bluuebunny/crossref_metadata_2025_split huggingface dataset:
Generating broadband cylindrical vector modes based on polarization-dependent acoustically induced fiber gratings using the dispersion turning point
Authors: Xie Meiting , Xu Jiangtao , Wang Jiajun , Zhao Huihui , Liu Yeshuai , Wen Jianxiang , Pang Fufei , Sun Jianfeng , Zeng Xianglong 
Published: June 2024

Cylindrical vector beams (CVBs) with special polarization distribution have been extensively investigated due to the unique ways of interacting with matter. Although several configurations have been developed to generate CVBs, such as Q-plates and subwavelength gratings, the bandwidth of a single CVB is inherently narrow due to the phase geometry, which would limit its application for femtosecond lasers. Here, a broadband CVB mode converter based on an acoustically induced fiber grating (AIFG) and a tuning method of dispersion turning point (DTP) is demonstrated both theoretically and experimentally with the 3-dB bandwidth of 125 nm, which is more than 10 times that of conventional AIFGs. Not only can the DTP wavelength be tuned from the original 1500 nm to 1650 nm by thinning the fiber, but also the stable generation of a single broadband HE21odd/even mode can be controllably implemented by adjusting the polarization state of the incident light, owing to the larger beat length difference between HE21 and other CV modes. Additionally, the femtosecond CVBs and orbital angular momentum (OAM) modes are successfully generated and amplified by combining the broadband AIFG with a figure-9 mode-locked fiber laser. Meanwhile, it is verified by simulation that the choice of broadband CV mode and the tunability of DTP wavelength can be realized by designing ring-core fibers with different structures, which can furthermore improve the flexibility of generating high purity CVBs. This study provides a highly controllable technique for the generation of broadband CVBs and OAMs paving the way for high-capacity CVBs communication.
Research on the evolution of cross-platform online public opinion for public health emergencies considering stakeholders
Authors: Shen Yan , Luo Zhou , Song Xinping , Liu Chunhua 
Published: June 2024

Objective
To explore the different processes of the themes and emotional evolution of various stakeholders in the network public opinion of sudden public health emergencies at different stages of the public opinion evolution lifecycle.

Methods
This paper proposes a cross-platform analysis method for online public opinion during the public health emergencies based on stakeholders. Firstly, data from multiple platforms are collected and integrated. Secondly, stakeholders are categorized and the stages of public opinion evolution are determined based on stakeholder theory and lifecycle theory. Finally, the Latent Dirichlet Allocation (LDA)+Word2vec model and Convolutional Neural Network (CNN) model are used to analyze the themes and emotional evolution of stakeholders during different stages of public opinion evolution.

Results
There are differences in the evolution patterns of different types of stakeholders. The evolution process of stakeholders’ focus points exhibits a two-stage transition from concentration to divergence. The focus points of stakeholders are closely associated with their respective social domains. The emotions of the public undergo a three-stage process of positive-negative-positive change.

Conclusions
This study can provide a reference for the government to have a more comprehensive understanding of the development trend of public opinion and reduce the negative impact of public opinion.
Postoperative opioids administered to inpatients with major or orthopaedic surgery: A retrospective cohort study using data from hospital electronic prescribing systems
Authors: Huang Yun-Ting , Dixon William G. , O’Neill Terence W. , Jani Meghna 
Published: June 2024

Background
Opioids administered in hospital during the immediate postoperative period are likely to influence post-surgical outcomes, but inpatient prescribing during the admission is challenging to access. Modified-release(MR) preparations have been especially associated with harm, whilst certain populations such as the elderly or those with renal impairment may be vulnerable to complications. This study aimed to assess postoperative opioid utilisation patterns during hospital stay for people admitted for major/orthopaedic surgery.

Methods
Patients admitted to a teaching hospital in the North-West of England between 2010–2021 for major/orthopaedic surgery with an admission for ≥1 day were included. We examined opioid administrations in the first seven days post-surgery in hospital, and “first 48 hours” were defined as the initial period. Proportions of MR opioids, initial immediate-release(IR) oxycodone and initial morphine milligram equivalents (MME)/day were calculated and summarised by calendar year. We also assessed the proportion of patients prescribed an opioid at discharge.

