bluuebunny/crossref_metadata_2025_split huggingface dataset:
Use of Peripheral Intravenous Access in Patients Undergoing Chemotherapy for Testicular Cancer
Authors: Wiesen Brett , Atwell Michael , Leavitt Colton , Clark Nathan , Kessler Elizabeth , Lam Elaine , Flaig Thomas , Kukreja Janet , Kim Simon , Maroni Paul , Cost Nicholas G. 
Published: December 2023

PURPOSE Systemic chemotherapy, depending on the regimen, can be administered through peripheral intravenous (pIV) access or through central venous access devices (CVADs). There is no current best practice regarding optimal access for chemotherapy for patients with testicular cancer (TC). We retrospectively evaluated patients undergoing systemic chemotherapy for TC and compared baseline characteristics and complications of patients using pIV versus CVADs. METHODS We included patients with TC who underwent first-line systemic chemotherapy at the University of Colorado Hospitals from 2005 to 2020. Data were collected on demographics, cancer characteristics, type, duration of chemotherapy, pIV or CVAD use, and associated complication rates. We then performed univariate and multivariate regression analyses to compare complication rates and risk factors for each group. RESULTS One hundred fifty-four patients met inclusion criteria. Ninety-two (60%) patients used CVADs, and 62 patients (40%) used pIV for their initial treatment. Only six (9.7%) of 62 patients transitioned from pIV to CVADs during therapy. Similarly, 10 of 92 (10.9%) patients with initial CVAD needed to transition to a different type of CVAD or to pIV ( P = .81). There were a greater number of venous access–related complications (48 of 92 patients, 52.2%) and overall thrombotic events (33 of 92 patients, 35.9%) for the CVAD group ( P > .001) when compared with the pIV group. We observed an association between the following factors and venous access–related complications during chemotherapy: higher stage TC, increased total chemotherapy cycles, and delayed therapy. CONCLUSION Peripheral IV use for first-line nonvesicant chemotherapy in patients with TC appears to be well tolerated with high rates of therapy completion and lower rates of complications when compared with CVADs. These data support our preferred treatment approach and provide evidence that pIV access is a safe and effective way to deliver chemotherapy for patients with TC.
Impact of Time-to-Antibiotic Delivery in Pediatric Patients With Cancer Presenting With Febrile Neutropenia
Authors: De Castro George C. , Slatnick Leonora R. , Shannon Morgan , Zhao Zhiguo , Jackson Kasey , Smith Christine M. , Whitehurst Daniel , Elliott Claire , Clark Chelsea C. , Scott Halden F. , Friedman Debra L. , Demedis Jenna , Esbenshade Adam J. 
Published: December 2023

PURPOSE Febrile neutropenia (FN) in pediatric patients with cancer can cause severe infections, and prompt antibiotics are warranted. Extrapolated from other populations, a time-to-antibiotic (TTA) metric of <60 minutes after medical center presentation was established, with compliance data factoring into pediatric oncology program national rankings. METHODS All FN episodes occurring at Vanderbilt Children's Hospital (2007-February 2022) and a sample of episodes from Colorado Children's Hospital (2012-2019) were abstracted, capturing TTA and clinical outcomes including major complications (intensive care unit [ICU] admission, vasopressors, intubation, or infection-related mortality). Odds ratios (ORs) were adjusted for age, treatment center, absolute neutrophil count, hypotension presence, stem-cell transplant status, and central line type. RESULTS A total of 2,349 episodes were identified from Vanderbilt (1,920) and Colorado (429). Only 0.6% (n = 14) episodes required immediate ICU management, with a median TTA of 28 minutes (IQR, 20-37). For the remaining patients, the median TTA was 56 minutes (IQR, 37-90), and 54.3% received antibiotics in <60 minutes. There were no significant associations between TTA (<60 or ≥60 minutes) and major complications (adjusted OR, 0.99 [95% CI, 0.62 to 1.59]; P = .98), and a TTA ≥60 minutes was not associated with any type of complication. Similarly, TTA, when evaluated as a continuous variable, was not associated with a major (OR, 0.99 [95% CI, 0.94 to 1.04]; P = .69) nor any other complication in adjusted analysis. CONCLUSION There is no clear evidence that a reduced TTA improves clinical outcomes in pediatric oncology FN and thus it should not be used as a primary quality measure.
Η διασύνδεση και συνεργασία των φορέων που ασχολούνται με τους θεσμούς της αναδοχής και της τεκνοθεσίας στην Περιφέρεια Κρήτης
Authors: Κούτρα Κλειώ , Πουπάκη Αικατερίνη , Σαμάρα Ραφαέλα , Κυπραίου Διονυσία 
Published: December 2023

