bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hospital-based skilled nursing facility survival: Organizational and market-level predictors
Authors: Gupta Shivani , Zengul Ferhat D. , Blackburn Justin , Hearld Larry R. , Jablonski Rita , Sen Bisakha , Weech-Maldonado Robert 
Published: August 2024

BackgroundRising health care costs and consequent increases in Medicare reimbursements have led to many payment reforms over the years. Implementation of the prospective payment system (PPS) for hospitals in 1983 incentivized hospitals to either purchase skilled nursing facilities (SNFs) or utilize their excess capacity to establish one within the hospital. With PPS reimbursement being applied to SNFs in 1998, prior monetary incentives for hospitals to own an SNF disappeared. However, despite the reduction in numbers, many hospitals continued to operate their hospital-based skilled nursing facilities (HBSNFs).PurposeThis study examines the organizational and market-level factors associated with the survival of HBSNFs using the population ecology of organizations framework.MethodologyUsing American Hospital Association survey data, event histories of all U.S. acute care hospitals with an open HBSNF in 1998 were plotted to examine if a hospital closed its HBSNF during a 22-year period (1998–2020). The primary independent variables included hospital size, ownership, total margin, market competition, and Medicare Advantage penetration. The independent and control variables were lagged by 1 year. Cox regressions were conducted to estimate the hazard ratios capturing the risk of HBSNF closure.ResultsThe results showed that HBSNFs located in large, not-for-profit hospitals and those operating in less competitive markets had greater odds of surviving.Practice ImplicationsThe HBSNF administrators of small, for-profit hospitals and those operating in highly competitive markets could utilize the findings of this study to judiciously allocate slack resources to their HBSNFs to keep those open given the current emphasis on continuity of care by regulatory bodies.
A Comprehensive Review of Donor Corneal Preservation Strategies
Authors: Cipolla Jack , Jo Minhee , Sabater Alfonso L. 
Published: August 2024

Abstract:
Successful corneal transplantation relies on the viability of the corneal endothelium. Although various preservation systems have been developed in the field of eye banking, long-term storage of the corneal endothelium poses challenges and is costly. Optisol-GS in the past has been the most commonly used solution for intermediate-term corneal storage in the United States. However, disruptions in the availability of Optisol-GS, caused by rising costs and supply shortages, have necessitated alternative methods of corneal preservation. Previously described preservation methods include hypothermia (2–8°C) for short-term storage (7–14 days), organ culture (28–37°C) for intermediate storage (4–7 weeks), and cryopreservation for longer-term storage. In this review, we examine standard practice and alternative methods for corneal storage.
The Intersection of Intimate Partner Violence, Strangulation, and Brain Injury Screening: A Pilot Project
Authors: Gbadebo Adenike 
Published: August 2024

ABSTRACT

Background
Survivors of intimate partner violence are at a high risk for having a brain injury because of high rates of strangulation and head and face injuries sustained from physical abuse. In addition to acute physical injuries, survivors experience various health complications.

Problem
Many survivors do not seek medical attention for their injuries, and when they do, their brain injury often goes unrecognized and untreated. Research indicates that screening for brain injury can be an effective intervention to increase the identification of brain injuries and medical referrals for diagnosis and treatment. Unfortunately, brain injury screening is not a standard of care.

Methods
Shelter-seeking clients were routinely screened for brain injury using a modified HELPS screening tool. A positive screen prompted a medical referral.

Intervention
A modified HELPS screening tool was utilized with permission for the project.

Results
Before implementation, 36 individuals entered shelter, 0 were screened for brain injury, and the medical referral rate was 19.4% (n = 7). After implementation, 40 clients entered shelter, 36 were screened for brain injury, 77.8% (n = 28) screened positive, and the medical referral rate was 80.6% (n = 29).

Conclusions
Brain injury screening may be an effective evidence-based intervention for shelter-seeking survivors of intimate partner violence to increase medical referrals.
Acupuncture for rehabilitation after total knee arthroplasty: a systematic review and network meta-analysis
Authors: Li Wen-Xuan , Wu Cai-Qin , Feng Wei , Zhan Yi-Jun , Yang Lei , Jia Heng-Jie , Pei Jian , Li Kun-Peng 
Published: August 2024

Background:
The increasing interest in acupuncture for promoting postoperative rehabilitation has encouraged its use in rehabilitation after total knee arthroplasty (TKA), but its effectiveness remains controversial.