Results
Among patients admitted for major/orthopaedic surgery, 71.1% of patients administered opioids during their hospitalisation. In total 50,496 patients with 60,167 hospital admissions were evaluated. Between 2010–2017 MR opioids increased from 8.7% to 16.1% and dropped to 11.6% in 2021. Initial use of oxycodone IR among younger patients (≤70 years) rose from 8.3% to 25.5% (2010–2017) and dropped to 17.2% in 2021. The proportion of patients on ≥50MME/day ranged from 13% (2021) to 22.9% (2010). Of the patients administered an opioid in hospital, 26,920 (53.3%) patients were discharged on an opioid.

Conclusions
In patients hospitalised with major/orthopaedic surgery, 4 in 6 patients were administered an opioid. We observed a high frequency of administered MR opioids in adult patients and initial oxycodone IR in the ≤70 age group. Patients prescribed with ≥50MME/day ranged between 13–22.9%. This is the first published study evaluating UK inpatient opioid use, which highlights opportunities for improving safer prescribing in line with latest recommendations.
A national survey of children’s experiences and needs when attending Canadian pediatric emergency departments
Authors: Ma Keon , Rahimi Asa , Rajagopal Manasi , Yaskina Maryna , Goldman Ran D. , Jones Ashley , Erickson Tannis , Poonai Naveen , McGahern Candice , Weingarten Laura , Lerman Bethany , Auclair Marie-Christine , Wong Helen , Hartling Lisa , Schreiner Kurt , Scott Shannon , Ali Samina ,   on behalf of the Pediatric Emergency Research Canada Family Needs study team
Published: June 2024

Background
Optimizing a child’s emergency department (ED) experience positively impacts their memories and future healthcare interactions. Our objectives were to describe children’s perspectives of their needs and experiences during their ED visit and relate this to their understanding of their condition.

Methods
514 children, aged 7–17 years, and their caregivers presenting to 10 Canadian pediatric EDs completed a descriptive cross-sectional survey from 2018–2020.

Results
Median child age was 12.0 years (IQR 9.0–14.0); 56.5% (290/513) were female. 78.8% (398/505) reported adequate privacy during healthcare conversations and 78.3% (395/504) during examination. 69.5% (348/501) understood their diagnosis, 89.4% (355/397) the rationale for performed tests, and 67.2% (338/503) their treatment plan. Children felt well taken care of by nurses (90.9%, 457/503) and doctors (90.8%, 444/489). Overall, 94.8% (475/501) of children were happy with their ED visit. Predictors of a child better understanding their diagnosis included doctors talking directly to them (OR 2.21 [1.15, 4.28]), having someone answer questions and worries (OR 2.51 [1.26, 5.01]), and older age (OR 1.08 [1.01, 1.16]). Direct communication with a doctor (OR 2.08 [1.09, 3.99]) was associated with children better understanding their treatment, while greater fear/ ‘being scared’ at baseline (OR 0.59 [0.39, 0.89]) or at discharge (OR 0.46 [0.22, 0.96]) had the opposite effect.

Interpretation
While almost all children felt well taken care of and were happy with their visit, close to 1/3 did not understand their diagnosis or its management. Children’s reported satisfaction in the ED should not be equated with understanding of their medical condition. Further, caution should be employed in using caregiver satisfaction as a proxy for children’s satisfaction with their ED visit, as caregiver satisfaction is highly linked to having their own needs being met.
Psychological factors associated with exercise self-efficacy in the recipients of an implantable cardioverter defibrillator
Authors: Chen Pei-Yun , Chou Ching-Yi , Lien Miao-Hsin , Chen Shu-Wen , Lu Shu-Hua , Lo Chyi 
Published: June 2024

Background
Insufficient exercise affects the health of patients who have implantable cardioverter defibrillators (ICD). The purpose of this study was to investigate the correlations between exercise self-efficacy (ESE) and its associated psychological factors in ICD recipients.

Methods
This cross-sectional study included individuals who had undergone ICD implantation at the cardiology department of a medical centre in Taiwan. A face-to-face survey was conducted. The survey questionnaire included questions regarding the participants’ demographics, perceived health (PH), ICD shock–related anxiety (ICD-SRA), self-care self-efficacy (SSE), perceived exercise benefit (PE-benefit), perceived exercise barrier (PE-barrier), and ESE. Data were analysed using SPSS 20.0 Software. Stepwise multiple regression analyses were also performed to evaluate the predictive effects of the aforementioned factors on ESE.

