bluuebunny/crossref_metadata_2025_split huggingface dataset:
Implementation of a telemedical urgency assessment procedure in the
pediatric emergency room: evaluation results
Authors: Beyer Angelika , Moon Kilson , Hirsch Thomas , Lode Holger N. , Hoffmann Wolfgang , van den Berg Neeltje 
Published: May 2024

Abstract
Background In rural areas in Germany, the number of emergency departments
with pediatric expertise decreases. Telemedicine solutions are used
sporadically, but they lack certain parameters for assessing a child's
health status, such as touch and smell. We tested and evaluated the
implementation of a telemedical, cross-hospital urgency assessment in pediatric
emergency rooms. The telemedical urgency assessments were carried out via video
conferences and were compared to the usual on-site procedure. Primary results of
the concordance analysis have been published elsewhere. This work describes the
results of the evaluation of the implementation.
Methods The telemedical urgency assessment was carried out in 5 pediatric
emergency departments during the years 2015-2019. Various methods were used to
evaluate the implementation. The following reports are based on (a) a parent
questionnaire with two statements to be evaluated (entire project duration), (b)
a survey of the physicians using telemedicine after each case (entire project
duration) and (c) detailed process documentation (July 2017 until end of the
project).
Results A total of 266 patients under 18 years old, recruited from four
hospitals, were included in the study. (a) 210 parents completed the
questionnaire. 78% of the parents felt adequately cared for and 70% could
imagine telemedicine becoming established as a future supplementary care
procedure. (b) The physicians' questionnaires for the telemedicine site
were completed in 232 cases (87%). The average satisfaction rating was 1.8 on a
6-point-likert-scale (95% confidence interval: 1.64; 1.95). (c) The most
frequent implementation problem concerned the technical implementation of the
video conference. The evaluation of the accompanying documentation revealed in
particular implementation barriers in the technical area (e. g. limited video
and/or audio quality) and in the provision of human resources.
Conclusion Despite implementation barriers, the project showed that
telemedical urgency assessment in acute pediatric care is a promising option for
supporting care. Most of the participating clinicians needed a high level of
support, which in some cases indicated a rather low level of digital competence.
Increasing acceptance of telemedicine functionalities requires changes in
society as a whole with improved framework conditions.
Sleep, Sleepiness, and Memory
Authors: Schmidt Bianca Estefani , Lopes-de-Souza Lucas Henrique , Gutierres Athany , Simon Tiago Teixeira 
Published: May 2024

Abstract
Objective To evaluate the relationship between sleep and sleepiness with memory complaints.
Materials and Methods Patients who were submitted to polysomnography between May and September of 2022 and answered the prospective and retrospective memory questionnaire and the Epworth sleepiness scale were included, respectively. Data were entered into an Excel spreadsheet and converted to a file compatible with the SPSS software.
Results The sample consisted of 98 subjects, 62.2% male, mean age of 45.9 years, 73.4% overweight, 54.1% with comorbidities, and 51% with excessive sleepiness. There was a significant difference in sleep efficiency, respiratory disturbance index (RDI), slow wave sleep (SWS), and rapid eye movement (REM) sleep for the group with comorbidities; in latency to sleep and SWS between genders; and in RDI for the body mass index group. No correlation between RDI and memory could be identified, but there were statistically significant correlations between REM and sleep efficiency; RDI and REM sleep; RDI and SWS; SWS and sleep efficiency; and sleep efficiency and latency to sleep onset. Older adults performed better on memory tests when total sleep time (TST) is longer than 5 hours and excessive daytime sleepiness is related to complaints of prospective, retrospective, and total memory.
Conclusion Elderly people with TST longer than 5 hours have a better memory. Although a correlation between RDI and memory was not observed, a correlation between excessive daytime sleepiness—one of the main symptoms of patients with sleep disorders—and memory was.
Can Improving Postoperative Sleep Speed Up Surgical Recovery?
Authors: da Silva Flavia Rodrigues , Guerreiro Renato de Carvalho , Barreto Amaury Tavares , Brant Valdênio Martins , Silva Andressa , De-Mello Marco Túlio 
Published: May 2024

