bluuebunny/crossref_metadata_2025_split huggingface dataset:
Epidemiology and risk factors of bloodstream infections among adolescents and young adults with acute lymphoblastic leukaemia: An 11‐year retrospective cohort study
Authors: Xue Longlong , Tang Yishu , Wang Liwen , Xu Cong , Cheng Qian , Li Xin 
Published: March 2024

AbstractAdolescent and young adults (AYAs) belong to a unique category of patients diagnosed with acute lymphoblastic leukaemia (ALL). Bloodstream infection (BSI) is a leading cause of treatment‐related mortality in ALL patients. However, the epidemiology and risk factors for mortality from BSIs in AYA patients remain unclear. In this study, we analysed these aspects in AYAs patients and compared similarities and differences with children (<15 years old) and older adults (>39 years old). We analysed the pathogenic epidemiology, antibiotic resistance and BSI risk factors of 73 children, 180 AYAs, and 110 older adults with ALL in three comprehensive hospitals from January 2010 to August 2021. The data on BSIs in AYAs were compared to that of the other two groups. In this study, the epidemiology of BSIs in AYAs was similar to that of older adult patients. Concerning clinical characteristics, most AYAs and older adults with BSIs were in a relapsed or uncontrolled state (34.5% vs. 35.4%, p = 0.861). In terms of pathogen distribution, Gram‐negative bacteria (GNB) were the most common causative pathogens in AYAs and older adult groups. Extended‐spectrum beta‐lactamase (ESBL)‐producing bacteria were more commonly found in AYAs than in children (32.8% vs. 16.4%, p = 0.09). Regarding risk factors, the length of hospitalization (>14 days) and renal inadequacy (creatinine ≥ 177 μmol/L) were influencing factors for 30‐day mortality in AYAs patients with BSIs. In our study, AYA patients with BSIs showed clinical characteristics and pathogen distributions similar to those of older adult patients but quite different from those of children.
Rethinking the tiered trauma team response: A case‐series study in a regional trauma centre
Authors: Curtis Kate , Clark Benjamin , Lam Mary K , Huckle Ryan , Melville Geoffrey , Binks Simon , Ryan Ms Wende , Gardner Trevor , Parsons Ms Brooke , Ashford Bruce 
Published: March 2024

AbstractObjectiveTo reduce perceived unnecessary resource use, we modified our tiered trauma response. If a patient was not physiologically compromised, surgical registrar attendance was not mandated. We investigated the effect of this change on missed injury, unplanned representation to ED, diagnostic imaging rates and staff satisfaction.MethodsA retrospective case series study assessing the 3‐month period before and after the intervention was conducted. Logistic regression analyses were used to examine the association between ordering of computerised tomography (CT) and ED length of stay (LOS), injury severity (ISS), age, surgical review and admission. A staff survey was conducted to investigate staff perceptions of the practice change. Free text data were analysed using inductive content analysis.ResultsThere were 105 patients in the control and 166 in the intervention group and their mean (SD) ISS was the same (ISS [SD] = 4 [±4] [P = 0.608]). A higher proportion of the control group were admitted (56.3% vs 42.2% [P = 0.032]) and they had a shorter ED LOS (274 min [202–456] vs 326 min [225–560], P = 0.044). The rate of missed injury was unchanged. A surgical review resulted in a 26‐fold increase in receipt of a whole‐body CT scan (odds ratio = 26.89, 95% confidence interval = 3.31–218.17). Just over half of survey respondents felt the change was safe (54.4%), and more surgical (90%) than ED staff (69%) reported the change as positive.ConclusionThe removal of the surgical registrar from the initial trauma standby response did not result in any adverse events, reduced admissions, pathology and imaging, but resulted in an increased ED LOS and time to surgical review.
Konfokale Line‐Field optische Kohärenztomographie, ein innovatives nichtinvasives Instrument zur Diagnose der Onychomykose
Authors: Eijkenboom Quirine Louise , Daxenberger Fabia , Gust Charlotte , Hartmann Daniela , Guertler Anne , Steckmeier Stephanie , Deussing Maximilian , French Lars Einar , Welzel Julia , Schuh Sandra , Sattler Elke Christina 
Published: March 2024

