bluuebunny/crossref_metadata_2025_split huggingface dataset:
The use of procedural kits may reduce unscheduled central line dressing changes: A matched pre–post intervention study
Authors: Bahl Amit , Mielke Nicholas , Gibson Steven Matthew , George Julie 
Published: February 2024

Background Unscheduled dressing changes for central venous lines (CVLs) have been shown to increase the risk of bloodstream infections. Objective The objective of this study is to determine if the use of an innovative dressing change kit reduces the rate of unscheduled dressing changes. Methods This pre–post interventional study took place at a large, academic, tertiary care center in metro Detroit, Michigan, the United States. We assessed the impact of the interventional dressing change procedure kit on the rate of unscheduled dressing changes for adult patients who underwent placement of a CVL inclusive of a central catheter, peripherally inserted central catheter, or hemodialysis catheter. Data was collected for the pre-intervention cohort through electronic health records (EHRs), while data for the post-intervention cohort were collected by direct observation by trained research staff in combination with EHR data. The primary outcome was the rate of unscheduled dressing changes. Secondary outcomes included rate of unscheduled dressing changes based on admission floor type, etiology of unscheduled dressing changes, and central line-associated bloodstream infections (CLABSIs). Results The study included a convenience sample of 1548 CVLs placed between May 2018 and June 2022 with a matched analysis including 488 catheters in each of the pre- and post-intervention groups. The results showed that the unadjusted rate of unscheduled dressing evaluations was significantly reduced from the pre-intervention group (0.21 per day) to the post-intervention group (0.13 per day) ( p < .001). The adjusted rate ratio demonstrated the same trend at 1.00 pre- and 0.60 post-intervention ( p < .001). Stratifying the analysis based on the highest level of care showed that the intervention was effective in reducing the unadjusted rate of unscheduled dressing evaluations for both the advanced and regular medical floor subgroups pre- to post-intervention; the advanced subgroup had an reduction from 0.22 to 0.15 per day ( p = .001), while the regular medical floor subgroup had a reduction from 0.21 to 0.09 per day ( p < .001). CLABSIs were similar in both groups (0.6% vs 0.8%; p = 1.00) in pre- and post-intervention groups, respectively. Discussion Procedural kits for central line dressing changes are effective in reducing unscheduled dressing changes and may have a role in reducing CLABSI. Further studies assessing the impact of dressing change kits on cost, procedural compliance, and the precise impact on CLABSI are needed.
Management and subsequent outcomes of patellar sleeve injuries: A retrospective case series of 90 pediatric and adolescent patients
Authors: Yellin Joseph L , Feroe Aliya G , Watkins Ian T , Franco Helena , Guevel Borna , Haber Daniel B , Kocher Mininder S 
Published: February 2024

Purpose: This study aims to report the epidemiology of patellar sleeve injuries, describe diagnostic findings and treatment, and assess functional outcomes following different treatments. Methods: A medical database was queried from 1990 to 2016 to identify patients ≤18 years presenting to a single pediatric institution with a patellar sleeve injury. Patients with significant comorbidities or previously operatively treated for ipsilateral knee injuries were excluded. Standard demographic data, mechanism of injury, skeletal maturity, injury-related radiographic parameters, along with treatment paradigms, post-treatment clinical and radiographic findings, and patient-reported outcomes were collected. Results: A total of 90 patients, mean age of 10.7 years (range: 7–17) was included, of which 69 (77%) were male. Seventy-three percent of all injuries occurred while playing sports (particularly football/basketball/soccer), with “direct blow” or “landing” being the most prevalent mechanisms of injury. Twenty-six (29%) underwent operative treatment, with transosseous suture fixation being the most popular surgical technique (73%). Of the 64 (71%) non-operatively treated patients, 18 (39%) were placed in a hinged knee brace locked in extension with the remainder split between casting and standard knee immobilizer. Compared to the non-operative cohort, a higher percentage of the operative group had a pre-treatment extensor lag (p < 0.001) and greater fragment displacement (p < 0.001) with patella alta (p < 0.001) on imaging. There was no difference in outcome scores (Pedi-IKDC/Lysholm) or patella alta on radiographs between groups. Post-treatment surveys indicated no difference in residual pain or ability to return to sport. Conclusion: This large case series provides valuable epidemiologic, clinical, and radiographic data describing patellar sleeve fractures, along with outcomes following non-operative and operative treatments. Level of evidence: IV.
Comparability Evaluation of Three Benchtop Glucose Analyzers With the Recently Withdrawn YSI 2300 Stat Plus
Authors: Dunseath Gareth J. , Vatavu Iulius-Dumitru , Luzio Stephen D. 
Published: February 2024

