bluuebunny/crossref_metadata_2025_split huggingface dataset:
Influence of ballast and railway substructure on the degradation of local geometry defects
Authors: Rodrigues Pedro , Teixeira Paulo F 
Published: February 2024

The degradation of track geometry is a very complex phenomenon that has typically been analysed considering global quality indicators. In this paper, the influence of ballast and track substructure on its geometric degradation is analysed by modelling the degradation rates of more than 17,400 local defects of longitudinal levelling, alignment, and twist from 66,892 km of track inspection measurements carried out during the period 2001-2012 on 19 conventional lines of the Portuguese railway network. It is corroborated that singularities markedly contribute to greater density and faster degradation of defects, especially culverts and level crossings. Ballast type and age significantly affect the probability of emergence and degradation rates of defects. In a significant number of situations, defects are found to degrade much faster than the standard deviation indicators, highlighting the importance of monitoring and modelling their evolution to prevent the need for carrying out corrective interventions as much as possible.
Kangaroo Mother Care in a Tertiary Hospital in Northeast India: A 36-month Quality Improvement Initiative
Authors: Ksoo Rosina , Barman Himesh , Monsang Ngoru Amila , Nongrum Barihun , De Manisha , Simon Anna Choondal 
Published: February 2024

Background: Kangaroo mother care (KMC) is a special method of care for low birth weight and preterm babies by providing early and prolonged skin-to-skin contact with the mother and exclusive breastfeeding. It is a simple and cost-effective ways to take care of low-birth-weight babies. Objectives: To give KMC as a routine practice and to provide extended KMC to all eligible babies. Methodology: We conducted a Quality improvement (QI) study in our out-born neonatal unit from July 2020, and reviewed every six month till June 2023. A QI team comprising of staff nurses and doctors was formed. The root cause analysis for doing KMC was evaluated using a fishbone diagram, and the issues were addressed using prioritization matrix. Multiple Plan-Do-Study-Act (PDSA) cycles were conducted. Results were analysed using descriptive statistics. Results: A total of 105 babies were enrolled during this period. The mean gestation age was 32 ± 3.28 weeks. The average weight was 1577 ± 417 grams. Our baseline was two hours and 30 minutes per baby per day. We did a total of three PDSA cycles, and as of June 2023, we were able to give an average of 5.3 hours per baby per day. Conclusion: Our QI measures ensured that KMC was provided to all eligible low-birth-weight babies with proper documentation. Sensitizing and capacity-building our nursing staffs on KMC empowered them and helped to achieve and sustain our aim.
STrIP Score for Neonatal Jaundice: From Bench to Bedside
Authors: D Srinivasa Murthy , Krishnegowda Sushma , Thandaveshwara Deepti 
Published: February 2024

Background Non-invasive assessment of neonatal hyperbilirubinemia is done clinically with the Kramer scale and transcutaneous bilirubinometer. Recently, the Stool color for Triage of Infants needing Phototherapy (STrIP) score was studied and found to be better than both of the above methods in predicting measured serum bilirubin. This study sheds light on the clinical utility of the STrIP score in making therapeutic decisions. Method This was a prospective study done in a tertiary-level neonatal unit. Breastfed term babies with clinical jaundice were recruited. The Kramer scale and STrIP score were performed on them and compared with respect to the therapeutic decision of commencing phototherapy based on measured serum bilirubin. Results One hundred and twenty-eight infants were studied. The Kramer scale correctly aided the therapeutic decision on phototherapy (either to start or not to start) in 47 (36.7%) and the STrIP score in 119 (93%) of our subjects ( p = .0001). In 81 (63.2%) of the subjects, the Kramer scale underestimated the need for phototherapy. In contrast, the STrIP score overestimated the need for phototherapy in 11 (9%). Conclusion The STrIP score helps in making more accurate therapeutic decisions in neonatal hyperbilirubinemia compared to the Kramer scale alone with respect to commencing phototherapy.
Mobility as an Effective Non-pharmacological Method for Parturition: A Pilot Study
Authors: Rathina N. , Srivastava Sunita , Rawat Sarita 
Published: February 2024