ZusammenfassungHintergrund und ZieleOnychomykose ist weit verbreitet und sollte von anderen Nagelerkrankungen unterschieden werden. Eine rasche und genaue Diagnostik ist für die optimale Behandlung des Patienten und ein bestmögliches Ergebnis erforderlich. Nichtinvasive Techniken haben ein wachsendes Potenzial bei der Diagnose von Nagelerkrankungen, einschließlich Onychomykose. In dieser Studie wurde die konfokale Line‐Field optische Kohärenztomographie (LC‐OCT) als schnelle nichtinvasive Methode zur Diagnose von Onychomykose im Vergleich zur konfokalen Laserscanmikroskopie (KLM), optischen Kohärenztomographie (OCT) und konventionellen Methoden bewertet.Patienten und MethodikIn dieser prospektiven Studie wurden 86 Patienten mit klinischem Verdacht auf Onychomykose und 14 Kontrollen mittels LC‐OCT, OCT und KLM untersucht. KOH‐Präparation, Pilzkultur, PCR und Histopathologie wurden als vergleichende konventionelle Methoden eingesetzt.ErgebnisseLC‐OCT hatte die höchste Sensitivität und den höchsten negativen Vorhersagewert aller verwendeten Methoden, dicht gefolgt von PCR und OCT. Die Spezifität und der positive Vorhersagewert der LC‐OCT waren genauso hoch wie bei der KLM, während OCT deutlich schlechter abschnitt. Das Goldstandardverfahren Pilzkultur zeigte die geringste Sensitivität und den niedrigsten negativen Vorhersagewert. Nur PCR und Kultur ermöglichten eine Differenzierung der Pilzspezies.SchlussfolgerungenLC‐OCT ermöglicht eine schnelle und nichtinvasive Diagnostik von Onychomykose, mit Vorteilen gegenüber KLM und OCT und ähnlicher diagnostischer Genauigkeit wie die PCR, aber ohne Differenzierung der Pilzarten. Für eine genaue Nageluntersuchung erfordert die LC‐OCT gut geschulte und erfahrene Anwender.
Patient Journey und krankheitsbezogene Nutzung digitaler Medien: Eine Querschnittsstudie unter Dermatologie‐Patienten in Deutschland
Authors: Wecker Hannah , Höllerl Lea , Schick Teresa Sophie , Biedermann Tilo , Zink Alexander , Ziehfreund Stefanie 
Published: March 2024

ZusammenfassungHintergrund und ZieleZiel dieser Studie war es, die Auswirkungen der Nutzung gesundheitsbezogener digitaler Medien auf die Arzt‐Patienten‐Beziehung und die Patient Journey (Weg des Patienten durch alle Phasen seiner Erkrankung) zu untersuchen, um positive Veränderungen in der dermatologischen Praxis zu bewirken.Patienten und MethodikVon Juni bis November 2022 füllten Personen mit Hautkrankheiten in Deutschland einen Fragebogen zur Bewertung der gesundheitsbezogenen Nutzung digitaler Medien, der E‐Health‐Kompetenz, des Einflusses der Nutzung digitaler Medien auf die Arzt‐Patienten‐Beziehung und die Patient Journey sowie soziodemografischer und gesundheitlicher Merkmale aus. Die Daten wurden deskriptiv und mittels linearer Regressionen analysiert.ErgebnisseInsgesamt wurden 919 Teilnehmer analysiert (medianes Alter: 47,00, Interquartilsbereich [28,00; 61,00] Jahre, weiblich: 53,6%, Nutzer digitaler Medien im Kontext der Erkrankung: 56,8%). Google und Online‐Enzyklopädien wurden am häufigsten vor und nach der dermatologischen Konsultation genutzt. Online‐Selbsthilfegruppen wurden von 76,3% der nicht behandelten Teilnehmer in Anspruch genommen. Die Nutzung digitaler Medien hatte keinen Einfluss auf die Arzt‐Patienten‐Beziehung und wirkte sich positiv auf die Patient Journey aus. Positive Auswirkungen wurden mit höherer E‐Health‐Kompetenz, Zufriedenheit mit der Qualität digitaler Medien, Bedeutung digitaler Medien, ländlichem Wohnsitz, höherem Bildungsniveau und Vertrauen in Dermatologen in Verbindung gebracht.SchlussfolgerungenDie dermatologische Versorgung in Arztpraxen kann vom Potenzial digitaler Gesundheitsmedien profitieren. Eine evidenzbasierte digitale Gesundheitsplattform ist erforderlich, um die E‐Health‐Kompetenz der Betroffenen zu erhöhen und ihre Zufriedenheit mit der Qualität digitaler Medien zu verbessern.
Lymphogranuloma venereum verläuft häufig asymptomatisch bei Männern, die Sex mit Männern haben, in Österreich
Authors: Chromy David , Sadoghi Birgit , Gasslitter Irina , Skocic Mattias , Okoro Anthony , Grabmeier‐Pfistershammer Katharina , Willinger Birgit , Weninger Wolfgang , Öllinger Angela , Sarcletti Mario , Stary Georg , Bauer Wolfgang Michael 
Published: March 2024

