bluuebunny/crossref_metadata_2025_split huggingface dataset:
Spatial distribution of Chikungunya cases in the state of Piauí – Brazil (2015-2019)
Authors: Lemos Matheus Henrique da Silva , Lopes Filho Lauro Lourival , Costa Maria Amélia de Oliveira , Araújo Dinah Alencar Melo , Soares Ticianne da Cunha , Silva Filipe Melo da , Pinto Raydelane Grailea Silva , Sousa Júnior Vicente de Paula 
Published: March 2024

This study aimed to analyze the spatial distribution of chikungunya cases in Piauí between 2015 and 2019. This was a spatial ecological study of notified and confirmed cases of chikungunya, with data from the Notifiable Diseases Information System (SINAN) from 2015 to 2019. The X² association test was applied for the bivariate analysis and the spatial analysis was performed from the data treatment to combine with the cartographic base in the free software Qgis (version 3.16.7 Hannover). During this period, 9596 cases and 7950 confirmed cases of chikungunya were reported. The city of Teresina (53.21%) and the health region Entre Rios (58.27%) had the highest records. Females (58.40%), aged between 20 and 34 years (29.63%) and mixed race (50.26%) were the most affected. Regarding education, 56.55% were ignored and, regarding the months of notification, the months of the 1st semester had the highest number of cases (62.8%). Chikungunya cases are concentrated in poles with large population flows. In this way, the identification of the epidemiological profile, as well as its main risk factors, is a way of helping the health system of the entire state in the elaboration of specific control policies for the population most vulnerable to the disease.
Orthopedic injuries in a tertiary hospital: an epidemiological and economic analysis of the implants used
Authors: Vieira Igor Fiorese , Vieira José Luiz Lopes , Ferreira Luciana , Schmiseila Eric , Silva Anitta Bittar e , Barreto Mateus Strazzi , Skrobot Sergio 
Published: March 2024

Identifying the cost and prevalence of orthopedic implants used to fix complex fractures. This is a retrospective study whose data analysis was carried out via a digital database from a tertiary trauma hospital in southern Brazil. A total of 481 fractures from 397 patients were included. In total, 479 orthopedic implants were used. Most patients were male (90.65%; n 364) with a mean age of 42.7 years. The lower limbs predominated in the sample with 90.44% prevalence (N = 435). The Ilizarov device was the most used implant (N = 61), mainly in fractures of the tibia diaphyseal region (N = 30), which was the most fractured bone region (N = 105). Considering this specific segment, the universal nail (N = 42) was the most used implant. The Ilizarov device showed the highest cost regarding the implants (6.33 times more expensive than the 3.5mm DCP implant - reference), whereas the femoral nail had an index of 6.09 and the tibial nail of 5.96. The use of conventional materials, that is, the ones with 4.5mm or 3.5mm, proved to be less expensive, however, less used in face of any orthopedic injury. The Ilizarov-type external fixator was the most expensive and most widely used device in the setting of complex orthopedic injuries.
Transitioning to Palliative Care in an Italian Cardiac Intensive Care Unit Network
Authors: Sacco Alice , Pagnesi Matteo , Frea Simone , Briani Martina , Dini Carlotta Sorini , Bertaina Maurizio , Marini Marco , Trombara Filippo , Villanova Luca , Ravera Amelia , Tavazzi Guido , Pappalardo Federico , Morici Nuccia , Potena Luciano 
Published: March 2024

Background
Recent data indicate that end-of-life management for patients affected by acute decompensated heart failure in cardiac intensive care units is aggressive, with late or no engagement of palliative care teams.

Objective
To assess current palliative care and end-of-life practices in a contemporary Italian multicenter registry of patients with cardiogenic shock due to acute decompensated heart failure.

Methods
A survey-based approach was used to collect data on palliative care and end-of-life management practices. The AltShock-2 registry enrolled patients with cardiogenic shock from 12 participating centers. A subset of 153 patients with cardiogenic shock due to acute decompensated heart failure enrolled between March 2020 and March 2023 was analyzed, with a focus on early engagement of palliative care teams and deactivation of implantable cardioverter-defibrillators (ICDs).

Results
“Do not resuscitate” orders were documented in patient records in only 5 of 12 centers (42%). Palliative care teams were engaged for 21 of 153 enrolled patients (13.7%). Among the 51 patients with ICDs, 6 of 17 patients who died (35%) had defibrillator deactivation. Of the 17 patients who died, 13 died in the hospital and 4 died within 6 months after discharge; 1 patient had ICD deactivation supported by palliative care services at home.

