bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outcomes in patients with acute stroke treated at a comprehensive stroke center using telemedicine versus in-person assessments
Authors: Ho Wilson , Fawcett Adrian P 
Published: April 2023

Introduction Telemedicine has been shown to be a safe and effective modality to assess and treat patients with acute stroke who present to a community hospital. There are no previous reports on using telemedicine to treat patients with acute stroke who present to a comprehensive stroke center. We report here the outcomes of patients with acute stroke treated in 2021 at our comprehensive stroke center using telemedicine versus an in-person assessment. Methods Patients with acute ischemic stroke who were treated after either a telemedicine or in-person assessment at our hospital in 2021 were identified by a retrospective chart review. The primary outcomes collected were door-to-needle (DTN) time for alteplase (tPA) administration, door-to-puncture (DTP) time for endovascular thrombectomy, symptomatic intracranial hemorrhage (sICH) rates and 3-month mortality. Results There were 302 patients with acute stroke treated at our hospital in 2021. Of these, 18.2% (n = 55/302) were treated using telemedicine. There were no differences in any of the outcomes between patients treated using telemedicine versus an in-person assessment: DTN (35.5 min (n = 42) vs 33 min (n = 182), p < 0.76), DTP (86.5 min (n = 30) vs 85 min (n = 134), p < 0.97), sICH (0% (n = 0/55) vs 1.6% (n = 4/245, p < 0.59) or 3-month mortality (20.6% (n = 7/34) vs 22.1% (n = 40/181), p < 0.29). Discussion To the best of our knowledge, this is the first study to report on outcomes for acute stroke patients treated using telemedicine at a comprehensive stroke center. In this study, there were no differences in outcomes between patients treated using telemedicine versus an in-person assessment.
Influence of parental anxiety and beliefs about medicines on feeding and exercise in children living with asthma
Authors: Clarke Rebecca , Heath Gemma , Nagakumar Prasad , Farrow Claire 
Published: April 2023

This study’s primary objective was to establish differences in beliefs about medicines, levels of asthma-related anxiety and diet and exercise behaviours between parents of children with well controlled and poorly controlled asthma. Secondary objectives were to explore how asthma control might shape relationships between parental cognitions and parenting practices concerning paediatric asthma. Parents of children with asthma aged 10–16 years ( N = 310) completed standardised questionnaires measuring beliefs about medicines, parental asthma-related anxiety, parenting attitudes towards child activity, parental feeding and asthma control. Parents of children with poorly controlled asthma reported significantly greater asthma medication necessity and concern, asthma-related anxiety, control of child activity, pressure to exercise and unhealthy feeding practices. Moderation analyses indicated that the relationship between parental concern about asthma medicine and parental control of child activity was strongest in children with poorly controlled asthma. Also, the relationship between parental asthma-related anxiety and use of food to regulate child emotion was only significant when asthma was poorly controlled. Parental beliefs about asthma medicines and asthma-related anxiety may indirectly influence asthma outcomes through unhealthy parenting practices around exercise and diet. Eliciting and understanding parents’ perceptions of asthma medications and anxiety may facilitate personalised interventions to improve asthma control.
Comparison of Radiofrequency Ablation and Saphenous Vein Stripping for the Treatment of Recurrent Lower Extremity Venous Insufficiency
Authors: Kanber Eyup Murat , Cetin Hakkı Kursat 
Published: April 2023

Objective To compare the efficiency and safety of radiofrequency ablation (RFA) and saphenous vein stripping (SVS) for the treatment of recurrent lower extremity chronic superficial venous insufficiency (CSVI). Methods Patients who underwent SVS and RFA for recurrent lower extremity CSVI following RFA and patients who had 2-year follow-up results were enrolled into the study. Total, 37 patients who underwent a second RFA session with 2-year follow-up results were available. Then 37 patients were selected from 88 patients who underwent SVS for recurrent lower extremity CSVI to achieve a 1:1 ratio for comparison. Groups were compared based on preoperative properties, operative parameters, postoperative outcomes, complications and follow-up results. Results Duration of the procedure was 20.7 minutes in the RFA group and 30.7 minutes in the SVS group (P = .001). Postoperative pain at first hour, sixth hour and 24th hour were significantly lower in patients who underwent RF (P = .001 for each parameter). Moreover, hospitalization time (18.1 hours vs 24.6 hours, P = .001) and time to return to normal daily activities (1.6 days and 2.5 days, P = .001) were significantly shorter in the RFA group. Success of the procedure did not statistically significant at first year follow-up (P = .304). However, success was significantly higher for the SVS group at second year follow-up (73% for RFA group and 91.9% for SVS group, P = .032). Conclusion We achieved significantly shorter procedure time, less postoperative hospitalization time, and a shorter time to return to daily activities with RFA. In contrast, the success rate of SVS was significantly higher at the second year follow-up, but not the first year follow-up in comparison with RFA.
Impact of X-Ray Exposure From Computed Tomography on Wearable Insulin Delivery Devices
Authors: Dong Frank , Johnson Paul , Fong Grant , Nguyen Alex , Lauand Felipe , Vienneau Todd 
Published: April 2023

