bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outcomes and Predictors of Delayed Intervention After Renal Trauma
Authors: Gross Megan G. , Filiberto Dina M. , Lehrman Benjamin H. , Lenart Emily K. , Easterday Thomas S. , Kerwin Andrew J. , Byerly Saskya E. 
Published: April 2024

Introduction Historically, a zone II hematoma mandated exploration after penetrating trauma, but this has been challenged given potentially higher nephrectomy rates and the advent of therapeutic endovascular and endoscopic interventions. We hypothesized penetrating mechanism was not a predictor for delayed intervention in the modern era. Methods This single-center, retrospective study included renal trauma patients from 3/2019 to 6/2022. Our institutional practice is selective exploration of zone II hematomas for active bleeding and expanding hematoma only, regardless of mechanism. Descriptive statistics and multivariable logistic regression (MLR) were performed. Results One-hundred and forty-four patients were identified, with median age 32 years (IQR:23,49), 66% blunt mechanism, and injury severity score 17(IQR:11,26). Forty-three (30%) required operative intervention, and of the 20 that had a zone II exploration, 3 (15%) underwent renorrhaphy and 17 (85%) underwent nephrectomy. Penetrating patients more frequently underwent immediate operative intervention (67%vs10%, P < .0001), required nephrectomy (27%vs5%, P = .0003), and were less likely to undergo pre-intervention CT (51%vs96%, P < .0001) compared to blunt patients. Delayed renal interventions were higher in penetrating (33%vs13%, P = .004) with no difference in mortality or length of stay compared to blunt mechanism. Ureteral stent placement and renal embolization were the most common delayed interventions. On MLR, the only independent predictor for delayed intervention was need for initial operative intervention (OR 3.803;95%CI:1.612-8.975, P = .0023). Four (3%) required delayed nephrectomy, of which only one underwent initial operative intervention without zone 2 exploration. Conclusions The most common delayed interventions after renal trauma were renal embolization and ureteral stent. Penetrating mechanism was not a predictor of delayed renal intervention in a trauma center that manages zone II retroperitoneal hematomas similarly regardless of mechanism.
Alone on the frontline: The first report of PTSD prevalence and risk in de-occupied Ukrainian villages
Authors: Ressler Austin , Hinchey Liza M , Mast Jonathan , Zucconi Beth E , Bratchuk Anatoliy , Parfenukt Nadia , Roth Dianne , Javanbakht Arash 
Published: April 2024

Importance: The ongoing Russian invasion of Ukraine marks a critical juncture in a series of events posing severe threat to the health of Ukrainian citizens. While recent reports reveal higher rates of PTSD in Ukrainian refugees following Russia’s invasion – data for Ukrainians remaining at the warfront is inherently difficult to access. A primarily elderly demographic, Ukrainians in previously Russian-occupied areas near the front (UPROANF) are at particular risk. Design: Data was sourced from screening questionnaires administered between March 2022 and July 2023 by mobile health clinics providing services to UPROANF. Setting: Previously occupied villages in Eastern and Southern Ukraine. Participants: UPROANF attending clinics completed voluntary self-report surveys reporting demographics, prior health diagnoses, and PTSD symptom severity ( n = 450; Meanage = 53.66; 72.0% female). Exposure: Participants were exposed to Russian occupation of Ukrainian villages. Main outcome and measures: The PTSD Checklist for the DSM-V (PCL-5) with recommended diagnostic threshold (i.e. 31) was utilized to assess PTSD prevalence and symptom severity. ANCOVA was used to examine hypothesized positive associations between (1) HTN and (2) loneliness and PTSD symptoms (cumulative and by symptom cluster). Results: Between 47.8% and 51.33% screened positive for PTSD. Though cumulative PTSD symptoms did not differ based on HTN diagnostic status, those with HTN reported significantly higher PTSD re-experiencing symptoms ( b = 1.25, SE = 0.60, p = .046). Loneliness was significantly associated with more severe cumulative PTSD symptoms ( b = 1.29, SE = 0.31, p < .001), re-experiencing ( b = 0.47, SE = 0.12, p < .001), avoidance ( b = .18, SE = 0.08, p = .038), and hypervigilance ( b = 0.29, SE = 0.13, p = .036). Conclusions and relevance: PTSD prevalence was higher than other war-exposed populations. Findings highlight the urgent mental health burden among UPROANF, emphasizing the need for integrated care models addressing both trauma and physical health. Given the significance of loneliness as a risk factor, findings suggest the potential for group-based, mind-body interventions to holistically address the physical, mental, and social needs of this highly traumatized, underserved population.
Pregabalin-Induced Parkinsonism: Case Report and Review of the Literature
Authors: Ali Hossam Tharwat , Khalil Sara Abdelhameed , Caprara Ana Leticia Fornari , Rissardo Jamir Pitton 
Published: April 2024