ZusammenfassungHintergrund und ZieleLymphogranuloma venereum (LGV) ist eine sexuell übertragene Erkrankung verursacht durch Chlamydia trachomatis (CT), Serovar L1–L3. Eine Zunahme von LGV ist vorwiegend bei Männern, die Sex mit Männern haben (MSM), beobachtet worden. Die Unterscheidung zwischen LGV und Nicht‐LGV‐Serovaren hat therapeutische Konsequenzen, daher wurden Prävalenz und Charakteristika von LGV innerhalb aller CT‐Infektionen untersucht.Patienten und MethodikAlle CT‐positiven Befunde, erhoben an den vier größten österreichischen HIV‐ und STI‐Kliniken von 04/2014–12/2021, wurden hinsichtlich Charakteristika der Erkrankung und Demographie der Patienten ausgewertet.ErgebnisseInsgesamt wurden n = 2083 CT‐Infektionen bei n = 1479 Personen dokumentiert. Das mediane Alter betrug 31,4 Jahre, 81% waren männlich, 59% MSM, 44% HIV‐positiv, 13% nutzten HIV‐Prä‐Expositionsprophylaxe. Serovaranalysen waren bei 61% (1258/2083) verfügbar, wobei L1–L3 in 15% (192/1258) aller Fälle nachgewiesen wurde. Bei MSM mit rektaler CT‐Infektion waren 23% (101/439) LGV. LGV‐Fälle verglichen mit CT‐Infektionen traten vermehrt bei MSM (92% [177/192] vs. 62% [1179/1891], p < 0,001), HIV‐Positivität (64% [116/180] vs. 46% [631/1376]; p < 0,001) und konkomitanter Syphilisinfektion (18% [32/180] vs. 7% [52/749]; p < 0,001) auf. LGV‐Infektionen verliefen zumeist asymptomatisch (45% [87/192]), gefolgt von Proktitis (38% [72/192]).SchlussfolgerungenLymphogranuloma venereum machte 23% der rektalen CT‐Infektionen bei MSM aus und 45% aller LGV‐Fälle waren asymptomatisch. Bei fehlender CT‐Serovar‐Analyse sollte in Risikopopulationen eine erhöhte LGV‐Prävalenz in Betracht gezogen und bei der empirischen Therapiedauer berücksichtigt werden.
Daily dynamics of feeling loved by parents and their prospective implications for adolescent flourishing
Authors: Xia Mengya , Coffey John K. , Fosco Gregory M. 
Published: March 2024

AbstractFeeling loved by one's caregiver is essential for individual flourishing (i.e., high levels of psychological well‐being in multiple dimensions). Although similar constructs are found to benefit adolescent well‐being, research that directly tests parental love as a feeling from the recipient's perspective is rare. Historically, parental love has been measured using single‐assessment methods and assumed to be a stable, trait‐like characteristic; yet, like any feeling, it may fluctuate in meaningful ways on a day‐to‐day basis—the implications of which are unknown. Using a sample of 150 adolescents (59.3% female; ages 14–16), this study estimated level (person's mean level across days) and instability (fluctuations across days) of feeling loved by a caregiver across 21 days for each adolescent, and then examined their prospective effects on adolescent flourishing 1 year later. After controlling for demographics (adolescent age, gender, family income, and parent's sex) and variable baseline levels, feeling more loved by one's caregiver in daily life significantly predicted higher levels of flourishing in two global measures 1 year later. Moreover, level and instability of feeling loved by one's caregiver played different roles for different dimensions of flourishing: higher levels significantly predicted higher levels of autonomy, purpose in life, and personal growth, whereas higher instability significantly predicted lower levels of positive relations with others and environmental mastery. Findings emphasized the importance of considering daily dynamics of feeling loved by one's caregiver and demonstrated that level (of feeling loved) is particularly important for intrapersonal aspects while instability is particularly important for interpersonal aspects of flourishing.Research Highlights
Adolescents feeling more loved by their caregiver in daily life had higher levels of overall flourishing 1 year later.
Level (of feeling loved) is particularly important for intrapersonal aspects of adolescent flourishing, including autonomy, purpose in life, and personal growth.
Stability (of feeling loved) is particularly important for interpersonal aspects of adolescent flourishing, including positive relations with others and environmental mastery.
The political economy of fiscal dominance: Evidence from the Chilean government of Salvador Allende
Authors: Espinosa Víctor I , Cueva David O 
Published: March 2024