Background: We compared the performance of three currently available laboratory benchtop glucose analyzers with the outgoing YSI 2300 Stat Plus. Methods: Plasma samples (100), across a wide glucose concentration range were analysed on the YSI 2500, Randox daytona+ (glucose oxidase) and EKF Biosen in a single laboratory and compared to the YSI 2300 Stat Plus. Results: All three analyzers showed good agreement with the YSI 2300 Stat Plus, and only a small bias (≤1% YSI 2500 and Randox daytona+, 4.6% EKF Biosen) was observed for each analyzer. None of the three comparator analyzers were affected by either proportional or constant bias, thus no significant differences between the YSI 2300 Stat Plus and the comparator methods were identified. Conclusions: The results from this study suggest all could be considered as suitable reference laboratory glucose analyzers and replacements for the recently withdrawn YSI 2300 Stat Plus.
Differences in risk of generalized anxiety disorder according to physical activity type in Korea adolescents: The Korea youth risk behavior web-based survey, 2020–2021
Authors: Shin Jhinyi , Lee Kihyuk 
Published: February 2024

Objective This study aimed to analyze the association between the types of physical activity (PA) and the level of generalized anxiety disorder (GAD) in Korean adolescents. Methods This study analyzed data from the Korea Youth Risk Behavior Web-based Survey (KYRBS) for, 2020–2021. The dependent variable was the level of generalized anxiety disorder-7 (GAD-7). The GAD-7 scores were divided into four levels: normal, mild, moderate, and severe. The independent variables were moderate PA, vigorous PA, and strength exercises. Sex, school grade, body mass index, stress, depression, suicidal thoughts, violent victimization, drinking, smoking, substance abuse, sleep satisfaction, and sedentary time were selected as confounding variables. Results The independent variable and all confounding variables showed significant differences with the level of GAD-7 (all p < .001). After adjusting for all confounding variables, we observed a 1.062 elevation in mild anxiety disorders, a 1.147 increase in moderate anxiety disorders, and a 1.218 increased incidence of severe anxiety disorders in the absence of vigorous PA. In the absence of strength exercises, there was a 1.057 elevation in mild anxiety disorders, a 1.110 increase in moderate anxiety disorders, and a 1.351 increased incidence of severe anxiety disorders. However, in the case of moderate PA, after adjusting for confounding variables, there was no significant association with GAD-7 levels. Conclusion To prevent anxiety disorders among Korean adolescents, the type of PA should be considered. Vigorous PA or strength exercises may help prevent GAD in Korean adolescents.
Association Between Social Media Activity and Ratings on Physician Review Websites Among Orthopaedic Surgeons With an Active Online Media Presence
Authors: Kerzner Benjamin , Dasari Suhas P. , Swindell Hasani W. , Obioha Obianuju A. , Khan Zeeshan A. , Rea Parker M. , Fortier Luc M. , Haynes Monique S. , Chahla Jorge 
Published: February 2024