Η οικονομική κρίση αλλά και η πανδημία του COVID-19 έφεραν στην επιφάνεια ένα διαχρονικό ζήτημα, αυτό της παιδικής παραμέλησης και κακοποίησης. Τα τελευταία χρόνια αν και γίνεται προσπάθεια εκσυγχρονισμού της παιδικής προστασίας σε πολλές χώρες του δυτικού κόσμου με σημαντικές νομικές βελτιώσεις για την αποδοτικότερη προστασία των παιδιών, η Ελλάδα έχει ακόμη πολλά βήματα για να επιτύχει ένα ικανοποιητικό επίπεδο προστασίας (European Union Agency for Fundamental Rights-FRA, 2015). Η παρούσα μελέτη έγινε με αφορμή την αλλαγή του νομοθετικού πλαισίου στην Ελλάδα στον τομέα της παιδικής προστασίας και ο σκοπός της είναι η διερεύνηση της διασύνδεσης των φορέων που ασχολούνται με ζητήματα αναδοχής - τεκνοθεσίας στην Περιφέρεια της Κρήτης. Τα αποτελέσματα της μελέτης αναδεικνύουν τις εκσυγχρονιστικές αλλαγές, που έφερε ο νόμος στον τομέα της παιδικής προστασίας πάνω στα θέματα εκπαίδευσης υποψηφίων, τη δημιουργία ηλεκτρονικής πλατφόρμας και κατά συνέπεια τη μείωση του χρόνου διαδικασίας, την καθιέρωση για πρώτη φορά της επαγγελματικής αναδοχής καθώς και την υποχρεωτική χαρτογράφηση των παιδιών στις δομές φιλοξενίας. Στον αντίποδα υπήρχαν κι αρκετές αδυναμίες, που σχετίζονται με ελλείψεις καίριων ειδικοτήτων και προσωπικού στις δομές, υπό-χρηματοδότηση, έλλειψη ενός ενιαίου πλαισίου λειτουργίας καθώς και έλλειψη εκτενούς επιμόρφωσης πάνω σε θέματα διαδικασίας των επαγγελματιών που εργάζονται στο πεδίο. Συμπερασματικά κρίνεται παραπάνω από επιτακτική η ανάγκη παρέμβασης των κοινωνικών υπηρεσιών, με σκοπό τον περιορισμό των επιπτώσεων των καταστάσεων κρίσης και την επιδίωξη διασφάλισης της προστασίας των παιδιών που βρίσκονται σε κίνδυνο.
CLASSIFICATION OF UNIVERSITY PROPERTY
Authors: Igitkhanyan Sergey S. 
Published: December 2023

