bluuebunny/crossref_metadata_2025_split huggingface dataset:
Using a LOng peripheral intraVEnous catheter with retractable guidewire to optimize first-insertion success for patients with Difficult IntraVenous Access in the emergency department (LOVE-DIVA): a study protocol for a randomized controlled trial
Authors: Xu Hui (Grace) , Corley Amanda , Ware Robert S. , Nghiem Son , Stirling Scott , Wang Carrie , Marsh Nicole 
Published: April 2024

Introduction: First-insertion success rates for peripheral vascular access devices (PVADs) in patients with difficult venous access (DIVA) are low, which negatively affects staff workload, patient experience, and organizational cost. There is mixed evidence regarding the impact of a peripheral vascular access device with retractable coiled tip guidewire (GW; AccuCath™, BD) on the first-insertion success rate. The aim of this study is to investigate whether the use of long GW-PVADs, compared with standard PVADs, reduces the risk of first-time insertion failure, in patients admitted to emergency departments (EDs). Methods and analysis: A parallel-group, two-arm, randomized controlled trial will be carried out in two Australian EDs to compare long GW-PVADs (5.8 cm length) against standard care PVADs (short or long). Patients ≥18 years of age meeting DIVA criteria will be eligible for the trial. The sample size is 203 participants for each arm. Web-based central randomization will be used to ensure allocation concealment. Neither clinicians nor patients can be blinded to treatment allocation. Primary outcome is the first-insertion success rate. Secondary outcomes include the number of insertion attempts, time to insert PVAD, all-cause failure, dwell-time, patient-reported pain, serious adverse events, complications, subsequent vascular access devices required, patient satisfaction, staff satisfaction, and healthcare costs. Differences between the two groups will be analyzed using Cox proportional hazards regression. Cost-effectiveness analysis will also be conducted. Intention-to-treat analysis will be used. Ethics and dissemination: The study is approved by Metro South Ethics Committee (HREC/2022/QMS/82264) and Griffith University (2022/077). The findings will be published in a peer-reviewed journal. Trial registration: ACTRN12622000299707
Establishing a plan to improve pediatric patient comfort during PIV insertions and blood specimen collection: a quality improvement effort
Authors: Lorenc Jamie , Flaucher Nicholas , Evans Emily , Schurman Jennifer V 
Published: April 2024

HIGHLIGHTS Patient comfort during peripheral intravenous (PIV) insertion and specimen collection was increased. The authors extended the contingency plan implemented for PICC insertion to include PIV insertion and specimen collection. The authors met their goals by using quality improvement methodology. Prioritizing patient comfort often requires institutional culture change. Background: Needle procedures can cause pain and distress, especially in pediatric patients. 1 Retrospective data collected at a freestanding pediatric facility revealed that approximately 30% of pediatric patients were not demonstrating sufficient levels of comfort during peripheral intravenous (PIV) catheter insertion and specimen collection (lab draws) even after successful implementation of comfort measures by the vascular access team (VAT) in an adjacent procedure (eg peripherally inserted central catheter placement). The current quality improvement project was implemented to support adaptation and expansion of previous lessons learned to PIVs and lab draws specifically. Design and Methods: The VAT used the Pediatric Sedation State Scale, 2 a standardized assessment tool integrated into the electronic medical record, to assess procedural comfort during PIVs and lab draws from February 2021 through April 2023. A total of 24 134 patients aged 0 to 18 years were included in the data collection. Interventions were delivered concurrently and included (1) reeducation/ongoing support for implementation of the Comfort Promise 3 measures, (2) the creation and implementation of advanced comfort options, and (3) culture change. Aims and Objectives: The goal of the interventions was to improve the percentage of pediatric patients achieving adequate levels of comfort beginning at 68% in year 1 to 90% in year 2. Results: From February 2021 to April 2023, the VAT team was able to improve procedural comfort scores from 68% to 90% of pediatric patients with adequate comfort for lab draws and/or PIV insertions. Conclusions: While standard comfort measures are a good first step in pain management during needle procedures, they are not sufficient for every pediatric patient. Nitrous, sedation, and the use of anxiolytics and analgesics can play an important role in reducing pain and anxiety during needle procedures and should be considered for patients not achieving adequate levels of comfort with standard comfort measures.
MPLC-based low-modal-crosstalk nine-mode-group demultiplexer for DSP-free IM/DD MDM transmission over MMF
Authors: Cui Jian , Deng Yu , Liu Zhuo , Hao Bin , Wu Chao , Tan Daiwei , Jiang Ming , Zhang Leimin , Chen Zhangyuan , He Yongqi , Li Juhao , Wan Qi 
Published: April 2024