Background: Social media has the potential to play a substantial role in the decision-making of patients when choosing a physician for care. Purpose: The purpose of this study was to determine whether an association exists between physician social media activity and patient satisfaction ratings on physician review websites (PRWs) as well as number of reviews. It was hypothesized that there would be a significant association between physician social media utilization and patient satisfaction ratings. Study Design: Cross-sectional study. Methods: The American Orthopaedic Society for Sports Medicine database was queried for the complete membership list. The online media profile and level of activity of the members were evaluated, and an online media presence score was calculated. The surgeons with the approximately top 10% of online media presence scores were compiled to assess the relationship between social media usage (Twitter, Instagram, YouTube, and Facebook) and patient satisfaction ratings on the Google Reviews, Healthgrades, and Vitals PRWs. Bivariate analysis was performed to compare demographic variables and level of online presence. Results: A total of 325 surgeons were included in the analysis. The most common platform used was Facebook (88.3%). There was no significant relationship between active social media use and overall ratings on any of the PRWs. Active Twitter use was associated with a greater number of ratings on all review websites, a greater number of comments on Google Reviews and Healthgrades, and shorter patient-reported clinic wait times on Healthgrades. Active Instagram use was associated with a greater number of comments on Vitals. No relationships were observed for YouTube or Facebook. Conclusion: For the included sports medicine surgeons who were most active on social media, no significant relationships were found between social media use and overall ratings on PRWs. Of all the platforms assessed, active use of Twitter was the only significant predictor of more reviews on PRWs. Thus, when deciding which form of social media engagement to prioritize in building one's practice, Twitter may serve as a relatively low-demand, high-reward option.
Cluster analysis to identify long COVID phenotypes using129Xe magnetic resonance imaging: a multicentre evaluation
Authors: Eddy Rachel L. , Mummy David , Zhang Shuo , Dai Haoran , Bechtel Aryil , Schmidt Alexandra , Frizzell Bradie , Gerayeli Firoozeh V. , Leipsic Jonathon A. , Leung Janice M. , Driehuys Bastiaan , Que Loretta G. , Castro Mario , Sin Don D. , Niedbalski Peter J. 
Published: February 2024

BackgroundLong COVID impacts ∼10% of people diagnosed with coronavirus disease 2019 (COVID-19), yet the pathophysiology driving ongoing symptoms is poorly understood. We hypothesised that129Xe magnetic resonance imaging (MRI) could identify unique pulmonary phenotypic subgroups of long COVID. Therefore, we evaluated ventilation and gas exchange measurements with cluster analysis to generate imaging-based phenotypes.MethodsCOVID-negative controls and participants who previously tested positive for COVID-19 underwent129Xe MRI ∼14 months post-acute infection across three centres. Long COVID was defined as persistent dyspnoea, chest tightness, cough, fatigue, nausea and/or loss of taste/smell at MRI; participants reporting no symptoms were considered fully recovered.129Xe MRI ventilation defect percent (VDP) and membrane-to-gas (Mem/Gas), red blood cell-to-membrane (RBC/Mem) and red blood cell-to-gas (RBC/Gas) ratios were used in k-means clustering for long COVID, and measurements were compared using ANOVA with post-hoc Bonferroni correction.ResultsWe evaluated 135 participants across three centres: 28 COVID-negative (mean±sdage 40±16 years), 34 fully recovered (42±14 years) and 73 long COVID (49±13 years). RBC/Mem (p=0.03) and forced expiratory volume in 1 s (FEV1) (p=0.04) were different between long COVID and COVID-negative; FEV1and all other pulmonary function tests (PFTs) were within normal ranges. Four unique long COVID clusters were identified compared with recovered and COVID-negative. Cluster 1 was the youngest with normal MRI and mild gas trapping; Cluster 2 was the oldest, characterised by reduced RBC/Mem but normal PFTs; Cluster 3 had mildly increased Mem/Gas with normal PFTs; and Cluster 4 had markedly increased Mem/Gas with concomitant reduction in RBC/Mem and restrictive PFT pattern.ConclusionsWe identified four129Xe MRI long COVID phenotypes with distinct characteristics.129Xe MRI can dissect pathophysiological heterogeneity of long COVID to enable personalised patient care.
Changes in the physical and affective dimensions of dyspnoea after a home-based pulmonary rehabilitation in fibrotic idiopathic interstitial pneumonias
Authors: Chenivesse C�cile , Gephine Sarah , Dornbierer Martin , Valentin Victor , Le Rouzic Olivier , W�meau Lidwine , Grosbois Jean-Marie 
Published: February 2024

Background
Our objective was to evaluate the short-, medium- and long-term benefits of home-based pulmonary rehabilitation (PR) on the physical and affective components of dyspnoea in people with fibrotic idiopathic interstitial pneumonias (f-IIPs). Anxiety and depressive symptoms, fatigue, health-related quality of life and exercise tolerance were also assessed.

