bluuebunny/crossref_metadata_2025_split huggingface dataset:
Work-related factors and the risk of common mental disorder 1 year later: A prospective cohort study among junior doctors
Authors: Petrie Katherine , Gayed Aimee , Spittal Matthew J , Glozier Nicholas , Shand Fiona , Harvey Samuel B 
Published: November 2023

Objective: This study investigated the relationship between work-related factors at baseline and the risk of common mental disorder at 12 month follow-up among a cohort of junior doctors. Method: The data comprised the junior doctor respondents from two annual waves of the ‘Medicine in Australia: Balancing Employment and Life’ (MABEL) survey, a national longitudinal cohort of Australian doctors. Individual and work-related risk factors were assessed at baseline and the mental health outcome of caseness of common mental disorder (CMD) was assessed using the 6-item Kessler Psychological Distress Scale at 12-month follow-up. Unadjusted and adjusted logistic regressions were conducted to estimate the association between each baseline variable and the likelihood of CMD caseness at follow-up 1 year later. Results: Among 383 junior doctors, 24 (6%) had CMD 1 year later. Five work-related baseline variables were significantly associated with a higher likelihood of CMD 1 year later in adjusted models; lack of social support in work location (odds ratios (OR) = 6.11; 95% confidence intervals (CI) = [2.52, 14.81]), work-life imbalance (OR = 4.50; 95% CI = [1.31, 15.46]), poor peer support network in the workplace (OR = 2.61; 95% CI = [1.08, 6.27]), perceptions of patient expectations (OR = 2.46; 95% CI = [1.06, 5.71]) and total weekly work hours (OR 1.04; 95% CI = [1.01, 1.07]; p = 0.002)in models adjusting for gender. Conclusion: These results identify key modifiable work-related factors that are associated with junior doctors’ future mental health. Our findings suggest the need for a greater focus upon interpersonal factors and work-life balance in multi-level interventions while continuing to address workplace and system-level factors to prevent future mental disorder in junior doctors.
Exposures to Bleach, Peroxide, Disinfectants, Antimalarials, and Ivermectin Reported to the California Poison Control System Before and During the COVID-19 Pandemic, 2015-2021
Authors: Ghai Alice , Sabour Emily , Salonga Raeann , Ho Raymond , Apollonio Dorie E. 
Published: November 2023

Objectives: The COVID-19 pandemic led to widespread fear of infection, with many people expanding their use of cleaning products and trying unproven prevention and treatment strategies. We described shifts in reported exposures related to COVID-19 home interventions. Methods: This study considered suspected toxicity exposures involving household cleaning products (bleach, peroxide, disinfectants), antimalarials (hydroxychloroquine and chloroquine), and ivermectin reported to the California Poison Control System from 2015 through 2021 and assessed trends in exposures by using interrupted time-series analyses. Results: We found a significant increase in exposures reported to the California Poison Control System related to household cleaning products and ivermectin during the COVID-19 pandemic. As of January 1, 2015, the baseline level of reported exposures to household cleaning products was 707.33 per month and was declining at a rate of 1.71 (95% CI, –2.87 to –0.56) per month through February 29, 2020. In March 2020, an increase of 466.57 (95% CI, 328.08-605.07) reported exposures above baseline occurred, after which exposures to cleaning products decreased at a rate of 23.40 (95% CI, –32.48 to –14.32) per month. The number of reported exposures to antimalarials did not change significantly before or during the pandemic. The number of reported ivermectin exposures before December 2020 was initially stable at 14.50 per month and then increased by 2.05 per month through December 2021. Conclusions: Our observations suggest that while some dangerous home prevention and treatment efforts resolve over time, further interventions may be needed to reduce the public health effects related to attempts to self-treat COVID-19 with ivermectin.
Mortality on extracorporeal membrane oxygenation: Evaluation of independent risk factors and causes of death during venoarterial and venovenous support
Authors: Deinzer Johannes , Philipp Alois , Kmiec Lukasz , Li Jing , Wiesner Sigrid , Blecha Sebastian , Petermichl Walter , Lubnow Matthias , Camboni Daniele , Schmid Christof , Stadlbauer Andrea 
Published: November 2023