Objective:
This study aims to assess the efficacy of different models of acupuncture-related therapies on pain relief, motor function, inflammation, and overall rehabilitation of the knee after TKA.

Methods:
Databases PubMed, Embase, Cochrane, Web of Science, Scopus, and Clinicaltrials.gov were searched to screen eligible randomized controlled trials (RCTs). All RCTs that used acupuncture/moxibustion on TKA patients were included by two researchers independently after rigorous quality evaluation, with data extracted. The statistics were performed by using R 4.2.3 and Stata 17.

Results:
The network meta-analysis incorporated 28 RCTs, 21 of which were conducted in mainland China and Taiwan. Evidence of the relation of several common acupuncture/moxibustion treatments was shown by the network meta-analysis (NMA). The results of NMA showed that electroacupuncture was the preferred therapy for soothing pain symptoms (standardized mean difference=0.58, 95% CI=0.36–0.81). Auricular acupressure was the best treatment to improve the knee motor function. Electroacupuncture was superior to special acupuncture in relieving knee joint stiffness and inflammation.

Conclusion:
Acupuncture intervention, especially electroacupuncture, can effectively alleviate pain, improve motion, reduce stiffness, and decrease inflammation in post-TKA patients with no serious adverse events.
Real-world Clinical Effectiveness and Safety of Vedolizumab and Adalimumab in Biologic-naive Patients With Crohn’s Disease
Authors: Yarur Andres J. , Bressler Brian , Brett Neil R. , Bassel Marielle , Adsul Shashi , Kamble Pravin , Mantzaris Gerassimos J. 
Published: August 2024

Goals:
This study evaluated the real-world effectiveness and safety of vedolizumab versus adalimumab over 12 months of treatment in biologic-naive patients with Crohn’s disease (CD), using data from the EVOLVE study.

Background:
A comparison of vedolizumab and adalimumab may help to better position them in the therapeutic algorithm for moderate-to-severe CD.

Study:
Data were collected from medical records of patients with CD aged ≥18 years initiating treatment with adalimumab or vedolizumab between May 2014 and July 2017. Adjusted analyses were performed using inverse probability weighting to account for differences in baseline characteristics. Cumulative rates for clinical effectiveness outcomes and treatment persistence were estimated using Kaplan-Meier analyses. Disease-related exacerbations, serious adverse events (SAEs), and serious infections (SIs) were also assessed.

Results:
Data from 218 vedolizumab- and 144 adalimumab-treated patients were analyzed. Adjusted cumulative rates of clinical remission were greater with vedolizumab than with adalimumab (66.3% vs. 46.4%; P=0.006). Probability of treatment persistence was higher with vedolizumab (89.3% vs. 77.5%; P=0.024); probabilities of clinical response (68.5% vs. 61.1%; P=0.586) and mucosal healing (67.7% vs. 56.0%; P=0.562) were similar. SAEs were less likely to occur with vedolizumab [hazard ratio, 0.45 (95% confidence interval, 0.22-0.93)]; however, the likelihood of SIs [0.27 (0.06-1.20)], CD exacerbations [0.91 (0.56-1.47)], and CD-related surgeries [1.55 (0.21-11.15)] was comparable between the 2 groups.

Conclusions:
In a real-world setting, biologic-naive patients with CD treated with vedolizumab demonstrated a greater likelihood of drug persistence and achieving clinical remission, with equivalent rates of response and mucosal healing versus adalimumab-treated patients.
Association between emergency medical services’ response times, low socioeconomic status, and poorer outcomes in out-of-hospital cardiac arrest: the MEDIC multicenter retrospective cohort study for disparities in access to prehospital critical care in the Paris metropolitan area
Authors: Heidet Matthieu , Frattini Benoit , Jost Daniel , Mermet Éric , Bougouin Wulfran , Lesaffre Xavier , Wohl Mathys , Marijon Eloi , Cariou Alain , Jouven Xavier , Dumas Florence , Lecarpentier Éric , Chollet-Xémard Charlotte , Vaux Julien , Khellaf Mehdi , Souihi Sami , Vivien Benoît , Sinden Sean , Grunau Brian , Travers Stéphane , Audureau Étienne 
Published: August 2024

Background and importance
Prolonged emergency medical services’ response times (EMS-RT) are associated with poorer outcomes in out-of-hospital cardiac arrest (OHCA). The patient access time interval (PATI), from vehicle stop until contact with patient, may be increased in areas with low socioeconomic status (SES).

