bluuebunny/crossref_metadata_2025_split huggingface dataset:
Challenging the Controversy Surrounding Percutaneous Brachial Artery Access Related Complications: A Systematic Review and Meta-Analysis
Authors: Khan Khuzaima , Amir Eiman , Akano Omobolaji , Borucki Joseph , Al Thaher Ahmad , Stather Philip , Ali Tariq 
Published: August 2024

Background Endovascular therapy has become increasingly preferred in the diagnosis and treatment of various conditions. The choice of arterial access usually depends on the type of procedure being performed with most via the common femoral artery and increasingly via the radial artery. Percutaneous access via the brachial artery has however been approached with caution due to the perceived increased risk for development of complications. Percutaneous brachial artery access (pBAA) has insufficient evidence when compared to femoral and radial access, with no large-scale studies available. The objective of this study is to review the literature and report the clinical and radiological complications associated with pBAA. Methods EMBASE, EMCARE, CINAHL and Medline were searched for existing data on the complications associated with pBAA. Systematic review and meta-analysis were carried out on the data of 31 studies. Results The results of this systematic review and meta-analysis indicates that the probability of post procedural haematoma was 4.76%, haemorrhage 1.43%, perforation 1.11% pseudoaneurysm 1.06%, spasm 0.9%, thrombus 0.55%, neuropathy 0.53%, occlusion 0.51%, ischaemia 0.37% and infection 0.24 %. Non-target vessel puncture, stenosis and stroke had a 0% incidence among the assessed population. Conclusion This study provides evidence to support clinical decision making when it comes to the utility of pBAA in endovascular diagnosis or therapy. The results demonstrate that pBAA is relatively safe with a low incidence of serious complications and thereby provide the clinician with the option of an alternate access point when planning treatment.
The Literature that Commercial Insurance Payers Use to Substantiate Knee Osteochondral Allograft Policies Are of a Low Level of Evidence
Authors: Fathi Amir , Kotlier Jacob L. , Telang Sahil S. , Patel Vishal S. , Bolia Ioanna K. , Biedermann Brett M. , Cruz Christian A. , Lin Eric H. , Petrigliano Frank A. , Liu Joseph N. 
Published: August 2024

Objective The purpose of this study is to analyze how the largest insurance companies support their medical necessity policies regarding osteochondral allograft transplantation (OCA) and to determine whether the literature they cite in their policies is of a high level of evidence (LOE). Design The 10 largest national health insurance companies were identified. Each payer was contacted via phone or email to obtain their coverage policy regarding OCA. For each policy, the medical necessity criteria were recorded, and all cited references were screened. For all references applicable to OCA, the LOE was recorded, and each reference was screened to determine whether they mentioned the specific criteria reported in the policies. Results The medical policies for 6 of the 10 national health insurance companies were identified. These 6 policies cited a collective total of 102 applicable references. Most of these studies were an LOE of IV ( n = 58, 56.9%) and an LOE of V ( n = 18, 17.6%). There were similarities amongst the medical necessity criteria between different commercial payers; however, most criteria were poorly supported by the cited literature. Conclusions Our results demonstrate that commercial insurance companies utilize studies that are of a low LOE when justifying their medical necessity criteria. Moreover, these cited studies infrequently support or mention the commercial payers’ criteria. Future studies should continue to explore how well-supported insurance policies are with the goal of potentially increasing access and authorization for well-supported treatment modalities.
Satisfaction with videoconferencing support for levodopa-carbidopa intestinal gel: An observational study
Authors: Gurevich Tanya , Evans Andrew , Hassin-Baer Sharon , Kägi Georg , Koziorowski Dariusz , Roszmann Anna , Bergmann Lars , Parra Riaza Juan Carlos , Sánchez-Soliño Olga , Sławek Jarosław 
Published: August 2024

