bluuebunny/crossref_metadata_2025_split huggingface dataset:
Geriatric Trauma Patients—Are They Receiving Trauma Center Care?
Authors: Lane Peter , Sorondo Barbara , Kelly John J. 
Published: March 2003

Abstract Objectives: The primary purpose of this study was to evaluate whether severely injured geriatric patients were as likely to be treated at designated trauma centers (TCs) within the statewide trauma system. The secondary objective was to compare the demographic and injury characteristics of severely injured older and young patients who received care in TCs with the characteristics of those patients cared for in non‐TCs. Methods: The authors reviewed files for all acute injury discharges in Pennsylvania for 1997. Injury diagnoses were mapped to Abbreviated Injury Scale (AIS) scores using ICDMAP software; the Injury Severity Score (ISS) was computed. The frequency of hospital discharges for injury from TC and non‐TC hospitals in both the older (E) (≥65 years) and younger (Y) (<65 years) groups were computed, and compared using chi‐square testing for significance. Logistic regression was performed to assess the influence of various factors. Severity of injury was controlled for with both ISS and Maximum AIS (MAIS). Results: 107,358 patients were admitted to hospitals in the state because of injury; 8,980 had an ISS > 15; 5,855 were Y and 3,125 were E. Forty‐seven percent of the Y patients received TC care compared with only 36.6% of the E patients (p < 0.001). Logistic regression analysis showed that age was a strongly negative predictor for TC care when injury severity was controlled. Conclusions: Seriously injured older patients were less likely to receive care in a trauma center than younger patients.
A Research Agenda for Geriatric Emergency Medicine
Authors: Wilber Scott T. , Gerson Lowell W. 
Published: March 2003

Abstract Objectives: The Research Agenda Setting Process (RASP), part of the American Geriatric Society's (AGS's) project “Increasing Geriatric Expertise in Surgical and Related Medical Specialties,” was designed to define a research agenda for the geriatrics aspects of participating specialties. This paper presents a summary of the research agenda for emergency medicine. Methods: The RASP was developed by the AGS in conjunction with experts from the participating specialty organizations. A “content expert” (CE) for each specialty developed a Medline search strategy in conjunction with RAND Health librarians. The CE reviewed the search to identify papers that were germane to research in the emergency care of older patients. The CE and a senior writing group member drafted a paper that synthesized the current literature and suggested areas for further research. A panel consisting of AGS members and emergency physicians with geriatrics expertise reviewed this paper. The research agenda was further refined at a two‐day retreat. Two senior geriatricians reviewed the resulting paper. Results: The Medline search for emergency medicine resulted in a list of 3,348 articles; 299 articles were pertinent and reviewed. The search for trauma resulted in a list of 1,838 articles; 133 were reviewed. Research agenda items were defined for multiple topics within geriatric emergency medicine and trauma. Conclusion: A research agenda for geriatric emergency medicine has been developed, using a combination of review of current literature and expert opinion.
Patient Satisfaction Data as a Quality Indicator: A Tale of Two Emergency Departments
Authors: Boudreaux Edwin D. , Mandry Cris V. , Wood Karen 
Published: March 2003

Abstract Objective: Patient satisfaction is a commonly measured indicator of quality emergency care. However, the existing empirical literature on emergency department (ED) patient satisfaction provides little guidance on how to analyze, interpret, and use data obtained in the clinical setting. Using two EDs as examples, the authors describe practical strategies designed to identify priority areas for potential improvement. Methods: The authors used a cross‐sectional, observational design. All patients who presented for emergency care during the designated time periods were eligible. Patients were randomly selected, contacted by telephone, and surveyed using three measures of global satisfaction, 23 perceived quality‐of‐care indicators, and six perceived wait times. Descriptive statistics were calculated. Comparisons were made of each of the perceived care and wait time indicators against explicitly defined acceptability criteria to determine satisfiers/dissatisfiers. Each indicator was correlated with the three global satisfaction indices. The authors integrated results obtained from applying the acceptability criteria with those obtained from the correlations to yield priority indicators for remediation and maintenance strategies. Results: For hospitals A and B, respectively, 15 (52%) and 16 (55%) of perceived care and wait time indicators failed to meet acceptability criteria. Using the correlations with overall satisfaction, the authors further narrowed the priority areas for remediation to six indicators for hospital A and three indicators for hospital B. One maintenance indicator was revealed for hospital A and four for hospital B. Conclusions: A combination of applying explicit acceptability criteria to descriptive statistics and using correlation coefficients with overall satisfaction can help to maximize the usefulness of patient satisfaction data by uncovering priority areas. These priority areas were broken down into maintenance and remediation indicators and were found to vary considerably depending on the hospital in question. Such strategies can help to refine performance improvement efforts by targeting those domains with the greatest impact on overall satisfaction.
Preventive Care in the Emergency Department: Should Emergency Departments Conduct Routine HIV Screening? A Systematic Review
Authors: Rothman Richard E. , Ketlogetswe Kerunne S. , Dolan Teresa , Wyer Peter C. , Kelen Gabor D. 
Published: March 2003

