bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of Lowered Inpatient Correctional Bedtime Insulin Dosing on Glycemic Outcomes of Veterans
Authors: Hiscox Allacyn , Armbrust Jennifer , Shin Maria , Bahng Jeffrey 
Published: January 2024

Purpose: This study evaluated glycemic outcomes for hospitalized patients after reduction in bedtime correctional insulin dosing. Methods: This was a retrospective, single-center analysis of a protocol change that reduced bedtime correctional insulin scale. Comparable cohorts pre- and post-protocol change were created which included patients who were ordered correctional insulin with at least 1 blood glucose (BG) reading. The primary outcome was number of nocturnal hypoglycemia readings. Secondary outcomes included, but were not limited to, mean fasting BG, BG within various ranges, and length of stay. Results: 3 percent of patients in the post-protocol change group (N = 100) experienced nocturnal hypoglycemia compared to 6% of patients in the pre-change group (N = 100) ( P = .507). There were no significant differences in BG ranges <110 mg/dL, <140 mg/dL, 140 to 180 mg/dL, and >180 mg/dL. However, 19% of patients in the post-protocol change group had BG of >250 mg/dL as compared to 9% in the pre-change group ( P = .033). Mean fasting BG was higher in the post-protocol change group compared to the pre-change group (156.5 mg/dL vs 139.3 mg/dL [ P = .002]), as was hospital length of stay (5.17 vs 4.6 days, [ P = .024]). Conclusions: A decreased bedtime correctional insulin scale had mixed results with more patients achieving goal fasting BG but also more patients experiencing BG > 250 mg/dL and longer length of stay. Larger prospective studies are required to evaluate the safety and efficacy of this type of intervention and its long-term impact.
Automated rerailing of a road-rail shunting vehicle on road-level tracks using 2D-Lidar
Authors: Jung Hyun-Suk , Niermeyer Philipp , Manjunatheswaran Harish , Schindler Christian 
Published: January 2024

Road-rail vehicles are emerging increasingly in small flat yards for shunting wagons. While numerous research works suggest automation of the shunting operation to improve its efficiency, the rerailing procedure of such vehicle, i.e., switching between road and rail mode, remains manually executed. Hence, we present a simple but novel method for a road-rail vehicle with skid-steer drive to rerail automatically on road-level tracks (e.g., level-crossing). The vehicle uses two 2D-Lidar sensors to scan the floor for (rail) in order to estimate its lateral displacement and angular orientation towards the track centre. A simplified model and a PID-type controller for the yaw rate were deployed while keeping the linear velocity constant for the vehicle to align itself at the centre of and parallel to the track. Upon reaching the goal, the rail wheels are descended and the rerailing is completed. Test runs were conducted from a random initial pose near the track centre while limiting the travel range in x-direction to 2.5 m, yet allowing a change of direction each time the vehicle reaches this limit. In 97% of the test runs, the vehicle rerailed successfully in 47 s on average (12 s of which was needed for lowering the rail wheels) with three changes of direction or less. In the remaining 3% of cases it took more attempts. Automated rerailing could be used not only as assistance function for the shunting personnel, but also as important feature of an autonomous shunting robot that is able to access both road and rail domains.
Human immunodeficiency virus prevention outcomes associated with arts-based sexual health workshop participation among Northern and Indigenous adolescents in the Northwest Territories, Canada
Authors: Lys Candice L , Logie Carmen H , Lad Anoushka , Sokolovic Nina , Mackay Kayley Inuksuk , Hasham Aryssa , Malama Kalonde 
Published: January 2024