Background Childbirth is a transformative process. Modern healthcare offers pharmacological and non-pharmacological interventions for safe and improved childbirth experience. Studies have found that maternal mobility during the first stage of labour has a significant effect on maternal and child outcomes. A pilot study was done to find the effect of mobility during the first stage of labour on maternal satisfaction and foetal outcome. Method An experimental study was done with 60 primigravida women with uncomplicated antenatal history reporting to the labour room of a tertiary care government hospital in Delhi chosen as study participants. Validated and reliable tools were used to measure labour, maternal and neonatal outcomes within 24 h post-delivery. Results The results showed that there was an impact on mobility intervention during the first stage of labour on parturition ( p = .03) and significant maternal satisfaction ( p = .001). However, the neonatal outcome of both groups was not significant. Conclusion Mobility was an effective non-pharmacological intervention for enhancing parturition and maternal satisfaction. Mobility during the first stage of labour can be recommended for practice guidelines for all midwives in the labour room as a protocol.
Outcomes of Joint-Preserving Surgery for Forefoot Deformities in Patients With Rheumatoid Arthritis
Authors: Tominaga Ayako , Ikari Katsunori , Yamada Akifumi , Yano Koichiro , Okazaki Ken 
Published: February 2024

Background: With the advent of effective disease-modifying medications, the surgical treatment of forefoot deformities in patients with rheumatoid arthritis (RA) has evolved from joint-sacrificing to joint-preserving surgery. However, it is unclear whether joint-preserving surgery is effective for the full range of metatarsophalangeal joint involvement. Hence, this study investigated the postoperative outcomes of joint-preserving surgery for rheumatoid forefoot deformities with a wide range of joint destruction. Methods: This retrospective observational study included 68 feet from 68 patients with RA who underwent joint-preserving surgery for forefoot deformities between 2014 and 2020. The Larsen grade classification was used to assess the first metatarsophalangeal joint destruction and classify patients into 4 groups as follows: 0 and 1 (n = 14), 2 (n = 21), 3 (n = 19), and 4 and 5 (n = 14). The Self-Administered Foot and Ankle Evaluation Questionnaire (SAFE-Q) score, hallux valgus angle (HVA), and intermetatarsal angle (IMA) were determined before surgery and at the last follow-up visit. Results: The median observation duration was 40 (range, 24-78) months. SAFE-Q scores of all groups significantly improved in all subscales at the last observation, with no significant differences among the study groups. Radiographic evaluations of all groups revealed significant improvements in HVA and IMA after surgery, with no significant differences among the groups. Conclusion: In patients using the surgical approaches described in this study, joint-preserving surgery for rheumatoid forefoot deformities led to satisfactory clinical and radiographic improvements, regardless of the severity of joint destruction. Level of Evidence: Level III, case-control study.
Analysis of Nonweightbearing MRI Fat Pad Thickness Under Central Metatarsals in Patients With and Without Metatarsalgia
Authors: Gauthier Chase , Guttman Anne , Bakaes Yianni , Jackson J. Benjamin , Gonzalez Tyler 
Published: February 2024

