bluuebunny/crossref_metadata_2025_split huggingface dataset:
Vascular access modalities in a pediatric intensive care unit in tertiary hospital indications and outcomes: a single-center cross-sectional study
Authors: Aziz Miriam Magdy , Bazaraa Hafez , Aboulmakarem Aly Sayed , Helal Dalia 
Published: December 2023

Abstract
Background
Vascular access is a mainstay of pediatric critical care. The selection of the route of access and equipment used will depend on patient- and provider-specific factors, which constantly need revision to achieve more effective assessment and management.

Objective
To evaluate the use, indication, and outcome of different vascular access modalities in critically ill children in the Emergency Pediatric Intensive Care Unit (ER-PICU) of a tertiary university hospital.

Patients and methods
This cross-sectional descriptive study was based on data collected by reviewing all modes of vascular access used for 168 consecutive patients admitted to ER-PICU during a 6-month period from May to October 2020.

Results
Among the study group (n = 168), there were 92 males (54.8%) and 76 females (45.2%). The median age of cases was 18 months. 333 vascular access devices were observed: 219 peripheral (65.8%) and 114 central catheters (34.2%). Catheters lasted a total of 1920 catheter days. Central venous catheters lasted significantly more than peripheral lines (P < 0.001); median of 8.5 and 3 days, respectively. The incidence of peripheral line complications (35.2%) was found significantly higher compared to central venous catheters (22.8%) (P. = 0.021). Longer dwell time of central access was associated with a higher incidence of catheter-related bloodstream infection. The incidence of catheter-related bloodstream infection was 9.05 per 1000 catheter days. Mortality rate was 24.4%.

Conclusions
Despite having lower incidence of complications than peripheral lines, central venous catheters’ complications are considered more serious. Dwell time of central venous catheters (CVC) should be revised daily to avoid the occurrence of infection.
Waveguide-based augmented reality displays: perspectives and challenges
Authors: Ding Yuqiang , Yang Qian , Li Yannanqi , Yang Zhiyong , Wang Zhengyang , Liang Haowen , Wu Shin-Tson 
Published: December 2023

AbstractAugmented reality (AR) displays, as the next generation platform for spatial computing and digital twins, enable users to view digital images superimposed on real-world environment, fostering a deeper level of human-digital interactions. However, as a critical element in an AR system, optical combiners face unprecedented challenges to match the exceptional performance requirements of human vision system while keeping the headset ultracompact and lightweight. After decades of extensive device and material research efforts, and heavy investment in manufacturing technologies, several promising waveguide combiners have been developed. In this review paper, we focus on the perspectives and challenges of optical waveguide combiners for AR displays. We will begin by introducing the basic device structures and operation principles of different AR architectures, and then delve into different waveguide combiners, including geometric and diffractive waveguide combiners. Some commonly used in-couplers and out-couplers, such as prisms, mirrors, surface relief gratings, volume holographic gratings, polarization volume gratings, and metasurface-based couplers, will be discussed, and their properties analyzed in detail. Additionally, we will explore recent advances in waveguide combiner design and modeling, such as exit pupil expansion, wide field of view, geometric architectures of waveguide couplers, full-color propagation, and brightness and color uniformity optimization. Finally, we will discuss the bottlenecks and future development trends in waveguide combiner technologies. The objective of this review is to provide a comprehensive overview of the current state of waveguide combiner technologies, analyze their pros and cons, and then present the future challenges of AR displays.
Impact of spirituality on elderly people's quality of life and life satisfaction after acute myocardial infarction: Iranian hospital-based study
Authors: Marznaki Zohreh Hosseini , Khalilizad Majid , Moradi Azadeh , Mamun Mohammed A. 
Published: December 2023

Background
As people age, survival after a heart attack can affect their quality of life and lead to a decrease in life satisfaction. After a myocardial infarction, elderly patients may experience physical, psychological, emotional and social changes that affect their thoughts and behaviour in relation to spirituality.

Aims
To investigate the relationship between spiritual well-being and other sociodemographic and medical history-related factors on quality of life and life satisfaction among elderly people after myocardial infarction.

Method
In a census-based cross-sectional study conducted at the Imam Reza Hospital in Amol, Iran, from May 2020 to May 2021, data on sociodemographics, medical history, subjective well-being, life satisfaction and quality of life were collected from 502 participants who were referred at the heart clinic.