Results
A total of 52 ICD recipients were enrolled. ESE was negatively correlated with ICD-SRA (r = −0.511; p < 0.01) and PE-barrier (r = −0.563; p < 0.01), but positively correlated with SSE (r = 0.339; p < 0.05) and PE-benefit (r = 0.464; p < 0.01). The stepwise multiple regression analysis revealed that PE-barrier, PE-benefit, and ICD-SRA effectively predicted ESE in the participants.

Conclusions
ESE may be improved by overcoming PE-barrier, ICD-SRA and enhancing PE-benefit. Consequently, improving ESE may enhance the health benefits of exercise.
Metacognitive beliefs, mood symptoms, and fatigue four years after stroke: An explorative study
Authors: Pedersen Synne G. , Anke Audny , Friborg Oddgeir , Ørbo Marte C. , Løkholm Mari T. , Kirkevold Marit , Heiberg Guri , Halvorsen Marianne B. 
Published: June 2024

Objective
This cross-sectional study investigated the relationship between metacognition and mood symptoms four years post-stroke and examined fatigue as a potential moderator for this relationship.

Methods
A number of 143 participants completed a survey that included the Hospital Anxiety and Depression Scale (HADS), the Metacognition Questionnaire-30 (MCQ-30), the Fatigue Severity Scale (FSS), and the modified Rankin Scale (mRS) (functional status) four years after stroke. Multiple regression analyses adjusting for demographic and stroke-specific covariates were performed with anxiety and depression as dependent variables and fatigue as a moderator.

Results
The proportions of participants satisfying the caseness criteria for anxiety and depression were 20% and 19%, respectively, and 35% reported severe fatigue. Analysed separately, all MCQ-30 subscales contributed significantly to anxiety, whereas only three MCQ-30 subscales contributed significantly to depression. In the adjusted analyses, the MCQ-30 subscales ‘positive beliefs’ (p < 0.05) and ‘uncontrollability and danger’ (p < 0.001), as well as fatigue (p < 0.001) and functional status at four years (p < 0.05) were significantly associated with anxiety symptoms. Similarly, the MCQ-30 subscales ‘cognitive confidence’ (p < 0.05) and ‘self-consciousness’ (p < 0.05), as well as fatigue (p < 0.001), stroke severity at baseline (p < 0.01), and functional status at four years (p < 0.01) were significantly associated with depression symptoms. Fatigue did not significantly moderate the relationship between any MCQ-30 subscale and HADS scores.

Conclusion
Maladaptive metacognitions were associated with the mood symptoms of anxiety and depression, independent of fatigue, even after controlling for demographic and stroke-specific factors. Future studies should implement longitudinal designs to determine whether metacognitions precede anxiety or depression after a stroke, and more strongly indicate the potential of metacognitive therapy for improving the mental health of individuals after a stroke.
The implementation of a new measles vaccine mandate in Germany: A qualitative study in local health departments
Authors: Werdin Sophia , Neufeind Julia 
Published: June 2024

Background
Measles is a highly contagious disease with the potential for severe complications. Despite the availability of effective vaccines, there have been recurrent measles outbreaks in Germany over the past decades. In response, a new measles vaccine mandate was introduced on March 1, 2020, aimed at closing vaccination gaps in high-risk populations. This study evaluates the mandate’s implementation, identifies operational challenges, assesses the impact of the Coronavirus disease 2019 pandemic, and investigates expert attitudes towards the new policy.

Methods
Semi-structured expert interviews were conducted with staff members of 16 different local health departments in Germany. The interviews, carried out in April and May 2021, were electronically recorded, transcribed verbatim, and analyzed using the Framework method.

Results
The implementation of the measles vaccine mandate in local health departments varied substantially. Challenges in implementing the mandate primarily arose from uncertainties regarding procedural specifics, such as handling fraudulent medical certificates and imposing sanctions, leading to a call from many interviewees for uniform guidelines to ensure coherent implementation. At the time the measles vaccine mandate came into force, managing the Coronavirus disease 2019 pandemic was a priority in most local health departments, often delaying the implementation of the mandate. Despite the difficulties encountered, most experts considered the mandate to be an effective step towards measles elimination.