AbstractSleep disturbance is common during recovery after surgical procedures and may have an important effect on mortality, and quality of life. Sleep restriction/deprivation, including decreased quantity and continuity, is common in patients who are patients and persons with acute and chronic illnesses. Age, gender, illness, primary sleep disorders, environment, and medical treatment factors are thought to influence sleep throughout the preoperative period, hospitalization, and recovery. Resulting sleep pattern disturbances include decreases in circadian patterning, continuity, duration, and perceived (subjective) sleep quality. This article synthesizes sleep disturbance in patients who have undergone surgery and highlights sleep strategies to improve faster surgical recovery.
Artéria mediana persistente e síndrome do túnel do carpo: Um estudo retrospectivo
Authors: Felix Yago de Andrade Fonseca , Pistilli Vitor Henrique de Lima , Rezende Luis Guilherme Rosifini Alves , Shimaoka Filipe Jun , Mandarano-Filho Luiz Garcia , Mazzer Nilton 
Published: May 2024

Resumo
Objetivo Este é um estudo retrospectivo acerca da persistência da artéria mediana associada à síndrome do túnel do carpo (STC).
Métodos Este é um estudo retrospectivo da persistência da artéria mediana e STC. Os critérios de exclusão foram pacientes que não apresentavam artéria mediana persistente, aqueles que eram diabéticos ou reumatoides e os que decidiram não realizar a cirurgia. Apenas 25 pacientes foram elegíveis para este estudo retrospectivo.
Resultados A trombose da artéria mediana apresentou diferenças estatísticas considerando as variáveis sexo (p = 0,009), achados eletroneuromiográficos (p = 0,021), profissão (p = 0,066) e “duração total desde o início dos sintomas” (p = 0,055). A atrofia da musculatura tenar não apresentou diferenças estatísticas à comparação das variáveis. O nervo mediano bífido apresentou diferenças estatísticas em comparação aos testes provocativos (p = 0,013), frequência dos sintomas (p = 0,001) e idade (p = 0,028).
Conclusão Embora incomum, a persistência da artéria mediana deve ser considerada um diagnóstico diferencial da STC. A ultrassonografia é um método confiável para prever a anatomia do túnel do carpo. O início tardio e os sintomas podem influenciar a trombose arterial e piorar os sintomas.
Food Consumption and Sleep Disturbances in 9-year-old Children
Authors: Faria Maria Emília de Carvalho , Mastroeni Silmara Salete de Barros Silva , Schultz Lidiane Ferreira , Corrêa Zaíne Glaci Duarte , Ferreira Renatha El Rafihi , Mastroeni Marco F. 
Published: May 2024

Abstract
Objective To assess the association of food consumption with sleep disturbances in 9-year-old children.
Material and Methods The present study is part of a larger cohort study named Predictors of Maternal and Infant Excess Body Weight (PREDI) that was conducted in the homes of the participants during the fourth study follow-up. Anthropometric assessment and demographic, socioeconomic, food consumption, and sleep data were obtained. The children's food consumption was evaluated using the Brazilian Food and Nutrition Surveillance System (SISVAN, in the Portuguese acronym). Sleep habits were assessed using the Sleep Disturbance Scale for Children to evaluate sleep pattern-related behaviors in children/adolescents aged 3 to 18 years. Data were self-reported by the mother and her child on the day of the visit. Logistic regression analysis was used to estimate the association of food consumption with sleep disturbances in children at 9 years of age.
Results Of the 142 children who participated in the study, 45.1% had sleep disturbances; most of them were boys (53.6%). The proportion of children with sleep disturbances was higher (55.6%) among children who did not consume fruits compared with those who ate fruits (p = 0.008). Logistic regression analysis revealed that the lack of fruit consumption was associated with sleep disturbances (OR = 2.26, p = 0.023), even after adjustment for other predictors.
Conclusion We showed that the lack of fruit consumption is a predictor of sleep disturbances. Since fruit consumption had a protective effect on sleep disturbances at 9 years of age, encouraging the consumption of fiber-rich foods may contribute to preventing the establishment of sleep problems even in infants.
Novel Therapeutic Approaches in Connective Tissue Disease-Associated Interstitial Lung Disease
Authors: Mulcaire-Jones Erica , Pugashetti Janelle Vu , Oldham Justin M. , Khanna Dinesh 
Published: May 2024

