bluuebunny/crossref_metadata_2025_split huggingface dataset:
Minimizing delays to hemodialysis access maturation: A quality improvement analysis
Authors: Warren Andrew S , Wolf Hannah , Hillenbrand Charles J , Tang Gale L 
Published: April 2024

Introduction: Pre-operative process optimization can expedite time-to-intervention and reduce overall health care costs. We hypothesized that the longest delay to hemodialysis (HD) access creation would be from pre-operative vessel mapping (mandatory in our practice), and that this would be correlated with increased catheter days. Methods: One hundred thirty patients (24 inpatients, 106 outpatients) who received initial hemodialysis (HD) access from 01/01/2017 to 12/31/2021, at the Veterans Affairs Puget Sound, Seattle, Washington, were identified. Median time differences between pre-operative events were compared between inpatients and outpatients using the Mann-Whitney U test. Outpatients were then stratified by time of catheter-based HD initiation (no catheter, pre-referral catheter, post-referral catheter) and compared. The impacts of mapping-related delays on catheter use were evaluated using regression. Results: Inpatients had shorter referral to access maturation times (125 days inpatient vs 146 days outpatient; p = 0.03). This was driven by shorter referral to mapping (2 days inpatient vs 27 days outpatient; p < 0.01) and mapping to pre-surgical evaluation (1-day inpatient vs 6 days outpatients; p < 0.01) times. Pre-surgical evaluation to OR times represented the longest pre-operative delay in both groups (51 days inpatient vs 29 days outpatient; p = 0.59). Among outpatients, tunneled catheter placement post-referral resulted in longer maturation times (74 days no catheter vs 67 days pre-referral vs 149 days post-referral; p < 0.01) but not additional pre-operative delays. No trend existed between increased mapping times and catheter-based dialysis duration ( R2 = 0.08). Conclusion: Preoperative vein mapping contributed up to 21% of referral to maturation times but was not associated with increased tunneled catheter duration. While tunneled catheter placement impacted access maturation it did not cause additional pre-operative delays. Earlier referrals for access creation and reduction of outpatient wait-time from referral to OR and increased AV graft placement may minimize catheter days in our system thereby mitigating the added delays caused by pre-operative vein mapping.
Validating the anatomical landmark technique for bedside tunneled central venous catheter placement in the medical intensive care unit
Authors: Sawaf Hanny , Lane James , Shingarev Roman , Siuba Matthew , Kwon Alvin G , Hanane Tarik , Vachharajani Tushar J 
Published: April 2024

Background: A non-tunneled dialysis catheter (nTDC) is often the vascular access of choice to initiate dialysis in an intensive care unit (ICU). In the absence of contraindications, if a patient remains dialysis dependent beyond 2-weeks, the options are either to replace the nTDC with another nTDC or convert to a tunneled dialysis catheter (TDC). As a standard of care, TDCs are placed under fluoroscopic guidance. Objectives: To determine if TDCs and other tunneled central venous catheters (tCVC) can be placed safely using anatomical landmark techniques without the use of fluoroscopy. Research design: Subjects that met a predetermined selection criteria underwent placement of tunneled catheters with the use of the anatomical landmark technique. We looked at various outcomes to determine the safety and effectiveness of this technique. Subjects: One hundred eleven TDCs and other tCVCs were placed using the anatomical landmark technique in the intensive care unit. Results: All but one (110/111) of the catheters placed had recommended tip placement confirmed by at least one blinded physician. Major complications encountered were bleeding (two cases), pneumothorax (one case), and line associated blood stream infection (one case). We did find a higher-than-expected rate of “unnecessary procedures” with 18/111 lines placed in patients who did not survive beyond 7 days after placement of the catheter. Conclusions: Using the anatomical landmark technique for bedside tunneled catheter placement can be an effective approach in the right population.
Occupational stress among Norwegian physicians: A literature review of long-term prospective studies 2007–2019
Authors: Oftung Bendik , Tyssen Reidar 
Published: April 2024