Background Levodopa-carbidopa intestinal gel (LCIG) is a continuously delivered Parkinson's disease therapy intended to stabilize plasma levodopa levels. Patients receiving LCIG require education and follow-up. Some LCIG support programs use video-assisted telenursing. Objective To examine how videoconferencing impacts satisfaction with LCIG support programs. Methods FACILITATE CARE (Feasibility of video-Assisted Care for Intestinal Levodopa Infusion with Telenursing – observAtional Trial Evaluating patient and Caregiver Acceptance in REal life) was a 12-week, prospective, open-label, 2-arm, parallel-group, observational study assessing satisfaction with LCIG support in patients who self-assigned to video or audio-only arms. Patients aged 18–85 years had completed LCIG titration and owned a videoconferencing device (video arm only). A visual analog scale measured satisfaction (1–10, 10 being most satisfied). Results Patients’ mean (standard deviation) ages were 67.9 (7.4, n = 26) and 71.1 (6.2, n = 15) years in the video and audio arms, respectively. Patients, caregivers, and physicians in both groups reported satisfaction scores of 8–10 with LCIG support personnel, communication access, and assistance with becoming independent. At week 12, the Modified Caregiver Strain Index least square means change from baseline was lower in the video vs. audio arm (−2.3 [1.0] vs. 1.6 [1.2]). LCIG support personnel travel time was lower in the video vs. audio arm (125.7 [70.2] vs. 203.0 [70.0] minutes). Conclusions LCIG support programs are associated with high patient, caregiver, and physician satisfaction; video and audioconferencing satisfaction are similarly high. Video-assisted telenursing may be a convenient communication avenue and may reduce caregiver burden. Registration ClinicalTrials.gov; NCT04500106.
Machine learning-based prediction of coronary care unit readmission: A multihospital validation study
Authors: Yau Fei-Fei Flora , Chiu I-Min , Wu Kuan-Han , Cheng Chi-Yung , Lee Wei-Chieh , Chen Huang-Chung , Cheng Cheng-I , Chen Tien-Yu 
Published: August 2024

Objective Readmission to the coronary care unit (CCU) has significant implications for patient outcomes and healthcare expenditure, emphasizing the urgency to accurately identify patients at high readmission risk. This study aims to construct and externally validate a predictive model for CCU readmission using machine learning (ML) algorithms across multiple hospitals. Methods Patient information, including demographics, medical history, and laboratory test results were collected from electronic health record system and contributed to a total of 40 features. Five ML models: logistic regression, random forest, support vector machine, gradient boosting, and multilayer perceptron were employed to estimate the readmission risk. Results The gradient boosting model was selected demonstrated superior performance with an area under the receiver operating characteristic curve (AUC) of 0.887 in the internal validation set. Further external validation in hold-out test set and three other medical centers upheld the model's robustness with consistent high AUCs, ranging from 0.852 to 0.879. Conclusion The results endorse the integration of ML algorithms in healthcare to enhance patient risk stratification, potentially optimizing clinical interventions, and diminishing the burden of CCU readmissions.
Exploring student preferences for implementing a digital mental health intervention in a university setting: Qualitative study within a randomised controlled trial
Authors: Jackson Hayley M , Gulliver Amelia , Hasking Penelope , Leach Liana , Batterham Philip J , Calear Alison L , Farrer Louise M 
Published: August 2024

Objective Digital interventions can be effective in preventing and treating common mental health conditions among university students. Incorporating student experiences and perspectives in the design and implementation of these programmes may improve uptake and engagement. This qualitative study explored university students’ perspectives of a low-intensity video-based mental health intervention, their recommendations for implementing the programme in university settings, and their views and recommendations to address barriers to engagement. Methods Participants (N = 115) were students (mean = 20.63 years, SD = 2.10) with elevated distress from 31 Australian universities drawn from a randomised controlled trial of the Uni Virtual Clinic-Lite (UVC-Lite). Data from students randomised to the intervention condition were collected via semi-structured interviews (n = 12) and open-ended questions during post-intervention surveys (n = 103). Data were analysed using content analysis. Results Participants generally reported positive views of the intervention, and most felt it should be offered to students as a universal intervention. Multiple methods of disseminating the intervention were suggested, including through university counselling, official platforms (e.g. student support services) and informal channels (e.g. word-of-mouth promotion). Difficulty integrating the programme into everyday life, pre-existing beliefs about mental health and technology-related factors were highlighted as barriers to engagement. Conclusion A low-intensity video-based mental health intervention was generally considered to be acceptable and appropriate for students with mild to moderate distress. Participants provided several suggestions to encourage uptake of the intervention and possible pathways to disseminate the intervention to students. The effectiveness of these should be examined in future trials.
Fracture predictions in impact three-point bending test of European beech
Authors: Kubík Petr , Šebek František , Hassan Vand Mojtaba , Brabec Martin , Tippner Jan 
Published: August 2024

AbstractHardwood has become widespread in European forests. The strongest factor is climate change and damage to conifers by the bark beetle. The effort to study hardwoods grows with increasing volume of applications. Therefore, European beech wood was investigated under two impact loads in two material directions, resulting in four unique combinations supplemented by the measurement of the friction coefficient. Then, it was computationally simulated to reproduce the cracking, while the material model reflected the orthotropic behaviour in elasticity, plasticity and failure. The model was coded using the user subroutine in Abaqus to initiate and propagate the crack using the element deletion. The resulting reaction forces were in good agreement with those from the experiments. Cracking was numerically simulated in three of four cases as experimentally observed, however, upon larger deflections. Therefore, the model is applicable for further investigations.
Game theory elucidates how competitive dynamics mediate animal social networks
Authors: Dubois Frédérique 
Published: August 2024

