bluuebunny/crossref_metadata_2025_split huggingface dataset:
24-hour Telemetry Monitoring May Not be Necessary for Patients With an Isolated Sternal Fracture and Minor ECG Abnormalities or Troponin Elevation: A Southern California Multicenter Study
Authors: Al-Khouja Fares , Grigorian Areg , Emigh Brent , Schellenberg Morgan , Diaz Graal , Duncan Thomas K. , Tuli Rahul , Coimbra Raul , Gilbert-Gard Kacy , Johnson Arianne , Marty Makenna , Jebbia Mallory , Obaid-Schmid Amal K. , Fierro Nicole , Ley Eric , Bayat Dunya , Biffl Walter , Ebrahimian Shayan , Tillou M Areti , Tay-Lasso Erica , Alvarez Claudia , Nahmias Jeffry 
Published: August 2024

Background Current guidelines recommend 24-hour telemetry monitoring for isolated sternal fractures (ISFs) with electrocardiogram (ECG) abnormalities or troponin elevation. However, a single-center study suggested ISF patients with minor ECG abnormalities (sinus tachycardia/bradycardia, nonspecific arrhythmia/ST-changes, and bundle branch block) may not require 24-hour telemetry monitoring. This study sought to corroborate this, hypothesizing ISF patients would not develop blunt cardiac injury (BCI). Materials & Methods A retrospective study was performed at 8 trauma centers (1/2018-8/2020). Patients with ISF (abbreviated injury scale <2 for the head/neck/face/abdomen/extremities) and minor ECG abnormalities or troponin elevations were included. Patients with multiple rib fractures or hemothorax/pneumothorax were excluded. The primary outcome was an echocardiogram confirmed BCI. The secondary outcome was significant BCI defined as cardiogenic shock, dysrhythmia requiring treatment, post-traumatic cardiac structural defects, unexplained hypotension, or cardiac-related procedures. Descriptive statistics were performed. Results Of 124 ISF patients with minor ECG abnormalities or troponin elevation, 90% were admitted with a mean stay of 35 hours. Echocardiogram was performed for 31.5% of patients, 10 (25.6%) of which had abnormalities. However, no patient had BCI diagnosed on echocardiography. In total, 2 patients (1.6%) had a significant BCI (atrial fibrillation and supraventricular tachycardia at 10 and 82 hours after injury). No patient died. Conclusions Following ISF with minor ECG changes or troponin elevation, <2% suffered significant BCI, and none had an echocardiogram diagnosed BCI, despite >30% receiving echocardiogram. These findings challenge the dogma of mandatory observation periods following ISF with associated ECG abnormalities and support the lack of utility for routine echocardiography in these patients.
Is bureaucracy ironclad after all? Prevalence and variances of performance- and strategy-oriented management in German local governments
Authors: Weiss Jens 
Published: August 2024

This study analyzes practices of performance management (PM) and strategic management (SM) and their prevalence in Neo-Weberian rule-of-law administrations. Based on data from Germany's local government sector, it is shown that after 30 years of New Public Management (NPM) reforms, no more than 20% of German municipalities have implemented the basic aspects of PM or SM. Actual practices combine ideas of PM and SM in quite different ways and can best be understood as variances of a performance- and strategy-oriented management. It is argued that even though patterns of normative as well as coercive isomorphism have existed in the organizational field, the influence of NPM ideas has led to a diversification of management practices within Germany's local government sector. But results also show that there is no tendency toward a broadly NPM-oriented administration and that typical models of Neo-Weberian administration do not truly align with actual practices. Points for practitioners The use of performance information and strategic goals are important management instruments for public organizations. This study shows that in public administrations adhering to more bureaucratic rule-of-law traditions, actual management practices combine aspects of PM and SM in various ways, often not aligning with the recommendations from the advisory literature. The presented insights may help practitioners to better understand the efforts and benefits of these management practices, as well as the trade-offs between them.
Aromatic (Co)polycarbonates bearing pendant norbornenyl groups: Synthesis, characterization and post-polymerization modification
Authors: Talanikar Aniket A , Nagane Samadhan S , Wadgaonkar Prakash P , Rashinkar Gajanan S 
Published: August 2024