Aims: There are signs of increased stress at work among Norwegian physicians over the last decades, not least among general practitioners (GPs). In this review, we identify trends in both occupational stress and adverse work-related predictors of such stress and burnout in Norwegian physicians. Methods: We performed an extensive literature search using MEDLINE, Embase and PsycINFO. We included prospective and repeated cross-sectional studies of work stress among Norwegian physicians published in 2007–2019. Results: Nine studies with observation periods of 1–20 years were included. Occupational stress (global measure) among all doctors decreased gradually from medical school to 20 years later. The prevalence of an effort–reward imbalance increased fourfold among GPs during the period 2010–2019. Five studies reported higher levels of occupational stress among female physicians than among their male colleagues. Work–home conflict levels increased after graduation until 10 years after leaving medical school and plateaued thereafter. Physicians who graduated in a later cohort reported lower levels of work–home conflict and less workplace violence. Work–home conflict, low colleague support, number of work hours and workload/low autonomy were all independent predictors of occupational stress. Conclusions: The reduction in occupational stress during the years after leaving medical school may result from increased competency in clinical work and decreased on-call work. The Co-ordination Act implemented in 2012 may explain the increase in occupational stress among GPs. These findings suggest that both reducing work–home conflict and increasing colleague support are important for doctors’ well-being.
Overview of health research in Greenland from 2001 to 2020
Authors: Ipsen Emil Ø. , Dalvad Jos , Koch Anders , Bundgaad Johan S. 
Published: April 2024

Aims: Health research in Greenlanders is challenged by a small population, few dedicated researchers and limited funding. Some research areas have proven impactful but gaps in knowledge are unknown. We aimed to quantify health research in Greenland, providing insights for researchers, policymakers and funding agencies to guide future research. Methods: We identified all peer-reviewed health research publications with the term ‘Greenland***’ in title or abstract from 2001 to 2020 through the platform entitled The Lens. Our bibliometric analysis included number of publications, publication rate, research types, research topics, citations and author affiliations, as well as funding. Results: From 2001 to 2020, a total of 640 health research publications concerning Greenland or Greenlanders were identified, with an average annual publication growth rate of 2.9%. The major health research topics studied in Greenland were infectious diseases, environmental health and general health. Several research fields, including rheumatology, nephrology and dermatology among others proved understudied at best. Three Danish universities contributed with 33% of all publications, with the International Journal of Circumpolar Health ( N=176, 28%) being the top journal destination. The most productive author had 119 article authorships during the period. Conclusion: During the past 20 years, Greenland’s annual publication rate has been steadily increasing, with an average of 32 articles about health research published each year, which is a higher publication rate than world average. The health research in Greenland is primarily epidemiologic with infectious disease being the most studied research area. Most publications were anchored in Denmark and centred around a few highly productive authors.
Differences in Daily Activity Performance Between Inpatient Rehabilitation Facility and Home Among Stroke Survivors
Authors: Somerville Emily , Blenden Gabrielle , Kretzer Danielle , Holden Brianna , Bollinger Rebecca M. , Krauss Melissa J. , Haxton Meghan , Martin Noah , Carter Alexandre , Stark Susan L. 
Published: April 2024

Background Stroke survivors are one of the largest consumer groups of rehabilitation services. Despite improvement in daily activities while in inpatient rehabilitation, many have difficulty performing daily activities at home after discharge. The difference in performance between a standard clinical context and at home is poorly understood. Objective To better understand differences in activity performance during transition from inpatient rehabilitation facility (IRF) to home, we examined daily activity performance scores from 2 different environments (IRF and home) at the same time point (discharge). Methods This was a cross-sectional analysis using baseline data from a randomized controlled trial. Participants were stroke survivors aged ≥50 who planned to discharge home from the IRF. The Functional Independence Measure and Section GG codes (both converted to International Classification of Functioning, Disability, and Health scores) were conducted per protocol first at home and then in the IRF at discharge (≤3 days apart, order not randomized). Results Among 57 participants, activity scores at home were significantly worse than scores at IRF discharge. Over 40% of participants had discharge scores indicating no-to-mild impairment for shower/tub transfer, walking, and going up/down stairs, while home visit scores indicated moderate-to-complete impairment for those activities. The greatest differences in scores were for shower/tub transfer (median difference 1.5, 95% CI 1.00-2.00) and going up/down stairs (median difference 1.50, 95% CI 1.00-2.00). Conclusion The environment plays an important role in stroke survivors’ functioning at home. Future studies should further examine how the environment impacts activity performance upon returning home following stroke.
Clinicopathologic characteristics of HPV-associated head and neck squamous cell carcinoma in Southern China: long-term retrospective study of 400 cases
Authors: Du Mingyuan , Lin Qiaohong , Yan Shida , Gao Xianlu , Yang Chulin , Li Zhaoyang , Liao Wei , Yang Ankui , Chen Shuwei 
Published: April 2024