Abstract Objective: To perform a systematic review of the emergency medicine literature to assess the appropriateness of offering routine HIV screening to patients in the emergency department (ED). Methods: The systematic review was conducted with the aid of a structured template, a companion explanatory guide, and a grading and methodological scoring system based on published criteria for critical appraisal. Two reviewers conducted independent searches using OvidR, PubMed, MD Consult, and Grateful Med. Relevant abstracts were reviewed; those most pertinent to the stated objective were selected for complete evaluation using the structured template. Results: Fifty‐two relevant abstracts were reviewed; of these, nine were selected for detailed evaluation. Seven ED‐based prospective cross‐sectional seroprevalence studies found HIV rates of 2–17%. Highest rates of infection were seen among patients with behavioral risks such as male homosexual activity and intravenous drug use. Two studies demonstrated feasibility of both standard and rapid HIV testing in the ED, with more than half of the patients approached consenting to testing by either method, consistent with voluntary testing acceptance rates described in other settings. Several cost–benefit analyses lend indirect support for HIV screening in the ED. Conclusions: Multiple ED‐based studies meeting the Centers for Disease Control and Prevention Guideline threshold to recommend routine screening, in conjunction with limited feasibility trials and extrapolation from cost–benefit studies, provide evidence to recommend that EDs offer HIV screening to high‐risk patients (i.e., those with identifiable risk factors) or high‐risk populations (i.e., those where HIV seroprevelance is at least 1%).
Oral Treatment of Organophosphate Poisoning in Mice
Authors: Bowls Bradford J. , Freeman Jack M. , Luna James A. , Meggs William J. 
Published: March 2003

Abstract Objective: Organophosphates are used as pesticides, herbicides, and chemical warfare agents. Treatment of organophosphate poisoning is with intravenous atropine and pralidoxime in addition to supportive care. This study determined the efficacy of oral agents in preventing death from organophosphate poisoning. Methods: The organophosphate paraoxon (8 mg/kg) was used in a murine model with lethality at four and 24 hours as an end point. For oral treatment, 15 male Balbc mice were given either atropine sulfate (4 mg/kg), or a combination of atropine sulfate (4 mg/kg) with pralidoxime (100 mg/kg), by oral gavage. A control group of 22 mice received water by oral gavage. Chi‐square analysis was used to compare results in the different groups. Results: Of the control group, six of 22 survived to four hours after paraoxon exposure. Of the exposed animals treated with oral atropine, eight of 15 survived to four hours. Of the exposed animals treated with a combination of atropine and pralidoxime, 13 of 15 survived to four hours. All animals surviving to four hours survived to 24 hours. The increased survival of animals in the atropine group relative to the control group was not significant (p = 0.09). Survival was significant in the group treated with atropine and pralidoxime relative to atropine alone (p = 0.02) and to the control group (p = 0.0002). All treated mice surviving at four hours were alive at 24 hours. Conclusions: Both oral atropine and a combination of oral atropine and pralidoxime improved survival, and combination therapy achieved statistical significance. Generalization of this result to other organophosphate pesticides, other doses of paraoxon, and other species cannot be made without further investigations.
Can Some Growth Hormone (GH)-Deficient Children Benefit from Combined Therapy with Gonadotropin-Releasing Hormone Analogs and GH? Results of a Retrospective Study
Authors: Tauber M. , Berro B. , Delagnes V. , Lounis N. , Jouret B. , Pienkowski C. , Oliver I. , Rochiccioli P. 
Published: March 2003