Results
The findings showed that spiritual well-being dimensions (religious well-being, [self-assessment of one's relationship with God], and existential well-being, [self-assessment of one's sense of purpose in life and life satisfaction]) were not significantly associated with life satisfaction, but a high perception of both dimensions of spiritual well-being were associated with higher self-reported quality of life. A history of past-year hospital admission and cardiopulmonary resuscitation were significant predictors of life satisfaction, and educational level was a predictor of quality of life.

Conclusions
The study found no significant association between spiritual well-being and life satisfaction among elderly people following myocardial infarction. This finding might have been influenced by the physical and emotional challenges experienced by the participants during the COVID-19 pandemic. Further studies are needed to confirm this relationship.
Molar Pregnancy–Induced Hyperthyroidism: The Importance of Early Recognition and Timely Preoperative Management
Authors: Walfish Laurel , Gupta Nisha , Nguyen Dong Bach , Sherman Mark 
Published: December 2023

Abstract
Hyperthyroidism due to gestational trophoblastic disease (GTD) is a rare but potentially life-threatening condition. Optimal perioperative management is crucial for favorable outcomes and prevention of thyroid storm. However, scarce data exist defining the ideal approach to this complex clinical presentation. This case report describes a first-time pregnant 32-year-old woman who was found to be biochemically hyperthyroid in the context of a 10-week gestation molar pregnancy. Despite her biochemical values, the patient remained clinically asymptomatic of her thyroid disease. The Gynecology and Anesthesiology services urgently consulted Endocrinology, and empiric treatment for prevention of potential impending thyroid storm was initiated prior to operative uterine evacuation. After 2 uneventful dilation and curettages with chemotherapy and a transient prescription of antithyroid medication, the patient normalized her human chorionic gonadotropin (hCG) level and recovered to biochemical euthyroidism. Other than a pruritic rash that may have been due to propylthiouracil, the patient's hyperthyroidism improved without further complications. This case highlights the importance of recognizing the link between GTD and thyrotoxicosis to allow for timely initiation of appropriate preoperative treatment. Fortunately, the multidisciplinary approach facilitated management to prevent evolution to thyroid storm.
Efficacious Primary Pasireotide Therapy in a Case of a Large Invasive Adrenocorticotropin-secreting Pituitary Tumor
Authors: Tamaki Yuko , Nakaue Junko , Nishimura Fumihiko , Takahashi Yutaka 
Published: December 2023

Abstract
A 41-year-old woman presented with a headache, diplopia, weight gain, moon face, and central obesity. Her plasma adrenocorticotropin (ACTH) level was 25.5 pmol/L (116 pg/mL) (normal range, 1.6-13.9 pmol/L [7.2-63.3 pg/mL]), serum cortisol level was 397.3 nmol/L (14.4 µg/dL) (normal range, 195.1-540.7 nmol/L [7.1-19.6 µg/dL]), and urinary free cortisol was 413.9 nmol/day (150.3 µg/day) (normal range, &lt;221.5 mmol/day [&lt;80.3 µg/day]). ACTH-dependent hypercortisolism was present, with cortisol suppression using a high-dose dexamethasone suppression test. Cushing disease was diagnosed and a contrast-enhanced magnetic resonance imaging scan demonstrated a 36-mm pituitary tumor with right cavernous sinus invasion. Before surgery, 20 mg pasireotide long-acting-release was initiated, and her symptoms rapidly improved. After 1 month, obvious tumor shrinkage was observed, ACTH and cortisol levels decreased, and diplopia resolved; therefore, we continued medical therapy. After 11 months, her ACTH and cortisol levels normalized, and most of the tumor had disappeared. The clinical course in this case suggests that pasireotide may be useful for preoperative treatment and primary medical therapy, at least in some patients with Cushing disease caused by a large tumor predicted to have difficulty achieving remission by surgery.
Effects of Dual-Release Hydrocortisone on Bone Metabolism in Primary and Secondary Adrenal Insufficiency: A 6-Year Study
Authors: Hasenmajer Valeria , Ferrari Davide , De Alcubierre Dario , Sada Valentina , Puliani Giulia , Bonaventura Ilaria , Minnetti Marianna , Tomaselli Alessandra , Pofi Riccardo , Sbardella Emilia , Cozzolino Alessia , Gianfrilli Daniele , Isidori Andrea M 
Published: December 2023

Abstract

Context
Patients with primary (PAI) and secondary adrenal insufficiency (SAI) experience bone metabolism alterations, possibly due to excessive replacement. Dual-release hydrocortisone (DR-HC) has shown promising effects on several parameters, but bone metabolism has seldom been investigated.