AbstractThis article examines the political economy of fiscal dominance during the Chilean government (1970–73) of Salvador Allende. Fiscal dominance appears when the monetary authority complies with the fiscal authority's demand to buy treasury bonds and monetise the deficit. It is argued that persistent fiscal dominance is inflationary, especially without robust fiscal and monetary rules. The Allende government financed the deficit with present taxes, debt (future taxes) and monetary issuance (inflation tax), causing the crowding‐out effect and, together with other policies such as expropriation and price controls, collapsed the demand for money, triggering hyperinflation. The lessons of Chile clarify the fiscal trigger of the inflation, stagnation, and widespread poverty that has affected Latin American countries in recent decades.
Effect of temperature on metabolic stress and recovery of two Argyrosomus species from simulated catch‐and‐release angling
Authors: Pringle Brett A. , Duncan Murray I. , Winkler Alexander C. , Mafwila Samuel , Jagger Charmaine , McKeown Niall J. , Shaw Paul W. , Henriques Romina , Potts Warren M. 
Published: March 2024

AbstractCatch‐and‐release (C&R) angling has grown in popularity due to increasing numbers of conservation‐minded anglers and regulations of recreational fisheries. C&R is often assumed to cause low mortality but can cause physiological and physical impairment. Fish metabolism and temperature interact to play a critical role in the biological functioning of fish. Understanding the relationship between temperature, fish metabolism, and physiological impairment is important for effective fisheries management and conservation, particularly for C&R angling in a changing thermal environment. We used respirometry to quantify post‐release metabolic stress and recovery of two popular Namibian angling species (Argyrosomus inodorus and A. coronus) subjected to simulated C&R angling across a range of temperatures. Metabolic stress and recovery time did not differ significantly between warm (A. coronus) and cold‐water (A. inodorus) species at any test temperature. However, several specimens of both species failed to recover physiologically and physically after 10 hours, thereby indicating C&R‐related impairment and potential for mortality. Given the predator‐rich environment of coastal waters in Namibia, best C&R practices are needed to minimise post‐release mortality.
Optimal treatment strategy and prognostic analysis of salvage liver transplantation for patients with early hepatocellular carcinoma recurrence after hepatectomy
Authors: Hung Hao‐Chien , Lai Yin , Lee Jin‐Chiao , Wang Yu‐Chao , Cheng Chih‐Hsien , Wu Tsung‐Han , Wu Ting‐Jung , Chou Hong‐Shiue , Chan Kun‐Ming , Lee Wei‐Chen , Lee Chen‐Fang 
Published: March 2024

AbstractAimWe aimed to investigate the prognostic factors for salvage liver transplant in patients with early hepatocellular carcinoma recurrence after hepatectomy.MethodsThis retrospective analysis included 53 patients who underwent salvage living‐donor liver transplantation between January 2007 and January 2018. There were 24 and 29 patients in the early (recurrence ≤24 months after primary liver resection) and the late recurrence groups, respectively.ResultsIn the multivariate Cox regression model, pre‐liver transplant downstaging therapy, early recurrence (ER) after primary liver resection , and recurrence‐to‐liver‐transplant ≥12 months were independent risks to predict recurrent hepatocellular carcinoma recurrence after salvage living‐donor liver transplantation. Compared with the late recurrence group, the ER group showed lower disease‐free survival rates (p < 0.001); however, the overall survival rates did not differ between the two groups (p = 0.355). The 1‐, 3‐, and 5‐year disease‐free survival rates were 83.3%, 70.6%, and 66.2%, and 96.0%, 91.6%, and 91.6% in the early and late recurrence groups, respectively. When stratified by recurrence‐to‐liver transplant time and pre‐liver transplant downstaging therapy in the ER group, disease‐free survival and overall survival rates were significantly different.ConclusionER after primary liver resection with advanced tumor status and a longer period of recurrence‐to‐liver‐transplant (≥12 months) have a negative impact on salvage liver transplant. Our findings provide novel recommendations for treatment strategies and eligibility for salvage liver transplant candidates.
East Asia's private higher education crisis: Demography as destiny?
Authors: Welch Anthony 
Published: March 2024