Pregabalin is an anti-epileptic drug approved for the treatment of neuropathic pain and focal-onset seizures. In a few cases, pregabalin was associated with parkinsonism. We present a case of a 48-year-old female who had hypertension and was on losartan 50 mg/daily. Her general practitioner prescribed pregabalin 150 mg/daily for fibromyalgia-related pain. The subject doubled the dosage without medical advice. After 5 days of the increased dosage, she started to experience difficulty and slowness in movement associated with resting tremors. Neuroimaging, electrodiagnostic studies, and laboratory exams were unremarkable. Secondary parkinsonism was suspected, so pregabalin was discontinued. The subject fully recovered within 7 days. To the authors’ knowledge, only 6 cases of pregabalin-induced parkinsonism were reported in the literature. Pregabalin discontinuation was the most common management. All individuals fully recovered after pregabalin withdrawal. The mechanism of pregabalin-induced parkinsonism is not fully understood.
Digital ethical reflection in home nursing care: Nurse leaders’ and nurses’ experiences
Authors: Jakobsen Lena , Olsen Rose Mari , Brinchmann Berit Støre , Devik Siri Andreassen 
Published: April 2024

Background Nurse leaders increasingly need effective tools that facilitate the prioritisation of ethics and help staff navigate ethical challenges and prevent moral distress. This study examined experiences with a new digital tool for ethical reflection, tailored to improve the capabilities of both leaders and employees in the context of municipal long-term care. Aim The aim was to explore the experiences of nurse leaders and nurses in using Digital Ethical Reflection as a tool for ethics work in home nursing care. Research design The study employed a qualitative design, incorporating individual and focus group interviews for data collection. Qualitative content analysis was used to analyse the data. Participants and research context The participants comprised six nurse leaders and 13 nurses, representing six home care zones across two Norwegian municipalities. Ethical considerations The study involved informed, voluntary participation and was approved by the Norwegian Agency for Shared Services in Education and Research. Findings Four themes were developed: a constant walk on the edge between engagement and discouragement and lost in translation describe the process, while tuning in to the ethical dimension and navigating ethical uncertainties illuminate the experienced significance of Digital Ethical Reflection. Conclusion Success with Digital Ethical Reflection in home nursing care depends on clear leadership planning, nurses’ understanding of the tool’s purpose, and active use of digital registrations. Support from ethically interested nurses enhances overall engagement. Further research is needed to explore the potential of Digital Ethical Reflection as an additional tool in long-term care ethics work.
The Impact of Provider Experience on Central Line Malposition
Authors: Lucena Michelle H. , Liszewski Mark C. , Kim Mimi , Xie Xianhong , LaTuga M. Susan 
Published: April 2024