Methods
Data on 166 individuals with f-IIPs who enrolled in an 8-week home-based PR programme (weekly supervised 90-min session) were retrospectively analysed. Assessments included the Dyspnoea-12 (D-12) questionnaire, Hospital Anxiety and Depression Scale, Fatigue Assessment Scale, Visual Simplified Respiratory Questionnaire and 6-min stepper test, and were performed at home at short, medium (6 months) and long (12 months) term.

Results
Among the 166 individuals with f-IIPs who enrolled in PR, 75 (45%) and 91 (55%) participants had a diagnosis of idiopathic pulmonary fibrosis and fibrosing non-specific interstitial pneumonia, respectively, and 87 (52%) participants concluded a full year of follow-up. In the total group, both physical and affective components of dyspnoea were improved, at short, medium and long term, after PR. Overall, half of the participants reached the minimally important difference of 3 points of the D-12 questionnaire at the end of PR, and at the 6- and 12-month follow-ups. Anxiety and depressive symptoms, fatigue and health-related quality of life were also improved, while the short-term benefits in exercise tolerance were not maintained 1 year after PR.

Conclusion
An individualised home-based PR programme resulted in short-, medium- and long-term improvements in both physical and affective components of dyspnoea assessed by the D-12 questionnaire.
Multimodal Biomedical Image Segmentation using Multi-Dimensional U-Convolutional Neural Network
Authors: Srinivasan Saravanan , Durairaju Kirubha , Deeba K. , Mathivanan Sandeep Kumar , Karthikeyan P. , Shah Mohd Asif 
Published: February 2024

AbstractDeep learning recently achieved advancement in the segmentation of medical images. In this regard, U-Net is the most predominant deep neural network, and its architecture is the most prevalent in the medical imaging society. Experiments conducted on difficult datasets directed us to the conclusion that the traditional U-Net framework appears to be deficient in certain respects, despite its overall excellence in segmenting multimodal medical images. Therefore, we propose several modifications to the existing cutting-edge U-Net model. The technical approach involves applying a Multi-Dimensional U-Convolutional Neural Network to achieve accurate segmentation of multimodal biomedical images, enhancing precision and comprehensiveness in identifying and analyzing structures across diverse imaging modalities. As a result of the enhancements, we propose a novel framework called Multi-Dimensional U-Convolutional Neural Network (MDU-CNN) as a potential successor to the U-Net framework. On a large set of multimodal medical images, we compared our proposed framework, MDU-CNN, to the classical U-Net. There have been small changes in the case of perfect images, and a huge improvement is obtained in the case of difficult images. We tested our model on five distinct datasets, each of which presented unique challenges, and found that it has obtained a better performance of 1.32%, 5.19%, 4.50%, 10.23% and 0.87%, respectively.
Are 6 more accurate than 4? The influence of different modes of delivery on postpartum depression and PTSD
Authors: Beck-Hiestermann Franziska Marie Lea , Hartung Lisa Kathrin , Richert Nadine , Miethe Sandra , Wiegand-Grefe Silke 
Published: February 2024

Abstract
Background
Empirical evidence shows that 4.6–6.3% of all women develop a post-traumatic stress disorder (PTSD) and approximately 10–15% postpartum depression (PPD) following childbirth. This study explores the relationship between delivery mode and the occurrence of PTSD and PPD, specifically examining four distinct caesarean section (CS) modes: primary on maternal request (Grade 4), medically indicated primary (Grade 3), secondary CS from relative indication (Grade 2) and emergency secondary CS (Grade 1), compared to vaginal and assisted vaginal delivery (AVD). The research aims to understand how these six subcategories of delivery modes impact PPD and PTSD levels. Common predictors, including the need for psychological treatment before childbirth, fear of childbirth, planning of pregnancy, induction of labor, birth debriefing, and lack of social support after childbirth, will be analyzed to determine their association with postpartum mental health outcomes.

