bluuebunny/crossref_metadata_2025_split huggingface dataset:
Managing End of Life Care for the Critically Ill: A Novel Program to Deliver Bedside Critical Care Without Transfer to the Intensive Care Unit
Authors: Bass Kathryn , Gupta Rohit , Wells Celia , Ortiz Muriel Samantha , Hackett Anna , Ahmed Sanam , Kohli-Seth Roopa 
Published: March 2024

Background: Navigating medical care at the end of life can be a challenging experience for patients. There are also significant resource burdens, including intensive care unit (ICU) admissions, accompanying terminal illness. For actively dying patients, developing a care plan based on patient goals and delivering care at the bedside can enhance patient well-being, avoid inappropriate transfers or interventions, and improve resource management. Methods: The Rapid Response Team (RRT) is an around the clock intensivist service that responds to all acutely decompensating patients in our hospital. Through the Appropriate Care Escalation (ACE) program, the RRT intensivist identifies amongst decompensating patients, terminally ill individuals for whom prognosis is extremely poor irrespective of available interventions. These patients receive discussions about goals of care, code status, and management options. They receive care on a dedicated stepdown unit without escalation to the ICU. If aligned with patient goals, care plans incorporate critical care interventions including ventilator and vasopressor therapy. Results: Over 5 years, RRT identified 413 terminally ill patients under the ACE program to continue end of life care on the stepdown unit. Following discussions of goals, 60.8% of patients requested DNR/DNI, 30.9% were full code, and 8.5% requested DNR/OK-TO-INTUBATE status. At discharge, 82.1% of ACE patients expired compared to 23% of all RRT consultations. Patients received 233 critical care procedures at bedside including intubations, central access catheters and bronchoscopy. Conclusion: The ACE program helped identify, in real time, actively dying, terminally ill patients, establish patient goals, and expand critical care services outside the ICU.
The Effect of a Repeated Standardized Patient-Based End-of-Life Care Training Program on Nursing Students’ Knowledge, Attitudes, and Emotions Toward End-of-Life Patients
Authors: Çakmak Betül , Inkaya Bahar 
Published: March 2024

Background Sufficient knowledge of end-of-life care, positive attitudes, and emotions regarding death and dying are essential criteria for showcasing favorable palliative care educational results to undergraduate nursing students. However, nursing students have negative attitudes toward end-of-life care and know little about it. Aim This study aimed to examine the effect of a repeated standardized patient-based training program (intervention) on nursing students’ knowledge, attitudes, and emotions about end-of-life patients. Method This study adopted a pretest-posttest quasi-experimental research design. The sample consisted of 50 fourth-year nursing students divided into intervention (n = 25) and control (n = 25) groups. All participants attended the intervention. The intervention group attended the intervention twice, while the control group attended it only once. Data were collected using a personal information form, the Frommelt Attitudes Toward Care of the Dying Scale, the Positive and Negative Affect Schedule, and the End-of-Life Care Nursing Questionnaire. The data were analyzed using descriptive statistics, Pearson’s Chi-square test, dependent groups t test, Pearson-Spearman, Mann-Whitney test, Wilcoxon test, and Friedman test. Results The intervention helped participants learn more about end-of-life care (χ2 = 27.167, P = .000; F = 42.725, P = .000) and develop more positive attitudes toward end-of-life patients (F = 13.279, P = .000; F = 6.934, P = .000). The intervention also helped participants develop communication skills. Conclusion Universities should integrate repeated standardized patient-based into nursing curricula.
Strength and Functional Outcomes Following Achilles Tendon Reconstruction With Hamstring Tendon Autograft Augmentation
Authors: Eble Stephanie K. , Hansen Oliver B. , Kukadia Saanchi K. , Cho David J. , Kumar Prashanth , Papson Andrea K. , Drakos Mark C. 
Published: March 2024