Background Central lines are frequently used in the Neonatal Intensive Care Unit (NICU). Incorrectly positioned central lines are associated with increased complications. Central line malposition has been related to prematurity, catheter size, and small-for-gestation-age status. The impact of provider experience on proper central line positioning has not been established. Methods In this retrospective cohort study, neonates had central lines placed within the first 10 days of life. Central lines included umbilical artery catheters (UAC), umbilical vein catheters (UVC), and peripherally inserted central catheters (PICC). Central line malposition was confirmed with thoracoabdominal radiography. Different providers with various months/years of experience were coded. Logistic regression models were fit to adjust for potential confounders of the association of years of experience with line malposition. Results Between 2019 and 2021, 301 neonates had 616 central lines. 66% (405/616) of all central lines were malpositioned. The median years of providers’ experience who placed malpositioned and properly positioned lines were 1.93 (interquartile range [IQR]: 1.03–5.48) years and 2.17 (IQR: 1.38–4.85) years, respectively ( P = .78). The distribution of malposition lines was UVC 49% (199/405), UAC 20.5% (83/405), and PICC 30.5% (123/405). Only UVC was significantly associated with malposition ( P = .002). Conclusions Malposition of central lines frequently occurred in the NICU and was associated with UVC placement, irrespective of the provider’s experience who accessed it. Anatomical variations in neonates with different gestational ages and birth weights may mean that current methods to estimate insertion depth can be misleading. Future interventions should involve novel techniques of confirming real-time positioning during insertion rather than focusing on placement calculations.
Can Digital Skills Empower Disadvantaged Castes and Women? Evidence From India
Authors: Liu Che-Wei , Saldanha Terence J.V. , Mithas Sunil 
Published: April 2024

How do digital skills influence individuals’ wages in contexts where caste-based and gender-based social stratification play an important role? We draw on sociology and economics literature to argue that the returns to digital skills in such contexts are shaped by caste and gender, and that digital skills empower disadvantaged individuals to increase their wages. Our empirical analysis of a rich micro-dataset on more than 20,000 individuals across all states in India from two waves of Indian Human Development Survey in 2005 and 2011 yields two key findings. First, we find that the positive returns to digital skills are greater for individuals from the Scheduled Castes and Scheduled Tribes in India than for individuals from other castes. Second, we find that the returns to digital skills are greater for women than for men. We also find that movement up the skilled occupation ladder is a mechanism that mediates the relationship between digital skills and wages. Our post hoc exploratory analyses suggest that among individuals from the lowest castes (Scheduled Castes and Scheduled Tribes), the returns to digital skills are greater for women than for men, and that returns to digital skills are lower in regions with less developed infrastructure and lower literacy rates than in other regions. We discuss the implications of our findings for diversity, equity, and inclusion research in operations management.
Exploring Age-Related Variations in Carpal Bone Volume: Implications for Clinical Practice and Anatomical Understanding
Authors: Ganhewa Aparna D. , Seth Ishith , Wu Rui , Chae Michael P. , Tobin Vicky , Smith Julian A. , Hunter-Smith David J. , Rozen Warren M. 
Published: April 2024

Background: Clinically recognizing the changes in carpal bone volumes and understanding their implications in predicting osteoarthritis (OA) is crucial in clinical practice This study aimed to explore age-related differences in carpal bone volumes across genders, leveraging computed tomography (CT) wrist scans to create 3D surface models of these bones. Methods: Carpal bone volumes were calculated using the 3D Slicer software from CT scans obtained from Frankston Hospital and additional datasets from Brown and Auckland Universities. The data were statistically processed using Stata V13. Double-sided P-values < .05 were considered statistically significant. The study was conducted in accordance with the ethical standards laid out in the Declaration of Helsinki. Results: A total of 181 patients were analyzed, and 48% of whom were female. A statistically significant positive Spearman correlation (rho = 0.37-0.611, P <.05) was observed between increasing age and the volume of all surveyed carpal bones (scaphoid, lunate, triquetrum, pisiform, hamate, capitate, and trapezium) across genders. Intrauser and interuser reliabilities for 3D Slicer–generated volumes of trapezium and pisiform bones were statistically significant, with Interclass Correlation Coefficient (ICC) values of 0.86 and 0.95, respectively. Conclusion: Trapezial volumes increase with age, potentially due to the presence of OA and consequent osteophyte formation. This pattern is more prevalent among older individuals and women. However, the positive correlation between carpal bone volume and age was consistent across all carpal bones and both genders, regardless of OA presence. These findings suggest that carpal bone volume may naturally increase with age, independent of OA-related changes. Level of Evidence: III, cohort study.
Influenza vaccination in community pharmacy: A cross-sectional survey of Canadian adults’ knowledge, attitude and beliefs
Authors: Houle Sherilyn K. D. , Johal Ajit , Roumeliotis Paul , Roy Bertrand , Boivin Wendy 
Published: April 2024