Introduction Most patients on extracorporeal membrane oxygenation (ECMO) decease during therapy on the system. However, the actual causes of death have not been studied sufficiently. This study analyses the etiology, prevalence, and risk factors for the outcome variable death during ongoing ECMO for all patients and divided according to venoarterial (VA) or venovenous (VV) support. Methods We retrospectively analysed all patients receiving ECMO support at our institution between March 2006 to January 2021. Only the patients deceased during ongoing support were included. Results 2016 patients were placed on VA ( n = 1168; 58%) or VV ( n = 848; 42%) ECMO; 759 patients (37.7%) deceased on support. The causes of death differed between the support types: VA ECMO patients mostly died from cerebral ischemia (34%), low-cardiac output (LCO; 24.1%) and multi-organ failure (MOF; 21.6%), whereas in VV ECMO cases, refractory respiratory failure (28.2%), and sepsis (20.4%) dominated. Multivariate regression analysis revealed cardiopulmonary resuscitation (CPR) and acidosis prior to ECMO as risk factors for dying on VA ECMO, while high inotropic doses pre-ECMO, a high fraction of inspired oxygen on day 1, elevated lactate dehydrogenase, and international normalized ratio levels lead to an unfavourable outcome in VV ECMO patients. Conclusion Even in highly experienced centers, ECMO mortality remains high and occurs mainly on support or 24 h after its termination. The causes of death differ between VV and VA ECMO, depending on the underlying diseases responsible for the need of extracorporeal support.
Frequency of dysnatremia in patients admitted with COVID-19 infection and its prognostic implication
Authors: Gul Khan Farah , Sattar Saadia , Yaqoob Muhammad M. , Vallani Nida , Asad Maryam 
Published: November 2023

Objective We aimed to investigate the frequency of dysnatremia among patients admitted with COVID-19 infection and its association with inpatient mortality. Methods This retrospective longitudinal study was conducted for 12 weeks. Serum sodium levels were recorded at admission, during the hospital stay, and within 48 hours of discharge or death. Logistic regression was used to determine the predictors of mortality. Results This study included 574 patients (69.7% men, age 55.6 ± 14.4 years). On admission, mean sodium was 135.9 ± 6.4 mEq/L; 39% had hyponatremia and 4.7% had hypernatremia. During admission, hypernatremia increased to 18.8%; maximum sodium in patients who survived was 140.6 ± 5.0 mEq/L versus 151.0 ± 9.9 mEq/L in those who died. The final sodium was 145.4 ± 9.4 mEq/L in patients who died versus 137.7 ± 3.7 mEq/L in those who survived (odds ratio [OR]: 1.22, 95% confidence interval [CI]: 1.13–1.32). Other predictors of mortality included ischemic heart disease (OR: 3.65, 95% CI: 1.39–9.61), acute kidney injury (OR: 6.07, 95% CI: 2.39–15.42), invasive ventilation (OR: 28.4, 95% CI: 11.14–72.40), and length of stay (OR: 0.91, 95% CI: 0.86–0.97). Conclusion Hypernatremia was frequently observed in patients who were critically ill and died and may be considered a predictor of mortality in COVID-19 infection.
Impact of a Pharmacist-Conducted Preoperative Beta-Lactam Allergy Assessment on Perioperative Cefazolin Prescribing
Authors: Hitchcock Allison M. , Kufel Wesley D. , Seabury Robert W. , Steele Jeffrey M. 
Published: November 2023

Background: Cefazolin is guideline recommended for perioperative prophylaxis in orthopedic surgery. Despite its unique R1 side chain, cefazolin is often avoided in patients with beta-lactam allergy with concern for cross reactivity. Objectives: The primary outcome was the percentage of patients who received cefazolin perioperatively. Secondary outcomes included the percentage of patients with a beta-lactam allergy clarified following the telephone interview and clinical outcomes including acute kidney injury, surgical site infection, Clostridioides difficile infection, and re-admission at 30 and 90 days. Methods: This single-center, quasi-experimental study evaluated a pilot program in which a pharmacist phoned patients > 18 years of age with a scheduled orthopedic surgery and a documented beta-lactam allergy to assess their allergy preoperatively. Recommendations to use cefazolin were based on an algorithm. Patients were divided into pre- and post-intervention cohorts. Results: A total of 832 patients were screened for inclusion with 135 and 66 patients included in the pre- and post-intervention cohorts. No significant difference was identified in the primary outcome. In the post-intervention cohort, 62% had a beta-lactam reaction updated in the electronic medical record. Those with a beta-lactam allergy delabeled or made less severe were numerically more likely to receive cefazolin than those with an unchanged reaction or a reaction made more severe (95.2% vs 68% vs 65%). There were no differences in clinical outcomes between groups. Conclusion: A pharmacist-conducted preoperative beta-lactam allergy interview in adult patients undergoing elective orthopedic surgery improved beta-lactam allergy documentation but, did not result in increased utilization of cefazolin.
Design optimization and power management of a fuel cell-battery fixed-wing electric UAV
Authors: Saib Sabah , Achour Yahia , Ghennam Tarak , Marouani Khoudir , Rizoug Nassim 
Published: November 2023

