bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy and safety of a digital check-in and triage kiosk in emergency departments: a systematic review protocol
Authors: Sehgal Himani Laxshmi Kaur , Greenfield Geva , Neves Ana Luisa , Harmon Mark , Majeed Azeem , Hayhoe Benedict 
Published: July 2024

IntroductionIncreasing demand for healthcare services worldwide has led to unprecedented challenges in managing patient flow and delivering timely care in emergency care settings. Overcrowding, prolonged waiting times, reduced patient satisfaction and increased mortality are some of the consequences of this increased demand. To address this issue, some healthcare providers have turned to digital systems, such as self-check-in kiosks, for efficient patient triage and prioritisation. While digital triage systems hold promise for efficient patient prioritisation, reduced data duplication, shorter waiting times, improved patient satisfaction, the impact on workflow, the accuracy of triage and staff workload require further exploration for successful implementation in emergency care settings. This systematic review aims to assess the efficacy and safety of digital check-in and triage kiosk implementation within emergency departments.Methods and analysisA systematic review will be conducted in MEDLINE (Ovid), Web of Science, Scopus and Science Direct and will include quantitative and mixed method studies with a significant quantitative component, related to self-service kiosk implementation in emergency departments. The outcomes of interest will focus on the efficacy and safety of digital triage, including triage time, workflow, the diagnostic accuracy of triage and adverse events. Risk of bias will be assessed using the Cochrane Risk of Bias Tool. A narrative synthesis will be used to summarise the findings of the included studies.Ethics and disseminationThis review is exempt from ethical approval because it will be analysing published studies containing non-identifiable data. The findings will be disseminated through peer-reviewed publications.PROSPERO registration numberCRD42024481506.
Evaluation of the risk relationship between average alcohol volume consumed and suicide in the USA: an analysis of mortality linked cohort data
Authors: Lange Shannon , Zhu Yachen , Probst Charlotte 
Published: July 2024

ObjectiveAlcohol use disorder is an established risk factor for suicide; however, it is largely unknown whether subclinical levels of drinking may also contribute to the risk of suicide. The objective was to evaluate the relationship between average alcohol volume consumed per day and suicide.MethodsData from the annual, cross-sectional National Health Interview Survey, 1997–2018 in the USA, was obtained and linked to the 2019 National Death Index. The association between average alcohol volume consumed in grams per day (g/day) and suicide was quantified using Cox proportional hazards model (multiplicative) and Aalen’s additive hazard model. All analyses were stratified by sex, and adjusted for education, marital status, psychological distress, race and ethnicity, and survey year.ResultsOn the multiplicative scale, for males, former drinkers and those who consumed on average >40-60 g/day had about 43% (HR=1.43, 95% CI 1.03, 2.01) and 72% (HR=1.72, 95% CI 1.14, 2.60) greater risk of dying by suicide, compared with lifetime abstainers, respectively. There was no significant association found for former or current drinkers among females, on the multiplicative scale. On the additive scale, for males, drinking >40-60 g/day on average was associated with 22.7 (95% CI 6.0, 39.4) additional deaths per 100 000 person-years, while for females, being a former drinker and drinking >0-20 g/day on average was associated with 5.5 (95% CI 0.7, 10.4) and 1.9 (95% CI 0.2, 3.5) additional deaths per 100 000 person-years, compared with lifetime abstainers. The level of education was not found to modify the focal relationship for males or females.ConclusionsThe findings suggest that the relationship between average alcohol volume consumed per day and suicide is nuanced. Additional research on the respective relationship is needed, including repeated measures of average alcohol consumption over time.
Acceptability and feasibility of video-based firearm safety education in a Colorado emergency department for caregivers of adolescents in firearm-owning households
Authors: Haasz Maya , Betz Marian E , Ambroggio Lilliam , Cafferty Rachel , King Cheryl A , Wong Shale , Leonard Jan , Brooks-Russell Ashley , Sigel Eric 
Published: July 2024