AbstractConnective tissue diseases (CTD) comprise a group of autoimmune diseases that can affect multiple organs in the body including the lungs. The most common form of pulmonary involvement is interstitial lung disease (ILD). CTD-associated ILD (CTD-ILD) can take one of several courses including nonprogressive, chronically progressive, or rapidly progressive. Chronically and rapidly progressive patterns are associated with increased mortality. Limited randomized controlled trial data are available for treatment of CTD-ILD, with most data coming from systemic sclerosis-related ILD. The current first-line treatment for all CTD-ILD is immunosuppression with consideration of antifibrotics, stem cell transplant, and lung transplant in progressive disease. In this article, we review data for ILD treatment options in systemic sclerosis, rheumatoid arthritis, myositis, and primary Sjögren's syndrome-related ILDs.
Dietary Inflammatory Potential and its Association with Sleep Complaints in Institutionalized Older Adults: A Pilot Study
Authors: Ferreira Letícia do Nascimento Maximiano , Melo Camila Maria de , Ramos Lilian Barbosa , Silva Henrique Salmazo da , Roriz Anna Karla Carneiro , Ribeiro Sandra Maria Lima 
Published: May 2024

Abstract
Objective To evaluate the inflammatory potential of diets, the specific dietary contributors to said inflammatory potential, the nutritional adequacy of these diets, and the association between the dietary inflammatory potential and sleep complaints among residents of long-term care facilities.
Materials and Methods The present is a cross-sectional, quantitative, and exploratory study, with a convenience pilot sample from two long-term care facilities. To assess sleep complaints, the sleep domain of the Nottingham Health Profile was applied, as well as a question about daytime napping. To evaluate the inflammatory potential of the diet, the Dietary Inflammatory Index (DII) was calculated.
Results The participants presented energy and protein intakes below the recommendation. The intake of saturated fatty acids, omega 6, dietary fiber, vitamins D, E, B6, and magnesium were inadequate in some of the participants. The mean score on the DII was of 1.6, representing a more proinflammatory potential, due to insufficient intake of anti-inflammatory components. The foods with the most significant inflammatory effect consumed were whole milk and butter. On the other hand, those with less inflammatory potential were beans, beets, coffee, and sweet potatoes. No significant association was observed between the sleep complaints and the DII.
Conclusion The data showed inadequacy of many nutrients and a proinflammatory potential regarding the diet in the long-term care facilities. However, the DII was not significantly associated with sleep complaints in our sample. The present study highlights the need for greater attention to meal planning in these institutions.
Chapter 6: What Else Can I Do with This Equipment?
Authors: Palmer Catherine , Zitelli Lori 
Published: May 2024

AbstractIf there is sound in the ear canal, you can measure it with a probe microphone in the ear. The following are a few examples of how you might use your real-ear probe microphone measures beyond verifying hearing aid fittings, signal processing, and function of features. A process to simulate hearing loss to educate and support family members and patients is described.
Chapter 4: Introduction and Getting Ready for Real-Ear Probe Microphone Measures
Authors: Zitelli Lori , Palmer Catherine 
Published: May 2024

AbstractProbe microphone measurements are an essential step in an individualized hearing aid fitting. These measurements allow audiologists to account for the individual's hearing and ear canal acoustics when programming hearing aids. An evidence-based hearing aid fitting includes matching the measured output of the hearing aids to targets for each input level and frequency. This allows the audiologist to confidently counsel the patient that the acoustic fitting is accurate, and the next step is for the individual to use the amplification during all waking hours to adapt to the newly amplified sounds. This also avoids mistakes such as overamplification or insufficient gain, which can endanger the patient and/or lead to a compromised fitting.
Effect of Bleaching on Surface Roughness and Color Parameters of Coffee-Stained Nanohybrid Dental Composites with Different Viscosities
Authors: Redwan Hetaf S. , Hussein Mohamed A. , Abdul-Monem Mohamed M. 
Published: May 2024