Background: The proposed advantages of hamstring autograft reconstruction when compared to alternative procedures, such as flexor hallucis longus (FHL) transfer, V-Y lengthening, and allograft reconstruction, are improved healing and reproduction of normal tendon biomechanics and reduced morbidity within the foot and ankle. In this study, we examined the effect of Achilles tendon reconstruction using hamstring autografts on strength and functional outcomes. Methods: Patients who underwent Achilles repair with a hamstring autograft for insertional or midsubstance tendinopathy, delayed diagnosis of rupture, or infection after primary repair were evaluated for inclusion. Forty-six patients were identified; 12 further augmented with an FHL transfer are included in the analysis. Isokinetic testing was completed with a Biodex dynamometer under supervision of a physical therapist masked to surgical side. Pre- and postoperative Foot and Ankle Outcome Scores (FAOS, before March 2016) or Patient-Reported Outcomes Measurement Information System (PROMIS, after March 2016) surveys were collected. Results: For knee flexion, peak torque was not significantly different when comparing operative and nonoperative sides at 180 degrees/second (45.38 Nm vs 45.96 Nm; P = .69) nor at 300 degrees/second (44.2 Nm vs 47.02 Nm; P = .069). Knee extension absolute peak torque was only found to be significantly weaker on the operative side at the faster testing (75.5 Nm vs 79.56 Nm; P < .05). Peak ankle plantarflexion torque was significantly weaker on the operative side at both the slower speed (60 degrees/second: 39.9 Nm vs 48.76 Nm; P < .005) and the faster speed (120 degrees/second: 31.3 Nm vs 40.7 Nm; P < .001). Average power for ankle plantarflexion did not differ significantly from the operative side to the nonoperative side in the slower test (26.46 W vs 27.48 W; P = .60) but did significantly differ on the faster test (32.13 W vs 37.63 W; P = .041). At an average of 19.9 months postoperation, all physical function and pain-related patient-reported outcome scores showed clinically and statistically significant improvement. Conclusion: Achilles reconstruction with a hamstring autograft ± FHL transfer allowed patients with severe Achilles pathology to return to good subjective function, with modest deficits in calf strength compared with the uninjured side. Overall knee flexion strength did not appear impaired. These results suggest that hamstring autograft reconstruction is a viable method to treat these complex cases involving a lack of healthy tissue, allowing patients to return to symptom-free physical function and athletic activity. Level of Evidence: Level IV, case series.
Rotational thrombectomy versus balloon maceration in dialysis access salvage
Authors: Byun Jee Hyuk , Rennie Andrew , Huang Junjian , Raja Junaid 
Published: March 2024

Background: Although end stage renal disease patients who undergo hemodialysis frequently experience dialysis-associated thrombotic complications, there remains a paucity of literature comparing the efficacy of different endovascular salvage techniques for grafts and fistulas. This study aims to compare primary patency in dialysis access following salvage mechanical thrombolysis/thrombectomy with a rotational thrombolysis device versus balloon maceration. Methods: Using a database of patient records at a tertiary medical center, all patients who underwent rotational thrombectomy with the Cleaner XT™ Rotational Thrombectomy System for endovascular salvage of arteriovenous fistula or arteriovenous graft from August 2016 to July 2022 were included in the population. Fourteen patients who underwent balloon maceration for endovascular salvage were matched to the patients in the rotational thrombectomy group based on date of procedure. The primary patency of the fistula or graft for the two groups was measured. Results: A total of 13 patients who underwent dialysis access salvage with rotational thrombectomy (10 grafts, 3 fistulas) were matched with 14 patients who underwent balloon maceration for dialysis access salvage (10 grafts, 4 fistulas). Six patients in both groups required additional graft access salvage (46% rotational thrombectomy; 43% balloon maceration). The median time to next dialysis salvage was 51 days for rotational thrombectomy and 43.5 days for balloon maceration (W + 9, critical value 1; compatible with statistically significant difference). Conclusion: Endovascular access salvage by rotational thrombectomy may provide longer primary patency compared to salvage by balloon maceration. However, a longer follow-up prospective study of a larger study population is necessary to clarify the safety and efficacy of rotational thrombectomy using the Cleaner XT™ device.
Prognostic Significance of the Cachexia Index in Patients with Non-Small-Cell Lung Cancer and Brain Metastases after Stereotactic Radiotherapy
Authors: Xu Hui , Zhang Bin , Zhang Yongqian , Yang Chunchun , Bo Changwen , Guo Yuanyuan , Cheng Yuan , He Li 
Published: March 2024