Background: In Canada, influenza vaccination rates are below recommended targets, with pharmacies the leading setting for vaccine administration. This work aimed to determine the Canadian public’s current knowledge, attitudes and practices related to pharmacy-based influenza vaccination services. Methods: We surveyed 3000 Canadian residents aged ≥18 years using a cross-sectional, self-reported, online structured questionnaire between December 5 and 21, 2022. A representative survey population was recruited from the Léger Opinion (LEO) consumer panel. Data were weighted by age, region and gender, based on 2021 census data. Results: During the 2022–2023 season, 56.6% (95% confidence interval [CI], 54%-59.2%) of respondents reported receiving an influenza vaccine at a pharmacy, including 57.5% (95% CI, 54.2%-60.8%) of respondents considered to be at high risk of complications from influenza. Among respondents previously vaccinated at a pharmacy, 94.1% (95% CI, 91%-97.2%) were satisfied with the experience, citing convenience, accessibility and availability as factors influencing their decision. Among all respondents, 29.3% (95% CI, 27.5%-31.1%) reported that a pharmacist’s recommendation for the influenza vaccine would affect their decision to be vaccinated, yet only 10.4% (95% CI, 5.9%-15%) who had discussions with a pharmacist specifically discussed the importance of influenza vaccination. Conclusion: Canadians are satisfied with pharmacy-based influenza vaccinations and value pharmacist recommendations. Pharmacists have an opportunity to boost influenza vaccination coverage in Canada by providing counselling on the importance of influenza vaccination to those seeking their advice on other health care needs, including younger adults and those with risk factors for serious illness from influenza.
Real-world study of hepatic artery infusion chemotherapy combined with anti-PD-1 immunotherapy for hepatocellular carcinoma patients with portal vein tumor thrombus
Authors: Li Jinghuan , Quan Bing , Liu Wenfeng , Zhao Menglong , Yao Fan , Chen Rongxin , Ren Zhenggang , Yin Xin 
Published: April 2024

Background: Patients with hepatocellular carcinoma (HCC) with portal vein tumor thrombus (PVTT) present a poor prognosis. Current systemic therapies offer limited benefits. Hepatic artery infusion chemotherapy (HAIC) is a local regional treatment for advanced HCC, particularly in selected patients such as patients with PVTT or high intrahepatic tumor burden. Objectives: The purpose of this study is to retrospectively evaluate the efficacy and safety of HAIC combined with anti-PD-1 immunotherapy for HCC patients with PVTT, and explore factors related to survival prognosis, providing clues for treatment decisions for HCC patients. Design: This is a single-center retrospective study conducted over 2 years on consecutive PVTT patients receiving HAIC combined anti-PD-1 antibodies. Methods: The primary endpoint was overall survival (OS). Univariate and multivariate analyses were performed to identify prognostic factors affecting OS. Treatment-associated adverse events were evaluated as well. Results: A total of 119 patients were analyzed. The median OS and PFS were 14.9 months and 6.9 months. A total of 31.1% of grade 3–4 adverse events were reported, with elevated transaminase and total bilirubin being the most common. The independent variables correlated with survival include treatment-related alpha-fetoprotein (AFP) response, the presence of extrahepatic organ metastasis, absolute value of platelet (PLT), neutrophil-to-lymphocyte ratio, and combined usage of tyrosine kinase inhibitors (TKIs). Conclusion: In HCC patients with PVTT, combination therapy with HAIC and anti-PD-1 antibodies might be a promising therapy. The efficacy and safety of this combination protocol on patients with HCC complicated by PVTT warrants further investigation prospectively, especially in combination with TKIs.
Toward Healthy Underground Spaces: A Review of Underground Environmental Design Factors and Their Impacts on Users' Physiological and Psychological Health
Authors: Baek Daehwa , Baek Jeongyeop , Noh Jaechang , Oh Yeinn , Lim Lisa 
Published: April 2024