Abstract
Objective The aim of this study was to test the effect of different bleaching protocols on surface roughness, color stability, and translucency parameter of coffee-stained nanohybrid dental composites with different viscosities.
Materials and Methods Five nanohybrid dental composites with different viscosities (n = 250)—Neo Spectra LV, Neo Spectra HV, Neo Spectra Flow (Dentsply, Konstanz, Germany), Grandio, and Grandio Flow (Voco, Cuxhaven, Germany)—were used to test surface roughness, color stability, and translucency parameter after bleaching of coffee-stained specimens using either in-office bleaching, home bleaching, or a combination of both. The viscosity of the five types of dental composites was tested using a viscometer. A scanning laser microscope (SLM) was used to examine the surface topography of representative samples from each dental composite after the combined effect of both bleaching agents. Effect of composite type, bleaching protocol, and their interaction was assessed by two-way analysis of variance. For multiple comparisons, Tukey's post hoc test was used with Bonferroni correction.
Results Surface roughness of all coffee-stained dental composites increased after bleaching; however, those of Grandio and Grandio Flow increased significantly (p < 0.0001). This was confirmed by SLM images that showed rough surface with protruding fillers after in-office and home bleaching protocol. Results revealed that bleaching, regardless of the protocol, decreased the delta E values of all dental composites; however, it was still higher than the accepted threshold value of 3.7. Neither of the bleaching protocols enhanced translucency parameter of all dental composites. Neo Spectra Flow and Voco Flow had the highest translucency parameter after the three bleaching protocols.
Conclusion Bleaching does not improve color stability and translucency of coffee-stained nanohybrid dental composites regardless of the viscosity. Surface roughness of coffee-stained nanohybrid dental composites increases after application of bleaching agents.
Levetiracetam Dosing Based on Glasgow Coma Scale Scores in Pediatric Traumatic Brain Injury Patients
Authors: Miklus Victoria , Trout Lindsay , Even Katelyn 
Published: May 2024

Abstract
Introduction Severe traumatic brain injury (TBI) increases the risk of early posttraumatic seizures (EPTS). Guidelines suggest the use of prophylactic antiseizure agents, including levetiracetam. This study aims to evaluate the feasibility of using levetiracetam dosing based on Glasgow Comas Scale (GCS) scores with higher doses used for more severe TBI.
Methods Patients 6 months to 18 years old admitted to Penn State Hershey Children's Hospital (PSHCH) with a TBI who received levetiracetam for EPTS prophylaxis with at least one documented GCS score were included. Patients were divided into two cohorts: before and after implementation of the pediatric TBI Cerner PowerPlan at PSHCH which standardized levetiracetam dosing based on GCS scores. Primary outcome was appropriate dosing of levetiracetam based on GCS. Secondary outcomes included seizure occurrence and adverse effects.
Results Eighty-five patients were included: 42 in the pre-PowerPlan group and 43 in the post-PowerPlan group. Overall, 46 (54%) patients received the appropriate levetiracetam dose based on GCS (pre-PowerPlan, n = 19 [45%] vs. post-PowerPlan n = 27 [63%], p = 0.104). Sixty-four percent of severe TBI patients received appropriate levetiracetam dosing after implantation of the PowerPlan compared with 28% prior to the PowerPlan (p = 0.039). Three patients in each group experienced a seizure while on levetiracetam. Two patients experienced agitation and somnolence attributed to levetiracetam.
Conclusion Levetiracetam dosing based on GCS scores in pediatric TBI patients is a novel approach, and dosing accuracy may be increased with use of a PowerPlan. Additional large-scale studies are needed to evaluate efficacy and safety of this approach prior to widespread implementation.
Application of Computerized Surgical Planning in Craniosynostosis Surgery
Authors: Parikh Neil , Aral Ali , Lewis Katelyn , Alperovich Michael 
Published: May 2024

AbstractCraniosynostosis, a medical condition characterized by premature fusion of one or multiple cranial sutures, has historically been treated through surgical correction. Computerized Surgical Planning (CSP) and three-dimensional (3D) modeling have gained significant popularity across craniofacial surgery. Through a collaborative effort between surgeons and engineers, it is now possible to virtually execute a surgical plan based on preoperative imaging using computed tomography scans. The CSP workflow involves several elements including virtual 3D modeling, CSP computer-aided surgical guide design, manufacturing of guides and templates, and intraoperative implementation. Through the gradual optimization of this workflow, it has been possible to achieve significant progress in the surgical process including improvements in the preoperative planning of complex craniosynostosis cases and reduction of intraoperative time. Furthermore, CSP and 3D modeling have had a positive impact on surgical simulation and residency training, along with patient education and counseling. This article summarizes the CSP workflow in the treatment of craniosynostosis and the implications of this treatment modality on medical trainee education and patient management.
Endoscopic Third Ventriculostomy for the Management of Obstructive Hydrocephalus in Pregnancy: A Case Report and Review of the Literature
Authors: Durán-Ojeda Alejandro , Campos-Fajardo Santiago , Suárez-Monsalve Silvia , Lindado-Pacheco Carlos Alberto , Becerra-Ospina Jaime Eduardo 
Published: May 2024

