bluuebunny/crossref_metadata_2025_split huggingface dataset:
Relationship Between Health Care Team Segregation and Receipt of Care by a Cardiologist According to Patient Race in a Midwestern State
Authors: Quintero Bisonó Janina , Knapp Shannon M. , Trabue Dalancee , Yee Ryan , Williamson Francesca , Johnson Adedoyin , Watty Stephen , Pool Natalie , Hebdon Megan , Moore Wanda , Yankah Ekow , Ezema Nneamaka , Kimbrough Nia , Lightbourne Karen , Tucker Edmonds Brownsyne , Capers Quinn , Brown David , Johnson Denee , Evans Jalynn , Foree Brandi , Holman Anastasia , Blount Courtland , Nallamothu Brahmajee , Hollingsworth John M. , Breathett Khadijah 
Published: February 2025

Background
Segregation index (SI) has been associated with worsened health. However, the relationship between SI within health care teams (degree of heterogeneity between teams caring for Black compared with White patients) and cardiovascular care is unclear among adequately insured populations. We sought to assess the relationship between health care team SI, patient race, receipt of care by a cardiologist, 1‐year survival, and 30‐day readmission rates for Black compared with White patients admitted with heart failure, ischemic heart disease, or valvular heart disease.

Methods
Using Optum's de‐identified Clinformatics Data Mart Database (CDM) from 2009 to 2020, generalized linear mixed‐effects were used to analyze effects of patient race and SI on receipt of care by a cardiologist, and care by a cardiologist on 1‐year survival and 30‐day readmission.

Results

Among 6572 patients (17.1% Black), the odds of receiving care by a cardiologist were 31.3% less for Black than White patients (adjusted odds ratio 0.687 [95% CI, 0.545–0.872];
P
=0.001). However, there was no statistically significant association of SI on receipt of care by a cardiologist (
P
=0.14). For those seen by a cardiologist, the adjusted odds ratio (Black‐to‐White) of 1‐year survival increased with increasing SI (
P
=0.02). SI had no statistically significant effect on 30‐day readmission (
P
=0.86).

Conclusions
Among patients hospitalized for heart failure, ischemic heart disease, or valvular heart disease, segregation of health care teams was not associated with receipt of care by cardiologists in Indiana hospitals. When cardiologists were included, the odds of 1‐year survival increased for Black versus White patients with increasing segregation of clinicians, and segregation was not associated with 30‐day readmission.
Relationship Between the Frequency of Energy Drink Consumption and Sleep Time by Sex Among Korean Adolescents: A Secondary Analysis Using National Survey Data
Authors: Choi Yumi , Lee Su Jung , Seo Hyun-Ju 
Published: February 2025

Background: Energy drinks are becoming increasingly popular among adolescents despite potential adverse health effects. This study addresses the research question: “Is there an association between the frequency of energy drink consumption and insufficient sleep by sex?” Purpose: This study aimed to assess the frequency of energy drink consumption by sex among Korean adolescents aged 12 to 18 years and investigate its relationship with insufficient sleep. Methods: We analyzed secondary data using data from the 18th Korea Youth Risk Behavior Survey (2022). The study included 36 361 middle- and high school students. Complex sample logistic regression analysis examined the relationship between energy drink consumption and insufficient sleep by sex. Results: Among the respondents, 9.0% of male and 9.2% of female students reported consuming energy drinks frequently. In complex sample logistic regression analyses, those who reported consuming frequent energy drinks had significantly higher odds of insufficient sleep than the no-consumption group, controlling for potential confounding variables (adjusted odds ratio (OR) 2.15, 95% confidence interval (CI) 1.76-2.61 in male students; adjusted OR 3.25, 95% CI 2.39-4.41 in female students). Notably, female students who frequently consume energy drinks pose a substantial concern regarding insufficient sleep. Conclusions: Frequent energy drink consumption was associated with insufficient sleep time in both male and female adolescents. This highlights the need for public health policy interventions to reduce energy drink consumption and promote appropriate amounts of sleep among adolescents.
SPIN-IT and Quit It: A Nurse-Driven Protocol to Improve Inpatient Interventions for Tobacco Use Disorder
Authors: DeMarco James T. 
Published: February 2025