Background Contextually tailored, arts-based HIV prevention strategies hold potential to advance adolescent sexual health and wellbeing. We examined HIV prevention outcomes associated with arts-based sexual health workshop participation with Northern and Indigenous adolescents in the Northwest Territories (NWT), Canada. Methods An Indigenous community-based youth agency delivered arts-based workshops in school settings to adolescents aged 13-18 in 24 NWT communities. Pre and post-test surveys included socio-demographic characteristics, sexually infections (STI) knowledge, HIV/STI risk perception, sexual relationship equity, condom use self-efficacy, and safer sex efficacy (SSE). Latent change score models were conducted to assess pre-post differences and factors associated with these differences. Results Among participants ( n = 344; mean age 14.3 years, SD: 1.3; Indigenous: 79%) most (66%) had previously attended this workshop. Latent change score models revealed a significant and large effect size for increased STI knowledge (β = 2.10, SE = 0.48, p < .001) and significant and small effect sizes for increased HIV/STI risk perception (β = 0.24, SE = 0.06, p < .001) and SSE (β = 0.16, SE = 0.07, p = .02). The largest increases across several outcomes occurred with first time workshop participants; yet previous workshop participants continued to report increases in HIV/STI risk perception and SSE. Conclusion Arts-based HIV prevention approaches show promise in advancing STI knowledge, risk perception, and SSE with Northern and Indigenous youth.
Impact of a Divided Phenobarbital Load and Taper Compared With Lorazepam Symptom Triggered Therapy in Hospitalized Patients
Authors: Esteves Alyson M. , Buchfellner Matthew C. , Holmes Brooke M. , Berndsen Joseph A. , Roginski Matthew A. 
Published: January 2024

Background: Benzodiazepines are the preferred treatment for alcohol withdrawal. Phenobarbital is an alternative in the setting of prescriber expertise or benzodiazepine contraindication. Objective: To evaluate the efficacy and safety of a phenobarbital dosing strategy aimed at treating a spectrum of alcohol withdrawal symptoms across various patient populations. Methods: Retrospective review of patients admitted with concerns of alcohol withdrawal between May 2018 and November 2022. Patients were separated into a before-after cohort of lorazepam or phenobarbital. The primary outcome was hospital length of stay (LOS). Secondary outcomes were intensive care unit (ICU) LOS, escalation of respiratory support, increased level of care (LOC), and incidence of delirium tremens and/or seizures. Results: Two hundred and seventy-seven patients received lorazepam and 198 received phenobarbital. Hospital LOS was longer in the phenobarbital cohort compared with the lorazepam cohort (6.9 vs 9.3 days). There was no difference in ICU LOS. Level of care increases were fewer in the phenobarbital cohort (4 events vs 19 events). There were higher rates of non-invasive respiratory interventions in the lorazepam cohort and higher rates of mechanical ventilation in the phenobarbital cohort. Utilization of phenobarbital was attributed to a reduction in delirium tremens and seizures. Conclusion and Relevance: This study is novel because of the broad application of a phenobarbital order set across multiple levels of care and patient admission diagnoses. A risk targeted split load intravenous phenobarbital order set can safely be administered to patients with fewer escalations of care, seizures, delirium tremens, and respiratory care escalation.
Nationwide Aquatic Envenomations Reported to US Poison Control Centers from 2011 to 2020
Authors: Kirchberg Tyler N. , Cantrell F. Lee , Coffey Christanne H. , Tomaszewski Christian 
Published: January 2024

Introduction Aquatic envenomations are common injuries along the coastal United States that pose a public health risk and can cause significant morbidity. We examined aquatic envenomation exposures that were called in to poison control centers (PCC) in the United States from 2011 to 2020. Methods The Association of Poison Control Center's (AAPCC) National Poison Data System was queried for all aquatic envenomations reported during the 10 y period from January 1, 2011, to December 31, 2020. Data collected included date, exposure and geographic location, patient age and sex, signs and symptoms, management setting, treatments, and clinical outcome. Duplicated records, confirmed nonexposure, and reports not originating within the United States were excluded. Results There were 8517 human aquatic envenomations reported during the study period, 62% (5243) of whom were male; 56% (4264) of patients were 30 y or younger. There were an average of 852 calls per year, with 46% of calls occurring during June to August. California, Texas, and Florida had the highest number of envenomations during the study period. Fish (61%; 5159) and Cnidaria (30%; 2519) envenomations were the most common exposures. Overall, 37% (3151) of exposures were treated in healthcare facilities, with no deaths reported. Conclusions The highest proportion of aquatic envenomations occurred among younger males (≤30 y) during the summer months. While rarely leading to major adverse events, aquatic envenomations were commonly reported injuries to PCC and occurred in all 50 states. Poison control centers continue to be real-time sources of information and data regarding aquatic envenomation trends.
Neurotrophic Keratopathy after wide retinal endolaser and postoperative Ketorolac eye drops: A case series
Authors: Fossati Giovanni , Bartoli Elena , Montericcio Alessio , Buzzi Matilde , Barone Gianmaria , Santoru Francesco , Allegrini Davide , Romano Mario R. , Panico Claudio 
Published: January 2024