Objectives
The objective of this study is to identify predictors of prolonged EMS-RT intervals, and to evaluate associations with clinical outcomes in OHCAs occurring in the largest metropolitan area in France.

Design
Using the Utstein-style, prospectively implemented, population-based SDEC registry for OHCAs, we conducted a multicenter, region-wide, retrospective cohort study of EMS dispatches for OHCA cases occurring in the 124 cities of the Greater Paris area, France, between January 1, 2017 and December 31, 2018.

Settings and participants
Adult, nontraumatic, EMS-assessed, non-EMS witnessed OHCAs.

Exposure
Geographic location and scene-level SES.

Outcome measures and analysis
The primary outcome was the EMS-RT interval, from activation until arrival at patient’s side. As secondary outcomes, we evaluated patient access outcomes of: (1) dispatch-to-patient contact interval (‘EMS-RT’); and (2) vehicle scene arrival-to-patient contact interval (PATI); and patient clinical outcomes of: (1) death; and (2) unfavorable neurological status, both at 30 days. Area-level SES was assessed at census tract level using the European Deprivation Index (EDI; continuous, and divided into quintiles, Q5 = most deprived). We fitted multilevel mixed-effects regression models to identify predictors of patient access outcomes, and their association with clinical outcomes.

Main results
We included 4082 cases; the median EMS-RT was 10.85 min (interquartile range [8.87–13.15]), and 138 (3.4%) survived to hospital discharge. Independent predictors of increased EMS-RT and PATI were age >65, female sex, residential location, occurrence at elevated floors, arrest unwitnessed by a bystander, and low EDI (all P < 0.018). After multivariable analysis, an overall EMS-RT interval >8 min was associated with higher mortality and poorer neurological status at hospital discharge (both P < 0.001).

Conclusion
In OHCA cases occurring in the Greater Paris metropolitan area, after adjustment for scene characteristics, EMS delays until patient contact were longer in neighborhoods of low SES, and were associated with poorer clinical outcomes.
Effect of single-photon emission computed tomography acquisition method and sampling angles on image quality and quantitative accuracy in xSPECT-reconstructed images
Authors: Hasegawa Daisuke , Iguchi Toshihiro , Takatani Masayasu , Tokunaga Kotaro , Minoda Takuma , Miyai Masahiro 
Published: August 2024

Objective
The aim of this study was to evaluate the effects of the single-photon emission computed tomography (SPECT) acquisition method and sampling angles on the qualitative and quantitative interpretations of xSPECT-reconstructed images.

Methods
The spatial resolution was evaluated using a JSP phantom, and the uniformity and quantitative accuracy were verified with a NEMA IEC Body Phantom using an SIEMENS Symbia Intevo SPECT/computed tomography system. SPECT was performed using three acquisition methods (step-and-shoot, continuous, and acquire during the step), and the sampling angles were set to 2, 3, 4, 5, and 6°. The xSPECT-reconstruction technology which is used with ordered subset-conjugated gradient minimization was used for image reconstruction.

Results
Full width of half maximum, an evaluation index of spatial resolution, varied up to 2.73 mm with different sampling angles and up to 2.06 mm with different acquisition methods. Uniformity, as assessed by the coefficient of variation, improved with increasing sampling angles. The accuracy of the quantification of the hot sphere showed an error rate of approximately 10% depending on the sampling angle, and an error rate of approximately 5% depending on the different acquisition methods.

Conclusions
In xSPECT-reconstructed images, the difference in sampling angle has a greater impact on image quality and quantitativity than the difference in the acquisition method. For tests in which uniformity is important, a larger sampling angle is recommended.
Risk Factors of Negative Diagnosis of Magnetic Resonance Cholangiopancreatography in Acute Biliary Pancreatitis Patients With Choledocholithiasis
Authors: Chen Si-Hai , Wang Wen-Qing , Fei Xiao , Zhu Yin , Shu Xu , Yu Chen , Liao Qian , Xiong Hui-Fang 
Published: August 2024

Objectives
Detecting choledocholithiasis in acute biliary pancreatitis (ABP) is crucial. Magnetic resonance cholangiopancreatography (MRCP) and endoscopic ultrasonography (EUS) identify common bile duct stones. EUS offers better accuracy than MRCP but with sedation risks. We studied MRCP negative diagnosis risk factors in ABP patients with choledocholithiasis for improved diagnostic selection.