Conclusions
Therapy-limiting practices, including ICD deactivation, are not routine in the Italian centers participating in this study. The results emphasize the importance of integrating palliative care as a simultaneous process with intensive care to address the unmet needs of these patients and their families.
Hyperoxemia Induced by Oxygen Therapy in Nonsurgical Critically Ill Patients
Authors: da Silva Priscilla Barbosa , Fernandes Sérgio Eduardo Soares , Gomes Maura , da Silveira Carlos Darwin Gomes , Amorim Flávio Ferreira Pontes , de Aquino Carvalho André Luiz , Shintaku Lumie Sabanai , Miazato Laura Yumi , Amorim Felipe Ferreira Pontes , Maia Marcelo de Oliveira , Neves Francisco de Assis Rocha , Amorim Fábio Ferreira 
Published: March 2024

Background
Hyperoxemia, often overlooked in critically ill patients, is common and may have adverse consequences.

Objective
To evaluate the incidence of hyperoxemia induced by oxygen therapy in nonsurgical critically ill patients at intensive care unit (ICU) admission and the association of hyperoxemia with hospital mortality.

Methods
This prospective cohort study included all consecutive admissions of nonsurgical patients aged 18 years or older who received oxygen therapy on admission to the Hospital Santa Luzia Rede D’Or São Luiz adult ICU from July 2018 through June 2021. Patients were categorized into 3 groups according to Pao2 level at ICU admission: hypoxemia (Pao2&lt;60 mm Hg), normoxemia (Pao2= 60–120 mm Hg), and hyperoxemia (Pao2 &gt;120 mm Hg).

Results
Among 3088 patients, hyperoxemia was present in 1174 (38.0%) and was independently associated with hospital mortality (odds ratio [OR], 1.32; 95% CI, 1.04–1.67; P=.02). Age (OR, 1.02; 95% CI, 1.02–1.02; P&lt;.001) and chronic kidney disease (OR, 1.55; 95% CI, 1.02–2.36; P=.04) were associated with a higher rate of hyperoxemia. Factors associated with a lower rate of hyperoxemia were Sequential Organ Failure Assessment score (OR, 0.88; 95% CI, 0.83–0.93; P&lt;.001); late-night admission (OR, 0.80; 95% CI, 0.67–0.96; P=.02); and renal/metabolic (OR, 0.22; 95% CI, 0.13–1.39; P&lt;.001), neurologic (OR, 0.02; 95% CI, 0.01–0.05; P&lt;.001), digestive (OR, 0.23; 95% CI, 0.13–0.41; P&lt;.001), and soft tissue/skin/orthopedic (OR, 0.32; 95% CI, 0.13–0.79; P=.01) primary reasons for hospital admission.

Conclusion
Hyperoxemia induced by oxygen therapy was common in critically ill patients and was linked to increased risk of hospital mortality. Health care professionals should be aware of this condition because of its potential risks and unnecessary costs.
Impact of Virtual Reality Simulation on New Nurses’ Assessment of Pediatric Respiratory Distress
Authors: Raab Dana L. , Ely Kelly , Israel Keith , Lin Li , Donnellan Amy , Saupe Jennifer , Klein Melissa , Zackoff Matthew W. 
Published: March 2024

Background
Children often experience respiratory illnesses requiring bedside nurses skilled in recognizing respiratory decompensation. Historically, recognizing respiratory distress has relied on teaching during direct patient care. Virtual reality simulation may accelerate such recognition among novice nurses.

Objective
To determine whether a virtual reality curriculum improved new nurses’ recognition of respiratory distress and impending respiratory failure in pediatric patients based on assessment of physical examination findings and appropriate escalation of care.

Methods
New nurses (n = 168) were randomly assigned to complete either an immersive virtual reality curriculum on recognition of respiratory distress (intervention) or the usual orientation curriculum (control). Group differences and changes from 3 months to 6 months after the intervention were examined.

Results
Nurses in the intervention group were significantly more likely to correctly recognize impending respiratory failure at both 3 months (23.4% vs 3.0%, P &lt; .001) and 6 months (31.9% vs 2.6%, P &lt; .001), identify respiratory distress without impending respiratory failure at 3 months (57.8% vs 29.6%, P = .002) and 6 months (57.9% vs 17.8%, P &lt; .001), and recognize patients’ altered mental status at 3 months (51.4% vs 18.2%, P &lt; .001) and 6 months (46.8% vs 18.4%, P = .006).