Purpose We report a series of 5 cases, happened in a period of 5 months, who developed neurotrophic keratopathy (NK) following pars plana vitrectomy (PPV) and retinal endolaser for rhegmatogenous retinal detachment (RRD). In our several decennary experience of surgical center predominantly based on vitreoretinal surgery, we had rare cases of postoperative NK. These recent cases of post-surgical NK happened contextually to our change of postoperative non-steroidal anti-inflammatory drugs (NSAIDs) drops, based on Ketorolac Tromethamine 0.5% eye drops. Cases Presentation Five patients with a mean age of 61 ± 7.3 years were treated with one or more PPV with intraoperative peripheral endolaser for RRD. Nobody had previous herpetic keratitis, systemic disease like diabetes mellitus or other predisposing factors for NK. In the postoperative period, all patients received Ketorolac Tromethamine 0.5% eye drops for a mean period of 54 ± 25 days. During follow-up visits they developed NK and they were successfully treated with suspension of Ketorolac eye drops, application of therapeutic contact lens or amniotic membrane patch and topical lubricant therapy. Conclusions Postoperative Ketorolac eye drops, in patients who underwent PPV with endolaser, may reduce the corneal sensitivity, predispose to epithelial disruption and NK development. Studies are needed to explore the effect of NSAIDs on corneal sensitivity reduction in patient who will undergo PPV and extensive endolaser.
Community Health Risk Awareness and Knowledge of Air Pollution in Annadale, Polokwane Local Municipality, Limpopo Province, South Africa
Authors: Ngobeni Famola Charles , Kekana Mokoko Percy 
Published: January 2024

Background: Exposure to air pollution has detrimental effects on the elderly, women, people with pre-existing medical conditions, people living in poverty and children. The aim of the study was to investigate the extent of community awareness and knowledge on the health risks associated with exposure to air pollution. The study was conducted at Annadale residential area locally known as Ladanna surrounded by industrial areas and located in Polokwane Local Municipality under Capricorn District Municipality in Limpopo Province, South Africa. Methods: A cross-sectional study design was used for the study, using self-administered questionnaires. The questionnaire was pre-tested on 10 respondents at Emdo Park (Extension 29) in Polokwane from 02 to 06 February 2021 and another fifteen respondents were pre-tested at Lesedi Park. A simple random sampling technique was used to select 376 respondents. Systematic sampling method was applied to select the households. SPSS version 26 was used to analyze data. Data was presented in the form of frequencies and percentages. Spearman rank correlation was used to measure the degree of association between 2 variables. A Chi-square test was used to compare the groups between the categorical variables. Multivariate Logistic Regression Model was used to assess associations of knowledge/awareness outcomes and sociodemographic characteristics with odds ratios (ORs) and 95% confidence intervals (Cls) presented. Results: Of 376 respondents, 221 (59%) were males and 154 (41%) females. The majority 113 (70%) of respondents were those between the age group 23 and 47 years and 353 (94%) were aware that if they don’t protect themselves against polluted air, they may get sick, with age and educational status associated with their awareness ( P < .05). About 361 (96%) knew what air pollution is and 188 (50%) think the air they breathe in Annadale is moderate. A total number of 278 (74%) said they feel sick/uncomfortable when the quality of air is bad. About 293 (78%) knew that people are exposed to air pollution by breathing contaminated air and 237 (63%) identified sewage smell as the main cause of air pollution. Internet 199 (53%) and television 177 (47%) were identified as the main source of information Those who were not aware of actions implemented to reduce air pollution were 180 (48%). Based on the results of the study, respondents’ level of knowledge in Annadale was poor (71%) and their awareness was good (87%). Conclusions: It is crucial that air pollution risk communication strategies be implemented to empower residents and improve the level of knowledge on the dangers of exposure to polluted air.
Evaluation of video visit appropriateness for common symptoms seen in primary care: A retrospective cohort study
Authors: Chen Doris , Gonzales Elyse , Winget Marcy , Shaw Jonathan , Artandi Maja , Tsai Sandra A , Nelligan Ian 
Published: January 2024