The property of the educational organizations is a material basis of their accomplishment of significant public functions of education and upbringing. The increase in effective management of property of the educational organizations is important as it provides the improvement of education quality as well as the increase in the potential for science development/ It also promotes the increase in the efficiency of the use of the state-owned property as the state-owned property is transferred to the most educational organizations (namely – state and municipal ones) on the right of operational management. At the same time, the structure of the property of the organizations of higher education (OHE) is the most difficult. Some options of classification of the property of educational organizations are widely provided in literature. At the same time, the property is classified according to various bases. However, there is no system approach to the classification of property.
Purpose. The purpose of the research is to form the systematized classification of OHE property considering the main factors, which are significant for the determination of features and borders of managerial influences.
Method or methodology: the study was conducted based on the method of analyzing documents and synthesizing the information presented in them.
Результаты. The formed classification takes into account the organizational and legal forms of OHE, economic, as well as functional aspects.
Practical implications. The use of a systematized classification helps to take into account the specifics of the activities of OHE, allows you to optimize the “cost of ownership” of property, increase the efficiency of its use, and involve it in the educational and scientific process.
ASSESSMENT OF THE EFFECT OF DIFFERENT CLUSTERS OF THE METABOLIC SYNDROME ON THE EXPRESSION OF DEPRESSIVE DISORDERS
Authors: Moskalenko Olga L. , Kasparova Irina E. , Yaskevich Roman A. 
Published: December 2023

The purpose of the study. To study the influence of various metabolic syndrome clusters on the severity of depressive disorders according to the CES-D scale.
Materials and methods. 136 male patients were examined, including 60 with metabolic syndrome. Metabolic syndrome was diagnosed based on the criteria of clinical recommendations of the All-Russian Scientific Society of Cardiology in 2009. The severity of depression was assessed using the Center for Epidemiological Studies Depression Scale - CES-D.
Results. It was found that among the surveyed men with metabolic syndrome, depressive disorders of varying severity on the CES-D scale were found in 40% of the surveyed, while among men with MS, the number of people with severe depression on the CES-D scale was higher. Among persons with a four-component metabolic syndrome cluster, patients with severe depression were more common (57,1%). In men with depression on the CES-D scale of varying severity, a three-component cluster of metabolic syndromes was more common, consisting of abdominal obesity, arterial hypertension, and an elevated level of low-density lipoprotein cholesterol.
Conclusion. The combination of abdominal obesity, arterial hypertension, and lipid disorders characterized by high levels of low-density lipoprotein was the most common metabolic syndrome cluster among men with depressive disorders of varying severity on the CES-D scale.
Minimizing the Weighted Number of Tardy Jobs via (max,+)-Convolutions
Authors: Hermelin Danny , Molter Hendrik , Shabtay Dvir 
Published: December 2023

In this paper we consider the fundamental scheduling problem of minimizing the weighted number of tardy jobs on a single machine. We present a simple pseudo polynomial-time algorithm for this problem that improves upon the classical Lawler and Moore algorithm from the late 60’s under certain scenarios and parameter settings. Our algorithm uses (max,+)-convolutions as its main tool, exploiting recent improved algorithms for computing such convolutions, and obtains several different running times depending on the specific improvement used. We also provide a related lower bound for the problem under a variant of the well-known Strong Exponential Time Hypothesis (SETH). History: Accepted by Andrea Lodi, Area Editor for Design & Analysis of Algorithms – Discrete. Funding: This work was supported by the Israel Science Foundation [Grant 1070/20].
Digitale Kompetenzen im Wandel: Eine Neubewertung digitaler Kompetenzen in der IT-Funktion eines Automobilunternehmens
Authors: Pieczurczyk Svenja , Drews Paul 
Published: December 2023