Conclusions
The measles vaccine mandate has imposed a new responsibility on staff in German local health departments, which is associated with implementation challenges such as procedural uncertainties and vaccine hesitancy, but also the Coronavirus disease 2019 pandemic as a contextual impediment. Significant differences in the implementation approach underscore the need for harmonization to enhance implementation efficiency and public acceptance of the mandate. Despite the mandate’s potential to increase vaccination rates, our findings advocate for a comprehensive approach, incorporating public education, accessible vaccination, and measures to address social disparities.
Screening outcome of HPV-vaccinated women: Data from the Danish Trial23 cohort study
Authors: Nonboe Mette Hartmann , Napolitano George Maria , Kann Caroline , Andersen Berit , Bennetsen Mary Holten , Christiansen Sanne , Frandsen Anna Poulsgaard , Rygaard Carsten , Salmani Rouzbeh , Schroll Jeppe Bennekou , Lynge Elsebeth 
Published: June 2024

Background
Danish women—who were HPV-vaccinated as girls—are now reaching an age where they are invited to cervical cancer screening. Because of their expected lower cervical cancer risk, we must reassess our screening strategies. We analyzed Danish HPV-vaccinated women’s outcomes after the first screening test at age 23.

Methods and findings
Our study was embedded in Danish routine cytology-based screening. We conducted an observational study and included women born in 1994, offered the 4-valent HPV vaccine at age 14, and subsequently invited to screening at age 23. Cervical cytology was used for diagnostics and clinical management. Residual material was HPV tested with Cobas® 4800/6800. The most severe histology diagnosis within 795 days of screening was found through linkage with the Danish National Pathology Register. We calculated the number of women undergoing follow-up (repeated testing and/or colposcopy) per detected cervical intraepithelial neoplasia (CIN2+). A total of 6021 women were screened; 92% were HPV-vaccinated; 12% had abnormal cytology; 35% were high-risk HPV-positive, including 0.9% HPV16/18 positive, and 20% had follow-up. In women that were cytology-abnormal and HPV-positive (Cyt+/HPV+), 610 (98.5%) had been followed up, and 138 CIN2+ cases were diagnosed, resulting in 4.4 (95% CI 3.9–5.2) women undergoing follow-up per detected CIN2+. In contrast to recommendations, 182 (12.2%) cytology-normal and HPV-positive (Cyt-/HPV+) women were followed up within 795 days, and 8 CIN2+ cases were found, resulting in 22.8 (95% CI 13.3–59.3) women undergoing follow-up per detected CIN2+.

Conclusion
Overall, HPV prevalence was high in HPV-vaccinated women, but HPV16/18 had largely disappeared. In the large group of cytology-normal and HPV-positive women, 23 had been followed up per detected CIN2+ case. Our data indicated that primary HPV screening of young HPV-vaccinated women would require very effective triage methods to avoid an excessive follow-up burden.

Trial registration
Trial registration number: NCT0304955.
Visceral leishmaniasis follow-up and treatment outcomes in Tiaty East and West sub-counties, Kenya: Cure, relapse, and Post Kala-azar Dermal Leishmaniasis
Authors: Kennedy Grace C. , O’Brien Katherine , Nyakundi Hellen , Kitondo Mwatela , Biwott Wilson , Wamai Richard G. 
Published: June 2024

Background
Visceral Leishmaniasis (VL) is a neglected tropical disease (NTD) with the highest regional burden in East Africa. Relapse and Post Kala-azar Dermal Leishmaniasis (PKDL) contribute to the spread of VL in endemic areas, making their surveillance imperative for control and elimination. Little is known about long-term patient outcomes in Kenya through follow-up after VL treatment, despite its requirement for control and elimination by the World Health Organization (WHO) and the Kenya Ministry of Health (KMOH).

Methodology/Principal findings
36 follow-up patients in Tiaty East and West, sub-counties, Kenya, and records from 248 patients at the regional Chemolingot Sub-county Hospital (CSCH) were analyzed separately using Fisher’s Exact Tests, two-sample t-tests, and Welch’s t-tests in R (Version 4.3.0). The study found a prevalence rate of 88.89% (n = 32) final cure, 5.56% (n = 2) relapse, and 5.56% (n = 2) PKDL in follow-up patients and 92.74% (n = 230) initial cure, 6.86% (n = 17) relapse, and 0.80% (n = 2) PKDL in overall CSCH patients. The mean lengths of time at which follow-up patients relapsed and developed PKDL were 4.5 and 17 months, respectively. Young age (p = 0.04, 95% CI 0.63–24.31), shorter length of time from initial treatment to follow-up (p = 0.002, 95% CI 1.03-∞), lower Hb level at primary treatment (p = 0.0002, 95% CI 1.23–3.24), and living in Tiaty East sub-county (p = 0.04, 95% CI 0.00–1.43) were significantly associated (p<0.05) with VL relapse in follow-up study patients. Female sex (p = 0.04, 95% CI 0.84-∞) and living in Tiaty East sub-county (p = 0.03, 95% CI 0.00–1.43) were significantly associated with PKDL in follow-up study patients.