Background: The cachexia index (CXI) has been proposed as a novel biomarker of cancer cachexia. We aimed to investigate the association between CXI and survival outcomes after stereotactic radiotherapy (SRT) in patients with non-small cell lung cancer (NSCLC) and brain metastases. Methods: Data from 145 patients with NSCLC, who underwent SRT for brain metastases between April 2016 and August 2020, were retrospectively analyzed. Cachexia index was calculated as skeletal muscle index (SMI) × serum albumin level/neutrophil-to-lymphocyte ratio, whereas SMI was calculated from computed tomography images captured at the L1 level. Kaplan-Meier curves and Cox proportional hazards models were used to assess progression-free survival (PFS) and overall survival (OS). The prognostic values of CXI and other cachexia biomarkers were assessed using receiver operating characteristic (ROC) curve analysis. Results: Lower pretreatment CXI (<30.8) was significantly associated with older age ( P = .039), lower Karnofsky performance score ( P = .009), and a high likelihood of extracranial metastases ( P = .001). Patients with a lower pretreatment CXI had a significantly shorter PFS and OS than those with a higher CXI ( P < .001). Multivariate analysis revealed that pretreatment CXI was an independent risk factor for both PFS, hazard ratio (HR) = 2.375; 95% confidence interval (CI) = 1.610-3.504; P < .001, and OS, HR = 2.340; 95% CI = 1.562-3.505; P < .001. Compared with other biomarkers, pretreatment CXI had the highest area under the ROC curve value for prognostic assessment, reaching 0.734. Moreover, the loss of CXI was a strong risk factor for survival independent of pretreatment CXI ( P = .011). Conclusions: Cachexia index may serve as a clinically useful tool for predicting survival outcomes of patients with NSCLC and brain metastases who undergo SRT.
Short report: Do parents use asynchronous materials in a hybrid coaching via telehealth intervention?
Authors: Wallisch Anna , Little Lauren M , Dunn Winnie , Tomchek Scott 
Published: March 2024

Telehealth is rapidly expanding; however, few studies have investigated hybrid models that include synchronous and asynchronous components. While research recognizes the importance of tailoring interventions to meet individual child needs, we have yet to understand how to tailor interventions to parent characteristics. This study examined how baseline parent characteristics ( n = 25) were related to asynchronous material usage in a hybrid coaching via telehealth intervention for potty training in children with autism. Results suggested that parents with lower baseline competence used the asynchronous materials more frequently than parents with higher baseline competence and were more likely to make greater gains in parent competence between pre- and post-intervention. There were no differences between groups on the acceptability of the intervention. Future research should examine multiple baseline parent characteristics in a larger sample to better understand how to tailor interventions to meet both parent and child needs. Lay abstract Using telehealth to provide services to families and children with autism has grown since the start of the COVID-19 pandemic. Yet, we still know less about telehealth models that use both virtual sessions and online materials to support families. Research suggests it is important to make sure an intervention matches the characteristics of a child with autism, but fewer studies have examined the importance of matching an intervention to parent characteristics. In this study, we looked at parent characteristics (25 parents included in the study) before a parent coaching telehealth intervention for potty training in autism. We specifically looked at how parent competence (i.e. how confident and effective one feels with parenting) levels before the intervention influenced the usage of online education materials (i.e. podcasts/tip sheets). Results suggested that parents with lower competence used the online materials more often than parents with higher competence, and often made greater gains in parent competence during the intervention. Both parents with lower and higher competence found the intervention acceptable. Future research should study additional parent characteristics in a larger sample to better understand how to tailor interventions to meet both parent and child needs.
Using music to assist language learning in autistic children with minimal verbal language: The MAP feasibility RCT
Authors: Williams Tim I , Loucas Tom , Sin Jacqueline , Jeremic Mirjana , Meyer Sina , Boseley Sam , Fincham-Majumdar Sara , Aslett Georgia , Renshaw Ruan , Liu Fang 
Published: March 2024