Background: Metatarsalgia is a common diagnosis for patients with forefoot pain. Many have proposed metatarsal fat pad atrophy is a cause of metatarsalgia and therefore have suggested fat grafting instead of distal metatarsal osteotomies to treat metatarsalgia. For fat grafting to be a viable treatment, fat pad atrophy should correlate with metatarsalgia. This study looked to determine the relationship between metatarsal fat pad thickness and metatarsalgia and the correlation between metatarsal fat pad thickness and patient-reported outcomes. Methods: We conducted a retrospective review of patients with metatarsalgia and those with foot or ankle osteoarthritis who had a nonweightbearing MRI performed between February 1, 2021, and March 1, 2023. Data collected included demographics, PROMIS scores, metatarsal fat pad thickness in the second and third rays of the affected foot, and thinnest area on coronal section, measured on MRI. Student t test was used to compare continuous variables, whereas the χ2 test was used to compare categorical variables. Multivariable linear regression models were used to control for potential confounding factors. Results: A total of 112 patients were included in this study. Patients with metatarsalgia were significantly more likely to have a lower body mass index (29.3 vs 32.0, P  = .03) than patients with osteoarthritis, but this finding was not present when controlling for confounding variables. We found no significant difference in fat pad thickness between patients with metatarsalgia vs patients with foot or ankle osteoarthritis ( P  = .43). We found no correlation between metatarsal fat pad thickness and pain interference ( P  = .59), physical function ( P  = .64), or mobility ( P  = .94) PROMIS scores. Conclusion: In this retrospective comparative study of a relatively small cohort we found no significant difference in metatarsal fat pad thickness for patients with metatarsalgia vs patients with foot and ankle osteoarthritis based on nonweightbearing MRI, and no association between metatarsal fat pad thickness and patient-reported outcomes. Level of Evidence: Level III, case control study.
Biederman’s Contribution to the Understanding of Executive Function in ADHD
Authors: Schachar Russell , Crosbie Jennifer 
Published: February 2024

Objective: To examine the theoretical and empirical contribution of Joe Biederman and his colleagues to the understanding of executive function (EF) and ADHD. Method: We searched PubMed for references to EF in Biederman’s publications and conducted a narrative review of this literature. Results: In 50 or more papers using neuropsychological tests, rating scales and measures of mind wandering, Biederman demonstrated that EF are evident in ADHD and closely linked to its underlying neurobiological and genetic risk. He argued that EF need to be monitoring to ensure comprehensive assessment and treatment, but could not be used as a diagnostic proxy. Conclusion: Biederman built an innovative and impressive collaboration to address the issue of EF in ADHD. His work shows a commitment to understanding of EF in order to improve patient care. Biederman laid down a roadmap for research in ADHD and EF for the rest of the field to follow.
Use of a Novel Beyeonics One Three-dimensional Head-mounted Digital Visualization Platform in Vitreoretinal surgeries
Authors: Schwartz Shulamit , Gomel Nir , Loewenstein Anat , Barak Adiel 
Published: February 2024

Background Ophthalmic microscopes have been crucial in visualizing surgical fields, but their limitations in enhancing the surgical view through digital image processing have prompted the development of digital surgical microscopes. The Beyeonics One microscope, a novel digital microscope, offers ophthalmic surgeons a 3D visualization platform and an augmented reality (AR) surgical headset, potentially improving surgical decision-making and outcomes. While its initial use has been described in cataract and corneal surgeries, its application in vitreoretinal surgery remains relatively unexplored. Methods In this interventional case series, we collected data from the medical records of patients who underwent vitreoretinal surgery using the Beyeonics One 3D visualization platform at the Tel Aviv Medical Center. A total of 36 eyes from 36 subjects were included. Surgical techniques included retinal detachment surgeries and macular surgeries, performed by experienced surgeons. The surgical visualization was facilitated by the Beyeonics One 3D head-mounted display (HMD) platform. Results The procedures were uneventful, and none intra- or postoperative complications were reported, and surgeons did not experience any signal delay in the real-time video. Discussion The Beyeonics One microscope offers several potential advantages in vitreoretinal surgery, including digital image processing, enhanced depth perception through the 3D HMD platform, and hands-free image control using head gestures. While this study demonstrates the feasibility and safety of the Beyeonics One microscope, addressing limitations related to hazy views and optimizing image quality are crucial for consistent visualization.
Structure-function relationship of reading performance in patients with early to moderate glaucoma
Authors: Akar Serpil , Tekeli Oya , Idil Aysun , Ozturker Zeynep Kayaarasi 
Published: February 2024