Recombinant GH (rGH) treatment does not invariably correct height deficits in GH-deficient children once puberty has begun. The addition of GnRH analogs (GnRHa) to delay puberty has been advocated, but published results are few and sometimes conflicting.We retrospectively compared GH-deficient children treated with rGH and GnRHa for at least 1 yr after entering puberty and having attained their final height (n = 23) with a matched control group treated only with rGH. Overall, combined therapy did not significantly increase final height relative to rGH alone. However, the shortest girls at the onset of puberty (&lt;25th percentile) benefited more than the tallest (&gt;75th percentile) in both final height relative to predicted height and pubertal catch-up growth.In the control group, patients having experienced intrauterine growth retardation (IUGR) attained a lower mean final height than patients without IUGR (difference significant in boys, but not in girls). In the combined therapy group, IUGR did not affect the final height of either sex.Our results suggest that two populations might benefit most from combined GnRHa and rGH therapy: girls particularly short at the onset of puberty and patients who had experienced IUGR. Further prospective studies are required to confirm these preliminary hypothesis.
The effect of confirmation bias and racial stereotypes on perceptions of guilt and interrogation strategy decisions
Authors: Brimbal Laure , Atkinson Dominick J. , Meissner Christian A. 
Published: January 2024

AbstractWe examined whether racial stereotypes and guilt bias could affect perceptions of suspects and decisions in investigations. In three studies, participants read about a case, provided guilt judgments, and suggested questions they would ask a suspect. In all studies we manipulated race‐based stereotypes and guilt bias using different methods and operationalizations to provide a robust test of our hypotheses. In Experiment 1, we found that participants asked more guilt‐presumptive questions to the subject they decided was guilty. In Experiment 2, we found that when presented with more incriminating evidence, participants perceived suspects as more guilty and chose/generated more guilt‐presumptive questions. In Experiment 3, we found that those with less incriminating evidence reported lower levels of guilt and chose more coercive techniques. Our findings highlight the complexity of racial stereotypes and confirmation bias within investigation decision‐making.
Development of the American College of Rheumatology Patient‐Reported Outcome Quality Measures for Systemic Lupus Erythematosus
Authors: Katz Patricia P. , Barber Claire E. H. , Duarte‐García Alí , Garg Shivani , Machua Wambui , Rodgers Wendy , Santiago‐Casas Yesenia , Suter Lisa , Bartels Christie M. , Yazdany Jinoos 
Published: January 2024

ObjectiveAs part of a Centers for Disease Control and Prevention–funded American College of Rheumatology (ACR) initiative, we sought to develop quality measures related to Patient Reported Outcome Measure (PROM) use for systemic lupus erythematosus (SLE) clinical care.MethodsAn expert workgroup composed of physician, patient, and researcher representatives convened to identify patient‐reported outcome (PRO) domains of greatest importance to people with SLE. A patient advisory panel separately ranked domains. PROMs assessing priority domains were identified through structured literature review, and detailed psychometric reviews were conducted for each PROM. In a Delphi process, the expert workgroup rated PROMs on content validity, psychometric quality, feasibility of implementation, and importance for guiding patient self‐management. The patient advisory panel reviewed PROMs in parallel and contributed to the final recommendations.ResultsAmong relevant PRO domains, the workgroup and patient partners ranked depression, physical function, pain, cognition, and fatigue as high‐priority domains. The workgroup recommended at least once yearly measurement for (1) assessment of depression using the Patient Health Questionnaire or Patient Reported Outcomes Measurement Information System (PROMIS) depression scales; (2) assessment of physical function using PROMIS physical function scales or the Multi‐Dimensional Health Assessment Questionnaire; and (3) optional assessments of fatigue and cognition. Pain scales evaluated were not found to be sufficiently superior to what is already assessed in most SLE clinic visits.ConclusionExpert workgroup members and patient partners recommend that clinicians assess depression and physical function at least once yearly in all people with SLE. Additional PROMs addressing cognition and fatigue can also be assessed. Next steps are to incorporate PROM‐based quality measures into the ACR The Rheumatology Informatics System for Effectiveness registry.
Reservoir Microneedle Patch Mitigates Postsurgical Atrial Fibrillation
Authors: Wang Wenshuo , Chen Yansong , Huang Liqi , Lu Ziyi , Ullah Muhammad Asad , Wei Lai , Yang Guang 
Published: January 2024

