bluuebunny/crossref_metadata_2025_split huggingface dataset:
Calculation and Feedback of Risk-Adjusted Antibiotic Days as a Process Measure in a Statewide Trauma Collaborative
Authors: Sangji Naveen F. , Dougherty Jacob M. , Tignanelli Christopher J. , Maqsood Hannan A. , Cain-Nielsen Anne H. , Oliphant Bryant W. , Hemmila Mark R. 
Published: May 2024

Background Optimization of antibiotic stewardship requires determining appropriate antibiotic treatment and duration of use. Our current method of identifying infectious complications alone does not attempt to measure the resources actually utilized to treat infections in patients. We sought to develop a method accounting for treatment of infections and length of antibiotic administration to allow benchmarking of trauma hospitals with regard to days of antibiotic use. Methods Using trauma quality collaborative data from 35 American College of Surgeons (ACS)-verified level I and level II trauma centers between November 1, 2020, and January 31, 2023, a two-part model was created to account for (1) the odds of any antibiotic use, using logistic regression; and (2) the duration of usage, using negative binomial distribution. We adjusted for injury severity, presence/type of infection (eg, ventilator-acquired pneumonia), infectious complications, and comorbid conditions. We performed observed-to-expected adjustments to calculate each center’s risk-adjusted antibiotic days, bootstrapped Observed/Expected (O/E) ratios to create confidence intervals, and flagged potential high or low outliers as hospitals whose confidence intervals lay above or below the overall mean. Results The mean antibiotic treatment days was 1.98°days with a total of 88,403 treatment days. A wide variation existed in risk-adjusted antibiotic treatment days (.76°days to 2.69°days). Several hospitals were identified as low (9 centers) or high (6 centers) outliers. Conclusion There exists a wide variation in the duration of risk-adjusted antibiotic use amongst trauma centers. Further study is needed to address the underlying cause of variation and for improved antibiotic stewardship.
Impact of Concomitant Traumatic Pancreatic and Colon Injuries on Outcomes
Authors: Lewis Richard H. , Jacome Tomas , Dooley Danielle , Carr Brian , Magnotti Louis J. 
Published: May 2024

Background Colon and pancreatic injuries have both long been independently associated with intraabdominal infectious complications in trauma patients. The goal of this study was to evaluate the impact of concomitant pancreatic injury on outcomes in patients with traumatic colon injuries. Methods Consecutive patients over a 3-year period who underwent operative management of colon injuries were identified. Patient characteristics, severity of injury and shock, presence and grade of pancreatic injury, and intraoperative packed red blood cell (PRBC) transfusions were recorded. Outcomes including intraabdominal abscess formation and suture line failure were collected and compared. Multivariable logistic regression analysis was then performed to determine the impact of concomitant pancreatic injury on intraabdominal abscess formation. Results 243 patients with traumatic colon injuries were identified. 17 of these also had pancreatic injuries. Patients with combined colon and pancreatic injuries were clinically similar to those with isolated colon injuries with respect to age, gender, penetrating mechanism of injury, admission lactate, ISS, suture line failure, and admission systolic blood pressure. Both intraabdominal abscess rates (88.2% vs 29.6%, P < .001) and intraoperative PRBC transfusions (8 vs 1 units, P = .004) were higher in the combined pancreatic and colon injury group. Multivariable logistic regression identified both intraoperative PRBC transfusions (odds ratio, 1.09; 95% confidence interval, 1.04-1.15; P < .001) and concomitant pancreatic injury (odds ratio, 14.8; 95% confidence interval, 3.92-96.87; P < .001) as independent predictors of intraabdominal abscess formation. Discussion Both intraoperative PRBC transfusions and presence of concomitant pancreatic injury are independent predictors of intraabdominal abscess formation in patients with traumatic colon injuries.
National Analysis of Clinical Outcomes Associated With Cirrhotic Blunt Trauma Patients Undergoing Emergency Laparotomy Versus Non-operative Management: A Propensity Case-Matched Analysis
Authors: Elkbuli Adel , Bundschu Nikita , Nasef Hazem , Chin Brian , McClure David L. , Rhodes-Lyons Heather X. 
Published: May 2024