Conclusions
Implementation of a virtual reality–based training curriculum was associated with improved recognition of pediatric respiratory distress, impending respiratory failure, and altered mental status at 3 and 6 months compared with standard training approaches. Virtual reality may offer a new approach to nurse orientation to enhance training in pediatrics-specific assessment skills.
Pre-operative Serum Albumin Predicts Native Liver Survival in Biliary Atresia
Authors: Machino Kakeru , Mimori Kotaro , Ogata Seiya , Minami Yosuke , Shimizu Hirofumi , Yamashita Michitoshi , Tanaka Hideaki 
Published: March 2024

Abstract

Background:
To predict native liver survival (NLS) after Kasai portoenterostomy (KP) for biliary atresia (BA) using pre-operative clinical data.

Materials and Methods:
Pre-operative data were collected from 29 patients with BA who underwent KP at our department between 1989 and 2017 and were analysed including serum albumin, bilirubin, prothrombin time-international normalised ratio, body height, body weight, age at KP, paediatric end-stage liver disease score calculated using the pre-operative data and the period of NLS.

Results:
The 10-year NLS rate of all patients was 51%. A multivariate analysis revealed that among all factors, the pre-KP serum albumin level was the only independent predictor of NLS (P = 0.04, hazard ratio = 0.269, 95% confidence interval = 0.077–0.934). The area under the receiver operating characteristic curve for NLS, determined using pre-KP serum albumin was 0.760 and 3.75 mg/dl was selected as the cut-off value. There was a significant difference in NLS between patients with high (≥3.8 mg/dl) and low (≤3.7 mg/dl) pre-KP serum albumin (90.0% vs. 31.5%, P < 0.01).

Conclusions:
Decreased pre-KP serum albumin may reflect not only functional impairment of the liver, but also the inflammatory process, which is hypothesized to occur during its advancement. The pre-KP serum albumin level may be a good prognostic factor for NLS in post-KP BA patients.
Tata Memorial Centre Evidence Based Use of Nuclear medicine diagnostic and treatment modalities in cancer
Authors: Puranik Ameya D. , Choudhury Sayak , Ghosh Suchismita , Dev Indraja D. , Ramchandani Varun , Uppal Abhishek , Bhosale Vikrant , Palsapure Abhishek , Rungta Rachita , Pandey Rakesh , Khatri Shweta , George Gemson , Satamwar Yogesh , Maske Rahul , Agrawal Archi , Shah Sneha , Purandare Nilendu C. , Rangarajan Venkatesh 
Published: March 2024

Abstract
PET/CT and radioisotope therapy are diagnostic and therapeutic arms of Nuclear Medicine, respectively. With the emergence of better technology, PET/CT has become an accessible modality. Diagnostic tracers exploring disease-specific targets has led the clinicians to look beyond FDG PET. Moreover, with the emergence of theranostic pairs of radiopharmaceuticals, radioisotope therapy is gradually making it’s way into treatment algorithm of common cancers in India. We therefore would like to discuss in detail the updates in PET/CT imaging and radionuclide therapy and generate a consensus-driven evidence based document which would guide the practitioners of Oncology.
Association between anti-Helicobacter pylori immunoglobulin G status and coronary artery disease among hypertensives: Myth or fact?
Authors: Subbiah Gowri , Periyannan Anushiya , Santhanakumarasamy Poongodi Lakshmi , Subramanian Surendar , Ramalingam Sumathi 
Published: March 2024

Abstract

Background:
Chronic persistent inflammation associated with Helicobacter pylori (H. pylori) infection accelerates vascular complications which are prone to cause atherogenesis and coronary artery disease (CAD). This study was undertaken to assess the significance of the association between H. pylori immunoglobulin G (IgG) serostatus and the occurrence of CAD among hypertensives.

Materials and Methods:
A total of 90 hypertensive subjects without stroke and CAD symptoms were tested for serum H. pylori IgG. Their electrocardiogram and echocardiogram (ECHO) outcomes were analyzed after 3 months.

Results:
Among the 90 subjects, 52 (57.8%) were H. pylori IgG positive. The adjusted odds ratio for abnormal ECHO outcome and H. pylori IgG positivity was 2.494. There was a positive correlation between H. pylori IgG positivity, sedentary lifestyle, alcoholism, and elevated serum C-reactive protein and abnormal ECHO findings suggestive of CAD.

Conclusions:
This study found a positive correlation between H. pylori IgG seropositivity and abnormal ECHO outcomes. The prevention of CAD with antimicrobial therapy for H. pylori is simple and innovative. Lifestyle modification and hand hygiene can obviate the adverse circumstances of CAD to some extent.
Scurvy: A Rare Disease or a Rare Diagnosis?
Authors: Gaieski David F. 
Published: March 2024

Introduction:
Scurvy, the disease state caused by ascorbic acid deficiency, was once an extremely common disease but is now thought to be a rare disease in postmodern societies. Physicians are not trained to consider scurvy as a possible diagnosis in patients at risk; rather, it is considered a rare diagnosis to add to a differential for completeness’s sake.