Introduction Tobacco smoking remains a leading cause of preventable disease and death in the U.S., with a high prevalence among individuals with mental health disorders (MHD). Despite regulatory efforts to increase tobacco use disorder (TUD) treatment in psychiatric inpatient units (an ideal setting), compliance of offering and using these interventions remains suboptimal. Aims This project aims to examine the effectiveness of a nurse-driven protocol, Smoking treatment Protocol for Inpatients via Nurse-driven Interventions & Teaching (SPIN-IT), on improving compliance with evidence-based TUD treatment interventions in an inpatient psychiatric unit. Methods SPIN-IT was developed and implemented in a 20-bed inpatient psychiatric unit. The protocol allowed registered nurses (RNs) to deliver TUD counseling and prescribe nicotine replacement medication based on an algorithm without an independently licensed provider (LIP). Data on compliance with CMS tobacco measures (TOB-2 and TOB-2a) were collected for 12 months before and after SPIN-IT implementation and analyzed for statistical significance. Results The project included 835 patients over 2 years. Postintervention TOB-2 compliance increased significantly from 84.7% to 99.3% ( p < .001), and TOB-2a compliance rose from 24% to 56% ( p < .001). The protocol resulted in more patients being offered and receiving TUD treatment counseling and medications. Conclusion The SPIN-IT protocol significantly improved TUD treatment compliance in an inpatient psychiatric setting. It supports the effectiveness of nurse-driven protocols in enhancing patient outcomes and adherence to TUD treatment measures. Further research is needed to evaluate the long-term impact on TUD treatment and to explore the perceptions of nursing staff, physicians, and patients related to the protocol.
Preoperative Peripheral Blood Serotonin and Kynurenine Levels Are Associated With Oncological Outcomes in Glioblastoma IDH-wt Patients
Authors: Snider Silvia , Gagliardi Filippo , De Domenico Pierfrancesco , Comai Stefano , Bertazzo Antonella , Nasini Sofia , Barzon Benedetta , Ruban Angela , Roncelli Francesca , Mortini Pietro 
Published: February 2025

Background: In recent years, there has been a growing interest in exploring the potential contribution of tryptophan (TRP) metabolism via the kynurenine (KP) and serotonin (SP) pathways in Glioblastoma (GBM) biology. This study aims to address the association between pre-operative peripheral blood levels of TRP, kynurenine (KYN), 5-hydroxy-tryptophan (5-HTP), and serotonin (5-HT) and relevant oncological outcomes in GBM IDH-wt patients. Methods: This is a single-center, retrospective clinical study. Serum from 62 adult patients undergoing maximal safe resection of newly diagnosed glioblastoma WHO-grade 4 IDH-wt (GBM) and n = 27 healthy controls were analyzed. The variables of interest were dichotomized via maximally selected rank statistics. Kaplan Meier and Cox multivariate regression analysis were conducted to explore the single contributions of these parameters in building a predictive model of overall survival (OS) and progression-free survival (PFS) in these patients. Results: The mean baseline serum levels of 5-HT, KYN, and 5-HTP were significantly lower in GBM when compared to n = 27 healthy individuals ( P < .001). Patients with 5-HT <78 ng/mL had a median OS of 14.4 months compared to 22.5 months in patients with increased levels ( P = .01). Shorter OS was observed in patients with KYN <18 ng/mL (9.8 vs 17.5 months, P = .002), KYN/TRP <2.55 (11.4 vs 17.1, P = .002), 5-HTP/TRP <0.89 (11.5 vs 17.6 months, P = .02), and 5-HT/TRP <5.78 (13.4 vs 19.1 months, P = .002) compared to patients with high levels. Shorter PFS in patients with 5-HT <78 ng/mL ( P = .04), KYN <18 ng/mL ( P = .02), 5-HT/TRP <5.78 ( P = .001), KYN/TRP <2.55 ( P = .005). Reduced KYN, 5-HTP, and 5-HT were independent predictors of poor OS. Conclusions: This study highlights an intriguing association between the degradation of TRP along the KP and SP and median survival times in GBM. Decreased KYN, 5-HTP, and 5-HT levels were associated with shorter OS.
Effects of tirofiban in preventing neurological deterioration in acute ischemic stroke with intracranial artery stenosis: A post hoc analysis of the TREND Trial
Authors: Wang Jing , Qiao Yue , Li Sijie , Li Chuanhui , Wu Chuanjie , Wang Pingping , Yang Ting , Ji Xunming , Ma Qingfeng , Zhao Wenbo 
Published: February 2025