This study aims for endurance improvement and energy saving by addressing, on the one hand, the design optimization (DO) of a hybrid electric source (HES) consisting of a fuel cell (FC) and a battery, intended for a fixed-wing electric UAV (EUAV) and, on the other hand, the power management (PM) of the sources. The DO employed the particle swarm optimization (PSO) algorithm, which determines the FC power and the battery capacity that offer the sources the least weight; the findings resulted in a weight reduction of 8%; this gain saves a total energy of 90.28 kJ that can extend the “endurance stage” by more than 26 min. Three power management strategies (PMS) are examined: frequency separation (FS), which gives good performance in PM and protects the FC from dehydration by smoothing its response; power limitation (PL) which protects the FC from exceeding its maximum power, and fuzzy logic (FL), which allows for more flexible power distribution between the sources and has the main advantage of controlling the battery state of charge (SOC). A fourth strategy was developed by combining the benefits of these three strategies. This hybrid PMS (HPMS) saves 2% of FC energy compared to the FL strategy. FS and PL save, respectively, 41% and 44% of FC energy, but the SOC can drop significantly, especially for longer missions. The experimental findings, achieved using a laboratory test bench, validate the simulated results obtained from MATLAB/Simulink software, confirming the validity and performance of the proposed HPMS.
A Longitudinal Two-Armed Randomized Controlled Trial Protocol to Evaluate the Efficacy of Yoga on Progression of Disease in Early Parkinson’s Disease
Authors: Some Parameshwar , Majumdar Vijaya , N. K. Manjunath , Shetty Kuldeep , Snigdha Atmakur 
Published: November 2023

BackgroundNumerous studies have shown that yoga can aid patients with Parkinson’s disease (PD) in managing their motor function, functional mobility, balance, anxiety, and overall quality of life. However, most of the reported research either needed more power or evaluated the results during or after the intervention. Due to the long-standing nature of PD, there are still few longitudinal studies investigating the potential of yoga to decrease the progression of the disease.PurposeWe study whether sustained adjunct yoga intervention slows PD progression.MethodsOver 18 months, this study will investigate the long-term benefits of yoga-based intervention in Parkinson’s patients. The concept of “intention-to-treat (ITT)” will be employed. From the outpatient clinic of the Swami Vivekananda Yoga Anusandhana Samsthana in India, 160 patients with PD will be chosen. They will then be randomly assigned to either the interventional or control groups (1:1). The adjunct intervention group will participate in 21 daily contact yoga sessions (60 min) at the University Medical Center, followed by continued tele-supervised home practice and at-home self-practice. The effectiveness of the adjunct intervention will be evaluated at four different time points (baseline, 3-, 9-, 12-, and 18-month post-randomization). The primary endpoint will be the difference in the Movement Disorder Society-Unified Parkinson Disease Rating Scale (MDS-UPDRS) Part III score at baseline and after 18 months of intervention. Secondary outcomes will include subscores of MDS-UPDRS I, II, and IV, Parkinson’s Disease Questionnaire (PDQ)-39 scores, treatment adherence, the PDQ-39, the Depression, Anxiety, and Stress Scale-21, and the Scales for Outcomes in PD-Sleep Scale (SCOPA-S). The primary outcome will be analyzed using mixed-effect models for repeated measures, adjusted for covariates as fixed effects.ResultsThe protocol was conceptualized in October 2021 and approved by the Institutional Ethics Committee of SVYASA. Recruitment began in February 2022 and is underway with patient enrollment.ConclusionTo our knowledge, this is the first controlled study to examine the long-term effects of yoga as an adjuvant therapy on the progression of PD.Key messageThis would be the first long-term trial to assess the potential of an adjunct yoga intervention to modulate disease progression in early Parkinson’s patients.
Is Your City Too Big? Causes of Urban Primacy in India
Authors: Sridhar Kala Seetharam 
Published: November 2023