Introduction This study aims to evaluate clinical outcomes among severely injured trauma patients presenting with isolated blunt abdominal solid organ injuries with a pre-diagnosis of liver cirrhosis (LC) undergoing emergency laparotomy vs nonoperative management (NOM). Methods This retrospective cohort study utilized the American College of Surgeons Trauma Quality Program Participant Use File (ACS-TQIP-PUF) dataset from 2017 to 2021. Adults (≥18 years) with a pre-existing diagnosis of LC who presented with severe blunt (ISS ≥ 16) isolated solid organ abdominal injuries and underwent laparotomy or NOM were included. Outcomes of interest included in-hospital mortality, intensive care unit length of stay (ICU-LOS), and in-hospital complications such as acute renal failure and deep vein thrombosis. Results 929 patients were included in this analysis, with 355 undergoing laparotomy and 574 managed nonoperatively. Laparotomy patients suffered greater in-hospital mortality (n = 186, 52.3% vs n = 115, 20.0%; P < .01), required significantly more blood within 4 hours (8.9 units vs 4.3 units, P < .01), and had a significantly longer ICU-LOS (10.2 days vs 6.7 days, P < .01). In the 1:1 propensity score matched analysis of 556 matched patients, in-hospital mortality was greater for laparotomy patients (52.3% vs 20.0%, P < .01). Conclusion Laparotomy was associated with significantly higher in-hospital mortality in propensity-matched trauma patients, longer ICU-LOS, and more blood products given at 4 hours compared to NOM. These findings illustrate that NOM may be a safe approach in managing severely injured trauma patients with isolated blunt abdominal solid organ injuries and a pre-diagnosis of LC.
Critical engagement with digital health: A socio-material analysis of physical education teachers’ digital health mind maps
Authors: MacIsaac Sarah , Gray Shirley , Camacho-Miñano Maria José , Rich Emma , Kumpulainen Kristiina 
Published: May 2024

Objective: This paper forms part of a DigihealthPE project in which we have been working with physical education (PE) teachers to co-create critical and embodied digital health pedagogies. As part of the project, we invited PE teachers to mind map their personal engagements with digital health technologies. We aimed to explore the potential openings and opportunities (and limitations) within these maps for critical thinking and action. Method: Data were generated during a workshop with 12 PE teachers in Scotland. Informed by new materialism, we focus on the human and non-human factors and intra-actions evident within six narrative portraits generated from teachers’ mind maps. Results: Our findings suggest that teachers were engaging complexly and extensively with digital health technologies, which we considered an opening for further critical work. Importantly, experiences of strong (negative) affect had the potential to transform engagements with digital health technologies. Conclusion: We conclude by exploring how the process of mind mapping helped us to see further opportunities for supporting teachers to engage critically with digital health technologies. We also argue that new materialist-informed critical practices in education may have transformative potential for helping teachers and pupils to engage critically with the moving body, technology and health.
The Role of Capital Expenditure Forecasts in Debt Contracting
Authors: Ali Ashiq , Fan Zhongwen 
Published: May 2024

This study examines whether the issuance of capital expenditure forecasts facilitates debt contracting by acting as a commitment to not engage in the expropriation of lenders through opportunistic investment activities. We find that firms with higher leverage and lower credit quality are more likely to issue capital expenditure forecasts. Furthermore, for firms that issue capital expenditure forecasts, loan spreads are lower and investment efficiency is greater, and these associations are stronger when the forecasts are more credible. We do not find similar results for earnings forecasts. When comparing the roles of capital expenditure covenant (which typically specify the upper limit of the allowed amount) with capital expenditure forecast, we find that the former reduces overinvestments and the latter reduces underinvestments. These results suggest that capital expenditure forecasts can be a commitment mechanism to reduce contracting costs with creditors. JEL Classification: G31; M4
Dosimetric and NTCP analyses for selecting parotid gland cancer patients for proton therapy
Authors: Camarda Anna Maria , Vincini Maria Giulia , Russo Stefania , Comi Stefania , Emiro Francesca , Bazani Alessia , Ingargiola Rossana , Vischioni Barbara , Vecchi Claudio , Volpe Stefania , Orecchia Roberto , Jereczek-Fossa Barbara Alicja , Orlandi Ester , Alterio Daniela 
Published: May 2024