Conclusions/Significance
More research should be done on PKDL in Kenya with active follow-up to understand its true burden. These results on prevalence and risk factors for PKDL and relapse in Kenya should inform knowledge of patient outcomes and interventions in the region.
A Quality Improvement Study on Colonoscopy Wait Times in Underinsured Patients Following the COVID-19 Pandemic
Authors: Shim Hong Gi , Gupta Anuj , Fu Andrew , Flores Ricardo , Simmons Robert , Steinberg Jonathan , Guerson-Gil Arcelia , Liao Yunhan , Yang Jie , LaComb Joseph F. , D'Souza Lionel S. , Monzur Farah , Li Ellen , Guillaume Alexandra 
Published: June 2024

INTRODUCTION:
The coronavirus disease 2019 (COVID-19) pandemic limited access to colonoscopy. To advance colorectal cancer health equity, we conducted a quality improvement study on colonoscopy wait times in 2019–2023 for underinsured (Medicaid, uninsured) compared with insured patients at an academic medical center providing colonoscopy for surrounding Federally Qualified Health Centers.

METHODS:
Retrospective chart reviews were performed on adult outpatient colonoscopies in the preintervention period (2019–2021). In 2022, an institutional grant funded bilingual patient navigation to reduce colonoscopy wait times. Postintervention data were collected prospectively from May 2022 to May 2023 in 2 phases. Multivariable regression analyses were conducted for colonoscopy wait times as a primary outcome.

RESULTS:
Analysis of 3,403 screening/surveillance and 1,896 diagnostic colonoscopies revealed significantly longer colonoscopy wait times for underinsured compared with insured patients after 2019. For screening/surveillance colonoscopies, wait time differences between underinsured and insured patients in the second postintervention phase were reduced by 34.21 days (95% confidence interval [CI]: 11.07–57.35) compared with the postpandemic period and by 56.36 days (95% CI: 34.16–78.55) compared with the first postintervention phase. For diagnostic colonoscopies, wait time differences in the second postintervention phase were reduced by 27.57 days (95% CI: 9.96–45.19) compared with the postpandemic period and by 20.40 days (95% CI: 1.02–39.77) compared with the first postintervention phase.

DISCUSSION:
Colonoscopy wait times were significantly longer for underinsured compared with insured patients following the COVID-19 pandemic. This disparity was partially ameliorated by patient navigation. Monitoring outpatient colonoscopy wait times in underinsured patients is important for advancing health equity.
A global perspective on the status of clinical metabolomics in laboratory medicine – a survey by the IFCC metabolomics working group
Authors: Fux Elie , Lenski Marie , Bendt Anne K. , Otvos James D. , Ivanisevic Julijana , De Bruyne Sander , Cavalier Etienne , Friedecký David 
Published: June 2024

Abstract

Objectives
Metabolomics aims for comprehensive characterization and measurement of small molecule metabolites (<1700 Da) in complex biological matrices. This study sought to assess the current understanding and usage of metabolomics in laboratory medicine globally and evaluate the perception of its promise and future implementation.

Methods
A survey was conducted by the IFCC metabolomics working group that queried 400 professionals from 79 countries. Participants provided insights into their experience levels, knowledge, and usage of metabolomics approaches, along with detailing the applications and methodologies employed.

Results
Findings revealed a varying level of experience among respondents, with varying degrees of familiarity and utilization of metabolomics techniques. Targeted approaches dominated the field, particularly liquid chromatography coupled to a triple quadrupole mass spectrometer, with untargeted methods also receiving significant usage. Applications spanned clinical research, epidemiological studies, clinical diagnostics, patient monitoring, and prognostics across various medical domains, including metabolic diseases, endocrinology, oncology, cardiometabolic risk, neurodegeneration and clinical toxicology.

Conclusions
Despite optimism for the future of clinical metabolomics, challenges such as technical complexity, standardization issues, and financial constraints remain significant hurdles. The study underscores the promising yet intricate landscape of metabolomics in clinical practice, emphasizing the need for continued efforts to overcome barriers and realize its full potential in patient care and precision medicine.