A homo- and three co-polycarbonates (PC-NBs) bearing pendant norbornenyl groups were synthesized via solution polycondensation of triphosgene with 4, 4'-(bicyclo (2.2.1) hept-5-en-2 yl methylene) bis (2-methoxyphenol) (BPA-NB) or various mol % compositions of BPA-NB and bisphenol-A, respectively. 1H-NMR spectroscopy confirmed the chemical structure and composition of PC-NBs. Inherent viscosity and number-average molecular weight (Mn) values of PC-NBs were in the range 0.44 – 0.64 dL g−1 and 21,800 – 34,100 g mol−1, respectively, indicating the formation of polymers of medium to reasonably high molecular weights. Tough, transparent, and flexible films of PC-NBs could be cast from chloroform solution. X-Ray diffraction studies indicated the amorphous nature of PC-NBs. Glass transition temperature (Tg) values, determined by DSC analysis, of PC-NBs were in the range 154 – 175°C and Tg values increased with the increase in mol % of BPA-NB. The post-polymerization modification of a representative PC-NB was demonstrated using 3,6-diphenyl-1,2,4,5-tetrazine via tetrazine-ene reaction.
The tale of two Badakhshans: Determinants of access and utilization of HIV preventive services along the Afghan-Tajik border
Authors: Sidhu Harsimren , Gebreweldi Frezghi , Davis Alissa , Jonbekov Jonbek , Bahramov Mahbat , Dasgupta Anindita , McCrimmon Tara , Marotta Phillip , Dehghani Kianoush 
Published: August 2024

Background Injection of opioids has contributed to growing HIV epidemics in Tajikistan and Afghanistan. This qualitative study explored determinants of access to primary prevention and screening for HIV among people who inject drugs (PWID) residing in border communities of Gorno-Badakhshan, Tajikistan and Badakhshan, Afghanistan. Methods Semi-structured interviews were conducted with PWID, community leaders, and healthcare workers. The social-ecological model was used to inform a thematic analysis of determinants of access. Results There were no preventive or screening services for HIV in the border districts of Afghanistan. Barriers to accessing HIV-related services in Tajikistan, and to accessing general health services in Afghanistan, included: lack of knowledge about HIV, inaccessible communities with poor infrastructure, discrimination and violence against women, and stigmatization of PWID and people living with HIV. Access to HIV-related and other health services by PWID was facilitated by community leader support, family support, outreach services, and linkage of harm reduction services with HIV testing and care. Conclusion Urgent interventions are needed to stem the escalating HIV epidemic in Afghanistan and enhance existing services in Tajik border communities. This qualitative study offers insights into barriers and facilitators for accessing HIV prevention and screening services among PWID, suggesting potential interventions.
Bridging the Gap: Reducing Health Inequities in Access to Preventive Health Care Services in Rural Communities in the Philippines
Authors: Serafica Reimund , Reyes Andrew T. , Cacciata Marysol C. , Kawi Jennifer , Leyva Erwin William A. , Sy Francisco S. , Evangelista Lorraine S. 
Published: August 2024

Introduction: We used an implementation science framework to investigate perceived health inequities in preventive health care initiatives in rural communities in the Philippines. We also identified health equity–focused quality improvement strategies. Methods: Three health care providers and 12 barangay clinic patients were interviewed. Results: Patient interviews showed that social determinants of health, respect, and attitudes toward health care providers affected patient empowerment to engage in self-management for noncommunicable diseases (NCDs). Health care providers identified six challenges in managing NCDs: (a) inefficient work processes; (b) staffing shortages; (c) insufficient access to low-cost medications; (d) inadequate primary preventive health education from the schools; (e) health care not considered a priority; and (f) lack of local government support. Discussion: Inadequate preventive health care and education intensify health access and resource inequities in rural communities in the Philippines. A multi-sectoral plan may improve rural health infrastructure and education toward improving health care access and decreasing care disparities.
Study on the residual stress of simple cubic lattice structure produced by selective laser melting
Authors: Zhao Hongjian , Yang Binghua , Zhang Rui , Tian Yuxuan , Liu Changsheng , Zhan Yu 
Published: August 2024

