bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluating the clinical impact of resuscitative endovascular balloon occlusion of the aorta in patients with blunt trauma with hemorrhagic shock and coexisting traumatic brain injuries: a retrospective cohort study
Authors: Hsu Chih-Po , Liao Chien-An , Wang Chia-Cheng , Huang Jen-Fu , Cheng Chi-Tung , Chen Szu-An , Tee Yu-San , Kuo Ling-Wei , Ou Yang Chun-Hsiang , Liao Chien-Hung , Fu Chih-Yuan 
Published: June 2024

Background:
The impact of resuscitative endovascular balloon occlusion of the aorta (REBOA) on traumatic brain injuries remains uncertain, with potential outcomes ranging from neuroprotection to exacerbation of the injury. The study aimed to evaluate consciousness recovery in patients with blunt trauma, shock, and traumatic brain injuries.

Material and methods:
Data were obtained from the American College of Surgeons Trauma Quality Improvement Program from 2017 to 2019. During the study period, 3 138 896 trauma registries were examined, and 16 016 adult patients with blunt trauma, shock, and traumatic brain injuries were included. Among these, 176 (1.1%) underwent REBOA. Comparisons were conducted between patients with and without REBOA after implementing 1:3 propensity score matching to mitigate disparities. The primary outcome was the highest Glasgow Coma Scale (GCS) score during admission. The secondary outcomes encompassed the volume of blood transfusion, the necessity for hemostatic interventions and therapeutic neurosurgery, and the mortality rate.

Results:
Through well-balanced propensity score matching, a notable difference in mortality rate was observed, with 59.7% in the REBOA group and 48.7% in the non-REBOA group (P=0.015). In the REBOA group, the median 4 h red blood cell transfusion was significantly higher (2800 ml [1500–4908] vs. 1300 ml [600–2500], P<0.001). The REBOA group required lesser hemorrhagic control surgeries (31.8 vs. 47.7%, P<0.001). The incidence of therapeutic neurosurgery was 5.1% in the REBOA group and 8.7% in the non-REBOA group (P=0.168). Among survivors in the REBOA group, the median highest GCS score during admission was significantly greater for both total (11 [8–14] vs. 9 [6–14], P=0.036) and motor components (6 [4–6] vs. 5 [4–6], P=0.037). The highest GCS score among the survivors with predominant pelvic injuries was not different between the two groups (11 [8–13] vs. 11 [7–14], P=0.750).

Conclusions:
Patients experiencing shock and traumatic brain injury have high mortality rates, necessitating swift resuscitation and prompt hemorrhagic control. The use of REBOA as an adjunct for bridging definitive hemorrhagic control may correlate with enhanced consciousness recovery.
Unregulated male sexual enhancement treatments: Perils and pitfalls for patients and providers
Authors: Jackson Kristopher J. 
Published: June 2024

ABSTRACT
As the demand for “quick-fixes” and instant gratification intensifies among consumers of the US health care delivery system, health care providers remain essential to ensuring patients receive safe, evidenced-based care. Erectile dysfunction is a common health condition affecting as many as 42% of US men. As such, it is unsurprising that American health care consumers affected by erectile dysfunction (ED) may be tempted by “quick fixes” to ameliorate their symptoms—particularly if such fixes are perceived to be less embarrassing, more accessible, and/or more affordable. Although multiple therapies for the treatment of ED are approved by the US Food and Drug Administration, unregulated and/or counterfeit treatments are abundantly available to health care consumers on the Internet and US retail settings. These unregulated treatments may take the form of over-the-counter supplements or tainted prescription medications from illegal Internet pharmacies. This clinical brief is a call to action for health care professionals to advocate for patient safety, educate patients, and champion evidence-based therapies approved for the treatment of erectile dysfunction.
Heat Metrics and Maternal–Child Health Diagnoses in Emergency Departments in the United States
Authors: Oerther Sarah , Bultas Margaret 
Published: June 2024

Abstract

Objective:
To summarize current research on associations between heat metrics and emergency department discharge diagnoses for US pregnant women and children from birth to age 18 via a scoping review.

Background:
Climate change directly contributes to extreme weather conditions and environmental changes and indirectly affects health and the health care system. Pregnant women and children are believed to be more susceptible to extreme heat, but few empirical studies have been conducted evaluating effects of heat metrics on these populations.