AbstractOral amiodarone for 3–6 months is commonly required for the prevention and treatment of atrial fibrillation (AF) after surgical ablation of refractory AF. However, clinical data show that oral administration is likely to cause systemic toxicity, especially pulmonary fibrosis. Here, a new strategy is described for the treatment and prevention of postsurgical AF via the epicardial application of a monolithic reservoir microneedle device. These findings demonstrate that this strategy enables a sustained transport of amiodarone directly to the atrium, thereby maximizing therapeutic efficacy and minimizing systemic drug distribution. Notably, a significantly reduced drug dosage (only one dose of 6.3 mg for reservoir MNs versus a daily dose of ≈10 mg for oral administration) achieves therapeutic efficacy over a long period of 24 weeks in a rat AF model, circumventing the risks of pulmonary fibrosis associated with oral administration. This device can serve as a promising alternative to oral amiodarone, providing a robust therapeutic strategy for the prevention and treatment of postsurgical AF is antipicated.
Fast Ion Transport Interphase Integrated with Space Confinement Enabling High‐Rate and Long‐Lifespan Na Metal Batteries
Authors: Xia Shuixin , Fan Wenxuan , Hou Zhen , Li Chenrui , Jiang Zongyan , Yang Junhe , Mao Jianfeng , Zheng Shiyou 
Published: January 2024

AbstractThe practical application of sodium (Na) metal anode has been seriously hindered by the uncontrolled Na dendrite growth and severe volume expansion inducing short battery lifespan and safety concerns. Here, highly sodiophilic and ultrafine ZnS‐modified carbon fibers have been rationally constructed as a scaffold to obviate these drawbacks. The in situ generated Na2S‐reinforced fast ion transport interphase and the effective space confinement synergistically facilitate the fast sodium ion interfacial transfer and the homogeneous and dendrite‐free Na deposition, thus enabling high‐rate and dendrite‐free Na metal anode. The modified Na metal demonstrates ultrahigh rate capability (15 mA cm−2) and ultralong cycling life (5300 cycles). Moreover, the Na|Na3V2(PO4)3 (NVP) cell delivers ultrahigh rate capability (80 C) and extraordinarily ultralong lifespan cycling durability (2980 cycles). The Na|NVP pouch cell also exhibits an extraordinarily ultralong‐term cycle life of over 1070 cycles with an extremely low capacity decay rate of 0.0088% per cycle at 10 C. This work provides a facile and efficient strategy to propel the Na metal anode towards practicability.
Material and Device Design of Flexible Perovskite Solar Cells for Next‐Generation Power Supplies
Authors: Tian Ruijia , Zhou Shujing , Meng Yuanyuan , Liu Chang , Ge Ziyi 
Published: January 2024

AbstractThis review outlines the rapid evolution of flexible perovskite solar cells (f‐PSCs) to address the urgent need for alternative energy sources, highlighting their impressive power conversion efficiency, which increases from 2.62% to over 24% within a decade. The unique optoelectronic properties of perovskite materials and their inherent mechanical flexibilities instrumental in the development of f‐PSCs are examined. Various strategies proposed for material modification and device optimization significantly enhance efficiency and bending durability. The transition from small‐scale devices to large‐area photovoltaic modules for diverse applications is discussed in addition to the challenges and innovative solutions related to film uniformity and environmental stability. This review provides succinct yet comprehensive insights into the development of f‐PSCs, paving the way for their integration into various applications and highlighting their potential in the renewable energy landscape.
Microstructural Control of a Multi‐Phase PH Steel Printed with Laser Powder Bed Fusion
Authors: Fields Brandon , Amiri Mahsa , Lim Jungyun , Pürstl Julia T. , Begley Matthew R. , Apelian Diran , Valdevit Lorenzo 
Published: January 2024