In this article, we examine the degree of urban primacy and understand what explains urban primacy in the Indian states. We estimated Zipf’s law for Indian states for 2001 and 2011. We then regressed the urban population in the largest city in each state as dependent on various factors. We find Kerala had the least primacy as of 2011, whereby its biggest city contained only 5% of its urban population. Based on the second-stage regression, we find that the state per capita income, population and length of railways have a significantly negative effect on primacy, while MSME employment increases it. We examine the highway network in selected states characterized by severe primacy and find a major problem with national transport priorities. The policy implications are for improving the national highway network and rail routes in the states to increase MSME employment and increase state income to reduce primacy.
Knowledge, Beliefs, and Cultural Practices of Sexual and Reproductive Health Among Afghan Refugee Women in Türkiye
Authors: Kuru Alici Nilgün , Ogüncer Ali 
Published: November 2023

Introduction: Limited research on experiences of women, who constitute a double vulnerable group in both women and refugee status, regarding sexual and reproductive health. The purpose of this study is to examine the knowledge, beliefs, and cultural practices of Afghan women living in Türkiye regarding sexual and reproductive health. Method: This descriptive phenomenological study was conducted with 18 Afghan refugee women. In-depth, semi-structured interviews were conducted to collect data. Results: Four themes emerged from interviews: cultural practices and beliefs related to pregnancy and postpartum, use of contraceptive methods, gender-based violence, and access to health services. Conclusions: Afghan women have different cultural practices regarding prenatal, pregnancy, and postpartum and lack of knowledge about sexual and reproductive health. Considering individual differences in sexual and reproductive health, providing sensitive, supportive, and informative services is recommended.
Brown Tumors of the Jaws: A Retrospective Study
Authors: Fedhila Maya , Belkacem Chebil Raouaa , Marmouch Hela , Terchalla Sabrine , Ayachi Samia , Oueslati Yassine , Oualha Lamia , Douki Nabiha , Khochtali Habib 
Published: November 2023

Objectives: (1) Describe the clinical spectrum, imaging features, management, and outcome of brown tumors (BT) of the jaws. (2) Determine via a literature review the facts and controversies around the characteristics and management of this lesion. Materials and methods: Our study was approved by the institutional committee of Sahloul University Hospital in accordance with the ethical standards of the Declaration of Helsinki. Sixteen patients with BT in the context of a primary, secondary, and tertiary hyperparathyroidism were treated and followed up during their recovery. Results: This study reports 16 patients with a mean age of 48 years old. Brown tumor lesions were associated with primary hyperparathyroidism in 6 cases (38%), secondary hyperparathyroidism to chronic kidney failure in 5 cases (31%), and tertiary hyperparathyroidism in the context of a long lasting CRI in 5 cases. Their location was maxillary in 7 cases, mandibular in 5 cases, and bimaxillary in 4 cases. The treatment consisted of parathyroidectomy in 13 patients, maxillary resection in 3 cases, and vitamin D treatment in 2 cases. Favorable outcomes, characterized by tumor regression, were reported in 9 cases, whereas unfavorable evolution was observed among 7 patients. Conclusion: Parathyroidectomy is the gold standard treatment for primary hyperparathyroidism. It resulted in a total regression in all our cases. Regarding secondary hyperparathyroidism, blood screening and chronic renal insufficiency follow-up are critically valuable to detect this condition at an early stage, hence increasing the success rate of brown tumor regression. Our secondary and tertiary hyperparathyroidism results were miscellaneous; although it is important to emphasize the importance of the chronic renal insufficiency management to ensure a success. Clinical relevance: Brown tumors should be included in the differential diagnosis of giant cell lesions. Parathyroidectomy is usually sufficient to induce the total regression of the lesion in primary hyperparathyroidism cases. A more delicate approach is needed regarding secondary hyperparathyroidism. Meticulous control of chronic renal insufficiency is mandatory in addition to parathyroidectomy.
Better spiritual support for people living with early stage dementia: Developing the diamond conversation model
Authors: Haufe Marc , Leget Carlo , Potma Marieke , Teunissen Saskia 
Published: November 2023