Methods
This retrospective study included 2321 ABP patients. After exclusions, 337 ABP patients with negative MRCP results were analyzed, including 75 with positive EUS findings. Univariate and multivariate logistic regression identified MRCP negative diagnosis risk factors.

Results
Patients with positive EUS findings were older (62.0 vs 55.0) and had higher cholecystectomy rates (18.7% vs 7.3%). Univariate analysis showed cholecystectomy history, age, and sex as potential risk factors. Then, after adjusting the other potential risk factors (direct bilirubin, alanine transaminase, γ-glutamyl transpeptidase, and alkaline phosphatase), a history of cholecystectomy (odds ratio, 2.859; 95% confidence interval [CI], 1.312–6.23), older age (1.03; 95% CI, 1.009–1.052), and male (2.016; 95% CI, 1.152–3.528) were independent risk factors of negative diagnosis of MRCP in ABP patients with choledocholithiasis.

Conclusions
Cholecystectomy history, older age, and male sex increase MRCP negative diagnosis risk in ABP patients with choledocholithiasis. Patients with these risk factors should undergo EUS first for better diagnostic outcomes.
Adult with Coxsackie B virus-induced cardiomyopathy presents rare case of complicated acute embolic ischaemic stroke
Authors: KC Manish , Bhattarai Himal Bikram , Adhikari Subodh , Mandal Prince , Kashyap Ashutosh , Thapa Neeraj , Mehera Ishita 
Published: August 2024

Introduction and importance:
Stroke, a global health concern, often results from embolic events of cardiac origin. Coxsackie B virus (CBV) myocarditis, a common cause of viral heart infections, can lead to cardiac thrombi formation, subsequently causing devastating complications such as embolic stroke. The authors present a rare case of a 26-year-old male who experienced an embolic stroke following CBV myocarditis and cardiomyopathy.

Case presentation:
The patient exhibited left-sided weakness, facial droop, and respiratory distress. Laboratory findings indicated leukocytosis, hyponatremia, and elevated troponin I. Imaging revealed an acute right basal ganglia infarct and multifocal pulmonary embolism. The diagnosis involved positive CBV serology, severely reduced left ventricular function, and a large apical thrombus.

Discussion:
Cardioembolic strokes, often attributable to atrial fibrillation, can also result from intracardiac thrombosis associated with myocarditis. CBV, implicated in up to 40% of acute myocarditis cases, binds to cardiac myocytes, triggering inflammation and potential thrombus formation. Myocarditis-induced hypercoagulability increases the risk of thromboembolic events, complicating the clinical course.

Conclusion:
CBV myocarditis poses a risk of heart failure, cardiomyopathy, and thromboembolic complications such as embolic stroke. Vigilant monitoring for complications and prompt management is crucial, as primary disease treatment remains primarily supportive. This case highlights the need for increased awareness and further studies to understand the intricate relationship between viral myocarditis and embolic strokes.
Assessment of knowledge, attitude and practice towards maternal healthcare among mothers in Illam: a cross-sectional study from Nepal
Authors: Yogi Tek Nath , Kafle Rijan , Uprety Samyog , Makaju Ranjit , Shrestha Simran , Gahatraj Manish , Bhusal Amrit , Ghimire Sinjin , B.K. Himal , Karki Simon , Mishra Bivek , Kunwar Anjila , Khatiwada Nirman , Niraula Sahil , Uprety Salina , Khanal Surav , Shah Purushotam , Mukhia Sweekriti , Chaudhary Dibya Raj , Malla Nakendra 
Published: August 2024

Introduction:
Healthcare during pregnancy and childbirth and after delivery is important for the survival and well-being of both the mother and the neonate. Maternal healthcare in Nepal faces challenges due to various causes. However, providing proper knowledge on maternal healthcare to mothers and promoting a positive attitude towards it can have a significant impact on maternal and child health outcomes. The objective of this study was to assess knowledge, attitude and practice towards maternal healthcare among mothers in Illam.

Methods:
A cross-sectional study was conducted among 197 mothers in Illam municipality who gave birth within the last 5 years. The study used face-to-face interviews with a semi-structured questionnaire to collect data. Descriptive as well as inferential statistics were used to analyze the data.