Methods
The study was planned and carried out by a research team of the psychology department at the Medical School Hamburg, Germany. Within an online-study (cross-sectional design) N = 1223 German speaking women with a baby who did not die before, during or after birth were surveyed once between four weeks and twelve months postpartum via an anonymous online questionnaire on demographic and gynecological data, delivery mode, PTSD (PCL-5) and PPD (EPDS).

Results
For both psychiatric disorders, ANOVA revealed significant differences between delivery mode and PPD and PTSD. With weak effects for PPD and medium to strong effects for PTSD. Post-hoc tests showed increased levels of PPD for two CS types (Grade 1, Grade 3) compared to vaginal delivery. For PTSD, secondary CS from relative indication (Grade 2), emergency secondary CS (Grade 1) and assisted vaginal delivery (AVD) were associated with elevated levels of PTSD. Regression analysis revealed delivery mode as a significant predictor of EPDS- (medium effect size) and PCL-5-Score (medium to high effect size).

Limitation
Delivery was considered as the potential traumatic event, and any previous traumas were not documented. Additionally, the categorization of delivery modes relied on subjective reports rather than medical confirmation.

Conclusion
The study highlights the influence of delivery mode on the mental health of postpartum mothers: different modes influence postpartum disorders in various ways. However, the definition of delivery mode was only stated subjectively and not medically confirmed. Further research should investigate which aspects of the different delivery modes affect maternal mental health and explore how the perception of childbirth may be influenced by specific delivery experiences.
Triage practices for emergency care delivery: a qualitative study among febrile patients and healthcare workers in a tertiary care hospital in Nepal
Authors: Adhikari Bipin , Shrestha Lava , Bajracharya Manjita , Aryal Nishika , Rajbhandari Anuja , Maharjan Ramesh K. , Das Santa K. , Sapkota Jyotshna , Tetteh Kevin K. A. , Das Debashish 
Published: February 2024

AbstractBackgroundImproving screening and triage practices is essential for early severity assessments at the first point of contact and ensuring timely attention by healthcare workers (HCWs). The main objective of this study was to explore the triage process among febrile patients and HCWs in the emergency department (ED) of a tertiary care hospital in a resource-constrained setting.MethodsThis qualitative study was conducted from March to May 2023 at the ED of Tribhuvan University Teaching Hospital (TUTH), Nepal. The study included in-depth interviews with febrile patients (n = 15) and HCWs (n = 15). Additionally, direct observation notes (n = 20) were collected to document the triage process and patients’ experiences in the ED. Data underwent thematic analysis using the Interpretative Phenomenological Analysis (IPA) approach.ResultsThe ED of TUTH offered comprehensive triage services with clear delineation for the severity of febrile patients in line with the World Health Organization (WHO) guidelines. Nonetheless, challenges and constraints were identified. In the ED, evenings were generally the busiest period, and the triage process was not thorough during night shifts. Perception of triage was limited among patients and variable among HCWs. Digitalizing recordings of patient information including payment was deemed necessary for effective management of patients’ waiting times at the triage station. High patient throughput added pressure on HCWs and had a potential influence on the delivery of services. Availability of medical equipment and space were also identified as challenges, with patients sometimes compelled to share beds. There were constraints related to waste disposal, hygiene, cleanliness, and the availability and maintenance of washrooms. Febrile patients experienced delays in receiving timely consultations and laboratory investigation reports, which affected their rapid diagnosis and discharge; nonetheless, patients were satisfied with the overall healthcare services received in the ED.ConclusionsImproving current triage management requires resource organization, including optimizing the waiting time of patients through a digitalized system. Urgent priorities involve upgrading visitor facilities, patient consultations, laboratory investigations, hygiene, and sanitation. HCWs’ recommendations to resource the ED with more equipment, space, and beds and a dedicated triage officer to ensure 24-hour service, together with training and incentives, warrant further attention.