Introduction: The degree of culprit artery stenosis affects the risk of early neurological deterioration (END) after acute ischemic stroke (AIS). The TREND trial demonstrated the efficacy of tirofiban in preventing END in patients with AIS. We aimed to investigate whether the degree of intracranial artery stenosis affects the efficacy of tirofiban in preventing END in patients with AIS. Patients and Methods: We conducted a post hoc analysis of the TREND trial, which enrolled patients within 24 h of onset and randomly allocated to receive intravenous tirofiban or oral aspirin. We stratified the stenosis degrees into three subgroups: no stenosis, mild-to-moderate stenosis (stenosis <70%), and severe stenosis or occlusion (stenosis ⩾70%). The primary endpoint is END4 defined as an increase of the NIHSS ⩾4 within 72 h after randomization. Secondary outcomes include END2 (defined as an increase of NIHSS ⩾2) within 72 h after randomization, the proportion of mRS 0–1 and 0–2 at 90 days. Results: A total of 296 patients were analyzed. In patients with severe stenosis or occlusion, tirofiban significantly reduced the incidence of END4 (5.7% vs 30.8%, adjusted OR 0.156, 95% CI 0.028–0.873, adjusted p = 0.034), whereas its effects in preventing END4 were similar to those of aspirin in patients with no stenosis (2.4% vs 4.6%, adjusted OR 0.193, 95% CI 0.018–2.083, adjusted p = 0.175) or mild-to-moderate stenosis (2.9% vs 10.0%, adjusted OR 0.171, 95% CI 0.015–1.943, adjusted p = 0.155). The p value for interaction between stenosis subgroups and treatment was 0.513. Furthermore, tirofiban significantly reduced the incidence of END2 in patients with mild-to-moderate stenosis (5.9% vs 22.5%, OR 0.146, 95% CI 0.022–0.951, adjusted p = 0.044) and severe stenosis or occlusion (11.4% vs 43.6%, adjusted OR 0.140, 95% CI 0.036–0.540, adjusted p = 0.004). A significant improvement in favorable outcomes with a 90-day mRS of 0–1 was observed only in patients with mild-to-moderate stenosis (85.3% vs 70.0%, adjusted OR 4.617, 95% CI 1.077–19.798, adjusted p = 0.039). Discussion and conclusion: Tirofiban may significantly reduce the incidence of END in patients with severe arterial stenosis or occlusion. Further studies are required to confirm the effects of intracranial artery stenosis on the benefits of intravenous tirofiban. Trial registration: ClinicalTrials.gov; identifier: NCT04491695.
Under the coconut palm – a retrospective analysis of trauma incidents caused by falling coconuts presenting to emergency department at a tertiary care centre in coastal India
Authors: Deepak A. Sai , Katyal Aaditya , Nair Neeraja A , Walia Tanvee , Bhat Rachana 
Published: February 2025

Abstract

Background
Injuries due to falling coconuts are a common yet underreported form of trauma in the tropical regions. Although these might appear insignificant at first glance, the physical forces involved are potentially fatal. Despite their global prevalence, research on this subject remains scarce, making it a neglected public health concern. This study seeks to bridge these gaps by analysing the affected demographics, contributing factors and injury patterns. By enhancing the understanding of coconut fall-related injuries, this research seeks to create awareness about dangers of falling coconuts and inform the development of effective public health strategies to mitigate their impact.