Objective
We evaluated the long-term effects of once-daily DR-HC on bone in PAI and SAI.

Methods
Patients on immediate-release glucocorticoid therapy were evaluated before and up to 6 years (range, 4-6) after switching to equivalent doses of DR-HC, yielding data on bone turnover markers, femoral and lumbar spine bone mineral density (BMD), and trabecular bone score (TBS).

Results
Thirty-two patients (19 PAI, 18 female), median age 52 years (39.4-60.7), were included. At baseline, osteopenia was observed in 38% of patients and osteoporosis in 9%, while TBS was at least partially degraded in 41.4%. Higher body surface area–adjusted glucocorticoid doses predicted worse neck (P &lt; .001) and total hip BMD (P &lt; .001). Longitudinal analysis showed no significant change in BMD. TBS showed a trend toward decrease (P = .090). Bone markers were stable, albeit osteocalcin levels significantly varied. PAI and SAI subgroups behaved similarly, as did patients switching from hydrocortisone or cortisone acetate. Compared with men, women exhibited worse decline in TBS (P = .017) and a similar trend for neck BMD (P = .053).

Conclusion
After 6 years of chronic DR-HC replacement, BMD and bone markers remained stable. TBS decline is more likely due to an age-related derangement of bone microarchitecture rather than a glucocorticoid effect. Our data confirm the safety of DR-HC replacement on bone health in both PAI and SAI patients.
Diagnostic and Monitoring Value of β-2 Transferrin and Transferrin for Intracranial Infection After Neurosurgery
Authors: Chen Yuxin , Ding Yaowei , Zhang Guojun , Yang Zhijun 
Published: December 2023

BACKGROUND AND OBJECTIVES:
After neurosurgery, intracranial infection is a common complication with high rates of clinical impairment and death. Traditional diagnostic approaches are time-consuming. Early and correct diagnosis improves infection control, treatment success, and survival. Novel markers are used to diagnose and classify post-neurosurgical meningitis (PNM) to overcome the difficulties of diagnosing postoperative intracranial infections and avoid the drawbacks of existing diagnostic measures. The objective was to investigate the diagnostic value of β-2 transferrin (β-2TF) and transferrin (TF) in the cerebrospinal fluid (CSF) for the identification of intracranial infection after neurosurgery.

METHODS:
Owing to their symptoms and laboratory results, 168 patients with suspected intracranial infection after neurosurgery were divided into 3 groups: post-neurosurgical bacterial meningitis (PNBM; n = 61), post-neurosurgical aseptic meningitis (PNAM; n = 45), and non-PNM (n = 62). We measured lactate (LA), β-2TF, and TF levels in the CSF.

RESULTS:
CSF LA levels were significantly higher in the PNM, PNBM, and PNAM groups compared with the non-PNM group (P < .05). The CSF β-2TF level in PNM, PNBM, and PNAM were statistically higher than those in non-PNMs (P < .05). CSF TF levels in the PNBM group were statistically higher than those in the PNAM and non-PNM groups (P < .05). The PNBM and non-PNM receiver operating curve (ROC) analysis indicates that the cutoff values for the combination (LA, β-2TF, TF) was 0.349, and the area under the curve (AUC) was 0.945 (P < .0001), with 92.86% sensitivity and 92.98% specificity. The PNAM and non-PNM ROC analysis indicates that the cutoff values for the combination (LA, β-2TF, TF) was 0.346, and the AUC was 0.962 (P < .0001), with 89.29% sensitivity and 90.24% specificity. The PNM and non-PNM ROC analysis indicates that the cutoff values for the combination (LA, β-2TF, TF) was 0.609, and the AUC was 0.941 (P < .0001), with 96.36% sensitivity and 82.83% specificity. A Glasgow Coma Scale score ≤8, LA, β-2TF/TF ratio, length of hospital stay, intensive care unit admission, poor surgical wound, and craniotomy were associated with poor outcomes (P < .05). LA and β-2TF were independent risk factors for intracranial infection.