Methods:
We sought to describe the scorbutic patients seen by one physician during a busy academic emergency medicine career. Case series of patients seen by one physician between 1993 and 2023 at five academic teaching hospitals with Emergency Departments (EDs) in the mid-Eastern United States. Presenting signs and symptoms, known scurvy risk factors, Vitamin C levels, clinical course, and outcome for each patient are described.

Results:
There were 14 presentations by 12 patients diagnosed with scurvy who were initially evaluated in the ED between 1993 and 2023. Each patient had a known risk factor for inadequate Vitamin C intake. All had clinical findings suggestive of scurvy and all but one had a subnormal serum Vitamin C level detected on serum samples sent from the ED.

Conclusion:
The detection of 12 cases of scurvy by one physician over a three-decade period highlights the importance of screening for scurvy in at-risk populations and generates the hypothesis that scurvy is not a rare disease but rather a rare diagnosis. This research hypothesis should be investigated in further studies.
Global Perspectives on Innovations in Emergency Care during the COVID-19 Pandemic: A Mixed Methods Study
Authors: Visclosky Timothy , Funk Tara , Agubosim Chinonso , Chaou Chung-Hsien , Mahajan Prashant 
Published: March 2024

Introduction:
In mid-2020, the Emergency Medicine Education and Research by Global Experts (EMERGE) network surveyed the emergency response to the COVID-19 pandemic. We demonstrated that innovative measures were being generated at unprecedented rates. Our aim was to build on these findings to develop the first theoretical model with utility in assessing and developing emergency innovations.

Methods:
Phase 1 of a two-phase, explanatory sequential mixed methods study was a secondary analysis of the original EMERGE survey. Phase 2 involved follow-up interviews of a purposeful sample of 15 of the original survey respondents, representing 12 countries and all 6 World Health Organization regions. Thematic analysis was performed by three members of the research team.

Results:
Innovation is a nonlinear process in which ideas are developed, implemented, refined, and spread. Ideas grew from departmental needs or the spread of successful innovations from other sites. Development was highly localized, influenced by institutional and regional factors. Obtaining buy-in from relevant stakeholders and addressing various barriers were essential to implementation. The majority of innovations then underwent a process of evolution before some were spread to other institutions through a largely unidirectional flow of information.

Conclusions:
This study proposes the first model for emergency innovation processes and highlights multiple areas for improvement. Understanding how to prioritize departmental needs and the barriers may streamline development and implementation. Furthermore, the apparent unidirectional flow of information demonstrated by our participants suggests both an opportunity and a need for improved information systems. We present a framework for further research and an outline for innovation management.
Seizure Prophylaxis in Young Patients Following Traumatic Brain Injury
Authors: Bahey Ahmed Abdel-Aziz , Chughtai Talat , El-Menyar Ayman , Verma Vishwajit , Strandvik Gustav , Asim Mohammad , Consunji Rafael , Younis Basil , Parchani Ashok , Rizoli Sandro , Al-Thani Hassan 
Published: March 2024

Introduction:
Phenytoin is one of the commonly used anti.seizure medications in nontraumatic seizures. However, its utility and safety in young patients with traumatic brain injury (TBI) for the prevention of early-onset seizures (EOS) are debatable. We sought to explore the use of phenytoin as a seizure prophylaxis following TBI. We hypothesized that administering phenytoin is not effective in preventing EOS after TBI.

Methods:
This was a retrospective observational study conducted on adult TBI patients. EOS was defined as a witnessed seizure within a week postinjury. Data were compared as phenytoin versus no-phenytoin use, EOS versus no-EOS, and among TBI severity groups.

Results:
During 1 year, 639 TBI patients were included with a mean age of 32 years; of them, 183 received phenytoin as seizure prophylaxis, and 453 received no prophylaxis medication. EOS was documented in 13 (2.0%) patients who received phenytoin, and none had EOS among the nonphenytoin group. The phenytoin group was more likely to have a higher Marshall Score (P = 0.001), lower Glasgow Coma Scale (GCS) (P = 0.001), EOS (P = 0.001), and higher mortality (P = 0.001). Phenytoin was administrated for 15.2%, 43.2%, and 64.5% of mild, moderate, and severe TBI patients, respectively. EOS and no-EOS groups were comparable for age, gender, mechanism of injury, GCS, Marshall Score, serum phenytoin levels, liver function levels, hospital stay, and mortality. Multivariable logistic regression analysis showed that low serum albumin (odds ratio [OR] 0.81; 95% confidence interval [CI] 0.676.0.962) and toxic phenytoin level (OR 43; 95% CI 2.420.780.7) were independent predictors of EOS.