Purpose To assess reading performance in patients with mild to moderate primary open-angle glaucoma (POAG), and to determine the relationship between reading ability and visual field (VF), microperimetry, and optical coherence tomography (OCT) parameters. Methods Reading performance of 30 POAG patients examined by the Minnesota Reading Acuity Chart (MNREAD) was compared to that of 21 age-matched controls collected from Ankara University in Turkey. Humphrey Field Analyzer (HFA) 24-2 SITA Standard and 10-2 patterns, and microperimetry were used for VF measurements. All subjects underwent OCT analysis for retinal nerve fiber layer thickness (RNFLT), optic nerve head (ONH) measurements, and ganglion cell inner plexiform layer thickness (GCIPLT). The linear relationship between reading parameters and VF, microperimetry, and OCT parameters was investigated. Univariate and multiple logistic regression models were used to identify the risk factors for glaucoma. Results In POAG patients, maximum reading speed (MRS) had a significant association with average rim area, mean cup-to-disc ratio (CDR), and cup volume ( p < 0.05, for all). Decreased MRS was associated with thinner average GCIPLT and inferotemporal, superior, and inferior GCIPLT quadrants ( p < 0.05, for all). Global index values for the HFA 24-2/10-2 tests, microperimetry, and ONH/RNFLT parameters had no correlation with reading performance. After accounting for the better and worse eyes, gender, education, age, and visual acuity of the glaucoma patients, MRS score was 23 units lower in the worse eye ( p = 0.009), critical print size (CPS) was 0.21 units larger in the better eye ( p = 0.03) and 0.25 units larger in the worse eye ( p < 0.001), reading accesibility index (ACC) was 0.11 units lower in the better eye ( p = 0.02) and 0.13 units lower in the worse eye ( p = 0.002), and RA was 0.13 units higher in the worse eye ( p = 0.003) of POAG patients. Conclusion POAG had significantly lower reading performance when compared to healthy subjects. Reading speed was associated with decreased macular GCIPLT indicating that reading performance may be affected in the earlier stages of the disease.
Rapid evidence assessment of student-assisted assessment and brief intervention clinics: Addressing the gaps in rural and remote health care
Authors: Varela Sharon M , Wells Georgia , Henderson Mason , Collins Danielle , Stenhouse Lynette , Subramaniam Prema 
Published: February 2024

Objectives With high disease and disability burden in rural and remote regions, student-assisted clinics can be an effective workforce development tool to meet community health needs and workforce shortages. This research sought to identify the conditions under which student-assisted clinics can be successfully utilised as a workforce development strategy, with specific application to remote Queensland, Australia. Methods A rapid review of the international literature in English was conducted. This was the most appropriate type of review because the results of the review were time-sensitive, with the student-assisted clinic model being trialled in Queensland soon. A mixed methods design was applied, with the search strategy piloted with one database. Results Eleven studies met the inclusion criteria. Seven reported data on participant experiences, including consumers, students, services/clinics, and educators/supervisors/health professionals. Each of the studies operationalised student-assisted clinics through practice models (university-driven learning need), service delivery models (service driven need addressed through a student workforce), community need models (student delivered services primarily addressing a community health need), and blended models (practice need and community need). Some studies reported concerns about fragmentation of services, referral pathways and issues with follow-up, while others reported concerns about sustainable funding. All models reported successful outcomes when focused on service or consumer health outcomes, or student learning outcomes. Conclusions Student-assisted clinics make an important contribution to the development of the rural and remote health workforce. Student-assisted clinics can complement and extend existing services, supporting workforce development in an overstretched health system impacted by an ongoing pandemic.
Evaluation of the satisfaction and experiences of oncology patients and doctors using teleconsultation during the COVID-19 pandemic
Authors: Kastrisiou Myrto , Karimi Maryam , Christou Evangelos AA , Bizot Alexandra , Ropers Marie-Alix , De-Jesus Anne , Mokdad-Adi Meriem , To Thi Hong Van , Viansone Alessandro , Delaloge Suzette , Besse Benjamin , Kfoury Maria 
Published: February 2024