BackgroundEasy firearm access increases injury risk among adolescents. We evaluated the acceptability and feasibility of improving knowledge of a 3 min safe firearm storage education video in the paediatric emergency department.MethodsWe conducted a single-centre block trial in a large paediatric emergency department (August 2020–2022). Participants were caregivers of adolescents (10–17 years) in firearm-owning households. First block participants (control) completed a baseline survey about child safety behaviours (including firearms). Second block participants (intervention) completed a baseline survey, watched the safe firearm storage video and evaluated acceptability. Participants completed a 3-month follow-up survey about firearm safety behaviours and knowledge recall. Demographic and clinical variables were compared between the intervention and control groups using Fisher’s exact and χ2tests. McNemar’s test was used to compare firearm storage behaviours at the initial and 3-month visit within each group.ResultsResearch staff approached 1264 caregivers; 371 consented to participate (29.4%) and 144 (38.8%) endorsed firearm ownership. There were 95 participants in the control group and 62 in the intervention group. Follow-up was lower in the intervention group (53.7% vs 37.1%, p=0.04). Among participants viewing the video, 80.3% liked the video and 50.0% felt they learnt something new from the video.ConclusionsVideo-based firearm education in a paediatric emergency department is acceptable among a population of caregivers of adolescents with household firearms. This is a higher-risk group that may uniquely benefit from consistent education in the paediatric emergency department. Further study with larger populations is needed to evaluate intervention effectiveness.Trial registrationThe study was registered with ClinicalTrials.gov (NCT05168878).
Genetic characterisation of lymphogranuloma venereum in Spain: a multicentre study
Authors: Salmerón Paula , Serra-Pladevall Judit , Vall-Mayans Martí , Villa Laura , Otero-Guerra Luis , Milagro Ana , Maciá María D , Bernal Samuel , Piñeiro Luis 
Published: July 2024

IntroductionLymphogranuloma venereum (LGV) is a sexually transmitted infection caused byChlamydia trachomatisgenotypes L1–L3. A combination of techniques with high discriminatory capacity such as multilocus sequence typing (MLST) and the analysis of theompAgene may be useful to determine the greater penetration of certain strains in transmission networks and their relationship with certain tropisms.AimThe aim of this study was to investigate the molecular epidemiology of LGV isolates from different regions of Spain.MethodsGenetic characterisation of LGV isolates detected in six hospitals from Spain between 2018 and 2019 was performed. MLST (five variable regions:hctB, CT058, CT144, CT172 andpbpB) andompAsequence determination were used to study the LGV strains.ResultsMost of the 161 LGV isolates (93.8%) were detected in men who have sex with men (MSM). At least 43.5% of the patients presented with HIV coinfection and 53.4% were symptomatic, with proctitis being the most prevalent symptom (73.3%). Most isolates were detected in Barcelona (n=129).The distribution ofompAgenovariants was as follows: 56.1% belonged to L2, 24.3% to L2b, 5.4% to L2bV1, 4.7% to L2bV4, 4.1% to L1, 2.7% to L2b/D-Da, 2.0% to L2bV2 and 0.7% to L2bV7. MLST was successfully performed in 81 samples and 9 different sequence types (STs) were detected. TheompAand MLST combination obtained 17 different genetic profiles, with L2-ST53 and L2-ST58 being the most prevalent (29.5% and 14.1%, respectively). L1 genotype strains belonged to ST23 (n=3) and ST2 (n=3).ConclusionLGV infections were mainly found in MSM living with HIV and with proctitis. The joint analysis ofompAand MLST genetic characterisation techniques showed a high discriminatory capacity. Our findings suggest a cocirculation of L2 and L2bompAgenotypes, and with the inclusion of MLST characterisation, the most prevalent profiles wereompAgenotype L2-MLST ST53 and L2-MLST ST58.
Modulation of Internal Solitary Waves by One Mesoscale Eddy Pair West of the Luzon Strait
Authors: Huang Hao , Qiu Shi , Zeng Zhi , Song Pengyang , Guo Jiaqi , Chen Xueen 
Published: July 2024