Methods
A retrospective study was conducted over a period of 3 years from January 2021 to December 2023 at a tertiary care centre on the southern coast of India. Patients who presented to emergency with coconut-fall related injuries were identified through a comprehensive review of nursing ledgers. Additional data including imaging, consultations & treatment details were retrieved from patient files and electronic medical records. Descriptive statistics of the recorded data like demographic variables, time of injury, injury patterns, injury severity score (ISS) and ED disposition were analysed by using Microsoft Excel 365.

Results
The study population included 17 males and 12 females. Most patients were within the age group of 40–60, which comprised 48% of the total participants. The months of September and October reported the highest frequency of cases. Out of the 29 patients, 14 were farm workers who sustained coconut fall-related injuries. Injury patterns varied from mild soft tissue injuries to severe TBIs which include SDH and SAH. There were 3 patients who required surgery, and 7 patients were admitted. There were no fatalities reported, and average hospital stay was 4.5 days.

Conclusion
Coconut fall-related injuries in tropical regions is a significant but less recognised public health issue. Our study shows the necessity of seasonal preventive strategies, public awareness and safety measures for high-risk population like outdoor workers and older adults. Community focussed interventions, such as regular coconut tree pruning, installation of coconut safety nets and educational campaigns will help to reduce the incidence and severity of these injuries.
Role of the inferior vena cava collapsibility index in predicting propofol-induced hypotension in patients undergoing colonoscopy
Authors: Zhou Zhou , Li Yujie , Zhu Jinxian , Liu Yingge , Wang Yuxin , Sang Xiaoqiao , Wang Xinxin , Zhang Xiaobao 
Published: February 2025

Abstract

Background
Hypotension is a common side effect of propofol induction, and when severe, it is associated with adverse outcomes. Ultrasonography of the inferior vena cava (IVC) is a reliable indicator of the intravascular volume. This study investigated whether preoperative IVC ultrasound measurements could predict hypotension after propofol induction in patients undergoing colonoscopies.

Methods
Sixty-two adult patients with American Society of Anesthesiologists physical status (ASA) I-II scheduled for colonoscopy after propofol induction were recruited. The Ultrasound Maximum IVC diameter (dIVCmax), minimum IVC diameter (dIVCmin), and collapsibility index (IVC-CI) were assessed in all patients before propofol induction. Mean blood pressure (MBP) was recorded before induction. Propofol was injected intravenously after ultrasound measurements. MBP was recorded 1, 3, 5, and 10 min after propofol induction. The receiver operating characteristic (ROC) curve of IVC-CI was compared with that of patients who developed hypotension after propofol induction.

Results
Sixty-two patients completed the study, and their data were considered for statistical analysis. After induction,30 patients developed hypotension. The area under the curve (95% confidence interval) was 0.72 (0.595 to 0.849) for IVC-CI. The optimal IVC-CI cutoff value was 38.25%, with a sensitivity of 56.7% and specificity of 71.9%. IVC-CI before induction strongly correlated with the maximum percentage of MBP drop after propofol induction. (regression coefficient = 0.33, P = 0.008), respectively.

Conclusion
Pre-induction IVC-CI > 38.25% is a non-invasive predictor of propofol-induced hypotension in patients undergoing colonoscopy and is strongly correlated with MBP drop.

Trial registration
This clinical trial was approved by the Ethics Committee of The Affiliated Lianyungang Hospital of Xuzhou Medical University (YJ-20190529001). All the study procedures were performed in accordance with the ethical standards of the Helsinki Declaration of 2013.
An exploration of changes in the mental models of middle management and their association with activities to implement a dialogue tool to address mental health in the workplace
Authors: Anzion Lily Joanne , Schaafsma Frederieke G. , Boot Cécile R. L. , Formanoy Margriet A. G. , Schelvis Roosmarijn M. C. 
Published: February 2025

Abstract

Background
There is a growing awareness for addressing mental health in the workplace. Although interventions to promote mental health at the organizational-level exist, implementation is a challenge. Middle management can play a crucial role in implementing organisational-level interventions. Also, we know that mental models often need to change first, before enactment of such interventions occur. The aim of this study is therefore to better understand whether and how changes in mental models of middle managers are associated with the implementation activities of an organisational-level intervention to support mental health. Ultimately, this is meant to lead to the enactment of, in this case, a dialogue tool to normalize a conversation between middle manager and employee to enhance mental health.