Introduction Little is known about which conditions seen in primary care are appropriate for video visits. This study evaluated video visits compared to office visits for six conditions: abdominal pain, joint pain, back pain, headache, chest pain, and dizziness. Methods Six hundred charts of adult patients from our institution's same-day outpatient clinic were reviewed in this study. Charts for video visits evaluating the aforementioned chief complaints that occurred between August and October 2020 were reviewed and compared with charts for office visits that occurred from August to September 2019. Frequencies of 3-week follow-up visits, Emergency Room visits, imaging, and referrals for office and video visits were measured. Reasons for in-person evaluation for patients seen by video were determined by review of clinician notes. Results Three-week in-person follow-up was more frequent for patients presenting with chest pain (52% vs 18%, p = 0.0007) and joint pain (24% vs 8%, p = 0.05) after video evaluation, relative to an office evaluation. Three-week in-person follow-up was also more frequent for patients presenting with dizziness (38% vs 28%) and low back pain (24% vs 14%); however, this difference was not statistically significant. Patients presenting with headache and abdominal pain did not have a higher rate of follow-up. Discussion Based on the frequency of in-person follow-up, this study suggests that video visits are generally adequate for evaluating headache and abdominal pain. Patients with dizziness and chest pain have the highest frequency of in-person and Emergency Room follow-up within 3 weeks when first seen by video compared to other conditions evaluated and may be less suitable for an initial video visit. Institutions can consider these findings when scheduling and providing guidance to patients on what type of visit is most appropriate for their symptoms.
The reality of transitioning from orphanages to family homes: Life in extended families in Zimbabwe
Authors: Moen Melanie , Chiimba Cathrine , Etokabeka Elsa 
Published: January 2024

Summary Many young orphans in Zimbabwe grow up in residential care facilities, but according to governmental policies and literature in this field, these children should be transitioned to extended families to ensure optimal development. Thus, semi-structured interviews was conducted with a social worker, two residential care administrators and five extended families; whereas the participating orphans were asked to draw and narrate their lives in RCC and their extended families. This article provides empirically derived insights to the inner experiences of the transition processes of five young orphans and their extended family members, two residential care administrators, and one social worker. The theoretical approach taken to analyze the data consisted of the inductive data analysis. Findings Although transitioning to a family is deemed ideal for orphans it was apparent in this study that most of the orphans found their new family life challenging and stressful. Several themes emerged from the data, namely financial constraints hindering the transition experiences in families; lack of training of family members on how to support orphans in their families, as well as emotional and cognitive challenges faced by orphaned children. Application The insights of this study can be used to improve the transition experiences of young orphans, especially in Zimbabwe. Future practical and policy changes are also suggested.
Rad51 and Systemic Inflammatory Indicators as Novel Prognostic Markers in Esophageal Squamous Cell Carcinoma
Authors: Wu Ning , Song Yang , Zhu Yongjun , Pang Liewen , Chen Zhiming , Chen Xiaofeng 
Published: January 2024