Methods:
Ovid MEDLINE, CIHAHL, SCOPUS, Web of Science, JSTOR, and PsycINFO databases were searched using a combination of key words.

Results:
Twelve studies were selected for this review. In pregnant women, positive associations were found between mean daily temperature and multiple subtypes of pregnancy complications, including threatened or spontaneous abortion, renal diseases, infectious diseases, diabetes, and hypertension. In children, positive associations were found with all-cause diagnoses; asthma; dehydration; electrolyte disorders; heat-related illness; infection; endocrine, nutritional, and metabolic diseases; injury; and otitis media and external emergency department discharge diagnoses and temperature or heatwave versus non-heatwave.

Conclusion:
By tracking associations between maternal–child emergency department discharge diagnoses and various heat metrics, researchers can contribute to better clinical practices that promote environmental justice and climate resilience.
Evaluation of Automated Finger Compression for Capillary Refill Time Measurement in Pediatrics
Authors: Nickel Amanda J. , Jiang Shen , Napolitano Natalie , Donoghue Aaron , Nadkarni Vinay M. , Nishisaki Akira 
Published: June 2024

Objectives
Early shock reversal is crucial to improve patient outcomes. Capillary refill time (CRT) is clinically important to identify and monitor shock in children but has issues with inconsistency. To minimize inconsistency, we evaluated a CRT monitoring system using an automated compression device. Our objective was to determine proper compression pressure in children.

Methods
Clinician force for CRT was collected during manual CRT measurement as a reference for automated compression in a previous study (12.9 N, 95% confidence interval, 12.5–13.4; n = 454). An automated compression device with a soft inflation bladder was fitted with a force sensor. We evaluated the effectiveness of the automated pressure to eliminate pulsatile blood flow from the distal phalange. Median and variance of CRT analysis at each pressure was compared.

Results
A comparison of pressures at 300 to 500 mm Hg on a simulated finger yielded a force of 5 to 10 N, and these pressures were subsequently used for automated compression for CRT. Automated compression was tested in 44 subjects (median age, 33 months; interquartile range [IQR], 14–56 months). At interim analysis of 17 subjects, there was significant difference in the waveform with residual pulsatile blood flow (9/50: 18% at 300 mm Hg, 5/50:10% at 400 mm Hg, 0/51: 0% at 500 mm Hg, P = 0.008). With subsequent enrollment of 27 subjects at 400 and 500 mm Hg, none had residual pulsatile blood flow. There was no difference in the CRT: median 1.8 (IQR, 1.06–2.875) in 400 mm Hg vs median 1.87 (IQR, 1.25–2.8325) in 500 mm Hg, P = 0.81. The variance of CRT was significantly larger in 400 mm Hg: 2.99 in 400 mm Hg vs. 1.35 in 500 mm Hg, P = 0.02, Levene's test. Intraclass correlation coefficient for automated CRT was 0.56 at 400 mm Hg and 0.78 at 500 mm Hg.

Conclusions
Using clinician CRT measurement data, we determined either 400 or 500 mm Hg is an appropriate pressure for automated CRT, although 500 mm Hg demonstrates superior consistency.
A Case Series Study Assessing an Equity-Focused Implementation of Self-Monitoring Blood Pressure Programs Using Telehealth
Authors: Greene Leah K. , Song Glory , Palma Ana V. , Santarelli Claire , Wetzel Caroline , Spillane Janet , Nielsen Victoria M. 
Published: June 2024

Context:
Self-monitoring blood pressure (SMBP) programs are an evidence-based hypertension management intervention facilitated through telehealth. SMBP programs can provide a continuum of care beyond a clinical setting by facilitating hypertension management at home; however, equitable access to SMBP is a concern.

Objectives:
To evaluate the implementation of telehealth SMBP programs using an equity lens in 5 federally qualified health centers (FQHCs) in Massachusetts (MA).

Design:
A prospective case series study.

Setting:
Five FQHCs.

Participants:
The MA Department of Public Health (MDPH) selected 5 FQHCs to implement SMBP programs using telehealth. FQHCs were selected if their patient population experiences inequities due to social determinants of health and has higher rates of cardiovascular disease. Each of the 5 FQHCs reported data on patients enrolled in their SMBP programs totaling 241 patients examined in this study.