Background: Human papillomavirus (HPV)-associated head and neck squamous cell carcinoma (HNSCC) is an evolving and growing disease, especially in developing countries. However, the clinical characteristics of HPV-associated HNSCC in regard to HPV infection rates, patient features, and prognosis are under-reported in the Asian population. Methods: In this study, we retrospectively enrolled a 400-case cohort of HNSCC with p16 immunochemistry and analyzed with long-term follow-up. We investigate the current HPV prevalence of HNSCC, unique HPV-associated patient clinical characteristics, and patient prognosis in the southern China population. Results: HPV infection exhibited a 15% prevalence in all HNSCC cases, notably higher in oropharyngeal cases (30.7%), followed by oral cavity (11.8%), laryngeal (10.1%), and hypopharyngeal (2.5%). HPV status, gender, old age, and location of tumor were significantly associated with the patient’s survival. Tonsil invasion was found more frequent in HPV-positive oropharyngeal HNSCC than in HPV-negative cases. HPV-associated HNSCC patients tend to possess stronger tobacco and alcohol habits, which were correlated to poor survival. HPV status’s correlation with gender, age, and anatomical location is associated intricately with patient survival. The secondary primary tumor rate was found higher within the HPV-negative group, compared to the HPV-positive group (9.12% versus 1.67%). Conclusion: Our study provided a current picture of HPV-associated HNSCC in the southern China population and elaborated the understanding of key factors that correlate to HNSCC prognosis. Our findings indicated a strong susceptibility of HPV-associated oropharyngeal HNSCC in the tonsil and the difference in secondary primary tumor rates associated with HPV status.
Automated Insulin Delivery in Adults With Type 1 Diabetes and Suboptimal HbA1c During Prior Use of Insulin Pump and Continuous Glucose Monitoring: A Randomized Controlled Trial
Authors: Christensen Merete B. , Ranjan Ajenthen G. , Rytter Karen , McCarthy Olivia M. , Schmidt Signe , Nørgaard Kirsten 
Published: April 2024

Background: Automated insulin delivery (AID) systems offer promise in improving glycemic outcomes for individuals with type 1 diabetes. However, data on those who struggle with suboptimal glycemic levels despite insulin pump and continuous glucose monitoring (CGM) are limited. We conducted a randomized controlled trial to assess the effects of an AID system in this population. Methods: Participants with hemoglobin A1c (HbA1c) ≥ 58 mmol/mol (7.5%) were allocated 1:1 to 14 weeks of treatment with the MiniMed 780G system (AID) or continuation of usual care (UC). The primary endpoint was change in time in range (TIR: 3·9-10·0 mmol/L) from baseline to week 14. After this trial period, the UC group switched to AID treatment while the AID group continued using the system. Both groups were monitored for a total of 28 weeks. Results: Forty adults (mean ± SD: age 52 ± 11 years, HbA1c 67 ± 7 mmol/mol [8.3% ± 0.6%], diabetes duration 29 ±13 years) were included. After 14 weeks, TIR increased by 18.7% (95% confidence interval [CI] = 14.5, 22.9%) in the AID group and remained unchanged in the UC group ( P < .0001). Hemoglobin A1c decreased by 10.0 mmol/mol (95% CI = 7.0, 13.0 mmol/mol) (0.9% [95% CI = 0.6%, 1.2%]) in the AID group but remained unchanged in the UC group ( P < .0001). The glycemic benefits of AID treatment were reproduced after the 14-week extension phase. There were no episodes of severe hypoglycemia or diabetic ketoacidosis during the study. Conclusions: For adults with type 1 diabetes not meeting glycemic targets despite use of insulin pump and CGM, transitioning to an AID system confers considerable glycemic benefits.
Primary Care Providers’ Experiences Treating Opioid Use Disorder Using Telehealth in the Height of the COVID-19 Pandemic
Authors: Marshall Sarah Alexandra , Siebenmorgen Lachan E. , Youngen Katherine , Borders Tyrone , Zaller Nickolas 
Published: April 2024