Background People with early-stage dementia could benefit greatly from on-going spiritual support. However, health care professionals working in dementia care often do not have a clear idea of what such support might entail. There is a lack of tools that can help professionals provide such support. The Diamond conversation model used in palliative care could provide such a support. Aims: To develop the Diamond model for early-stage dementia so that professionals can provide better spiritual support. Methods Participatory research was conducted. Reflective interviews with chaplains, case managers and health psychologists identified frequently occurring existential and spiritual issues of clients and family members. A core participatory group consisting of chaplains, a psychologist and a researcher further analysed these issues thematically and co-developed the Diamond model for early stage dementia over three co-creation sessions. Researchers with Diamond model expertise provided feedback to the core participatory group in between these sessions based on the session output. Findings Central existential and spiritual issues were found to be: self-confidence and –worth, adaptability and capacity, security and loss, burden and enrichment of memory and faith and meaning. The five polarities of the Diamond model were found helpful to understand tensions surrounding these issues. Specific tensions were identified between maintaining a self and being valued, finding direction in what to do and a way to bear changes in ability, a strong need for attachment and letting go of past ways to relate to one another, the renewed intensity of long term memories and decline of the short term ones and surrendering to one’s life situation and wanting certainty and meaning. Conclusions The newly developed Diamond model for people with early-stage dementia offers a valuable framework to help professionals provide conversational support. More research needs to be done to further test and develop the model in practice.
Pancreatic Ischemia-Reperfusion Injury Following Endovascular Treatment of Symptomatic Celiac and Superior Mesenteric Artery Stenosis
Authors: Mihatsch Patrick W. , Schmidt Alexander M. , Augustin Anne Marie , Thurner Annette , Peter Dominik , Kickuth Ralph 
Published: November 2023

Ischemia-reperfusion injury occurring after endovascular treatment of chronic mesenteric ischemia and its effects on abdominal organs, especially the intestines, have been previously described in the literature. Here, we present a rare case of predominantly pancreatic ischemia-reperfusion injury following 2-vessel mesenteric artery revascularization in a patient with symptomatic chronic mesenteric ischemia. Clinical Impact With endovascular therapy becoming the first-line treatment for symptomatic chronic mesenteric ischemia, acute pancreatitis within the context of abdominal ischemia-reperfusion injury may be seen more often in cross-sectional imaging following this kind of interventions and should therefore be kept in mind by the reading physician.
The relationship between loneliness and depression among college students: Mining data derived from passive sensing
Authors: Qirtas Malik Muhammad , Zafeiridi Evi , White Eleanor Bantry , Pesch Dirk 
Published: November 2023

Background While there is recognition of the relationship between loneliness and depression, specific behavioural patterns distinguishing both are still not well understood. Objectives Our objective is to identify distinct behavioural patterns of loneliness and depression from a passively collected dataset of college students, understand their similarities and interrelationships and assess their effectiveness in identifying loneliness and depression. Methods Utilizing the StudentLife dataset, we applied regression analysis to determine associations with self-reported loneliness and depression. Mediation analysis interprets the relationship between the two conditions, and machine learning models predict loneliness and depression based on behavioural indicators. Results Distinct behavioural patterns emerged: high evening screen time (OR = 1.45, p = 0.002) and high overall phone usage (OR = 1.50, p = 0.003) were associated with more loneliness, whereas depression was significantly associated with fewer screen unlocks (OR = 0.75, p = 0.044) and visits to fewer unique places (OR = 0.85, p = 0.023). Longer durations of physical activity (OR = 0.72, p = 0.014) and sleep (OR = 0.46, p = 0.002) are linked to a lower risk of both loneliness and depression. Mediation analysis revealed that loneliness significantly increases the likelihood of depression by 48%. The prediction accuracy of our XGBoost-based machine learning approach was 82.43% for loneliness and 79.43% for depression. Conclusion Our findings show that high evening screen time and overall phone usage are significantly associated with increased loneliness, while fewer screen unlocks and visits to fewer unique places are significantly related to depression. The findings can help in developing targeted interventions to promote well-being and mental health in students.