Intervention:
SMBP programs implemented through telehealth.

Main Outcome Measure:
Systolic blood pressure and diastolic blood pressure.

Results:
Approximately 53.5% of SMBP participants experienced a decrease in blood pressure. The average blood pressure decreased from 146/87 to 136/81 mm Hg. Among all patients across the 5 FQHCs, the average blood pressure decreased by 10.06/5.34 mm Hg (P < .001). Blood pressure improved in all racial, ethnic, and language subgroups.

Conclusions:
Five MA FQHCs successfully implemented equitable telehealth SMBP programs. SMBP participants enrolled in the programs demonstrated notable improvements in their blood pressure at the conclusion of the program. A flexible, pragmatic study design that was adjusted to meet unique patient needs; engaging nonphysician team members, particularly community health workers; adapting health information technology; and partnerships with community-based organizations were critical facilitators to program success.
Using a Cohort-Based Quality Improvement Coaching Model to Optimize Chronic Disease Management for Federally Qualified Health Center Patients
Authors: Barragan Noel C. , Green Gabrielle , Cruz Gerardo , Pogosyan Sarine , Newman Deanna , Kuo Tony 
Published: June 2024

Context:
In fall 2020, Community Clinic Association of Los Angeles County, in collaboration with the Los Angeles County Department of Public Health, launched a 3-year, cohort-based quality improvement (QI) coaching program to assist Federally Qualified Health Centers (FQHCs) in improving their clinical management of hypertension, high blood cholesterol, diabetes, and chronic kidney disease.

Program:
The QI program utilized a cohort-based coaching model in which 5 FQHCs were each assigned a practice transformation coach who provided them with guidance and support to monitor clinical quality measures. These measures were then used to facilitate changes and improvements in clinical workflows and approaches to patient care. To encourage peer learning and promote inter-organizational collaboration, the coaching team hosted quarterly cohort check-ins and an online group messaging board where the participating FQHCs could share lessons learned. Throughout the program, the FQHCs were provided trainings and resources to advance their clinical quality measures of choice.

Implementation:
To implement the program, each FQHC selected 2 clinical quality measures to focus on, completing a minimum of 1 Plan-Do-Study-Act cycle per year for each measure. Throughout, the coaches met regularly with FQHC staff to discuss progress, strategize on how best to address challenges encountered, and identify training or resource needs for their clinic sites.

Evaluation:
To drive implementation of QI interventions and monitor overall progress, the FQHCs reported quarterly on the clinical quality measures being addressed. By program's end, all 5 FQHCs reached their 10% improvement goals.

Discussion:
This QI coaching program allowed participating FQHCs to build new competencies and achieve measurable improvements in how they managed their patients' chronic diseases. This model of practice serves as a promising approach for achieving sustainable clinical improvements in these FQHCs.
Increasing the Writing Capacity and Dissemination of Evaluation Findings Among US Public Health Practitioners Funded to Improve Cardiovascular Health
Authors: Scott Amber , Bostic Myles , Sreedhara Meera , McAtee Jennifer , Minaya-Junca Jasmin , Vaughan Marla 
Published: June 2024

Context:
Contributing to the evidence base, by disseminating findings through written products such as journal articles, is a core competency for public health practitioners. Disseminating practice-based evidence that supports improving cardiovascular health is necessary for filling literature gaps, generating health policies and laws, and translating evidence-based strategies into practice. However, a gap exists in the dissemination of practice-based evidence in public health. Public health practitioners face various dissemination barriers (eg, lack of time and resources, staff turnover) which, more recently, were compounded by the COVID-19 pandemic.

Program:
The Centers for Disease Control and Prevention’s Division for Heart Disease and Stroke Prevention (DHDSP) partnered with the National Network of Public Health Institutes to implement a multimodal approach to build writing capacity among recipients funded by three DHDSP cooperative agreements. This project aimed to enhance public health practitioners’ capacity to translate and disseminate their evaluation findings.