Music has been shown to improve social interaction and attention to verbal stimuli in autism. We report a feasibility randomised controlled trial of an online intervention using music-assisted programmes, compared with best-practice treatment (Social Communication Intervention for Pre-schoolers–Intensive) for language learning in preschool autistic children with minimal verbal language. Minimisation randomisation ensured comparability of groups before intervention. Ninety-one people expressed interest in taking part; 27 met eligibility criteria and were randomised to receive either music-assisted programmes or Social Communication Intervention for Pre-schoolers–Intensive. Children and their parent received two 45-min sessions weekly, over 18 weeks, coached online by a speech and language therapist. A smartphone app was developed to support home-based practice between sessions. Over the study period, 20% of participants completed the intervention and assessments of outcome measures. At 3 months post-intervention follow-up, social responsiveness, understanding of words and phrases and number of words spoken and parent–child interaction improved more in the music-assisted programmes than the Social Communication Intervention for Pre-schoolers–Intensive group. The results demonstrate the feasibility of recruiting this population into a randomised controlled trial and the music-assisted programmes had high perceived acceptability highlighted by parent interviews. A full clinical trial to establish music-assisted programmes’ effectiveness in improving early vocabulary learning in autistic children is warranted. Lay abstract Research has shown that autistic individuals often have unusually good musical skills and that combining words and music helps autistic individuals to focus on spoken words. This study tests the idea that music will help with early language learning of preschool autistic children. The results show that when caregivers sing words to autistic children, the children pay more attention to the caregiver than when the words are spoken and that they learn word combinations more easily.
Cross-language activation and semantic judgements of translation ambiguous words among Chinese–English bilinguals
Authors: Deng Ting , Schwieter John W. , Lv Huan , Zhang Yan , Yuan Jie , Wang Ruiming 
Published: March 2024

Aims and Objectives: Translation ambiguous words are lexical items with one-to-many equivalents in another language. Some of these equivalents are more dominant (i.e., more frequently used) than others. The aim of the present study is to explore non-target language activation of translation ambiguous words among Chinese–English bilinguals. Methodology: The implicit priming paradigm was used in three experiments to explore the activation of primary and secondary first language (L1) translations when bilinguals process second language (L2) translation ambiguous words (Experiment 1); the effect of L1 translation repetition on the processing of semantically related words in an L2 (Experiment 2); and whether such patterns are observed in the reverse direction, that is, whether L2 primary translations are activated when processing L1 translation ambiguous words (Experiment 3). Data and Analysis: We use repeated measures analyses of variance (ANOVAs) to analyse the data. Findings/conclusions: Experiment 1 showed that when processing pairs of semantically unrelated (SU) L2 words, primary L1 translation equivalents are activated, but not secondary L1 translation equivalents. Experiment 2 found that when the target L2 words were semantically related, performance was facilitated when their translation equivalents were the same L1 word (i.e., implicitly repeated). Similarly, Experiment 3 showed that when processing L1 words, the L2 translation equivalents are automatically activated. Moreover, under semantically related conditions, implicit repetition of the non-target L2 translation facilitated L1 judgements, while under SU conditions, L2 implicit repetition hampered L1 judgements. Originality: Most research on cross-language activation has examined L1 activation during L2 processing. However, few have investigated the reverse and findings from these few studies are inconsistent. Moreover, research on cross-language activation has mainly investigated the activation of primary translation equivalents, with very little focus on secondary translations. The present study uses the implicit priming paradigm to address these gaps in the literature. Significance: The findings support interactive theories of bilingual processing.
Connecting cohorts of Finnish biobanks creates a research resource for the study of healthy ageing
Authors: Eklund Niina , Pätsi Salla-Maaria , Lehtiniemi Heli , Rohkimainen Samppa , Kivelä Juha , Öhman Hanna , Sauramo Minttu , Sutinen Kyösti , Keskinarkaus Anja , Terho Perttu , Seppänen Tapio , Nyberg Pia , Männikkö Minna , Silander Kaisa 
Published: March 2024