AbstractGlobally, one in three students are now enrolled in private higher education institutions (PHEIs), with the total reaching almost 70 million enrolments. This pattern is similar across a highly diverse Asia: more than 35% of students are enrolled in the private sector, and around 60% of higher education institutions (usually much smaller than their public counterparts) are private. But in East Asia, a combination of high participation rates and a rapidly ageing demographic has led to a complex, developing crisis, particularly in a much‐expanded private sector. Adding to the existing suite of problems – finance, over‐supply, declining standards, regulatory issues, and in some cases, corruption – the combined effect of recent COVID disruptions, regional economic reversals, and a rapidly ageing demographic has intensified existing problems, constituting a major crisis for the sector, especially more marginal private institutions. The analysis charts the various responses of governments in Japan, South Korea, Taiwan, and China, draws out some of the limits to reform, and poses the dilemma for the future of private higher education in the region.
Unpacking “the system”: Multi‐level governance gaps in the labour market integration of highly skilled refugees
Authors: van Riemsdijk Micheline 
Published: March 2024

AbstractA plethora of government‐ and non‐government actors are involved in the labour market integration of highly skilled refugees, forming a complex “system” that is difficult to navigate for integration actors and refugees. Based on interviews with 32 labour market integration actors in Sweden, this article examines multi‐level governance gaps in the wake of the simultaneous centralization and decentralization of labour market preparation services. It examines various “steps” in the labour market integration process to gain a more holistic perspective of “the system”, and identifies governance gaps in each step. The article finds that the devolution of services has opened up participatory spaces for non‐government actors, but narrowly defined mandates and short‐term funding mechanisms hamper cooperation within and between territorial levels of policy implementation.
Clinical decision‐making processes among graduate nurses, specialist nurses and nurse practitioners A collaborative international study
Authors: Levy‐Malmberg Rika , Boman Erika , Lehwaldt Daniela , Fagerström Lisbeth , Lockwood Emily B 
Published: March 2024

AbstractAimTo explore clinical decision‐making by comparing the processes used by three groups of nurses in the emergency departments of three hospitals: in Norway, Finland and Ireland.BackgroundClinical decision‐making in an emergency department environment is a complex process often occurring in times of crisis. It is an important aspect contributing to the quality of care. However, empirical research is limited regarding the decision‐making process in different nursing roles.MethodsIn accordance with the consolidated criteria for reporting qualitative research, a qualitative and observational study was conducted to explore clinical decision‐making by comparing the processes used by three groups of nurses in the emergency departments of three hospitals: in Norway, Finland and Ireland. Six Registered Nurses, six Nurse Specialists and six Nurse Practitioners were observed. A total of 40 hours of observation was made at each setting according to a structured observation guideline, followed by clarifying questions. The data material was analysed by means of a qualitative manifest and latent content analysis.ResultsThree themes arose: acting in accordance with routines, previous experience and intuition; considering patient experience; and facilitating new alternatives based on critical thinking. The Registered Nurses mainly used the first approach, the Nurse Specialists used the first and the second approaches, and the Nurse Practitioners used all three approaches.ConclusionsThe results highlight the differences in decision‐making processes between these groups. Nurse Practitioners were the only group that facilitated and evaluated new alternatives using their clinical autonomy, such as stepping up and making independent and collaborative decision‐making.ImplicationThe results can be used in countries developing advanced practice nursing education and defining their scope of practice to inform stakeholders.
Tax enforcement and corporate cash holdings
Authors: Pang Jiaren , Wang Kun , Zhao Le 
Published: March 2024

AbstractStrengthened tax enforcement increases firms’ expected tax liabilities and uncertainty; thus, firms have incentives to hold more cash. Considering the staggered implementation of a new tax system that increases tax enforcement across provinces in China as a quasi‐natural experiment, we employ the difference‐in‐differences method to test the above prediction. The results indicate that stricter tax enforcement is associated with greater corporate cash holdings. This effect is stronger for financially constrained firms and those located in areas with high tax noncompliance penalties. Additionally, tax enforcement increases firms’ propensity to accumulate cash from cash flows and decreases capital expenditures and dividend payouts. The main findings are robust to the stacked difference‐in‐differences method, alternative cash holding measures and different sample selections.