Purpose/Objective: To perform a dosimetric and a normal tissue complication probability (NTCP) comparison between intensity modulated proton therapy and photon volumetric modulated arc therapy in a cohort of patients with parotid gland cancers in a post-operative or radical setting. Materials and methods: From May 2011 to September 2021, 37 parotid gland cancers patients treated at two institutions were eligible. Inclusion criteria were as follows: patients aged ⩾ 18 years, diagnosis of parotid gland cancers candidate for postoperative radiotherapy or definitive radiotherapy, presence of written informed consent for the use of anonymous data for research purposes. Organs at risk (OARs) were retrospectively contoured. Target coverage goal was defined as D95 > 98%. Six NTCP models were selected. NTCP profiles were calculated for each patient using an internally-developed Python script in RayStation TPS. Average differences in NTCP between photon and proton plans were tested for significance with a two-sided Wilcoxon signed-rank test. Results: Seventy-four plans were generated. A lower Dmean to the majority of organs at risk (inner ear, cochlea, oral cavity, pharyngeal constrictor muscles, contralateral parotid and submandibular gland) was obtained with intensity modulated proton therapy vs volumetric modulated arc therapy with statistical significance (p < .05). Ten (27%) patients had a difference in NTCP (photon vs proton plans) greater than 10% for hearing loss and tinnitus: among them, seven qualified for both endpoints, two patients for hearing loss only, and one for tinnitus. Conclusions: In the current study, nearly one-third of patients resulted eligible for proton therapy and they were the most likely to benefit in terms of prevention of hearing loss and tinnitus.
Assistive technology: Occupational therapy assessment and services for people with dementia
Authors: Curnow Eleanor , Maclean Fiona , McCormack Brendan 
Published: May 2024

Introduction: Research suggests that services are not effectively providing suitable assistive technology for people with dementia. There is a need to understand the challenges facing practitioners to identify where service changes should be focussed to improve this situation. Method: This study used an online survey to explore the experiences of 41 occupational therapists working with people with dementia, and/or assistive technology. Eight participants subsequently agreed to participate in online discussion groups. Group discussions were transcribed and checked. Data responses from group discussions and open questions in the survey were analysed thematically using the person-centred framework to identify domains supporting or obstructing effective assistive technology service delivery. Results: Forty-one occupational therapist participants described challenges to providing person-centred assistive technology services. These included restricted access to assistive technology interventions, limited knowledge regarding developments in the field, variable funding, unsupportive systems, limited relevant training and difficulties working across health and social care sectors. Conclusion: There is a need to revise the systems surrounding the provision of assistive technology for people with dementia. Occupational therapists need access to training relative to this field, and systems need to be adapted to support the provision of person-centred care by widening access to assistive technology.
Voluntary carbon assurance and the cost of equity capital: International evidence
Authors: Datt Rina , Luo Le , Segara Reuben 
Published: May 2024

We examine the impact of voluntary carbon assurance on a firm’s cost of equity capital (COE). Based on 6500 firm-year observations across 44 countries covering a period of 8 years (2010–2017), we find that the adoption of carbon assurance is negatively associated with the COE. Cross-sectional analyses show that the negative relationship is stronger for firms with poor emissions reduction performance and for firms that do not participate in an emissions trading scheme. We also find that a country’s legal institutions and economic development have significant moderating effects on this relationship. Furthermore, the scope and the percentage of carbon emissions assured, the level of carbon assurance, and the auditing standards adopted have varied effects on the COE. These findings should be useful to regulators, managers, and investors looking to improve the credibility of voluntarily reported information. JEL Classification: M41, M42, Q56, G32
Association Between Symptoms of Anxiety and Depression, Hip Pathology, and Patient-Reported Outcomes After Hip Arthroscopy for Femoroacetabular Impingement
Authors: Steiner Quinn , Watson Andrew M. , Mosiman Samuel J. , Spiker Andrea M. 
Published: May 2024