Aims: Connecting cohorts with biobanks is a Finnish biobank collaboration, creating an infrastructure for the study of healthy ageing. We aimed to develop a model for data integration and harmonisation between different biobanks with procedures for joint access. Methods: The heart of the collaboration is the integrated datasets formed by using data from three biobanks: (a) Arctic Biobank, hosting regional birth cohorts and cohorts of elderly; (b) hospital-affiliated Borealis Biobank of Northern Finland; and (c) THL Biobank, hosting population-based cohorts. The datasets were created by developing a data dictionary, harmonising cohort data and with a joint pseudonymisation process. Results: The connecting cohorts with biobanks resource at its widest consists altogether of almost 1.4 million individuals from collaborating biobanks. Utilising data from 107,000 cohort participants, we created harmonised datasets that contain attributes describing metabolic risk and frailty for studies of healthy ageing. These data can be complemented with medical data available from Biobank Borealis and with samples taken at hospital settings for approximately 38,000 cohort participants. In addition, the harmonised connecting cohorts with biobanks datasets can be expanded with supplementary data and samples from the collaborating biobanks. Conclusions: The connecting cohorts with biobanks datasets provide a unique resource for research on ageing-related personalised healthcare and for real-world evidence studies. Following the FAIR principles on findability, accessibility, interoperability, and reusability, the reused and harmonised datasets are findable and made accessible for researchers. The same approach can be further utilised to develop additional datasets for other research topics.
Incidence of Septic Arthritis After Vancomycin Soaking of the Graft During Arthroscopic Anatomic Anterior Talofibular Ligament and Calcaneofibular Ligament Reconstruction
Authors: Rougereau Grégoire , Kassab Hassan Sammy , Valentin Eugénie , Jehan Sacha , Bauer Thomas , Baudrier Nicolas , Hardy Alexandre 
Published: March 2024

Background: Vancomycin soaking of the graft during arthroscopic anterior cruciate ligament reconstruction has been shown to be effective in reducing the rate of postoperative infection. Purpose/Hypothesis: The present study aimed to (1) analyze the effect of vancomycin-soaked grafts during arthroscopic anatomic reconstruction of the anterior talofibular ligament (ATFL) and the calcaneofibular ligament (CFL) on the incidence of infection and (2) evaluate the influence of infection on functional outcomes and identify the risk factors of infection. It was hypothesized that vancomycin soaking of the graft would reduce the postoperative infection rate. Study Design: Cohort study; Level of evidence, 3. Methods: Consecutive patients at 2 centers who underwent ATFL/CFL reconstruction between December 2011 and July 2022 were included. All patients had undergone anterolateral arthroscopic debridement of the ankle and anatomic ATFL/CFL reconstruction with a gracilis tendon autograft. Vancomycin soaking of the graft was begun in both centers in January 2021. Complications, functional scores, return to sports (RTS) rates, and the level of return were compared between patients with and without vancomycin-soaked grafts and between patients with and without infection. Results: Overall, 182 patients (48% men; mean age, 34 ± 11.9 years) were included, with a mean follow-up of 23 ± 16.1 months. The rate of postoperative infection was significantly lower in the group with vancomycin soaking versus without (0/92 [0%] vs 8/90 [8.9%]; P = .001). At the final follow-up, there were 26 complications (14.3%): 8 infections, 6 recurrent tears, and 12 peripheral neuropathies. The infections developed after a mean of 17 ± 11 days. The functional scores were excellent at the final follow-up (American Orthopaedic Foot and Ankle Society [AOFAS] Ankle-Hindfoot Score, 86.5 ± 18.7; Karlsson score, 85 ± 18.3). Patients with infection had significantly decreased AOFAS scores (52.8 ± 27.6 vs 83.3 ± 21.5; P = .003), Karlsson scores (57 ± 27.7 vs 83.6 ± 20; P = .006), and RTS rates (25% vs 77%; P = .005) versus patients without infection. Conclusion: Vancomycin-soaked grafts for arthroscopic anatomic ATFL/CFL reconstruction decreased the rate of postoperative infection. Infection led to a deterioration in results. Vancomycin-soaking of the graft did not have a negative effect on functional results.