Background RAD51 is a central protein involved in homologous recombination, which has been linked to cancer development and progression. systemic inflammatory indicator markers such as neutrophil-to-lymphocyte ratio and lymphocyte-to-monocyte ratio have also been implicated in cancer. However, the relationship between Rad51 and these inflammatory markers in esophageal cancer patients undergoing esophagectomy is not yet understood. Methods We retrospectively observed 320 esophageal cancer patients who underwent esophagectomy. We collected clinical characteristics, postoperative complications, and survival analysis data and analyzed the relationship between Rad51 expression, inflammatory markers, and prognosis. Results We found significant linear relationships among the inflammatory markers. There were also close relationships between Rad51 expression and neutrophil-to-lymphocyte ratio or C-reactive protein. Patients with low lymphocyte percentage were more likely to have low Rad51 expression ( P = .026), high C-reactive protein ( P = .007), and high neutrophil-to-lymphocyte ratio ( P = .006). Low lymphocyte-to-monocyte ratio was associated with poor overall survival and was an independent prognostic factor (HR = 2.214; 95% confidence interval: 1.044-4.695, P = .038). In patients without lymph node metastases, low albumin (HR= 0.131; 95% confidence interval: 0.025-0.687, P = .016), high neutrophil-to-lymphocyte ratio (HR = 0.002; 95% confidence interval: 0.000-0.221, P = .009), and high Rad51 expression (HR = 14.394; 95% confidence interval: 2.217-97.402, P = .006) were associated with poor overall survival. Conclusions Our study found a close correlation between elevated Rad51 expression and inflammatory markers. High Rad51 expression, high neutrophil-to-lymphocyte ratio, and low lymphocyte-to-monocyte ratio are associated with lower survival rates. The combined assessment of Rad51 and inflammatory markers can be useful for preoperative assessment and prognostic evaluation in esophageal squamous cell carcinoma patients.
Exploring the recovery journey of COVID-19 critical care survivors during the first year after hospital discharge
Authors: Wodecka Lena , Koulouglioti Christina , Gonçalves Ana-Carolina , Hill Adele , Hodgson Luke 
Published: January 2024

Objectives: To explore the longitudinal recovery of patients admitted to critical care following COVID-19 over the year following hospital discharge. To understand the important aspects of the patients’ recovery process and key elements of their caregivers’ experiences during this time. Design: A longitudinal qualitative study using semi-structured interviews. Setting: Two acute hospitals in South East England and follow-up in the community. Participants: Six COVID-19 critical care survivors from the first wave of the pandemic (March–May 2020) and five relatives were interviewed 3 months after hospital discharge. The same six survivors and one relative were interviewed again at 1 year. Interviews were transcribed verbatim, anonymised and a reflexive thematic analysis was conducted. Results: Three themes were developed: (1) ‘The cycle of guilt, fear and stigma’; (2) ‘Facing the uncertainties of recovery’ and (3) ‘Coping with lingering symptoms – the new norm’. The first theme highlights survivors’ reluctance to share their experiences associated with contracting the disease. The second theme, explores challenges faced by the survivors and their relatives in navigating the recovery process, given the unknown nature of the illness. The final theme illustrates the mechanisms survivors develop to come to terms with the remnants of their illness and critical care stay. Conclusions: The longitudinal nature of the study highlighted the persisting symptoms of long COVID-19, their impact on survivors and coping methods amidst the ongoing pandemic. Further research into the experiences of those affected in the first and subsequent waves of the COVID-19 pandemic, is desirable to help guide the formulation of the optimally supported recovery pathways.
How does the general population approach their pain? A cross-sectional study in Palestine
Authors: Hamdan Anas , Mosleh Rami 
Published: January 2024

Background: Pain perception and management vary across cultural contexts; yet, little is known about pain approaches in the general population of Palestine. Existing research lacks specific knowledge about how pain is coped with in this region. Objective: To explore pain management among Palestine’s general population, studying prevalence, characteristics, and sociodemographic influences. It aims to uncover treatment choices and understand cultural impacts on pain experiences, offering insights into Palestinian pain perception and coping strategies. Methods: Convenience and snowball sampling methods were employed to collect data from 646 adults in Palestine. Participants’ sociodemographic characteristics, pain experiences, and pain management strategies were examined. Descriptive statistics, chi-square tests, and binary logistic regression followed by multiple logistic regressions were used for data analysis. Results: A significant portion of participants reported experiencing pain, with chronic pain being predominant. Pain prevalence varied across age groups, with higher rates in the elderly, followed by middle-aged and younger participants. Marital status and education level were linked to pain prevalence. Participants employed diverse pain management strategies, such as self-medication, physician visits, complementary medicine, and physical therapy. Age, gender, marital status, and education level influenced choices in pain management approaches. For instance, the elderly favored traditional medical interventions, while higher education levels were associated with reduced inclination toward conventional treatments. Conclusion: This study underscores the complex interaction of sociodemographic factors, pain experiences, and treatment preferences in pain management. It emphasizes personalized strategies considering age, marital status, education, and gender. Integrating these aspects improves treatment and satisfaction. The findings empower healthcare providers to create precise strategies, enhancing patient experiences for better outcomes.