Results:
The total number of participants was 197. The results showed majority (48.22%) belonged to the age group of 22–29 years and the mean age of the participants was 30.2± 5.37, majority were home-makers (44.7%), mean age at marriage was 21.39±3.99 years, mean age at first pregnancy was 23.9±4.33years and mean birth spacing from last child was 70±41.28 months. Overall, we found that knowledge, attitude and practice regarding antenatal care (ANC) were 72%, 83% and 69%, respectively. Similarly, knowledge, attitude and practice regarding post-natal care (PNC) were 39%, 91%, and 43%, respectively.

Conclusions:
Mothers showed satisfactory knowledge on ANC but inadequate knowledge on PNC. Most had a positive attitude towards both practices. However, actual practices related to ANC and PNC were poor despite adequate knowledge and attitude.
Malignant recto-jejunal fistula: a rare case report
Authors: Adhikari Roshna , Paudel Mukesh , Jha Ram M. , Sah Raman K. , Sitaula Saroj , Silwal Prabhat 
Published: August 2024

Introduction and importance:
Malignancy can lead to colo-enteric fistulas. A malignant fistula between the rectum and the jejunum is a rare occurrence.

Case presentation:
A 60-year-old female suffered from diarrhea, vomiting, and epigastric pain for 4 months. After demonstration of a dilated rectum with heterogeneous collection on ultrasonography, contrast-enhanced computed tomography (CECT) along with rectal contrast was done, which showed heterogeneously enhancing asymmetrical circumferential thickening of the proximal rectum, including rectosigmoid junction, collection in the rectum and two recto-jejunal fistulous tracts. Colonoscopy showed ulcero-proliferative growth in the rectum with two fistulous tracts communicating with the jejunum. Biopsy from the growth indicated a poorly differentiated adenocarcinoma. Conservative and palliative treatment was provided.

Clinical discussion:
Clinical features of colo-enteric fistulas can include abdominal pain, diarrhea, and weight loss. The patient may be asymptomatic in some cases. Options for diagnosis include barium studies, enteroscopy, colonoscopy, CECT, and computed tomography enterography (CTE). Malignant bowel fistula is associated with serious complications resulting in high morbidity and mortality rates. Surgical resection and fistula repair are the mainstay of curative treatment.

Conclusion:
Long-standing gastrointestinal symptoms like chronic diarrhea in the elderly should be investigated with imaging modalities like CECT. Early detection with imaging can reduce debilitating metabolic and nutritional deficiencies and improve patient’s morbidity and mortality.
Preoperative HIFU ablation combined with femoral bone marrow nailing for the treatment of pathological fracture of femur: a case report
Authors: Yao Long , Wang Bing , Wang Ziyi , Wei Ancheng , Huang Xin , Wang Zhiqiang 
Published: August 2024

Introduction and importance:
Bone is one of the common sites of metastasis in lung cancer. Pathological fractures of the femur significantly reduce patients’ quality of life and increase the risk of death. However, there is still no consensus on the optimal treatment of pathological femoral fractures. The authors’ report provides a treatment method for a patient with pathological fracture of lung cancer with preoperative HIFU lesion ablation followed by combined intramedullary nail fixation.

Case presentation:
A 61-year-old Chinese woman was hospitalized with severe pain in her right thigh. X-ray and CT examination at admission considered pathological fracture of the right femur. MRI showed a comminuted fracture of the middle and lower part of the right femur, swelling of the surrounding soft tissue, and effusion. WBS showed an abnormal concentration of imaging agent at the right femoral fracture end and abnormal bone metabolism. After a lung biopsy, it was diagnosed as lung cancer with femoral metastasis and pathological fracture.

Clinical discussion:
The patient underwent HIFU ablation before surgery to reduce the lesion, and a re-examination MRI showed that the signal at the lesion was significantly reduced, and the lesion volume was significantly reduced. The operation was performed by open reduction and intramedullary nail fixation, focal excision, and bone cement filling. After 6 months of follow-up, the patient’s bone metastasis was not aggravated, and there was no loosening or fracture of the right femoral intramedullary nail.

Conclusion:
This is a case of pathological fracture of the femur caused by bone metastases from pulmonary cancer. The patient used HIFU to reduce the lesion before the operation and combined it with intramedullary nail internal fixation to treat the pathological fracture. A satisfactory therapeutic effect was obtained. The authors believe that this is a safe and effective treatment. This case may be beneficial to the treatment of pathological fracture of bone metastasis of lung cancer.