Abstract
Introduction Hydrocephalus is a condition characterized by the abnormal accumulation of cerebrospinal fluid within the brain's ventricular system. It can stem from obstructive and nonobstructive causes. Pregnancy introduces physiopathological changes that may heighten the risk of developing or worsening symptomatic hydrocephalus. Nevertheless, comprehensive reports on this aspect, especially regarding surgical interventions, remain scarce.
Case Report A young woman with a history of recurrent headaches experienced a worsening of her symptoms at the onset of her pregnancy. A magnetic resonance imaging (MRI) in the first trimester revealed increased ventricular dilation, indicating an obstructive cause due to aqueduct stenosis. During a neurosurgical board meeting, treatment options were discussed, considering the identifiable obstruction, the heightened intra-abdominal pressure associated with pregnancy, and the risk of ventricular shunt dysfunction. The patient underwent an endoscopic third ventriculostomy (ETV) without complications, leading to both symptom relief and a successful conclusion to the pregnancy.
Discussion Neurosurgical procedures in pregnant women are uncommon due to the increased risks to both the mother and the fetus. However, when performed by a qualified multidisciplinary team, they can lead to positive outcomes. In cases of hydrocephalus during pregnancy, ETV appears to be a viable alternative for surgical intervention, particularly when hydrocephalus becomes symptomatic and an obstructive cause is identified, whether in patients with existing shunts or those with newly developed hydrocephalus.
Pulmonary Embolism Following Lung Transplantation: Prevention and Management
Authors: Mohammadi Daniel , Keshavamurthy Suresh 
Published: May 2024

AbstractThromboembolic events are the third leading cardiovascular diagnosis following stroke and myocardial infarction. In the United States, 300,000 to 600,000 people per year are diagnosed with venous thromboembolism, either deep venous thrombosis or pulmonary embolism (PE). Of those patients, thousands die from PE despite heightened vigilance and improved therapies. Lung transplant recipients are at increased risk of developing PE due to multiple risk factors unique to this population. Additionally, the transplant recipients are more susceptible to morbid complications from PE. As a result, prevention, timely recognition, and intervention of PE in the lung transplant population are of the utmost importance.
A Prospective Study on the Use of Deep Inspiration Breath-Hold Technique in External Beam Radiotherapy for Breast Cancer
Authors: Jose Nijo , N.P Jayashree , Lewis Shirley , Sharan Krishna , Velu Umesh , Reddy Anusha , Singh Anshul , Rao Shreekripa , C. Shambhavi , Nisha Rachel , Nair Sarath , Nagesh Jyothi , Chandraguthi Srinidhi 
Published: May 2024

Background Breast cancer is the most common cancer and the leading cause of death in women. The deep inspiration breath-hold (DIBH) technique helps reduce the dose received by the heart and lungs in breast cancers during adjuvant radiotherapy (RT). We present the dosimetry of heart and lungs with DIBH technique, reproducibility, and ease of execution.
Materials and Methods This is a prospective study among breast cancer patients planned for adjuvant RT following either breast conservation or mastectomy. Patients received adjuvant RT to a dose of 42.5 Gy/16 Fr to the chest wall/whole breast followed by a boost of 10 Gy/5 Fr for breast conservation surgery patients with either three-dimensional conformal RT or volumetric modulated arc therapy technique. The dosimetric parameters such as lung mean dose, heart mean dose, and V25 Gy were compared between DIBH and free-breathing (FB) scans. Data were analyzed using SPSS software, and p-value <0.05 was considered statistically significant.
Results The study was conducted from September 2018 to August 2020, and 32 patients were included. The compliance to the DIBH technique was good. The dose received by ipsilateral lung V20 (17 vs. 25%) and mean dose (9 vs. 12 Gy) were significantly lower in DIBH compared with FB (p < 0.001). The V5 (31 vs. 15%), V25 (9 vs. 2%), and mean dose (7 vs. 3.3 Gy) to the heart were much higher in FB compared with DIBH (p < 0.001).
Conclusion DIBH-based RT treatment delivery for breast cancer patients requiring adjuvant RT showed good compliance and offers a significant reduction in radiation dose to the heart and lung.