Lattice structures become the focus for scholars to research due to its unique lightweight, high impact resistance and ideal noise reduction. Selective laser melting has become a very effective and convenient method for preparing lattice structures of excellent quality. However, it is imperative to acknowledge that rapid heating and cooling processes inherent to the method can generate excessive residual stresses within the lattice structures, thereby significantly compromising their mechanical properties. To address this issue, the present study seeks to elucidate the patterns and characteristics of distribution of residual stresses and deformations within simple cubic lattice structures, employing a combination of experimental techniques and finite element analysis. The fabrication of these simple cubic lattice structures is accomplished through selective laser melting. The investigation encompasses both two methods, involving X-ray measurements at discrete points on the structure, and finite element simulations to depict the overall stress distribution. The results show that the residual stress and deformation are more likely concentrated on the initial surface to be processed, and residual stress on the substrates is bigger than that on bars. Specifically, the biggest stress concentrates on the Z-bars, up to 1393 MPa. However, in terms of the overall state of stress distribution in the structure, the residual stress on the substrate is slightly higher than that on the lattice structure.
Evaluation of the Effect of Radiosurgery for Target and Non-Target Lesions in Patients with Brain Metastases Using RANO-BM Criteria
Authors: Popov Veselin , Raycheva Gabriela , Graklanov Vasko , Uchikov Petar , Grudeva-Popova Zhanet 
Published: August 2024

Objectives The current therapeutic indications of radiosurgery are constantly expanding. Magnetic resonance imaging (MRI) has an important role in the diagnostic and post-therapeutic period of primary and secondary brain tumor formations. Methods A total of 66 patients with verified cancer disease and brain metastases were separated into two groups. The first group includes 34 patients with primary non-small cell lung cancer and the second one 32 patients with other types of primary cancer. All of them received high-dose radiotherapy in 1–5 fractions. The number, size, and location of the treated lesions responded to robotic stereotactic radiosurgery criteria. The Response Assessment Criteria for Brain Metastases (RANO-BM) is an international multidisciplinary group of experts who developed acceptable criteria for assessing brain metastases. Before treatment and on the first, third, sixth month after radiosurgery, a MRI and blood tests were performed. Results Treated lesions were separated into four groups depending on the results – complete response, partial response, progressive disease, and stable disease. In both groups of patients, the percentage of complete or partial response had increased in the third and sixth months. Conclusion The results give us a reason not to recommend an MRI 1 month after treatment if the patient doesn't have any new neurological symptoms, because there may be a pseudo-progression. MRI results valued by RANO-BM criteria give us a good option to evaluate brain metastases on the third and sixth month after after stereotactic radiosurgery.
Rare neurovascular variants that you probably have not seen before
Authors: Abdalkader Mohamad , Hanz Samuel Z , Raz Eytan , Zedde Marialuisa , Hu Wei , Pascarella Rosario , Qiu Zhongming , Kikano Raghid , Nguyen Thanh N 
Published: August 2024

Background Recognition of neurovascular variants is crucial for safe endovascular and neurosurgical interventions. We aim to review and highlight various uncommon neurovascular variants and anomalies with a discussion of their relevant embryology and pathology. Methods A retrospective review of a prospectively maintained neurovascular database was performed to identify uncommon neurovascular variants and anomalies. A pictorial review of these neurovascular findings is provided along with relevant embryological development, clinical significance, and potential pathological associations. Results A pictorial review of selected neurovascular variants and anomalies is presented. These entities, divided between intra- and extra-cranial findings, include infra-optic origin of the anterior cerebral artery, meningo-ophtalmic artery, duplicated posterior cerebral artery, duplicate middle cerebral artery (MCA), MCA fenestration, twig-like MCA, pure arterial malformation, corkscrew basilar artery, persistent hypoglossal artery, persistent trigeminal artery and its variants, direct branches from the common carotid and cervical internal carotid arteries (ICA) (ascending pharyngeal artery from the ICA, thyroidal arteries from the CCA/brachiocephalic, arteria thyroidea ima), and extra-cranial carotid fenestration. The angiographic findings of these entities are presented with relevant 3D reconstruction and multimodal cross-sectional imaging correlation when available. Conclusions This pictorial review highlights uncommon neurovascular variants and anomalies that neuroradiologists, interventionalists, and neurosurgeons should be aware of for accurate diagnosis and safe interventions.
Managing cardiovascular risk factors with telemedicine in primary care: A systematic review and meta-analysis of patients with arterial hypertension and type 2 diabetes
Authors: Mihevc Matic , Virtič Potočnik Tina , Zavrnik Črt , Klemenc-Ketiš Zalika , Poplas Susič Antonija , Petek Šter Marija 
Published: August 2024