Implementation:
Internal evaluation technical assistance expertise and external subject matter experts helped to implement this project and to develop tailored multimodal capacity-building activities. These activities included online peer-to-peer discussion posts, virtual writing workshops, resource documents, one-to-one writing coaching sessions, an online toolkit, and a supplemental issue in a peer-reviewed journal.

Evaluation:
Findings from an informal process evaluation demonstrate positive results. Most participants were engaged and satisfied with the project’s activities. Across eight workshops, participants reported increased knowledge (≥94%) and enhanced confidence in writing (≥98%). The majority of participants (83%) reported that disseminating evaluation findings improved program implementation. Notably, 30 abstracts were submitted for a journal supplement and 23 articles were submitted for consideration.

Discussion:
This multimodal approach serves as a promising model that enhances public health practitioners’ capacity to disseminate evaluation findings during times of evolving health needs.
Characterization of atypical BAR domain-containing proteins coded byToxoplasma gondii
Authors: Al-Qatabi Noha , Magdeleine Maud , Pagnotta Sophie , Leforestier Amélie , Degrouard Jéril , Arteni Ana Andreea , Lacas-Gervais Sandra , Gautier Romain , Drin Guillaume 
Published: June 2024

AbstractToxoplasma gondii, the causative agent of toxoplasmosis, infects cells and replicates insideviathe secretion of factors stored in specialized organelles (rhoptries, micronemes, dense granules) and the capture of host materials. The genesis of the secretory organelles and the processes of secretion and endocytosis depend on vesicular trafficking events whose molecular bases remain poorly known. Notably, there is no characterization of the BAR (Bin/Amphiphysin/Rvs) domain-containing proteins expressed byT. gondiiand other apicomplexans, although such proteins are known to play critical roles in vesicular trafficking in other eukaryotes. Here, by combining structural analyses within vitroassays and cellular observations, we have characterizedTgREMIND (REgulators of Membrane Interacting Domains), involved in the genesis of rhoptries and dense granules, andTgBAR2 found at the parasite cortex. We establish thatTgREMIND comprises an F-BAR domain that can bind curved neutral membranes with no strict phosphoinositide requirement and exert a membrane remodeling activity. Next, we establish thatTgREMIND contains a new structural domain called REMIND, which negatively regulates the membrane-binding capacities of the F-BAR domain. In parallel, we report thatTgBAR2 contains a BAR domain with an extremely basic membrane-binding interface able to deform anionic membranes into very narrow tubules. Our data show thatT. gondiicodes for two atypical BAR domain-containing proteins with very contrasting membrane-binding properties, allowing them to function in two distinct regions of the parasite trafficking system.
Drug resistance through ribosome splitting and rRNA disordering in mycobacteria
Authors: Majumdar Soneya , Kashyap Amuliya , Koripella Ravi K. , Sharma Manjuli R. , Hurst-Hess Kelley , Manjari Swati R. , Banavali Nilesh K. , Ghosh Pallavi , Agrawal Rajendra K. 
Published: June 2024

AbstractHflX is known to rescue stalled ribosomes and is implicated in antibiotic resistance in several bacteria. Here we present several high-resolution cryo-EM structures of mycobacterial HflX in complex with the ribosome and its 50S subunit, with and without antibiotics. These structures reveal a distinct mechanism for HflX- mediated ribosome splitting and antibiotic resistance in mycobacteria. In addition to dissociating ribosome into two subunits, mycobacterial HflX mediates persistent disordering of multiple 23S rRNA helices to generate an inactive pool of 50S subunits. Mycobacterial HflX also acts as an anti-association factor by binding to pre-dissociated 50S subunits. A mycobacteria-specific insertion in HflX reaches further into the peptidyl transferase center. The position of this insertion overlaps with ribosome-bound macrolides or lincosamide class of antibiotics. The extended conformation of insertion seen in the absence of these antibiotics retracts and adjusts around the bound antibiotics instead of physically displacing them. It therefore likely imparts antibiotic resistance by sequestration of the antibiotic- bound inactive 50S subunits.
Consumers' heterogeneous preference for organic ginger: a choice experiment
Authors: Liu Wei , Han Xiyan , Cao Xiuwei , Gao Zhifeng 
Published: June 2024