Abstract
The characteristics of modulated internal solitary waves (ISWs) under the influence of one mesoscale eddy pair in the Luzon Strait, involving one anticyclonic eddy (AE) and one cyclonic eddy (CE) induced by the Kuroshio intrusion, were investigated using a nested high-resolution numerical model in the northeastern South China Sea (SCS). The presence of mesoscale eddies greatly impacts the nonlinear evolution of type-a and type-b ISWs. The eddy pair contributes to distinct wave properties and energy evolutions. Compared to type-b waves, type-a waves display more pronounced modulatory characteristics with a larger spatial scale. CE currents and horizontal inhomogeneous stratification are crucial in modulating the wave behaviors, which induce extremely large-amplitude depression ISWs. The AE thereafter yields retardation effects on the wave energy evolution. The average depth-integrated available potential and kinetic energy showed relative growth rates of −66.12% and −46.07%, respectively, for type-a waves, and −24.26% and −20.15%, respectively, for type-b waves along the propagation path up to the AE core. The deformed and distorted ISW crest lines propagating further northward exhibit a more dramatic shoaling evolution. The maximum total energies of type-a and type-b waves at the north station are approximately 13.5 and 3.5 times, respectively, greater than those at the south station on the continental shelf of the Dongsha Atoll. This work provides essential insights into modulated ISW dynamics under the mesoscale eddy pair within the northeastern SCS deep basin.
Sublime and extended reality experiences to enhance emotional wellbeing for autistic people: A state of the art review and narrative synthesis
Authors: Bennewith Chris , Bellali Johara , Watkins Lance , Tromans Samuel , Bhui Kamaldeep , Shankar Rohit 
Published: July 2024

Background: Sublime is a centuries old concept of emergent experience arising from immense and threatening awareness provoked by overwhelming fear and dread when faced with an incomprehensible situation as is common to autistic people. Extended Reality (XR) technologies have been used since the mid-1990s, in regulating emotions, behaviour and supporting social skill development for autistic people. Aims: To understand utility of XR technologies in creating immersive experiences for autistic people to alleviate anxiety and the relationship to the sublime. Method: A State of the Art literature review and narrative synthesis was conducted. PubMed, CINAHL, EMBASE, Cochrane Library, Scopus, Web of Science were searched with terms Autism AND Technology. In addition, fields of digital technologies and wellbeing, digital art and mental health, generative arts and the sublime were explored through web searches of grey literature, conversations with digital designers and explorations of extended reality platforms. No time limits were placed. Searches were done in English. Papers were screened and shortlisted using the inclusion criteria applied by two reviewers. Results: Fifty-eight papers/articles met the preliminary inclusion criteria for in-depth review of which 31 were found suitable for the narrative synthesis related to XR technologies and sublime experiences as related to autistic people. Narrative synthesis lent itself to four themes that is current utility of XR Technologies in autism, the impact of immersive experiences on Behavioural, phenomenological and biological markers of autistic people, the Benefits of increased sensory stimulation using XR on autism and an inquiry into the potential of the sublime for autism. Conclusions: Mixed reality environments that experiment with a broad range of XR technologies including incorporating notions of the sublime, might be beneficial in reducing emotional dysregulation and improving social development in autistic people especially if co-designed with them.
Comparison of the VPF and Liquid C02 Foaming Processes
Authors: Blackwell J.B. , Buckley G. , Blackwell S.W. 
Published: July 2024

A number of technologies are now available to replace ozone depleting chemicals and hazardous air pollutants in the manufacture of flexible polyurethane slabstock. In the U.S.A. the Environmental Protection Agency has made provisional recommendations regarding the Presumptive Maximum Available Control Technology. Two of the options - Variable Pressure Foaming (V.P.F.) and the Liquid C02 Injection process are compared on the following basis: Production Range; Economics of Production; Process Improvements; Environmental Considerations; Capital Costs Both V.P.F. and Liquid C02 fulfil the requirements of the Montreal Protocol. The comparisons illustrate that Liquid C02 is a part solution to the Environmental problem, V.P.F. is the more complete solution.
Assessment of the diagnostic efficacy of radiological and functional evaluation of primary adrenal mass and its’ surgical outcomes
Authors: Tilala Yash Manharlal , Panda Sabyasachi , Tripathi Abhilekh , Sharma Sachin , Paul Amiya Shankar , Choudhuri Sanjay , Swain Samir 
Published: July 2024