Objectives To review the effect of telemedicine interventions on cardiovascular risk factors control in people with arterial hypertension (AH), type 2 diabetes (T2D), or both in primary care. Methods We conducted a systematic review in February 2024 using PubMed/MEDLINE, Cochrane Library, and EMBASE databases. We included randomised controlled trials from 2010 onwards, lasting ≥3 months, comparing telemedicine to standard care for managing cardiovascular risk factors in adults with AH, T2D, or both. Results Among 1803 records, 54 were included. Telemonitoring with teleconsultations showed the best outcomes. For AH, systolic blood pressure decreased by −5.63 mmHg (95% CI −9.13 to −2.13) at 6 months and −5.59 mmHg (95% CI −10.03 to −1.14) at 12 months compared to standard care. For T2D, HbA1c decreased by −0.45% (95% CI −0.90 to 0.00) at 6 months and −0.18% (95% CI −0.41 to 0.05) at 12 months compared to standard care. Blood glucose self-monitoring was as effective as telemonitoring for T2D at 6 months. The effect on diastolic blood pressure, low-density lipoprotein, triglycerides, and body mass index was non-significant. Discussion Telemedicine offers short-term benefits but lacks long-term effectiveness. Optimal outcomes require a combined telemedicine approach, health education co-intervention, ≥12-month follow-up, and careful patient selection.
Are occupational therapists in hand therapy working in an occupation-centered way? A cross sectional survey
Authors: Ransby Thea Birch , Jacobsen Nicolaj Schøler , Hansen Alice Ørts 
Published: August 2024

Introduction The dominance of the biomedical approach has previously caused a limited focus on occupation within hand therapy. This study aimed to investigate the rehabilitation offered to patients with a hand-related disorder (HRD) in Denmark including to determine the extent to which occupation-focused and/or occupation-based assessments and interventions are used and to identify barriers against their use. Methods A cross-sectional survey with 45 questions was conducted among members of the Danish Association for Hand Therapy. Data were analysed with descriptive statistics. Categorical variables were reported with frequency and percentage, and continuous variables with average and standard deviation. Results One hundred and six occupational therapists working as hand therapists ( n = 106) completed the survey. They reported common use of assessments measuring range of motion, pain, edema, and occupational performance. Occupational performance was assessed by non-standardized occupation-focused assessments, such as informal conversations. Exercise, pain management, and occupation-focused informal conversations were reported as the most frequently used interventions. Out of 82 respondents, 74 (91.4%) reported that they used interventions focused on body function and structures to the extent they wanted. Only 41 (50.0%) used occupation-focused or occupation-based interventions to the extent they wanted. Discussion Assessments and interventions reporting body function and structure were used most frequently whereas assessments and interventions reporting activity and participation were used to a lesser extent. Occupation-focused assessments and interventions were used more commonly than occupation-based. Hand therapists considered occupation-based assessments and interventions to be important in rehabilitation after HRD, despite using them with few patients. Several barriers were reported regarding the implementation of an occupation-centered approach: habit, workload, time constraints, and setting.
When Avoidance Backfires: Interracial Officer-Citizen Dyads and the Consequences for Fleeing Suspects
Authors: Flexon Jamie L. , D’Alessio Stewart J. , Stolzenberg Lisa 
Published: August 2024