Abstract
Background
While most game theoretical models assume that individuals randomly interact with all other group members, strong evidence indicates that individuals tend to preferentially interact with some of them. The position of an individual in a network affects, among other factors related to survival, its predation risk and competitive success. Here I then modified the Hawk-Dove game to explore the effect of social network structure on competitive strategy of individuals that differ in their fighting ability and may adjust their use of the Hawk, Dove and Assessor tactics to maximize their foraging success when they meet opponents they are connected with.

Results
From randomly generated networks, I demonstrate that phenotypic assortment by fighting ability reduces individuals’ aggressiveness and, as such, favours cooperative interactions. Furthermore, the success of individuals with the weakest fighting ability is usually highest within networks where they most frequently meet opponents with the same fighting ability as their own, suggesting they might benefit from breaking connections with strong contestants. This might be the case when strong contestants systematically rely on the aggressive Hawk tactic or the risk of being predated is low and independent of the number of neighbours. Thus, I extended the model and built a dynamic model to allow individuals not only to adjust their behaviour to local conditions but also to modify the structure of the social network. The number of connections and degree of phenotypic assortment are then affected by ecological factors (e.g. resources value and predation risk), but above all by whether individuals can reliably assess the competitive ability of their opponents and adjust their behaviour accordingly.

Conclusions
These findings provide strong evidence that behaviour can play a key role in shaping network structure and highlight the importance of considering the coevolution of network and behaviour to apprehend its consequences on population dynamics.
Multiple sclerosis and amyotrophic lateral sclerosis: is there an association or a red flag? A case report and literature review
Authors: Aljthalin Raseel , Albalawi Rawan , Alyahya Atheer , Alhathlool Rawabi , Alhashemi Moustafa 
Published: August 2024

Abstract
Background
Multiple sclerosis (MS) is an inflammatory disease of the central nervous system that causes damage to the myelin and axons and is caused by genetic or environmental factors. Amyotrophic lateral sclerosis (ALS) is characterized by rapidly progressive degeneration of the motor neurons resulting in the presence of upper and lower motor-neuron signs and symptoms.

Case presentation
A 46-year-old female patient presented with symmetrical weakness of the lower limbs and numbness that developed over weeks. Magnetic resonance imaging (MRI) of the brain exhibited typical demyelination features, high signal abnormality involving the periventricular and subcortical white matter, and an oval-shaped lesion. The patient was diagnosed with MS based on the clinical presentation and radiological examination. However, there was rapid progression of the symptoms, involvement of bulbar dysfunction, and muscle atrophy. Furthermore, the patient did not respond to acute therapy and immunotherapy, which made the diagnosis of MS less likely or suggested that it could be associated with another diagnosis. Her neurophysiological test met the criteria of ALS, and she was started on riluzole.

Literature review
We reviewed all articles from 1986 to 2023, and there were 32 reported cases describing the co-occurrence of ALS and MS in different populations. Our case is the 33rd, and to our knowledge, it is the only case reported in the Middle East and specifically in Saudi Arabia. The main proposed mechanism according to postmortem examinations is a combination of degenerative and inflammatory processes with a cascade of production of reactive oxygen species and nitric oxide, which lead to cell death and apoptosis during concomitant ALS with MS.

Conclusion
The co-occurrence of ALS and MS is extremely rare, but it can be explained by pathogenesis related to neurodegeneration, inflammation, or genetic susceptibility. Rapid progressive motor and bulbar symptoms could be red-flag symptoms, extensive evaluation might be needed for these patients.
Dietary supplement use is common in older adult drivers: an analysis from the AAA LongROAD study
Authors: Moran Ryan , Baird Sara , DiGuiseppi Carolyn G. , Eby David W. , Hacker Sarah , Isom Chelsea , Jones Vanya , Lee Kelly C. , Li Guohua , Molnar Lisa J. , Patrick Rudy , Strogatz David , Hill Linda 
Published: August 2024

Abstract
Background
Dietary supplement (DS) use is common and increasing among older adults, though much data available on use frequencies are from surveys and performed cross-sectionally. This paper sought to assess the frequency and pattern of dietary supplement use among older adults over time.