Introduction: Objective of this study was to assess the diagnostic efficacy of the most commonly used radiological evaluation in form of contrast enhanced computed tomography of abdomen with adrenal protocol, basic functional evaluation and surgical outcomes of primary adrenal masses. Material and methods: We have retrospectively analysed the institutional records of 108, patients admitted from August 2017 to September 2023, who had underwent surgical intervention for their adrenal mass after thorough evaluation and stabilization. Results: Flank pain was the most common symptoms in 44 (40.74%) patients. Non-functional adrenal adenoma was found in 36 (33.33%) patients. Pheochromocytoma was the most the common functional adrenal mass found in 24 (22.22%) patients. CECT abdomen had suggested features of malignancy in 16(14.81%) patients. In final histopathological report 26(24.07%) patients had pheochromocytoma and 12 (11.11%) patients had adrenocortical carcinoma. CECT abdomen had sensitivity of 75%, specificity of 95.6%. Plasma free metanephrines and normetanephrine analysis had shown sensitivity of 90%, specificity of 92.86%, aldosterone to renin ratio had sensitivity of 92%, specificity of 100%. Sensitivity and specificity of the low-dose dexamethasone suppression test and plasma dehydroepiandrosterone was 100% in our study. Eighty patients (74.07%) were operated with laparoscopic adrenalectomy, 20 (18.52%) patients with open adrenalectomy. Eight patients (7.41%) were converted from laparoscopic to open. Laparoscopic approach had significantly lesser mean operating time, lesser blood loss, lesser hospitalization and lesser post-operative complications. Conclusion: Radiological analysis and functional analysis has shown good sensitivity and high specificity. Laparoscopic approach has advantage of lesser operative time, lesser hospitalization and lesser post-operative complications.
Bringing Radical Assessment into Radical Political Economy: An Ungrading Experience
Authors: Ramnarain Smita , Santucci Anna 
Published: July 2024

This article shares an experience with an “ungrading” experience in a radical political economy course at the University of Rhode Island (URI). Using qualitative data in the form of student narratives gathered from their written work, we argue that this form of student assessment empowers students to deepen metacognition, fosters their resilience and self-awareness, and privileges principles such as cooperation, collaboration, and sharing in learning, in contrast to the individualized and competitive atmosphere conventional grading creates. Student narratives also point to ways in which ungrading allowed them to engage deeply with the world around, to examine their own lives and work in the context of capitalism, and to uncover possibilities for resistance and action. Thus, ungrading can provide an entry point into anti-capitalist assessment practices. JEL classification: A20, B14, B50
Hyperekplexia: A Single-Center Experience
Authors: Dolu Merve Hilal , Öz Tunçer Gökçen , Akça Ünal , Aydın Seren , Bahadir Oğuzhan , Sezer Özlem , Aksoy Ayşe , Taşdemir Haydar Ali 
Published: July 2024

Background Hyperekplexia is a rare neurogenetic disorder that is classically characterized by an exaggerated startle response to sudden unexpected stimuli. This study aimed to determine clinical and genetic characteristics of our patients with hyperekplexia. Methods The age of onset and diagnosis, familial and perinatal history, clinical course, complications, metabolic screening tests, magnetic resonance imaging (MRI), medications, neuropsychometric evaluations, and gene mutations of patients diagnosed with hyperekplexia were reviewed retrospectively. Results All hyperekplexia patients had displayed neonatal excessive startle response and muscle stiffness, which we accepted as the major form of the disorder. Sixteen patients had mutations in genes associated with hyperekplexia. The ages at clinical diagnosis and genetic confirmation ranged from newborn to 16 years old and from 2.5 to 19 years, respectively. Nine patients (56.25%) were initially misdiagnosed with epilepsy. Seven patients (43.75%) carried a diagnosis of intellectual disability, defined here as a total IQ <80. Delayed gross motor development was detected in 4 patients (25%), and speech delay was reported in 3 (18.75%). Mutations in GLRA1 (NM_000171.4) and SLC6A5 (NM_004211.5) were identified in 13 (81.25%) and 3 patients (18.75%), respectively. Fifteen of the 16 patients (93.75%) showed autosomal recessive inheritance. Only 1 patient (6.25%) showed autosomal dominant inheritance. Conclusion Although hyperekplexia is a potentially treatable disease, it can be complicated by delayed speech and/or motor acquisition and also by intellectual disability. This study shows that hyperekplexia is not always a benign condition and that all patients diagnosed with hyperekplexia should be evaluated for neuropsychiatric status and provided with genetic testing.
Long-term outcomes and associated factors of Crohn’s disease patients achieving transmural healing based on magnetic resonance enterography: a Chinese retrospective cohort study
Authors: Lu Yaming , Xiong Shanshan , Zhang Mengchen , Zu Xiaoman , Li Jinbin , Mao Ren , Zeng Zhirong , Li Xuehua , Chen Minhu , He Yao 
Published: July 2024