Objective: This study aims to review and synthesize what design factors are associated with the physiological and psychological health of occupants in underground spaces. Background: The development of underground spaces offers options to global challenges, such as traffic congestion, urban overcrowding, the revitalization of dormant underground areas, disaster mitigation, and adaptation to extreme environments. Despite these advantages, concerns persist about potential adverse effects on human health in these environments. This situation underlines the necessity of systematically identifying concerns and perceptions related to health in underground spaces. Methods: A narrative literature review was conducted to examine the relationship between design factors and health factors across 21 empirical studies. Based on the review of the identified literature, a relationship diagram was developed to depict the interconnections between the identified design and health factors. Results: The analysis identified design factors related to the air, sound, light, nature, transport, and spatial context of underground spaces, each of which exerted relationships with occupants’ physiological and psychological health factors. The relationship diagram indicated that the psychological factor “feeling of confinement” was mentioned most frequently, suggesting that it is one of the most extensively researched factors in this context. Conclusions: The relationship diagram aims to bridge the existing knowledge gap and set the stage for future research endeavors. The ultimate goal is to refine urban living standards by leveraging the potential of underground spaces while ensuring health and well-being.
Palliative Care in the Community: The Greek Version of the Supportive and Palliative Care Indicators Tool (SPICT™)
Authors: Bouri Maria , Sakellari Evanthia , Krentiris Dimitrios , Lagiou Areti 
Published: April 2024

Introduction/Objectives: Systematic identification of persons with palliative care needs constitutes a major challenge for promoting palliative care in all levels of the health system, including primary care. The aim of this study was to translate, cross-culturally adapt, and content validate Supportive and Palliative Care Indicators Tool (SPICT) for use in the Greek primary care context. Secondary objectives were to probe the use of SPICT-GR in exemplary case vignettes, to discuss the clarity and comprehensibility of its content as well as the appropriateness, acceptability, and feasibility of the tool within the Greek primary care. Methods: The Greek translation and cross-cultural adaptation of SPICT™ followed World Health Organization recommendations for translation and adaptation of instruments. For this purpose a working group was set up consisting of 2 senior researchers, a primary care professional with postgraduate training in Palliative Medicine and a general practitioner (GP) with special interest in primary palliative care. Three focus groups comprised of health professionals (n = 23) working in primary care settings participated in the pilot testing phase. Participants also completed a questionnaire including rating their perceptions on tool’s utility and feasibility as well as on the clarity and relevance of its items. Thematic analysis was used for focus groups discussions on how the tool was perceived and interpreted by health professionals in a Greek healthcare context and descriptive statistics for the quantitative analysis of the questionnaire data. Results: The majority assessed the tool as useful (65%), considered its implementation in primary care as feasible (91%) and rated its items as “relevant” or “very relevant” and “clear” or “very clear.” Three themes emerged from focus groups discussions: Guiding clinical practice and facilitating collaboration; promoting comprehensive care and awareness for palliative care; applicability in and suitability for primary care. Conclusions: SPICT-GR™ was identified as a practical and applicable tool for primary care, a source of guidance for the comprehensive identification of patients’ palliative care needs, promoting awareness on palliative care and facilitating a shared language among health care professionals.
Progress of Trade Facilitation in India: A Quantitative Assessment
Authors: Chauhan Vijay Singh , Singla Nikita 
Published: April 2024

In this paper, the authors present a long-term quantitative assessment of the trade facilitative environment in India. This pioneering exercise uses average cargo release time as a performance indicator, drawing upon secondary data sources based on transaction-level digital timestamps, as distinct from perception-based global surveys. It concludes that the unsegregated average import cargo release time has improved from 14 days in 2010–2011 to 86 hours and 44 hours for marine and air cargo, respectively, in 2023, yet falling short of 48 hours and 24 hours respective target set by the government. Highlighting the trade facilitation measures that have worked, the paper recommends focusing on the quality of regulatory measures, infrastructural improvement and wider adoption for the next generation of reforms. JEL Classifications: F1, F14, F18, F19