Background: In patients with femoroacetabular impingement (FAI), mental health has been implicated in both symptom severity and postoperative outcomes. However, there are limited data regarding the independent influences of baseline mental health and hip pathology on patient-reported outcomes over time after hip arthroscopy. Purpose: To evaluate the association between mental health and structural hip pathology with pain, hip function, and quality of life (QOL). Study Design: Cohort study; Level of evidence, 3. Methods: Patient records from a single surgeon’s hip outcomes registry were retrospectively reviewed. Mental health was evaluated using the Patient-Reported Outcomes Measurement Information System Anxiety and Depression scores. Pain was evaluated with the Single Assessment Numeric Evaluation score for Activities of Daily Living (SANE-ADL), while hip-related QOL was evaluated with the 12-item International Hip Outcome Tool (iHOT-12). Hip function was assessed with the Hip Outcome Score (HOS) Sport-Specific (SS) and ADL subscales. Separate mixed models were used to predict pain, QOL, and hip function, including hip pathology measures (size of labral tear, grade of chondral damage, preoperative alpha angle), anxiety, depression, and time as fixed effects and individuals as a random effect. Results: A total of 312 patients were included in this study. The preoperative alpha angle, degree of intraoperative cartilage damage, and size of the labral tear were not associated with pain or QOL ( P > .05 for all). However, higher levels of anxiety and depression were significantly associated with lower SANE-ADL scores (estimate ± SE) (anxiety: –0.59 ± 0.07, P < .0001; depression: –0.64 ± 0.08, P < .0001), iHOT-12 scores (anxiety: –0.72 ± 0.07, P < .0001; depression: –0.72 ± 0.08, P < .0001), HOS-SS scores (anxiety: –0.68 ± 0.09, P < .0001; depression: –0.57 ± 0.10, P < .0001), and HOS-ADL scores (anxiety: –0.43 ± 0.05, P < .0001; depression: –0.43 ± 0.06, P < .0001). Conclusion: Patients had similar improvements in pain scores, QOL, and hip function after hip arthroscopy for FAI irrespective of their degree of hip pathology. Additionally, preoperative symptoms of anxiety and depression symptoms were associated with greater pain, decreased QOL, and worse hip function both pre- and postoperatively, independent of the degree of hip pathology. This suggests that efforts to directly address symptoms of anxiety and depression may improve outcomes after hip arthroscopy.
Mortality in patients with systemic lupus erythematosus: A meta-analysis of overall and cause-specific effects
Authors: Lee Young Ho , Song Gwan Gyu 
Published: May 2024

Objectives Our objective was to assess the overall and cause-specific standardized mortality ratios (SMRs) among patients diagnosed with systemic lupus erythematosus (SLE). Methods An exhaustive systematic review was undertaken, encompassing studies that scrutinized SMRs, both overall and for specific causes, in patients diagnosed with SLE compared to the general populace. The databases of PUBMED, EMBASE, and Cochrane were meticulously searched to collate relevant literature. Following this comprehensive search, a meta-analysis was executed to methodically assess all-cause, sex-specific, ethnicity-specific, and cause-specific SMRs in individuals with SLE. Results The inclusion criteria were met by 29 studies encompassing 72,342 patients with SLE and documenting 7352 deaths. The meta-analysis disclosed a pronounced 2.87-fold elevation in the SMR for all-cause mortality in SLE patients relative to the general population (SMR, 2.866; 95% confidence interval [CI], 2.490–3.242; p < .001). Region-specific assessments showed variable all-cause SMRs, with Europe reporting 2.607 (95% CI, 1.939–3.275; p < .001), Asia revealing 3.043 (95% CI, 2.082–4.004; p < .001), and particularly high SMRs noted in North America and Oceania. Gender-focused analyses presented a pooled SMR of 3.261 (95% CI, 2.674–3.848; p < .001) for females, and 2.747 (95% CI, 2.190–3.304; p < .001) for males. Evaluations specific to cause of death illustrated notably elevated SMRs for renal disease (SMR, 4.486; 95% CI, 3.024–5.948; p < .001), infections (SMR, 4.946; 95% CI, 4.253–5.639; p < .001), cardiovascular diseases (CVD) (SMR, 2.931; 95% CI, 1.802–4.061; p < .001), cerebrovascular accidents (CVA) (SMR, 1.588; 95% CI, 0.647–2.528; p = .001), and cancer (SMR, 1.698; 95% CI, 0.871–2.525; p < .001). Conclusions This meta-analysis underscores a significant 2.87-fold elevation in the SMR among patients with SLE compared to the general population, transcending differences in sex or geographical regions. Moreover, an appreciable increase in mortality due to specific causes, including renal disease, infection, CVD, CVA, malignancy, and neuropsychiatric SLE, accentuates the imperative for targeted interventions to mitigate these elevated risks in SLE patients.
Physician-nurse collaboration in the relationship between professional autonomy and practice behaviors
Authors: Bulut Arzu , Sengül Halil , Mumcu Çeçenya İrem , Mumcu Berkan 
Published: May 2024