AbstractThe established approach to materials design for additive manufacturing (AM) consists of attempting to reproduce the uniform structures and properties of conventionally processed materials. While this certainly helped facilitate material certification and the rapid introduction of AM technologies in several industries, the opportunity to exploit unique features of specific AM processes to generate spatially varying microstructures–and hence novel materials, remains largely untapped. This work presents a method for manufacturing materials through laser powder bed fusion (LPBF), in which control over the spatial variation in phase composition and mechanical properties is achieved. This technique is demonstrated using 17‐4 precipitation‐hardened stainless steel (17‐4PH), by controlling spatial modulation of energy densities during printing. This results in local control of ferrite/martensite volume fractions, allowing the fabrication of metal/metal architected composites with hard/brittle regions interspersed with soft/tough regions. Local variations of ~20% in tensile strength and ~150% in elongation are achieved, with a spatial resolution of ~100 microns. The approach is general and robust, fully compatible with commercially available LPBF equipment, and applicable to virtually any multi‐phase alloy system. This work shifts the paradigm from attempting to print components with uniform properties to manufacturing alloys with controlled spatial property gradients.
Enhanced Performance of Gallium‐Based Wide Bandgap Oxide Semiconductor Heterojunction Photodetector for Solar‐Blind Optical Communication via Oxygen Vacancy Electrical Activity Modulation
Authors: Wu Chao , Zhao Tianli , He Huaile , Hu Haizheng , Liu Zeng , Wang Shunli , Zhang Fabi , Wang Qinfeng , Liu Aiping , Wu Fengmin , Guo Daoyou 
Published: January 2024

AbstractGallium oxide (β‐Ga2O3) is a prominent representative of the new generation of wide‐bandgap semiconductors, boasting a bandgap of ≈4.9 eV. However, the growth process of β‐Ga2O3 materials introduces unavoidable oxygen vacancies (Vo), leading to persistent photoconductivity (PPC), a phenomenon that severely hinders device performance. In this study, an innovative approach is successfully developed by introducing high p‐orbital energy nitrogen (N). This leads to the formation of a hybridized state with O 2p orbitals in β‐Ga2O3, resulting in the creation of GaON and suppressing the electrical activity of Vo. Through meticulous experimentation and advanced computational methods, a comprehensive and insightful explanation of the regulation and mechanism underlying this passivation process is offered. Moreover, pn‐junction solar‐blind photodetectors are engineered using hybridized GaON thin films with p‐type CuPc. These photodetectors demonstrate exceptional characteristics, including ultra‐low dark current (10−14 A), high photo‐to‐dark current ratio (106), and rapid decay speed (0.008 s) even at zero bias. Based on these advancements, a solar‐blind ultraviolet communication system is designed, featuring straightforward and reliable encoding, easy implementation, and robust anti‐interference capabilities.
Gate‐Tunable Spectral Response in β‐Ga2O3/Te Hybrid Photogating Structure for Ultrasensitive Broadband Detection
Authors: Liu Weijie , Peng Meng , Yu Yiye , Zheng Zhihua , Jian Pengcheng , Zhao Yongming , Zeng Yuhui , Xu Dan , Chen Maohua , Luo Yuang , Chen Changqing , Dai Jiangnan , Wu Feng 
Published: January 2024

AbstractThe increasing demand for multispectral information acquisition and the complexity of application environments have sparked a growing interest in broadband detection. However, achieving a high level of responsivity across a wide response range remains a significant challenge. Herein, an ultrasensitive broadband phototransistor based on hybrid photogating (HPG) structure is demonstrated, which consisted of a quasi‐2D beta‐phase gallium oxide (β‐Ga2O3) nanoflake as the carrier transport channel and a tellurium (Te) nanoflake as the photogating layer. Attributed to the strong doping influence of the Te nanoflake, a low off‐state current of pA level and a high on/off current ratio of ≈108 are obtained. Upon 255 nm wavelength illumination, the device exhibited an ultrahigh responsivity up to 3.82 × 106 A W−1 and a detectivity as high as 1.59 × 1014 Jones across a large gate voltage range. Notably, an exciting infrared response is obtained with a responsivity of 138 A W−1 and a detectivity of 3.70 × 109 Jones under the 1550 nm wavelength illumination, exclusively achievable when the gate voltage exceeded 4 V. Leveraging the gate‐tunable spectral response, an innovative model for secure optical communication was proposed. This work presents an efficient and feasible strategy for fabricating multifunctional optoelectronic devices.