Background: Transmural healing (TH) has emerged as a potential treatment goal for Crohn’s disease (CD). However, further research is needed to confirm its benefits and risk factors associated with TH remain unclear. Objectives: We aimed to assess the value of TH based on magnetic resonance enterography (MRE) in Chinese CD patients regarding the long-term outcomes and its associated factors. Design: Retrospective, observational cohort study. Methods: Patients with CD diagnosed by colonoscopy and MRE examination between 2015 and 2022 were included. All patients were evaluated with endoscopy together with MRE within 6–12 months after baseline and followed up for at least 6 months after evaluation. The primary endpoint was the occurrence of major outcomes during the follow-up, including drug escalation, hospitalization, and surgery. The cumulative probabilities of major outcomes were calculated using Kaplan–Meier survival curves. Logistic regression analyses were used to predict TH within 6–12 months after baseline. Results: A total of 175 patients were included in the study. Of these, 69 (39.4%) patients achieved mucosal healing (MH), but only 34 (19.4%) of them achieved TH. The median follow-up duration was 17.4 months (interquartile range, 11.6–25.5), and major outcomes occurred in 58.3% of patients. A lower occurrence rate of major outcomes was noted in patients who achieved TH than in those who achieved MH only ( p = 0.012). The baseline lymphocyte/C-reactive protein ratio (LCR) [odds ratio (OR), 1.60; 95% confidence interval (CI), 1.02–2.50; p = 0.039] and bowel wall thickness (BWT) (OR, 0.72; 95% CI, 0.59–0.90; p = 0.003) were independent predictors associated with TH. According to multivariate Cox regression analysis, low LCR [hazard ratio (HR), 2.34; 95% CI, 1.51–3.64; p < 0.001], and no healing (HR, 5.45; 95% CI, 2.28–13.00; p < 0.001) were associated with an increased risk of major outcomes. Conclusion: Patients with CD who achieved TH showed improved prognosis compared to those who achieved MH only. Baseline LCR and BWT might predict TH.
Retrospective evaluation of the short-term effectiveness of non-enzymatically isolated stromal vascular fraction cells in patients with knee osteoarthritis
Authors: Safarli Aytan , Kirnaz Berkay , Kumcuoglu Derin , Mahmudov Vusal , Karimov Ziya , Berdeli Afig 
Published: July 2024

Background Knee osteoarthritis (KOA) is the most common degenerative joint disease. Adipose-derived stromal vascular fraction cell therapy slows the progression of knee osteoarthritis and prevents hyaline cartilage degeneration without serious side effects. This study aims to present retrospectively the effectiveness of stromal vascular fraction cells isolated from adipose tissue by the non-enzymatic method applied to 55 osteoarthritis patients of different age groups and Kellgren-Lawrence grades on the recovery of the disease. Material and Methods Fifty-five patients with knee osteoarthritis, treated with stromal vascular fraction cells at the International Medical Centre (Azerbaijan) between 2020 and 2021, were included in the study to be evaluated retrospectively. Patients aged 32–67 years, Grades I–IV according to Kellgren-Lawrence classification, were included in this study. Pain and functional limitations were assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaires before treatment, at the 5th month, and 12th month after stromal vascular fraction injection. Results At the fifth and 12th months post-treatment, it was observed that the WOMAC scores were significantly improved compared with pre-treatment scores. It was also observed that stromal vascular fraction therapy was effective for Kellgren-Lawrence Grades I and II at 12 months. The most significant decrease in the WOMAC score after stromal vascular fraction treatment was observed in patients aged 45–60 years, and it was also found that there was no meaningful relationship between stromal vascular fraction efficiency and gender. Conclusion According to our results, non-enzymatically stromal vascular fraction treatment is more effective for longer in osteoarthritis patients with early age and low Kellgren-Lawrence grades (I and II). Moreover, our finding is that the stromal vascular fraction cells could be used safely in osteoarthritis treatments and significantly benefit patients’ quality of life.