Methods
Participatory Action Research was used as a method to design our implementation of a dialogue tool primarily focused on middle management to address mental in health in one SME company with 238 employees. In-depth interviews with 11 (middle) managers at the start of the implementation phase were held. After nine months, 9 out of the same 11 (middle) managers were interviewed again to gain understanding whether and how changes occurred during the implementation. Thematic analysis was applied to the interviews, from inductive and deductive perspective. Focus groups with employees and observations during the implementation activities were used for triangulation purposes.

Results
The mental models of the (middle) managers were analyzed based on readiness for change, perceived challenges and perceived opportunities. These mental models were generally positive towards the project, despite the low trust towards the Top Management and the general lack of experience with addressing mental health at the workplace. Nine months later, mental models changed towards more awareness and engagement in addressing mental health. Also, enactment of the dialogue tool by middle management and employees occurred. An association of these changes with, for example, the frequency and pace of implementation activities in which all employees were involved was reported.

Conclusion
To implement interventions addressing mental health at the workplace, taking the time and using implementation activities that match the needs of middle management might help to change mental models of (middle) management.
Life course trajectories of maternal cardiovascular disease risk factors by obstetric history: a UK cohort study using electronic health records
Authors: Birnie Kate , Howe Laura D. , Jones Timothy , Madley-Dowd Paul , Martin Florence Z. , Forbes Harriet , Redaniel Maria Theresa , Cornish Rosie , Magnus Maria C. , Davies Neil M. , Tilling Kate , Hughes Alun D. , Lawlor Deborah A. , Fraser Abigail 
Published: February 2025

Abstract

Background
Women who experience adverse pregnancy outcomes (APOs; gestational hypertension, preeclampsia (PE), gestational diabetes (GD), preterm birth (PTB), small or large for gestational age, miscarriage, multiple miscarriages, stillbirth, and offspring with major congenital anomalies) have increased risk of developing cardiovascular disease (CVD). We aimed to compare cardiometabolic health trajectories across the life course between women with and without APOs.

Methods
We studied 187,186 women with a registered pregnancy in the UK Clinical Practice Research Datalink (CPRD) GOLD linked to Hospital Episode Statistics. Fractional polynomial multilevel models were used to compare trajectories of cardiometabolic risk factors (body mass index [BMI], blood pressure [BP], cholesterol, and glucose) between women with and without a history of APOs (individual APOs in any pregnancy and number of APOs). We explored two underlying time axes: (1) time relative to first pregnancy (from 10 years before first pregnancy to 15 years after) and (2) age. Models controlled for age at first pregnancy, residential area deprivation, non-singleton pregnancy, parity, smoking status, ethnicity, and medications use.

Results
Women with a history of PE, gestational hypertension, or GD had higher BMI, BP, and glucose 10 years before first pregnancy compared to women without these APOs. These differences persisted 15 years post-first pregnancy. Women with a history of GD had a steeper post-partum rise in glucose. Women who experienced multiple (3 +) miscarriage, stillbirth, and/or medically indicated PTB had higher BP and BMI before and after pregnancy, with BP trajectories converging 15 years after first pregnancy. Women who experienced multiple APOs had the most adverse measurements across all cardiometabolic risk factors, with more unfavourable mean levels with each additional APO. There was little difference in cardiometabolic trajectories between women with and without a history of 1 or 2 miscarriages or congenital anomalies.

Conclusions
Women with APOs had adverse cardiometabolic profiles before first pregnancy, persisting up to 15 years post-pregnancy. Findings highlight the potential for targeted public health interventions to promote good cardiometabolic health in young adults transitioning from contraceptive use to planning pregnancies. APOs may identify young women who could benefit from monitoring CVD risk factors and interventions to improve cardiometabolic health.