Background Nurses and physicians are key members of healthcare teams. While physicians are responsible for the diagnosis and treatment of patients, nurses are part of the treatment and the primary practitioners of patient care. Nurses’ professional autonomy, collaboration with physicians, and practice behaviors in treatment and patient care practices are interrelated. Objectives In the present study, we examined the mediating effect of physician–nurse collaboration on the relationship between nurses’ practice behaviors and their professional autonomy. Design The present study utilized a cross-sectional survey design following quantitative methods. Methods This study was conducted in the Istanbul Province of Turkiye from September to October 2022. The sampling method used was a convenience sampling strategy to provide easier access to participants when selecting nurses from different health institutions. The mean age of the 295 nurses was 31.23 years, with ages ranging from 21 to 59 years. The data analysis was conducted using IBM’s SPSS 24.0 software package and the Process Macro 4.0 plug-in. Ethical consideration Research ethics approval was obtained from the researcher’s university. Results Physician–nurse collaboration is positively associated with practice behaviors and professional autonomy. Nurses’ professional autonomy in practice behaviors through physician–nurse collaboration is significant (95% CI [0.043, 0.135]). Discussion Our results revealed the relationships among physician‒nurse collaboration, professional autonomy, and practice behaviors among nurses. Conclusion Our results provide evidence on the underlying factors of nurses’ practice behaviors in patient care and guide the development of an intervention program to enhance this collaboration. Hospital managers can contribute to a collaborative physician‒nurse working environment.
Biomechanical study of 3D-printed titanium alloy pad for repairing glenoid bone defect
Authors: Huang Danlei , Wang Jun , Ye Zhiyang , Chen Feixiong , Liu Haoyuan , Huang Jianming 
Published: May 2024

Background: The purpose of this study was to investigate the effect of 3D-printed technology to repair glenoid bone defect on shoulder joint stability. Methods: The shoulder joints of 25 male cadavers were tested. The 3D-printed glenoid pad was designed and fabricated. The specimens were divided into 5 groups. Group A: no bone defect and the structure of the glenoid labrum and joint capsule was intact; Group B: Anterior inferior bone defect of the shoulder glenoid; Group C: a pad with a width of 2 mm was installed; Group D: a pad with a width of 4 mm was installed; Group E: a pad with a width of 6 mm was installed. This study measured the distance the humeral head moved forward at the time of glenohumeral dislocation and the maximum load required to dislocate the shoulder. Results: The shoulder joint stability and humerus displacement was significantly lower in groups B and C compared with group A ( p < .05). Compared with group A, the stability of the shoulder joint of group D was significantly improved ( p < .05). However, there was no significant difference in humerus displacement between groups D and A ( p > .05). In addition, compared with group A, shoulder joint stability was significantly increased and humerus displacement was significantly decreased in group E ( p < .05). Conclusion: The 3D-printed technology can be used to make the shoulder glenoid pad to perfectly restore the geometric shape of the shoulder glenoid articular surface. Moreover, the 3D-printed pad is 2 mm larger than the normal glenoid width to restore the initial stability of the shoulder joint.
Fruit for thought
Authors: Hussain Shehnaz 
Published: May 2024

Objective This commentary discusses the New Zealand Labour Party’s announcement to remove tax on fresh and frozen fruits and vegetables. It aims to explore its potential impact on the psychological well-being of New Zealanders in the context of the growing global burden of mental illnesses in the current food environment. Conclusions The proposed tax exemption on fruits and vegetables demonstrates the government’s commitment to improving the food environment. While the precise mental health effects of this potential tax change remain unstudied, existing evidence suggests a positive impact on New Zealanders’ well-being, marking a pivotal step in addressing broader health issues and fostering a healthier, more equitable food landscape.