CONCLUSION:
Postoperative cerebral infections can be identified using CSF β-2TF as a particular marker protein. CSF TF helps distinguish PNBM from PNAM. Combining CSF LA with them improves diagnostic speed, sensitivity, and accuracy. LA and β-2TF were independent risk factors for cerebral infection.
May the Force Be with Youth: Foundational Strength for Lifelong Development
Authors: Faigenbaum Avery D. , Ratamess Nicholas A. , Kang Jie , Bush Jill A. , Rial Rebullido Tamara 
Published: December 2023

AbstractToday's youth are weaker than previous generations, and measurable reductions in physical fitness are beginning to emerge. Without targeted initiatives that recognize the foundational importance of resistance training, weaker children and adolescents may be more likely to experience the inevitable consequences of neuromuscular dysfunction and less likely to experience the pleiotropic benefits of exercise and sport. Early exposure to strength-building activities is needed to prepare today's youth for ongoing participation in varied physical activities throughout this developmental phase of life. The novel iceberg of physical development is a metaphoric image that illustrates the sequential and cumulative influence of muscular strength on motor skills and physical abilities. Efforts to enhance the physical capacity of youth should include resistive skills that improve basic movement patterns and enhance motoric competence. A shift in our conceptual thinking about youth resistance training is needed to alter the current trajectory toward physical inactivity and related comorbidities.
Pediatric residency milestone performance is not predicted by the United States Medical Licensing Examination Step 2 Clinical Knowledge
Authors: Miller Benjamin , Nowalk Andrew , Ward Caroline , Walker Lorne , Dewar Stephanie 
Published: December 2023

Objectives: This study aims to show whether correlation exists between pediatric residency applicants’ quantitative scores on the United States Medical Licensing Exam Step 2 Clinical Knowledge examination and their subsequent performance in residency training based on the Accreditation Council for Graduate Medical Education Milestones, which are competency-based assessments that aim to determine residents’ ability to work unsupervised after postgraduate training. No previous literature has correlated Step 2 Clinical Knowledge scores with pediatric residency performance assessed by Milestones. Methods: In this retrospective cohort study, the United States Medical Licensing Exam Step 2 Clinical Knowledge Scores and Milestones data were collected from all 188 residents enrolled in a single categorical pediatric residency program from 2012 - 2017. Pearson correlation coefficients were calculated amongst available test and milestone data points to determine correlation between test scores and clinical performance. Results: Using Pearson correlation coefficients, no significant correlation was found between quantitative scores on the Step 2 Clinical Knowledge exam and average Milestones ratings (r = -0.1 for post-graduate year 1 residents and r = 0.25 for post-graduate year 3 residents). Conclusions: These results demonstrate that Step 2 scores have no correlation to success in residency training as measured by progression along competency-based Milestones. This information should limit the importance residency programs place on quantitative Step 2 scores in their ranking of residency applicants. Future studies should include multiple residency programs across multiple specialties to help make these findings more generalizable.
HR TECH IN THE RECRUITMENT AND SELECTION OF CANDIDATES: FROM MANUAL OPERATIONS TO THE TASK’S MANAGEMENT
Authors: Panova E. , Oparina Natalya 
Published: December 2023

In modern society, digitalization of the human resource (HR) system and processes is an objectively set need of companies, a vector and format of HR policy and HR strategy. The transfer of HR management processes to “digital” has become a powerful factor in the survival of the enterprise in the ever-increasing “struggle for Talents”, a driver of increasing the effectiveness of implemented HR policies. HR management today is moving to a new level — the “HR 3.0” model, based on the use of algorithms, digital products, cloud technologies, mobile applications, artificial intelligence, integrated software, etc. One of the main directions of using digital technologies in the field of HR management is digital recruitment (digital recruiting). Digital recruiting as one of the most progressively developing areas of HR policy, which determines the practical value of this research. The focus of the article is the question of the forms and possibilities of using various digital technologies within the key stages of the process of recruitment and selection of candidates for vacant positions of the organization. The conclusion is made about the most striking trends in the digitalization of recruiting from the point of view of the analysis of the practice of Russian state and commercial structures. The request for transformation of the spectrum of key functions of a modern recruitment manager operating in a highly improvised social space is indicated. The scientific novelty of the article consists in determining the capabilities of modern digital technologies in the search and selection of candidates.
Estimating Battery Size Requirements for Tractor Electrification of Row-Crop Planting Operations
Authors: Liew CheeTown , Donesky Andrew , Freyhof Mark , Tempelmeyer Ian , Pitla Santosh Kumar 
Published: December 2023

Highlights

Calculate and compare engine power needed for row-crop planting from ASAE standards and reported CAN data.