Weakly coupled mode-division multiplexing (MDM) transmission over legacy laid multimode
fiber (MMF) has great economic efficiency and can enormously enhance
the capacity of short-reach optical interconnections. In order to be
compatible with cost-efficient intensity-modulation/direct-detection
(IM/DD) transceivers, weakly coupled mode-group demultiplexers that
can simultaneously receive each mode group of MMFs are highly desired.
In this paper, we propose a scalable low-modal-crosstalk mode-group
demultiplexer over MMF based on multiplane light conversion (MPLC).
Multiple input Hermite–Gaussian (HG) modes of MMF are first converted
to bridging modes that are composed of HG00 modes distributed as a right-angle
triangle in Cartesian coordinates, and then each HG00 mode belonging to a degenerate mode
group is mapped to different overlapped HGn0 modes with vertical orientation for
simultaneous detection. With the help of bridging modes, the
MPLC-based mode-group demultiplexer can efficiently demultiplex all
mode groups in standard MMFs with less than 20 phase masks. A
nine-mode-group demultiplexer is further designed for demonstration,
and simulation results show that the MPLC-based demultiplexer achieves
low modal crosstalk of lower than −22.3dB at 1550 nm and lower than −17.9dB over the C-band for all the nine mode
groups with only 16 phase masks.
Broadband photoelectric fusion transceiver-multiplexed conversion system with high spurious rejection
Authors: Wang Hanyu , Zhao Zeping , Hu Zijian , Wang Chaoquan , Liu Jianguo , Zhang Weijie 
Published: April 2024

In this paper, a broadband photoelectric fusion transceiver-multiplexed system is
proposed to realize a frequency converter. The system achieves a high
spurious suppression ratio through two frequency conversions that
utilize the advantages of microwave and photonics technology
simultaneously to reduce the complexity of the system and improve the
effective spectrum utilization. In addition, the core components, such
as the Mach–Zehnder modulator (MZM), are multiplexed in the up and
down frequency conversion link. High-frequency local oscillator (LO)
signals are used to keep image frequency signals and various kinds of
spurious signals obtained by beating frequency outside the system
bandwidth. Experimental results demonstrate that the operating
frequency ranges from 2 to 18 GHz with high performance
for both transmitter and receiver. The image rejection is
57.35 dB for up-conversion and 46.56 dB for
down-conversion, and the in-band spurious suppression achieves at
least 55.02 dB. At the same time, the spurious-free dynamic
range (SFDR) can reach at least 89.11dB⋅Hz2/3.
Cardiovascular risk of veterans’ football: An observational cohort study with follow-up
Authors: Egger Florian , Schilling Tilman , Baumann Sybille , Meyer Tim , Scharhag Jürgen 
Published: April 2024

Background
The cardiac stress for veteran football players during match is considerable. In this specific elderly population, the kinetics of exercise-induced cardiac troponin I (cTnI) and B-Type natriuretic peptide (BNP) could potentially be related to cardiovascular risk factors (CVRF) and cardiovascular disease and are therefore be investigated for their usefulness as an complement to established screening measures.

Methods
cTnI and BNP was measured in 112 veteran football players (age: 51 ± 10 years) within 30 minutes pre- and post-match. Players with elevated cTnI (cTnI-positive) and a control group (out of the 112 veteran players) with normal cTnI (cTnI-negative) underwent cardiac follow-up 4.2 ± 3.5 months post-match, comprising history, resting and stress ECG (including 30 minutes pre- and post cTnI and BNP), and echocardiography.

Results
In 33 players (29%) cTnI and in 6 players BNP (5%) exceeded the upper range limit for increased risk of myocardial damage (cTnI ≥ 5 ng/l) and myocardial wall stress (BNP ≥ 100 pg/ml) post-match, respectively. No correlation was observed between Δ cTnI (pre- vs. post-match) and the number of CVRF (r = -0.06, p = 0.50). Follow-up was conducted in 62 players (31 cTnI-positive and 31 cTnI-negative players) of which 6 (10%, 3 cTnI positive and 3 cTnI negative players) had cardiac abnormalities (hypertrophic cardiomyopathy n = 2, coronary artery disease n = 2, coronary artery anomaly n = 1, hypertensive heart disease n = 1).