Background: The COVID-19 pandemic catalyzed a rapid shift in healthcare delivery towards telehealth services, impacting patient care, including opioid use disorder (OUD) treatment. Regulatory changes eliminated the in-person evaluation requirement for buprenorphine treatment, encouraging adoption of telehealth. This study focused on understanding experiences of primary care providers in predominantly rural areas who used telehealth for OUD treatment during the pandemic. Methods: Semi-structured interviews were conducted with 22 primary care providers. Participants practiced in 13 rural and 9 urban counties in Kentucky and Arkansas. Data were analyzed using conventional content analysis. Results: The pandemic significantly impacted healthcare delivery. While telehealth was integrated for behavioral health counseling, in-person visits remained crucial, especially for urine drug screenings. Telehealth experiences varied, with some facing technology issues, while others found it efficient. Telehealth proved valuable for behavioral health counseling and sustaining relationships with established patients. Patients with OUD faced unique challenges, including housing, internet, transportation, and counseling needs. Stigma surrounding OUD affected clinical relationships. Building strong patient-provider relationships emerged as a central theme, emphasizing the value of face-to-face interactions. Regarding buprenorphine training, most found waiver training helpful but lacked formal education. Conclusion: This research offers vital guidance for improving OUD treatment services, especially in rural areas during crises like the COVID-19 pandemic. It highlights telehealth’s value as a tool while acknowledging its limitations. The study underscores the significance of strong patient-provider relationships, the importance of reducing stigma, and the potential for training programs to elevate quality of care in OUD treatment.
Determinants of Nurses’ Knowledge Toward the Elderly Care, Southwest, Ethiopia
Authors: Abdu Mehd , Daniel Tariku , Yesuf Mohammed 
Published: April 2024

Introduction Elderly individuals are the segment of the population that needs special care. The quality of care provided for elderly individuals is highly determined by the knowledge of nurses in elderly care. Hence, there are limited studies conducted to determine the level of knowledge of nurses regarding elderly care. Therefore, this study aimed to assess determinant factors of nurses’ knowledge of elderly care. Methods A facility-based cross-sectional study design was employed from April 1 to 10, 2021, among 345 nurses. Respondents were selected by a simple random sampling technique. The data were collected through a self-administered structured questionnaire. The collected data were entered and analyzed by using Statistical Package for Social Science software version 25.0. A multivariable binary logistic regression was used to identify factors significantly associated with the knowledge of nurses about elderly care. Result The response rate of this study was 98.3%. More than half of the respondents were female (51.6%) and 38.3% were single in marital status. Being knowledgeable among nurses about elderly care was 51.9%. Ever living with the elderly (adjusted odd ratio [AOR]: 3.62; 95% CI: 1.661, 7.89) and taking geriatric care training (AOR: 5.209, 95% CI: 2.771, 9.79) were positively associated with the knowledge of nurses toward elderly care while work experience <5 years (AOR: 0.305; 95% CI: 0.134, 0,696), and work experience 5–10 years (AOR: 0.359; 95% CI: 0.15, 0.864) were negatively associated with the knowledge of nurses toward elderly care. Conclusion The knowledge of nurses about elderly care was moderate. Ever lived with the elderly, work experience, and taking geriatric care training contributed to nurses’ knowledge about elderly care. Therefore, hospital administrators and the Ministry of Health should facilitate training, design, and implement standard guidelines on nursing practice for elderly care.
Origins of the Glandular Mucosae in the Gastro-Esophageal Junction—A Study in a South Asian Population With Low Incidence of Esophageal Adenocarcinoma
Authors: Wijetunge Sulochana , De Silva Lakvahandhi Damindra Saseekalani , Kotakadeniya Rasika , Halahakoon Vijitha Chandima , Galketiya Kuda Banda , Samarasingha Bandula , Dharmapala Arinda 
Published: April 2024