ZusammenfassungDie digitale Transformation verändert nicht nur die Geschäftsmodelle und Unternehmensstrategien von Automobilunternehmen, sondern impliziert ebenfalls einen Wandel der Anforderungen an die digitalen Kompetenzen in deren IT-Funktion. Obwohl die Unternehmen sich mit dem Wissen und den Fähigkeiten ihrer Mitarbeitenden auseinandersetzen, besteht ein Defizit hinsichtlich der Aktualität und Präzision der Kompetenzen, welche zu einer Anpassungsfähigkeit und Wertschöpfung beitragen können. Daher sind eine fortlaufende Identifizierung von Veränderungen digitaler Kompetenzen sowie eine kontinuierliche Weiterentwicklung von Kompetenzmodellen erforderlich. In diesem Beitrag wird die Aktualisierung des Kompetenzmodells der IT der Volkswagen AG beschrieben. Mittels einer Fokusgruppenstudie und unter Verwendung eines Kompetenzkataloges wurde der Weiterentwicklungsbedarf an Wissen und Fähigkeiten in der IT-Funktion ermittelt und in einem Kompetenzmodell konsolidiert. In einem Zeitraum von drei Jahren haben sich insgesamt 25 Änderungen in 9 Kompetenzfeldern ergeben. Die Ergebnisse unterstreichen den schnellen Wandel von digitalen Kompetenzen in der IT, insbesondere in den Bereichen persönliche und soziale Kompetenzen. Das entwickelte Kompetenzmodell sowie das Vorgehen zur Aktualisierung des Modells können anderen Unternehmen helfen, eigene Kompetenzmodelle zu entwickeln bzw. weiterzuentwickeln.
Early observations of Tier-3 drug shortages on purchasing trends across Canada: A cross-sectional analysis of 3 case-example drugs
Authors: Santhireswaran Araniy , Chu Cherry , Kim Katherine Callaway , Gaudette Étienne , Burry Lisa , Clement Fiona , Suda Katie , Tadrous Mina 
Published: December 2023

Background
To curb the growing impact of drug shortages, Health Canada developed the Tiered Notification and Communication Framework which assigns potential shortages a corresponding tiered status. Tier-3 is assigned to shortages with the greatest potential impact on the healthcare system. This study aims to describe drug purchasing trends in response to Tier-3 shortages using three case-examples.

Methods
We conducted a time-series analysis of monthly purchasing data for three out of 17 Tier-3 drug shortages (hydralazine, sarilumab, and medroxyprogesterone acetate) with publicly available reports in July 2021 and available IQVIA MIDAS data from January 2016 to December 2021. We assessed percent changes in purchasing at 1-, 3-, and 6-months after the onset of each Tier-3 drug shortage and interventional ARIMA modelling was used to assess the statistical significance.

Results
Medroxyprogesterone acetate experienced a significant shift (p = 0.0370) in purchasing following its shortage, and the 1-, 3-, and 6-month percent changes were +14.9%, +6.8% and -3.1%, respectively. Hydralazine and sarilumab did not show a significant shift. The 1-, 3-, and 6-month percent changes for hydralazine were +15.5%, +10.2%, and +9.6% respectively and +25.2%, +45.1% and +39.2 for sarilumab.

Conclusions
These results indicate that drugs assigned a Tier-3 status may not show declines in purchasing in the months following status assignment, which may be due to policy responses following the assignment. However, more insight is needed into the mechanisms through which these policy measures impact shortages and whether they are functioning as intended.
The association of cobalturia with cobaltism symptoms a prospective blinded study of 229 post-arthroplasty patients
Authors: Tower Stephen S. , Gessner Bradford D. , Cho Christina S. , Bridges Robert L. 
Published: December 2023