Conclusion
Veterans’ football matches elicit increases in BNP and particularly cTnI in a considerable number of players. However, these biochemical alterations do not indicate acute cardiac damage as evidenced by follow-up. Routine determination of cardiac biomarkers is unlikely to improve cardiovascular screening in veteran football players.
Qualitative assessment of knowledge, attitude and practice of oncologists about precision medicine in cancer patients- study from Lahore, Pakistan
Authors: Naaem Rida , Hashmi Furqan Khurshid , Yaqub Sulaman , Mohamed Noor Dzul Azri 
Published: April 2024

Background
Precision medicine (PM) is in great progressive stages in the West and allows healthcare practitioners (HCPs) to give treatment according to the patient’s genetic findings, physiological and environmental characteristics. PM is a relatively new treatment approach in Pakistan Therefore, it is important to investigate the level of awareness, attitude, and challenges faced by oncology physicians while practicing PM for various therapies, especially cancer treatment.

Objectives
The present study aims to explore the level of awareness, attitude, and practice of PM in Pakistan along with the challenges faced by the oncologists for the treatment of cancer using the PM approach.

Methods
Phenomenology-based qualitative approach was used. Face-to-face in-depth interviews were conducted using the purposive sampling approach among oncologists in Lahore, Pakistan. The data were analyzed using thematic content analysis to identify themes and sub-themes.

Results
Out of 14 physicians interviewed 11 were aware of PM. They were keen on training to hone their skills and agreed on providing PM. Oncologists believed PM was expensive and given to affluent patients only. Other impeding factors include cost, lack of knowledge, and drug unavailability.

Conclusions
Despite basic knowledge and will to practice, resource and cost constraints were marked as significant barriers. Additional training programs and inclusion into the curriculum may help to pave the way to PM implementation in the future. In addition, health authorities and policymakers need to ensure a cheaper PM treatment can be made available for all cancer patients.
Effectiveness of ChAdOx1 nCoV-19 and BBIBP-CorV vaccines against COVID-19-associated hospitalisation and death in the Seychelles infected adult population
Authors: Theresa Pool Sylvie Nadine , Shroff Emelyn Helen , Chetty Agnes , Lewis Lara , Nonhlanhla Yende-Zuma , Abdool Karim Salim S. 
Published: April 2024

Background
The Seychelles COVID-19 vaccination campaign was initiated using two different vaccines during the first wave of the pandemic in 2021. This observational study estimated vaccine effectiveness against severe outcomes (hospitalisation and/or death) from individuals infected with COVID-19 in the Seychelles adult population during Beta and Delta variant transmission.

Methods
This nationwide retrospective cohort study included all Seychellois residents aged ≥ 18 years who tested positive by RT-PCR or rapid antigen test for COVID-19 between January 25, 2021, and June 30, 2021. We measured the relative risk (RR) of laboratory-confirmed SARS-CoV-2 hospitalisation and/or death among individuals partially or fully vaccinated with ChAdOx1 nCoV-19 (SII Covishield) or BBIBP-CorV (Sinopharm) vaccines compared to unvaccinated individuals using modified Poisson regression. Controlling for age, gender and calendar month, vaccine effectiveness was estimated as 1-RR ≥14 days after the first dose and ≥7 days after the second dose for each available vaccine versus an unvaccinated control group.

Results
A total of 12,326 COVID-19 infections were reported in adult Seychellois residents between January 25, 2021, and June 30, 2021. Of these, 1,287 individuals received one dose of either BBIBP-CorV (Sinopharm) or ChAdOx1-nCoV-19 (SII Covishield) vaccine, and 5,225 individuals received two doses. Estimated adjusted effectiveness of two doses of either Sinopharm or SII Covishield was high, at 70% (95% CI 58%–78%) and 71% (95% CI 62%–78%) respectively. Sinopharm maintained high levels of protection against severe outcomes in partially vaccinated individuals at 61% (95% CI 36%–76%), while the effectiveness of one dose of SII Covishield was low at 29% (95% CI 1%–49%).

