of-life care remain unresolved, despite ongoing initiatives and research to address these issues.
Nurses Navigating Mental Health During Uncharted Times: Self, Others, Systems (S.O.S)!
Authors: Akoo Chaman , Price Sheri , McMillan Kimberly , Ingraham Kenchera , Ayoub Abby , Rolle Sands Shamel , Shankland Mylène , Bourgeault Ivy 
Published: July 2024

Study Background The nursing profession is facing a multiplicity of stressors that have both predated and been exacerbated by the Covid-19 pandemic. The emotional and physical demands entailed in nursing predispose nurses to suboptimal mental health and burnout. Purpose This paper draws upon the narrative interviews of 53 Canadian nurses as part of a larger pan-Canadian, cross disciplinary study that examined the gendered experiences of mental health, leaves of absence, and return to work of 7 professions. Methods Thorne's interpretive descriptive guided Iterative and thematic analysis which identified three predominant themes within the nursing dataset, this paper focuses on the substantive theme of ‘ Navigating it Alone,’ Results Nurses expressed a profound sense of isolation at 3 particular levels: at home, at work, and in systems – while simultaneously balancing uniquely gendered familial responsibilities and workplace demands. Conclusions These results illuminate instrumental pathways for stakeholders to attenuate the personal and professional pressures that continue to be disproportionately carried by nurses as they navigate these particularly challenging times.
Ups and Downs in Experience Design
Authors: Chen Hongqiao , Hu Ming , Liu Jingchen , Ravid Yaniv 
Published: July 2024

We show how prospect theory uncovers critical decision-making insights in the design of sequential experiences by formulating a general framework and applying it to three experience design settings. First, we study the problem of releasing a piece of good news versus bad news, where a firm may incrementally reveal the news over a preemptive period. We characterize the optimal release strategy for both types of news and show that when the ultimate news is good (resp., bad) and the audience is sufficiently gain-seeking, it is optimal first to release information of a negative (resp., positive) sentiment. Second, we consider the problem of organizing an event such as a concert with performances of known valuations, where an event organizer needs to arrange the sequence of all performances. We show that for both loss-averse and gain-seeking audiences, interior peaks can be optimal, where pleasant and aversive performances are arranged to alternate throughout the event. Lastly, we investigate the problem of simultaneous versus sequential release of a series, such as songs or TV episodes, where a content provider does not know a priori the audience’s exact valuation of each item. We show that if the audience’s sensitivity to losses is sufficiently small (resp., large), the optimal strategy is to release all items in the series sequentially (resp., simultaneously). Across all of the settings, we show that the audience’s sensitivity to losses relative to a reference point is a critical factor that governs how to design and manage the audience’s evolving experience dynamics.
Evaluation of Local Prescribing Patterns and Antimicrobial Resistance in Women With Acute Pyelonephritis Caused by E. coli
Authors: Seales Callie C. , Welch Tanis , Seifert Charles F. 
Published: July 2024

Background: Owing to increasing local Escherichia coli resistance and current guidelines for the treatment of acute pyelonephritis (APN) over 14 years old, an evaluation of local prescribing patterns is warranted. Objective: The purpose of this study was to evaluate local prescribing patterns and appropriateness of antibiotics in acute uncomplicated APN. Methods: This is a retrospective cohort study of female patients aged 18 to 89 years diagnosed with APN and positive urine culture growing E. coli. Exclusion criteria included pregnancy, immunocompromised status, and complicated urinary tract infections. Outcomes included antibiotic appropriateness and its effects on hospital admission, hospital length of stay, and 30-day readmission. Results: Between 2017 and 2022, 308 female patients were diagnosed with APN and had positive urine cultures, with 104 seen only in the emergency department (ED) and 109 admitted to the hospital. Patients seen in the ED had a significant increase in E. coli resistance to discharge antibiotics (12.5% vs 2.8%, P = 0.0070). In those patients discharged on antibiotics resistant to E. coli, significantly more patients returned to the ED in 30 days (31.3% vs 10.7%, P = 0.0155). Conclusion and Relevance: Patients seen only in the ED were more likely to have resistant organisms to discharge antibiotics compared with those admitted to the hospital. Patients discharged on antibiotics resistant to E. coli had a 3-fold increase in returning to the ED within 30 days regardless of admitted location. Follow-up of all cultures should be performed, and patients resistant to discharge antibiotics should be contacted and antibiotic regimens changed.
Major Dietary Patterns, Exercise Addiction, and Eating Disorders Among a Sample of Physically Active Young Adults
Authors: Khoshro Sahar , Abbasalizad Farhangi Mahdieh 
Published: July 2024