PurposeDue to ginger holds a special and indispensable place in Chinese cuisine, understanding consumers’ preferences for organic ginger is of significance, especially given the growing interest in organic food products and sustainable agriculture. This study thus examines Chinese consumers’ preference for fresh ginger and the sources of their preferences heterogeneity for organic ginger consumption.Design/methodology/approachThe study is using choice experiment (CE) method and mixed logit (MXL) modeling with 1,312 valid samples. The participants are regular consumers who are 18 years old or above and had bought fresh ginger within the past 12 months.FindingsThe results show that consumers prefer organic product certification labeling ginger to conventional ginger, preferred to purchase ginger at wet markets to at supermarkets or online, and preferred either ginger with regional public brand or private brand to unbranded ginger. Results also indicate that age, education level, income, purchasing experience of organic and branded ginger, and cognition of ginger health benefits are the sources of heterogeneity in consumer preferences for organic ginger.Originality/valueThis study contributes to ginger growers, marketers and policy makers. This study tracks how consumers' preferences change under different attribute combinations, capture the complex preference structure of consumers, and help reveal the motivations behind consumers' preferences for organic ginger. These findings will be crucial for developing marketing strategies, promoting organic products, and meeting consumer needs.
Does awareness of SDGs influence tourists’ behavior? An examination of the determinants of sustainable travel behavior considering the UN2030 Agenda
Authors: Assaker Guy 
Published: June 2024

Purpose
This study aims to examine a comprehensive model for the concurrent effects of tourists’ sustainability concerns, social norms, frugality and awareness of the UN’s sustainable development goals (SDGs) on sustainable travel behavior (STB), with sustainability in this case extending beyond the environmental to include economic and socio-cultural aspects as well.

Design/methodology/approach
The model is tested using a structural equation modeling technique based on data collected from 200 US respondents who traveled internationally in the past year.

Findings
Results reveal that all aforementioned variables, namely, sustainability concerns, social norms, frugality and SDG awareness, when considered together each positively influenced STB. However, SDG awareness did not accentuate tourists’ sustainability concerns associated with travel and tourism, as initially hypothesized.

Originality/value
Unlike previous studies that have mainly focused on the pro-environmental aspects of sustainability and failed to consider the aforementioned variables concurrently, the results from this study advance our understanding of the determinants of STB (more generally) while accounting specifically for the expected role of the UN SDG agenda.
Human capital and micro-business performance: the effective roles of bricolage and technology adoption in times of crises
Authors: Taleb Taleb S. T. , Hashim Norashidah , Ahmad Shuhymee , Abu Bakar Lily Julienti 
Published: June 2024

PurposeThis study develops and tests a model that explores how human capital impacts micro-business performance through the sequential mediation of new technology adoption and entrepreneurial bricolage.Design/methodology/approachA cross-sectional study was conducted on 508 women entrepreneurs engaged in micro-businesses in Malaysia. This study used partial least squares structural equation modeling to test the hypotheses.FindingsThis study demonstrates the significant impact of human capital on micro-business performance. It establishes a sequential mediation model in which technology adoption and entrepreneurial bricolage mediate the nexus of human capital–micro-business performance.Research limitations/implicationsThis study contributes to the theory by innovatively integrating human capital, new technology adoption, entrepreneurial bricolage, and microbusiness performance, drawing on the resource-based view and human capital theory. However, its cross-sectional nature limits causal inference, and focusing solely on women entrepreneurs in Malaysian micro-businesses may constrain novelty. Additionally, the reliance on self-reported data introduces bias, emphasizing the need for future research.Practical implicationsFostering entrepreneurial bricolage and embracing technology adoption can enhance performance. Business managers can optimize strategies by promoting continuous learning, innovative problem-solving, and technological advancements.Social implicationsThis study highlights the potential social and economic impacts of supporting women-owned micro-businesses in Malaysia. Policymakers can promote economic growth, employment, and community well-being by emphasizing innovation, human capital development, and technology adoption in Malaysia’s diverse ethnic contexts.Originality/valueThis study introduces a distinctive serial mediation framework to understand the impact of human capital on micro-business performance. It explores mediation dynamics, extends the knowledge of serial mediation in the human capital-performance relationship of microbusinesses, and contributes to the unexplored roles of technology adoption and entrepreneurial bricolage in Malaysian micro-businesses.