Conclusions
This observational study demonstrated high levels of protection of two doses of two vaccine types against severe outcomes of COVID-19 during the first wave of the pandemic driven by Beta (B.1.351) and Delta (B.1.617.2) variant predominance. One dose of ChAdOx1-nCoV-19 (Covishield SII) was found to be inadequate in protecting the general adult population against hospitalisation and/or death from COVID-19.
Development and web deployment of prediction model for pulmonary arterial pressure in chronic thromboembolic pulmonary hypertension using machine learning
Authors: Matsunaga Takaaki , Kono Atsushi , Nishio Mizuho , Yoshii Takahiro , Matsuo Hidetoshi , Takahashi Mai , Takahashi Takuya , Taniguchi Yu , Tanaka Hidekazu , Hirata Kenichi , Murakami Takamichi 
Published: April 2024

Background and purpose
Mean pulmonary artery pressure (mPAP) is a key index for chronic thromboembolic pulmonary hypertension (CTEPH). Using machine learning, we attempted to construct an accurate prediction model for mPAP in patients with CTEPH.

Methods
A total of 136 patients diagnosed with CTEPH were included, for whom mPAP was measured. The following patient data were used as explanatory variables in the model: basic patient information (age and sex), blood tests (brain natriuretic peptide (BNP)), echocardiography (tricuspid valve pressure gradient (TRPG)), and chest radiography (cardiothoracic ratio (CTR), right second arc ratio, and presence of avascular area). Seven machine learning methods including linear regression were used for the multivariable prediction models. Additionally, prediction models were constructed using the AutoML software. Among the 136 patients, 2/3 and 1/3 were used as training and validation sets, respectively. The average of R squared was obtained from 10 different data splittings of the training and validation sets.

Results
The optimal machine learning model was linear regression (averaged R squared, 0.360). The optimal combination of explanatory variables with linear regression was age, BNP level, TRPG level, and CTR (averaged R squared, 0.388). The R squared of the optimal multivariable linear regression model was higher than that of the univariable linear regression model with only TRPG.

Conclusion
We constructed a more accurate prediction model for mPAP in patients with CTEPH than a model of TRPG only. The prediction performance of our model was improved by selecting the optimal machine learning method and combination of explanatory variables.
Mainstreaming Gays: Critical Convergences of Queer Media, Fan Cultures, and Commercial Television, Eve NG (2023)
Authors: O’Meara Damien 
Published: April 2024

Review of: Mainstreaming Gays: Critical Convergences of Queer Media, Fan Cultures, and Commercial Television, Eve NG (2023)
Rutgers University Press, 212 pp.,
ISBN 978-1-97883-133-9, p/bk, USD 32.95
Endoscopic Ultrasound-Guided Coil Embolization of Refractory Rectal Dieulafoy Bleeding
Authors: Mai Hugh D. , Panicker Linoj , Restrepo Alexander , Proenza Jose L. , Aaron Hayden , Scott Curtis E. 
Published: April 2024

ABSTRACT
Hematochezia due to recurrent bleeding from rectal Dieulafoy can be challenging for endotherapy. We report the first case of successful endoscopic ultrasound-guided coil embolization of a feeding arteriole to the peripheral Dieulafoy vessels in the region of a colorectal anastomosis. The patient presented with recurrent lower gastrointestinal hemorrhage despite multiple previous conventional endoscopic treatment modalities.
Bleeding Mass in Remnant Stomach, Unveiling Lynch Syndrome 18 Years After Bariatric Roux-En-Y Gastric Bypass Surgery
Authors: Qazi Adam , Mathur Karan , Rosen Ryan D. , Stroud Alyssa , Webber John , Mutchnick Milton 
Published: April 2024

ABSTRACT
There is sparse literature on the development of malignancy in remnant gastric stomach after bariatric Roux-en-Y gastric bypass surgery. We report a case of overt upper gastrointestinal bleeding from malignant adenocarcinoma in the remnant stomach presenting several years after bariatric Roux-En-Y gastric bypass surgery. The mass in the remnant stomach was surgically resected, and the patient was subsequently diagnosed with Lynch syndrome on genetic analysis.
Instrumento para potenciar nociones intuitivas del cálculo de volúmenes desde la perspectiva de los indivisibles de Cavalieri
Authors: Pinilla Castañeda Angie Daniela , Díaz Hernández Alejandra , Castellanos Gámez Cristian Daniel 
Published: April 2024