Introduction: Gastro-esophageal junction (GEJ) is subjected to controversy due to limited knowledge of its anatomy and histology. We conducted a study to determine the origins of the glandular mucosa at GEJ. Methods: Three groups were used, groups A and B, with grossly normal GEJs and Group C with endoscopic evidence of reflux damage. Group A comprised 23 esophago-gastrectomies, group B, 112 dyspeptic patients with normal GEJ and group C, 46 dyspeptic patients with reflux damaged GEJs. Origins of cardiac mucosa (CM), intestinal metaplasia (IM), and oxyntocardiac mucosa (OCM) were determined by studying their associations with esophageal markers (EM): esophageal glands and ducts, multilayered epithelium and squamous islands highlighted with immunohistochemistry. The histological gap between esophageal squamous and gastric oxyntic mucosa containing CM/IM/OCM was considered as squamo-oxyntic (SO) gap. Results: In Group A and B, a microscopic SO gap was detected in 58.1% and the prevalence of CM was 43% and IM 4.4% and CM 89.7%; 100% IM were associated with EM. Prevalence of CM and IM, in group C was 56.5% and 15.2% respectively and EM were present in 85.7% IM and 88.5% CM. When only OCM is present, 41.2% were proven to be metaplastic. Conclusions: Even when GEJ is grossly normal, microscopic columnar lined esophagus was common at the GEJ and with increased sampling and using several EM almost all CM and IM at the GEJ could be proven to be metaplastic in origin.
Electron density changes accompanying high-pressure phase transition in AlOOH
Authors: Gajda Roman , Parafiniuk Jan , Fertey Pierre , Dera Przemysław , Woźniak Krzysztof 
Published: April 2024

AbstractAn attempt to compare and describe the differences in the electron density distribution between two phase structures of AlOOH has been made. High-resolution, high-pressure experiments with α-AlOOH diaspore were conducted using single-crystal synchrotron X-ray diffraction data. A multipole model of experimental electron density in the α-AlOOH single crystal was refined. Simultaneously, similar multipole refinement was conducted for another phase of diaspore (δ-AlOOH), this time based on a previously published data set. Both results were compared and supported by density functional theory (DFT) calculations. Although the results are affected by the limited quality of the data, it is clear that the phase transition caused significant changes in the shape and arrangement of the atomic basins.Atomic basins are a much better tool to present subtle electron density distribution changes than traditional polyhedra. Straightforward comparison of datasets available in older scientific papers and current datasets is challenging because of differences in data quality and collection parameters. However, augmenting experimental data with computational results can help reveal important information in even incomplete datasets.
The science behind the nose: correlating volatile organic compound characterisation with canine biodetection of COVID-19
Authors: Charles Marthe , Ruszkiewicz Dorota , Eckbo Eric , Bryce Elizabeth , Zurberg Teresa , Meister Austin , Aksu Lâle , Navas Leonardo , Myers Renelle 
Published: April 2024

BackgroundThe SARS-CoV-2 pandemic stimulated the advancement and research in the field of canine scent detection of COVID-19 and volatile organic compound (VOC) breath sampling. It remains unclear which VOCs are associated with positive canine alerts. This study aimed to confirm that the training aids used for COVID-19 canine scent detection were indeed releasing discriminant COVID-19 VOCs detectable and identifiable by gas chromatography (GC-MS).MethodsInexperienced dogs (two Labradors and one English Springer Spaniel) were trained over 19 weeks to discriminate between COVID-19 infected and uninfected individuals and then independently validated. Getxent tubes, impregnated with the odours from clinical gargle samples, used during the canines’ maintenance training process were also analysed using GC-MS.ResultsThree dogs were successfully trained to detect COVID-19. A principal components analysis model was created and confirmed the ability to discriminate between VOCs from positive and negative COVID-19 Getxent tubes with a sensitivity of 78% and a specificity of 77%. Two VOCs were found to be very predictive of positive COVID-19 cases. When comparing the dogs with GC-MS, F1 and Matthew's correlation coefficient, correlation scores of 0.69 and 0.37 were observed, respectively, demonstrating good concordance between the two methods.InterpretationThis study provides analytical confirmation that canine training aids can be safely and reliably produced with good discrimination between positive samples and negative controls. It is also a further step towards better understanding of canine odour discrimination of COVID-19 as the scent of interest and defining what VOC elements the canines interpret as “essential”.