Background: Regular exercise has been widely acknowledged for its numerous health benefits, including improvements in physical fitness, body function, and mental well-being. However, excessive exercise and unhealthy dietary patterns can lead to adverse effects on individuals’ physical and psychological well-being. This study aimed to examine the association of dietary patterns, exercise addiction, and eating disorders among physically active young adults. Method: In this cross-sectional study, a total of 200 physically active young adults aged 18-35 years were included. The participants’ dietary intake was assessed using a validated semi-quantitative food frequency questionnaire (FFQ) consisting of 80 food items. To determine dietary patterns, factor analysis was employed. Exercise addiction was evaluated using The Exercise Addiction Inventory (EAI) and Exercise Dependence Questionnaire (EDQ), and eating disorders were assessed using The Eating Disorder Examination—Questionnaire Short (EDE-QS). Result: Three main dietary patterns were identified: western, healthy, and traditional dietary patterns. The western dietary pattern was associated with increased waist-to-hip ratio ( P = .01) that remained significant after adjustment for confounders (eg, age, gender, BMI, and physical activity P = .03), while the adherence to traditional dietary pattern was linked to higher waist circumference and body shape index ( P < .05). Participants that followed the healthy dietary pattern showed a higher score of EAI and body shape concern ( P = .04). Furthermore, in structural equation modelling (SEM), eating disorder was identified as a significant positive predictor of exercise addiction ( r = .17, P < .05). Conclusion: According to our finding, those with the higher adherence to healthy dietary pattern had higher scores of exercise addiction and body shape concern. Also, eating disorder was a potential predictor of exercise addiction among young physically active individuals. Further research and targeted interventions are needed to better understand these complex relationships and develop effective strategies to promote healthy behaviors and mitigate the risk of adverse outcomes.
Rethinking the matrix language: Vietnamese–English code-switching in Canberra
Authors: Nguyen Li 
Published: July 2024

Research motivation: Myers-Scotton’s Matrix Language Framework (MLF) has long been extremely influential, claiming ‘universality of support, no matter which languages are involved’. Support for this model, however, has largely come from language pairs that are typologically different in terms of their clausal word order, or else have vastly different inventories of inflectional morphology. My aim in this work is thus to test the extent to which the underlying principles of the MLF can be applied to Vietnamese–English, that is, two languages that are both subject–verb–object (SVO) and highly analytic. Approach: I apply the MLF’s main principles, i.e. the System Morpheme Principle and the Morpheme Order Principle, to Vietnamese–English codeswitching data to determine the extent to which the matrix language of each utterance could be straightforwardly established. Data and analysis: Data come from the Canberra Vietnamese English corpus (CanVEC), which contains 45 speakers from both first- and second-generation immigrants. I provide both quantitative and qualitative analyses of the MLF performance on this dataset. Findings/conclusions: Results show that MLF model fails to account for the majority of the CanVEC bilingual data, including both first- and second-generation speakers’ production. I further highlight, on empirical grounds, the equivocal nature of assuming speakers’ monolingual code as a basis of comparison, the ‘Composite ML’ notion, and the assumption of null elements in mixed speech. Originality: This is the first study that examines Vietnamese–English language contact with respect to the matrix language, using natural language production from the Vietnamese–English bilingual community in Canberra. This is also the first that empirically shows how various parts of the MLF can be both quantitatively and qualitatively problematic. Significance/implications: This work addresses a lacuna in the field, where work on minority languages and their speech communities is still much more limited, especially in comparison to English and other Indo-European languages. The data and analysis offered here serve as a modest contribution in this direction, allowing us to address existing biases and to reexamine ‘universal’ assumptions of various kinds.
Delayed presentation of traumatic diaphragmatic injury and a spleno-pulmonary fistula with haemoptysis as only sign: A case report
Authors: Caragounis Eva-Corina , Högberg Dominika 
Published: July 2024

Background Injury to the spleen caused by blunt trauma is common and may be associated with traumatic diaphragmatic injury. We describe a unique presentation with haemoptysis due to complications of concurrent splenic and diaphragmatic injuries resulting in a spleno-pulmonary fistula. Case Report A healthy 37-year-old man presented with severe abdominal pain 3 days after blunt abdominal trauma. Contrast-enhanced computed tomography (CT) of the thorax and abdomen showed an American Association for the Surgery of Trauma grade 3 splenic injury with a large subcapsular haematoma, intraperitoneal blood and ongoing intraparenchymal extravasation managed by successful angioembolization of the proximal splenic artery. The patient returned to the emergency department 5 weeks later with a three–day history of progressively worsening haemoptysis. A new CT showed an increase in the splenic haematoma with protrusion into the thorax and a diaphragmatic rupture. Thoracotomy identified a spleno-pulmonary fistula – the splenic haematoma was evacuated, a non-anatomic lung resection was performed and the diaphragmatic defect closed. Cultures from the splenic haematoma grew Cutibacterium acnes which was treated with intravenous antibiotics. Conclusion We report a unique complication of concurrent splenic and diaphragmatic injury with the development of a spleno-pulmonary fistula possibly due to infection of the splenic haematoma at the time of angio-embolization of the spleen. This case shows the importance of diagnosing diaphragmatic injuries promptly, adhering to sterile technique and considering giving prophylactic antibiotics before angio-embolization.