La enseñanza sistemática y teórica que se ha dado del cálculo en la educación básica y media, responde principalmente al uso y memorización de fórmulas matemáticas totalmente formales, inconexas de la realidad y faltantes de una significativa comprensión, ante esta situación, el presente artículo centra su interés en diseñar un Instrumento manipulativo tangible bajo la perspectiva histórica de Cavalieri, que promueva actividades matemáticas e ideas intuitivas hacia procesos de aprendizaje significativo de la integral respecto al cálculo y comparación de volúmenes a partir de "indivisibles"; caracterizando e interpretando los procesos intuitivos en la enseñanza de la integral, así como las actividades matemáticas emergentes. Desde una metodología cualitativa e interpretativa, se aplicó el recurso sobre un grupo de estudiantes de grado once, mediados por diferentes actividades y preguntas orientadoras a lo largo del estudio, que generaron discusión y evidencias de nociones primarias de: límite, infinito (potencial y actual) e infinitesimal vinculadas a la caracterización epistémica de la integral, al dejarse guiar por la percepción y manipulación, asimismo, se expresaron algunas generalizaciones en cuanto al cálculo de volúmenes. Finalmente, se considera que fomentar el uso no solo del recurso diseñado, sino de cualquier tipo de instrumento cuya construcción y manipulación involucren una reflexión histórico epistémica consciente o inconsciente, genera en los sujetos perspectivas inicialmente intuitivas que potencializan los significados asociados a la integral para el cálculo de volúmenes, dotando igualmente de diferentes sistemas de representación los múltiples conceptos matemáticos puestos en juego para dar respuesta a las preguntas orientadoras durante el desarrollo de la actividad propuesta.
Uncovering sympathetic nervous system dysfunction in disorders of consciousness via heart rate variability during head‐up tilt test
Authors: Cai Weiqiang , Han Xu , Tang Xinwei , Cao Zuojun , Yu Zi , Sun Zuowen , Wu Junfa , Wu Yi , Xie Hongyu 
Published: April 2024

AbstractFew standardized tools are available for evaluation of disorders of consciousness (DOC). The potential of heart rate variability (HRV) during head‐up tilt (HUT) test was investigated as a complementary evaluation tool. Twenty‐one DOC patients and 21 healthy participants were enrolled in this study comparing clinical characteristics and HRV time‐ and frequency‐domain outcomes and temporal changes during HUT test. During the 1st–5th min of the HUT, DOC group showed a significant increase and decrease in log low frequency (LF) (p = 0.045) and log normalized high frequency (nHF) (p = 0.02), respectively, compared to the supine position and had lower log normalized LF (nLF) (p = 0.004) and log ratio of low‐to‐high frequency (LF/HF) (p = 0.001) compared to healthy controls. As the HUT continued from the 6th to the 20th min, DOC group exhibited a significant increase in log LF/HF (16th–20th min) (p < 0.05), along with a decrease in log nHF (6th–10th and 16th–20th min) (p < 0.05) and maintained lower log LF, log nLF, and log LF/HF than controls (p < 0.05). 1st–10th min after returning to the supine position, DOC group demonstrated a significant decrease in log nHF (p < 0.01) and increases in log LF/HF (p < 0.01) and had lower log LF (p < 0.01) and log nLF (p < 0.05) compared to controls. In contrast, the control group exhibited a significant decrease in log nHF (p < 0.05) and increase in log LF/HF (p < 0.05) throughout the entire HUT test. Notably, no significant differences were observed when comparing time‐domain outcomes reflecting parasympathetic nervous system between the two groups. HRV during HUT test indicated a delayed and attenuated autonomic response, particularly in the sympathetic nervous system, in DOC patients compared with healthy individuals.
Auschwitz Survivor and Nobel Prize of Peace, Élie Wiesel as Theologian
Authors: de Saint Cheron Michaël 
Published: April 2024

Abstract
This article examines the life and work of Elie Wiesel (1928–2016), a Francophone writer of Romanian origin, Auschwitz-Birkenau survivor, American citizen, Nobel Peace Prize laureate of 1986. It specifically explores Wiesel’s complex engagement with the divine and the faith, which remained a central concern throughout his life, following his return from the Nazi extermination camps. This is most evident in his seminal book, Night, where he recounts the experience of God’s death in the death camps. Despite such profound crisis of faith, Wiesel remained a deeply religious Jew till the end. On the 16 July 2006, Oprah Winfrey dedicated her Book Club to The Night and called it “one of the greatest books of the century”. More than 3 million copies were sold in a few weeks in the United States. This study proposes that Wiesel’s confrontation with the divine can be best understood through his response to mysticism, expressed as a spiritual song of a fervent yet torn soul. It further suggests that his rejection of Nietzsche’s proclamation of “God’s death” and his alignment with Rabbi Nachman of Bratslav’s idea of a “broken faith” underscores his profound spiritual resilience.