Methods
A secondary analysis of data from the AAA LongROAD study, a longitudinal prospective cohort study of older adult drivers, using data from baseline and the first two years of follow up included a total of 2990 drivers aged 65–79 years recruited at five study sites across the US from July 2015 to March 2017. Participants underwent baseline and annual evaluations, which included a “brown bag” medication review. DS were identified and categorized according to type and key components. Prevalence and pattern of DS use over time and relationship to demographics were measured with frequency and Chi squared analyses.

Results
84% of participants took at least one dietary supplement during the 2-year study period, and 55% of participants continually reported use. DS accounted for approximately 30% of the total pharmacologic-pill burden in all years. Participants who were White non-Hispanic, female, 75–79 years of age at baseline, and on more non-supplement medications took significantly more dietary supplements (P < 0.05). Vitamin D, multivitamins, calcium, and omega-3 formulations were the most common supplements, with stable use over time. Use of individual herbal supplements and cannabis products was uncommon (< 1% participants per year).

Conclusions
DS use among older adults is common and relatively stable over time and contributes to polypharmacy. In clinical settings, providers should consider the influence of DS formulations on polypharmacy, and the associated cost, risk of medication interactions, and effect on medication compliance.
Medical students in distress: a mixed methods approach to understanding the impact of debt on well-being
Authors: Yang Adrienne , Langness Simone , Chehab Lara , Rajapuram Nikhil , Zhang Li , Sammann Amanda 
Published: August 2024

Abstract
Background
Nearly three in four U.S. medical students graduate with debt in six-figure dollar amounts which impairs students emotionally and academically and impacts their career choices and lives long after graduation. Schools have yet to develop systems-level solutions to address the impact of debt on students’ well-being. The objectives of this study were to identify students at highest risk for debt-related stress, define the impact on medical students’ well-being, and to identify opportunities for intervention.

Methods
This was a mixed methods, cross-sectional study that used quantitative survey analysis and human-centered design (HCD). We performed a secondary analysis on a national multi-institutional survey on medical student wellbeing, including univariate and multivariate logistic regression, a comparison of logistic regression models with interaction terms, and analysis of free text responses. We also conducted semi-structured interviews with a sample of medical student respondents and non-student stakeholders to develop insights and design opportunities.

Results
Independent risk factors for high debt-related stress included pre-clinical year (OR 1.75), underrepresented minority (OR 1.40), debt $20–100 K (OR 4.85), debt >$100K (OR 13.22), private school (OR 1.45), West Coast region (OR 1.57), and consideration of a leave of absence for wellbeing (OR 1.48). Mental health resource utilization (p = 0.968) and counselors (p = 0.640) were not protective factors against debt-related stress. HCD analysis produced 6 key insights providing additional context to the quantitative findings, and associated opportunities for intervention.

Conclusions
We used an innovative combination of quantitative survey analysis and in-depth HCD exploration to develop a multi-dimensional understanding of debt-related stress among medical students. This approach allowed us to identify significant risk factors impacting medical students experiencing debt-related stress, while providing context through stakeholder voices to identify opportunities for system-level solutions.
Support provided by outreach team leaders to caregivers of HIV/AIDS orphans in the North-West province of South Africa
Authors: Molato Boitumelo Joy , Moloko-Phiri Salaminah S. , Koen Magdalena P. , Matsipane Molekodi J. 
Published: August 2024

Abstract
Background
The human immunodeficiency virus (HIV) and acquired immunodeficiency deficiency syndrome (AIDS) epidemic have left an overwhelming impact on communities worldwide, particularly in Sub-Saharan Africa, where its effects on family structures are particularly pronounced. Caregivers of HIV/AIDS orphans encounter challenges in fulfilling their caring duties. Consequently, they rely on the outreach team leaders (OTLs) for support to care for HIV/AIDS orphans.

Aim
This study aimed to explore and describe support provided by OTLs to caregivers of HIV/AIDS orphans in the North West Province of South Africa.

Methods
The exploratory, descriptive, and contextual design meaning the study was conducted was in the contexts where caregivers of HIV/AIDS orphans reside. The study was conducted in five local municipalities in the Ngaka Modiri Molema district of the North West Province of South Africa. Ward-based outreach nurses were participants in the study. Semi-structured focus group interviews were used for data collection. Thematic analysis was used to analyze data. Throughout the study, ethical principles were adhered to. The study also adhered to four trustworthiness principles: credibility, confirmability, transferability, and dependability.

Results
Three main themes emerged from this study: the conduction of home visits to caregivers of HIV/AIDS orphans, the coordination of a multidisciplinary team for support, and the facilitation of support groups.

Conclusions
This study revealed that that caregivers of children orphaned by HIV/AIDS benefitted from the support provided by OTLs in the North West province of South Africa. The support provided by OTLs harnessed positive relationship between caregivers and children orphaned by HIV/AIDS.