IntroductionCobalt is a mitochondrial toxin, clinical cobaltism manifests with constitutional, neurologic, and cardiovascular symptomatology. Cobalt’s severe toxidrome is known through case reports from extreme wear or corrosion of cobalt-chromium arthroplasty components. However, the spectrum and epidemiology of orthopedic-implant cobaltism and its relationship to duration and degree of cobalt exposure are not well defined.MethodsThe relationship of urine-cobalt concentration and duration of exposure to cobalt-chromium joint implants and cobaltism symptomatology were prospectively studied in 229 patients. Subjects received a Cobaltism-Symptom-Inventory-Score (CSIS) based on a protocolized interview and examination followed by a spot urine-cobalt measurement.Results129 (56%) subjects were cobalturic (urine-cobalt ≥1.0 ppb). 122 (53%) subjects had a CSIS of >2, this status significantly associates with cobalturia. Median [IQR] urine-cobalt in the subjects with a CSIS >2 was 4.1[1.1–17.0] ppb compared to 0.5[0.5–1.4] ppb in subjects with CSIS ≤ 2. Cobalturia has a sensitivity of 0.69, a specificity of 0.77, and a positive predictive value of 0.74 for a CSIS of >2. The product of years-exposed to a cobalt-chromium implant and urine-cobalt by quartiles significantly positively associates with the Cobaltism-Symptom-Inventory-Score.ConclusionA urine-cobalt of ≥1 ppb likely indicates adverse systemic exposure to orthopedic-implant generated cobalt. Cobaltism severity as quantified by the CSIS significantly correlates with the product of spot urine-cobalt concentration and years-exposed to a cobalt-chromium orthopedic-implant indicating a dose-response relationship. Medical provider and public awareness of orthopedic-implant cobaltism is vital because tens-of-millions are at-risk and early cobaltism is reversible. Further use of cobalt-chromium orthopedic-implants should be questioned given cobaltism becomes clinically apparent at a spot urine-cobalt of 1 ppb or greater. Monitoring of patients with high-risk cobalt-chromium orthopedic-implants appears to be indicated.
Shiga toxin-producing Escherichia coli O157:H7 among diarrheic patients and their cattle in Amhara National Regional State, Ethiopia
Authors: Engda Tigist , Tessema Belay , Mesifin Nebiyu , Nuru Anwar , Belachew Teshome , Moges Feleke 
Published: December 2023

Background
Shiga toxin-producing Escherichia coli O157:H7 (STEC O157:H7) is a zoonotic pathogen that causes diarrhea, hemorrhagic colitis, and hemolytic uremic syndrome worldwide. This study aimed to determine the prevalence, antibiotic susceptibility, and associated risk factors of STEC O157:H7 among diarrheic patients and their cattle.

Methods
A cross-sectional study was conducted among diarrheic patients and their cattle in Amhara National Regional State, Ethiopia from December- 2020 to June- 2022. A total of 1,149 diarrheic patients and 229 cattle were included in the study. STEC O157:H7 detection was done using culture, latex agglutination test, and polymerase chain reaction on diarrheic stool samples and recto-anal mucosal swabs of cattle. Antibiotic susceptibility tests were performed using disk diffusion techniques. Risk factors association were identified using binary and multivariable logistic regression analysis.

Results
The overall prevalence of STEC O157:H7 in diarrheic patients and their cattle was 11.1% (128/1149) and 14.4% (33/229) respectively. High percentage of the study subjects were found in under-five children (34.5%). Age less than 5 (AOR: 4.02, 95%CI:1.608–10.058,P = 0.003), and greater than 64 years old (AOR:3.36, 95% CI:1.254–8.986, P = 0.016), presence of diarrheic patient in the house (AOR:2.11, 95%CI:1.309–3.390, P = 0.002), availability of cattle in the house (AOR:2.52, 95%CI:1.261–5.049, P = 0.009), and habit of consuming raw foods (AOR:4.35, 95%CI:2.645–7.148, P = 0.000) were risk factors. Antibiotic resistance was shown in 109(85.2%), and 31(93.9%) isolates from diarrheic patients and their cattle respectively. The highest levels of antibiotic resistance were found to tetracycline (54.7%, 69.7%) in diarrheic patients and their cattle respectively. Multiple drug resistance was also observed among 56(43.8%) and 11(33.3%) isolates in diarrheic patients and their cattle respectively.