Introduction During the coronavirus disease 2019 (COVID-19) pandemic, the Gustave Roussy Cancer Center introduced teleconsultation via telephone, as an alternative to face-to-face consultation to reduce patient hospital visits. This study was designed to assess patient and doctor satisfaction with this modality of care in oncology patient care during the period of the pandemic and beyond. Methods We designed two questionnaires based on validated scores to assess satisfaction from teleconsultation in patients (EORTC OUT-PATSAT 35 and Telemedicine Satisfaction Questionnaire [TSQ] scores) and doctors (Telehealth Usability Questionnaire [TUQ]), and anxiety levels in both groups (anxiety section of the Hospital Anxiety and Depression Scale [HADS], HADS-A). These were electronically sent to patients and doctors with experience of at least one remote consultation during the first wave of the COVID-19 pandemic. Results 239 patients and 32 doctors were eligible for the analyses. In the patient group, the mean satisfaction scores were 79.5 (SD 18.1) and 74.92 (SD 15.3) for EORTC OUT-PATSAT 35 and TSQ, respectively. In the doctor group, the mean satisfaction scores were 67.1 (SD 12.7) and 64.9 (SD 13.9) for TUQ and TUQ for Skype for Business, respectively. 65.7% of patients and 81.2% of doctors had no/low anxiety. Univariable analyses in patients showed correlation of the EORTC OUT-PATSAT 35 and TSQ scores with anxiety and gender, with lower mean scores in women compared to men. Multivariable analysis showed correlation of the EORTC OUT-PATSAT 35 and TSQ scores to anxiety in both patients and doctors. Conclusions Teleconsultation via telephone is an acceptable modality of care for oncology patients, with high satisfaction from its implementation during the pandemic reported by patients and doctors. This was consistent across responder groups with different characteristics. An individualized approach to patients should be implemented for the safe and effective use of teleconsultation in oncology beyond the pandemic.
Oncological outcomes in robot-assisted radical prostatectomy: the value of PSA density as a preoperative predictive factor
Authors: Vives Dilme Roser , Rivas Juan Gómez , Fernández Hernández Laura , De la Parra Sánchez Irene , Sánchez del Hoyo Rafael , Galante Romo María Isabel , Redondo González Enrique , Senovilla Pérez José Luis , Fernández Montarroso Lorena , Moreno Sierra Jesús 
Published: February 2024

Background: Pretreatment assessment of patients diagnosed with localized prostate cancer (PCa) is essential for therapeutic decision-making. Currently available staging systems based on prostate-specific antigen (PSA), Gleason score, and clinical stage allow for determining the prognostic characteristics of these patients. Several studies have evaluated the preoperative use of prostate-specific antigen density (PSAD) as a prognostic factor for further risk stratification. To date, the role of PSAD in this setting is still an object of debate. Objectives: The present analysis aimed to assess the predictive potential of PSAD for adverse oncological outcomes after robot-assisted radical prostatectomy (RARP) and to compare its accuracy to preoperative PSA (pPSA). Design and methods: We retrospectively reviewed 427 patients diagnosed with localized PCa who underwent RARP at a single institution between January 2015 and January 2020. Generating receiver operator characteristic (ROC) curves, calculating areas under the curves (AUCs), and using a linear regression model, we analyzed the association of PSAD and pPSA with postoperative positive surgical margins (PSM), Gleason score ⩾ 7, persistent PSA, and biochemical recurrence (BCR), with a median follow-up of 47 months. Results: PSAD showed a significant association with PSM ( p < 0.0001), PSA persistence ( p < 0.0001), and Gleason ⩾ 7 ( p < 0.0001), without being statistically significant in predicting BCR ( p = 0.098). The predictive value of PSAD was comparable to pPSA for outcomes of PSA persistence (AUC 0.727 versus 0.771) and Gleason ⩾ 7 (AUC 0.683 versus 0.649). Conclusion: PSAD is a predictive factor for postoperative oncological outcomes of PSM, Gleason score ⩾ 7, and persistence of PSA. Despite the need for further studies, PSAD could be useful as a prognostic parameter in conjunction with established staging systems.