Estimate energy requirements and the equivalent electric battery’s volume and mass for row-crop tractor.

Discuss the feasibility for electrification of a fully electric row-crop tractor.

Abstract. Power sources such as batteries, used for both on-road and off-road vehicles, are advancing at a rapid pace. Electric batteries are becoming more power dense, thus allowing them to be used as a power source to replace previous diesel or gasoline-powered systems. Efforts are underway to transition off-road agricultural vehicles from Internal Combustion Engine (ICE) vehicles to electric vehicles (EVs); however, the energy requirements of typical agricultural field operations need to be fully understood before such a transition can occur. Theoretical prediction equations available in the American Society of Agricultural and Biological Engineers (ASABE) standards or the use of engine load data from a tractor’s Controller Area Network (CAN) bus are two methods for determining the energy demands of implements on tractors. In this study, tractor CAN bus data was collected from multiple no-till corn planting operations to estimate the energy requirements of the planting operation in kWh. The estimated energy requirement was used to determine the equivalent physical mass and volume of a lithium-ion battery needed to power a hypothetical fully electric tractor for comparable planting operations. The estimated battery capacities using the worst-case field-use scenario in this study were 1117 kWh for operating a 16-row planter to plant 68 ha (168 acre) in a day at an average ground speed of 8.6 km h-1 (5.4 mph) for 14 hours, and 2658 kWh for operating a 48-row planter to plant 158 ha (391 acre) in a day at an average ground speed of 8.9 km h-1 (5.6 mph) for 15 hours. Given the current battery energy density requirements, the equivalent battery masses and volumes were found to be 5,319 kg and 3.33 m3, 12,657 kg and 7.93 m3, for 16-row planter and 48-row planter, respectively. These high kWh estimates needed to power future fully-electric tractor power units are based on worst-case scenarios that could be encountered in real field operations that use wide planters over long operating hours. Keywords: Battery, Controller Area Network, Electric Vehicles, Electrification, No-till, Planting, Row-crop, Tractor.
Time-dependent association between STOPP and START criteria and gastrointestinal bleeding in older patients using routinely collected primary care data
Authors: Veldhuis Anouk , Sent Danielle , Loijmans Rik J. B. , Abu-Hanna Ameen 
Published: December 2023

Purpose
Only few studies have assessed the preventive effect of the STOPP/START criteria on adverse events. We aim to quantify 1) the association between nonadherence to STOPP/START criteria and gastrointestinal bleedings, and 2) the association between exposure to the potentially harmful START-medications and gastrointestinal bleedings.

Design
A retrospective cohort study using routinely collected data of patients aged ≥ 65 years from the electronic health records (EHR) of 49 general practitioners (GPs) in 6 GP practices, from 2007 to 2014. The database is maintained in the academic research network database (AHA) of Amsterdam UMC, the Netherlands.

Methods
Gastrointestinal bleedings were identified using ICPC codes and free text inspections. Three STOPP and six START criteria pertaining to gastrointestinal bleedings were selected. Cox proportional hazards regression with time-dependent covariate analysis was performed to assess the independent association between nonadherence to the STOPP/START criteria and gastrointestinal bleedings. The analysis was performed with all criteria as a composite outcome, as well as separately for the individual criteria.

Results
Out of 26,576 participants, we identified 19,070 Potential Inappropriate Medications (PIM)/Potential Prescribing Omission (PPO) instances for 3,193 participants and 146 gastrointestinal bleedings in 143 participants. The hazard ratio for gastrointestinal bleedings of STOPP/STARTs, taken as composite outcome, was 5.45 (95% CI 3.62–8.21). When analysed separately, two out of nine STOPP/STARTs showed significant associations.

Conclusion
This study demonstrates a significant positive association between nonadherence to the STOPP/START criteria and gastrointestinal bleeding. We emphasize the importance of adherence to the relevant criteria for gastrointestinal bleeding, which may be endorsed by decision support systems.