Conclusion
Our study showed high prevalence of STEC O157:H7 in diarrheic patients and their cattle. Therefore, health education should be given to the community on how to care for animals, proper sanitation, and the impact of raw food consumption.
“I was screaming hallelujah”: Patient and provider perceptions of blood-based testing for colorectal cancer screening
Authors: Schneider Jennifer L. , Johnson Cheryl A. , Jenkins Charisma , Mummadi Rajasekhara , Coronado Gloria D. 
Published: December 2023

Background
Blood-based tests for colorectal cancer (CRC) screening can offer many advantages over stool-based tests such as FIT. Yet, we know little about patients’ and providers’ perceptions of this type of test. We report findings from a qualitative study comparing patient and provider perceptions of blood-based testing for CRC screening.

Methods
Patient participants were aged 45–75 years and members of a large, integrated health system. Participants were mailed, but did not complete, a FIT through an organized FIT-screening program and were scheduled for a health-care encounter at any of nine clinical sites. Participants were consented to complete a blood draw. We used purposive sampling to select and recruit patients (who did and did not complete the blood test) and providers/specialists who would be involved in offering the blood test to patients or explaining results. We administered telephone interviews using a semi-structured interview guide and recorded and transcribed all interviews, then coded and analyzed content.

Results
We interviewed 15 patients (11 completed and 4 did not complete the blood test) and 5 providers (3 primary care providers, one gastroenterologist (GI), and one GI medical assistant). Patients were enthusiastic about completing a blood test, citing the simplicity, ease, convenience, and high perceived accuracy of the test. Providers were also receptive to a blood-based option, if adequate test performance could be achieved and if they have information that informs patients about the pros and cons of blood-based screening versus other screening tests.

Conclusions
Patients and providers were willing and enthusiastic about blood-based CRC screening tests. Future research focusing on performance and communication is needed.
Intolerance upon statin rechallenge: A systematic review and meta-analysis of randomized controlled trials
Authors: Kraut Roni , Wierenga Faith , Molstad Elisa , Korownyk Christina , Perry Danielle , Dennett Liz , Garrison Scott 
Published: December 2023

Background
Although statins are often discontinued when myalgia arises, a causal relationship may not always exist. How well-tolerated statins are when rechallenge is blinded and controlled is unclear.

Methods and findings
We performed a systematic review and meta-analysis (PROSPERO CRD42023437648) to evaluate the success of statin rechallenge versus matched placebo in those who were previously statin intolerant. Our primary outcome was intolerance; our secondary outcome was the myalgia or global symptom score. Medline, Embase, CINAHL Plus, Scopus, and CENTRAL were searched from inception to May 1, 2023. Eligible trials were randomized controlled trials with parallel or crossover designs examining statin rechallenge in statin-intolerant adults. Two independent reviewers selected studies, extracted data, and assessed risk of bias (Cochrane Collaboration’s risk-of-bias tool 1). Relative risk (RR) and mean difference (MD) were estimated using fixed effect Mantel-Haenszel statistics. Of 1,941 studies screened, 8 met our inclusion criteria (8 to 491 participants from Asia, Europe, North America, and Oceana). Compared to placebo, intolerance was more common in statin users [325/906 (36%) vs 233/911 (26%), RR 1.40, 95% CI, 1.23 to 1.60, I2 = 0%, 7 trials, number needed to harm 10] and there was no statistically significant difference in myalgia or global symptom score on a 100-point scale [MD 1.08, 95% CI, -1.51 to 3.67, I2 = 0%, 5 trials]. Limitations include only 1 trial asking participants about intolerable symptoms (vs inferring intolerance from discontinuation or trial withdrawal); the small number of trials; the possibility of attrition bias; and the potential for carryover effects in crossover/n-of-1 trial designs.

Conclusions
Of those previously intolerant of statins who were rechallenged with a statin and compared to placebo recipients, medication intolerance was more common amongst statin recipients. However, there was no significant difference in mean myalgia or global symptom score between statin and placebo, and only one-third of those previously believed to be statin intolerant were unable to tolerate a statin on blinded rechallenge; one-quarter were intolerant of placebo.