Research suggests that Black citizens who experience an elevated fear of law enforcement frequently engage in avoidance strategies, such as fleeing, when confronted by police. There is also strong reason to speculate that this avoidance behavior commonly transpires when the police officer is White. Problematically, this avoidance strategy may place these citizens at an increased risk for officer use of force as the police seek to subdue fleeing suspects. The current study uses data drawn from the Evaluation of Less-Lethal Technologies on Police Use-of-Force project and a series of logistic regression equations and mediation analysis to determine whether Black suspects are more apt to flee from White police officers than other officer-suspect racial dyads and, because of this fleeing behavior, have a greater likelihood of experiencing force. After controlling for a variety of salient factors, results indicate support for this scenario. Policy implications are discussed. Plain language title When Avoidance Backfires: Mixed-Race Officer-Citizen Contacts and What Happens When Suspects Run From Police
Comparison of Patient-Reported Outcomes for Immediate Unrestricted Weightbearing Versus Restricted Rehabilitation Protocols After Osteochondral Allograft Transplantation to the Distal Femur
Authors: Prigmore Brian , Haneberg Erik , Elias Tristan , Wiedrick Jack , Ballin Jessica , Cole Brian J. , Yanke Adam B. , Crawford Dennis C. 
Published: August 2024

Background: There is no standardized rehabilitation protocol after osteochondral allograft (OCA) transplantation surgery to the distal femur. The spectrum of recommendations includes restrictions to toe-touch weightbearing (TTWB) for 6 weeks and immediate weightbearing as tolerated (WBAT). Purpose/Hypothesis: The purpose of this study was to compare outcomes for immediate unrestricted WBAT to restricted TTWB after OCA transplantation to the distal femur. It was hypothesized that the immediate WBAT protocol would be noninferior to delayed, restricted TTWB. Study Design: Retrospective cohort study. Methods: A total of 74 patients who underwent press-fit, dowel technique OCA transplantation to the femoral condyle(s) for contained (International Cartilage Repair Society grade 3-4) lesions were identified in the Metrics of Osteochondral Allograft multicenter database: 36 patients (18 women/18 men) who were prescribed TTWB were allocated to the control cohort and 38 patients (21 women/17 men) who were prescribed WBAT were allocated to the test cohort. Baseline characteristics were similar except for larger grafts in test patients (3.4 vs 2.7 cm2; P = .004) and higher body mass index (BMI) in control patients (27.8 vs 24.9 kg/m2; P = .01). Failure rates, final patient-reported outcome (PRO) scores, and PRO score changes from baseline were compared between the cohorts. Multiple regression was used to control for potential confounders and investigate noninferiority using minimal clinically important differences (MCIDs). Results: The mean follow-up was 2 years (range, 1-5 years) in both cohorts. Both cohorts showed significant improvement in all PRO scores, with no significant between-group differences in failure rates, final PRO scores, or PRO changes from baseline. There were 3 cases of failure in each cohort (control cohort: allograft revision [n = 2], debridement [n = 1]; test cohort: chondroplasty [n = 2], conversion to total knee arthroplasty [n = 1]). Regression analysis showed that adjusted differences in final PRO scores based on weightbearing protocol were minor and less than MCIDs when controlling for age, sex, graft size, BMI, and allograft location. Analysis of the MCIDs with respect to the lower bounds of the confidence intervals indicated that WBAT was noninferior to TTWB with a reasonable degree of confidence (range, 84.1%-99.9% confidence). Conclusion: Results indicated that immediate unrestricted WBAT after OCA transplantation to the distal femur was equally safe and effective compared to restricted TTWB.
How I treat acute venous thromboembolism in patients with brain tumors
Authors: Leader Avi , Wilcox Jessica A. , Zwicker Jeffrey I. 
Published: August 2024

Abstract
Venous thromboembolism (VTE) is a common complication in patients with brain tumors. The management of acute VTE is particularly challenging due to an elevated risk of intracranial hemorrhage (ICH). Risk of developing ICH on anticoagulation is influenced by a number of factors including tumor type, recent surgery, concomitant medications, platelet counts, and radiographic features. In patients with a heightened risk for ICH, the benefits of anticoagulation need to be balanced against a likelihood of developing major hemorrhagic complications. Management decisions include whether to administer anticoagulation, at what dose, placement of an inferior vena cava filter, monitoring for development of hemorrhage or progressive thrombus, and escalation of anticoagulant dose. This article discusses the complexities of treating acute VTE in patients with brain tumors and outlines treatment algorithms based on the presence or absence of ICH at the time of VTE diagnosis. Through case-based scenarios, we illustrate our approach to anticoagulation, emphasizing individualized risk assessments and evidence-based practices to optimize treatment outcomes while minimizing the risks of hemorrhagic events in patients with brain tumors.