Conclusions:
In this study, the prophylactic use of phenytoin in TBI was ineffective in preventing EOS. Large-scale matched studies and well-defined hospital protocols are needed for the proper utility of phenytoin post-TBI.
“I Thought It [University] was the Only Way to Go:” Competent Agents in Pursuit of Possible Paths beyond University Walls
Authors: Soares Roberta , Magnan Marie-Odile , Liu Yifan 
Published: March 2024

This qualitative study documents the experiences of youths in Montréal during both their university and post-university phases, specifically focusing on individuals whose parents originate from the Caribbean, sub-Saharan Africa, or Latin America. Through semi-structured interviews with six youths who interrupted their university studies, our investigation employs the theory of structuration and the concept of intergenerational temporality. The findings illuminate the challenges these individuals face in deciphering the intricacies of the academic landscape and highlight their struggle to establish a genuine sense of belonging within the university environment. Furthermore, our analysis sheds light on the discernible impact of parental expectations, which contribute to prolonging their educational journey. Notably, following the interruption of their university studies, our examination accentuates the agency displayed by these youths beyond the confines of the university. Their choices to either reenroll in a college or technical program or directly enter the job market underscore their agency. In conclusion, we underscore the imperative need to deconstruct the prevailing university model, advocating for a paradigm shift that prioritizes adapting the educational system to the diverse needs of students. This approach, rooted in principles of equity and social justice, emphasizes the significance of reconfiguring the educational landscape to better serve the student body.
PUSAT PELESTARIAN DAN PENGEMBANGAN KESENIAN TRADISIONAL LOMBOK DI PRAYA
Authors: Ari Hidayat  , Made Mariada Rijasa  , Ayu Putu Utari Parthami Lestari  
Published: March 2024

Secara umum, kebudayaan NTB terdiri dari tiga suku asli utama, yakni suku sasak di Lombok, suku Mbojo di Bima dan Dompu, suku Samawa di Sumbawa. Kebudayaan suku sasak di Lombok mengalami penurunan minat generasi muda untuk menekuni kesenian tradisional. Untuk menyokong pelestarian dan pengembangan kesenian tradisional maka dibutuhkan gedung Pusat Pelestarian dan Pengembangan Kesenian Tradisional Lombok di Praya, karena jarangnya pertunjukan menyebabkan tradisi Lombok ini berangsur-angsur dilupakan sehingga kepandaian-kepandaian teknik tradisionil yang merupakan salah satu ciri kepribadian setempat, juga terdampak. Agar bisa merangkum kebudayaan Lombok, dan dapat mempermudah akses wisatawan untuk melihat sekaligus mengenal kebudayaan Lombok. Fasilitas ini juga bertujuan untuk memberi informasi sekaligus pengembangan, pelestarian dan juga memperkenalkan kebudayaan Lombok sesuai dengan aspek kebudayaan Lombok meliputi keseniaan serta bangunan adat Lombok merupakan bagian dari wujud kebudayaan. Melalui metode desktiptif pada studi kasus di taman budaya NTB.
Kata kunci: Pusat Kesenian, Kesenian tradisional Lombok, Neo Vernakular
PERLINDUNGAN TERHADAP ANAK YANG BERHADAPAN DENGAN HUKUM SEBAGAI RANGKAIAN DIVERSI
Authors: Jauhari Jauhari , Angga Arnando  , Apriansyah Kelvin , Wijaya Deden Prima Ido , Irawan Rama Dika , Pratama Septe Aji 
Published: March 2024

Abstrak
Upaya perlindungan hukum terhadap anak sebagai pelaku tindak pidana dalam proses penyidikan dalam rangkaian diversi. Undang-undang Sistem Peradilan Pidana Anak untuk melindungi dan mengayomi anak. Penghambatan dalam penyidikan memberikan perlindungan hukum terhadap anak yang menjadi pelaku tindak pidana dalam rangkaian diversi adalah Sistem Peradilan Pidana Anak sebagai dasar hukum materil ialah masih berlandaskan dengan hukum formil Kitab Undang-Undang Hukum Acara Pidana. Undang-Undang ini bermaksud agar Anak dapat menyongsong masa depannya yang masih panjang serta memberi kesempatan kepada anak agar melalui pembinaan yang diperoleh jati dirinya untuk menjadi manusia yang mandiri.
Kata Kunci: Perlindungan, Hukum, Anak, Diversi