Background: To investigate the impact of radiation exposure from a computed tomography (CT) scanner on the functional integrity of a wearable insulin delivery system. Methods: A total of 160 Omnipods and four personal diabetes managers (PDMs) were evenly divided into four groups: (1) control group (no radiation exposure), (2) typical radiation exposure group, (3) 4× typical radiation exposure group, and (4) scatter radiation group. Pods were attached to an anthropomorphic torso phantom on the abdomen (direct irradiation) or shoulder (scatter radiation) region. A third-generation dual-source CT scanner was used to scan the pods using either a typical exposure (used for routine CT abdominal study of a median size patient) or 4× typical exposure. A manufacturer-recommended 20-step functionality test was performed for all 160 Omnipods. Results: The radiation dose (measured in volume CT Dose index) was 16 mGy for a typical exposure, and 64 mGy for 4× typical exposure. The scatter radiation is less than 0.1 mGy. All Pods passed the functionality test except one pod in the scatter radiation group, which sounded an alarm due to occlusion. The blockage to the fluid was due to a kink in the soft cannula, a mechanical issue not caused by the radiation exposure. Conclusions: This study suggests X-ray exposure levels used in radiological imaging procedures do not negatively impact the functional integrity of Omnipods. This finding may support the potential for the manufacturer to remove the warning that patients should remove the Pod for X-ray imaging procedures, which will have a huge impact on patient care.
A Literature Review on the Antiviral Mechanism of Luteolin
Authors: Lu Peng , Zhang Tingrui , Ren Yali , Rao Huanan , Lei Jieting , Zhao Guiying , Wang Miao , Gong Daoyin , Cao Zhixing 
Published: April 2023

Background Viral infections pose some of the most serious human health concerns worldwide. The infections caused by several viruses, including coronavirus, hepatitis virus, and human immunodeficiency virus, are difficult to treat. Methods This review details the findings of a literature search performed on the antiviral properties of luteolin. The keywords engaged in the search are “virus” along with “luteolin.” Results Luteolin possesses antiviral properties, which is the basis for the current review. It is an important natural flavonoid with numerous important biological properties, including anti-inflammatory, immune regulatory, and antitumor effects, and is found in vegetables, fruits, and several medicinal plants. Recent studies have revealed that many traditional Chinese medicines that contain luteolin inhibit the replication of coronaviruses. Conclusion Luteolin effectively inhibits the replication of coronavirus, influenza virus, enterovirus, rotavirus, herpes virus, and respiratory syncytial virus, among others. In particular, it prevents viral infection by improving the body's nonspecific immunity and antioxidation capacity and inhibiting many pathways related to virus infection and replication, such as MAPK, PI3K-AKT, TLR4/8, NF-κB, Nrf-2/hemeoxygenase-1, and others. It also regulates the expression of some receptors and factors, including hepatocyte nuclear factor 4α, p53, NLRP3, TNF-α, and interleukins, thereby interfering with the replication of viruses in cells. Luteolin also promotes the repair of damaged cells induced by proinflammatory factors by regulating the expression of inflammatory molecules. The overall effect of these processes is the reduction in viral replication and, consequently, the viral load. This review summarizes the antiviral effect of luteolin and the mechanism underlying this property.
Vocational School–Enterprise Cooperation in China: A Review of Policy Reforms, 1978–2022
Authors: Zhou (周英文) Yingwen , Xu (徐国庆) Guoqing 
Published: April 2023

Purpose This study conducted a review of policy reforms of school–enterprise cooperation in China's vocational education and its characteristics at different stages. Design/Approach/Methods This study systematically reviewed vocational educational policies on school–enterprise cooperation adopted by the Chinese government since 1978 using textual analysis. Findings The development of school–enterprise cooperation in China's vocational education can be divided into four stages: spontaneous development (Stage 1), central position establishment (Stage 2), systematic design (Stage 3), and institutional construction (Stage 4). After years of practice and exploration, China's school–enterprise cooperation has made impressive achievements, but also has several problems that require further improvement. Originality/Value This study examined over 40 years of history of the development of vocational school–enterprise cooperation in China, providing a useful reference for learning and understanding Chinese vocational education.
“To Be or Not to Be”—Cardiopulmonary Resuscitation for Hospitalized People Who Have a Low Probability of Benefit: Qualitative Analysis of Semi-structured Interviews
Authors: Kobewka Daniel , Lalani Yasmin , Shaffer Victoria , Adewole Tolulope , Lypka Kiefer , Wegier Pete 
Published: April 2023

Purpose Our aim was to understand the decision making of patients in hospital who wanted cardiopulmonary resuscitation despite low probability of benefit. Methods We included patients admitted to general medical wards who had a low chance of surviving in-hospital cardiopulmonary resuscitation (CPR) and had an order in the chart to administer CPR. We developed an interview guide to explore participants’ decision-making process, sources of information, and emotions associated with this decision. Results We developed 3 themes from the data. 1) “Life is worth living . . . for now”: Participants describe their enjoyment of life and desire to carry on in their current state. 2) “Making sense of CPR outcomes”: Participants saw CPR outcomes as binary, either they live, or they die; deciding not to receive CPR means choosing death. Participants were optimistic they would survive CPR and cited personal experience and TV as information sources. 3) “Decision process”: Participants did not engage in shared decision making. Instead, they were asked a binary yes/no question with no reflection on their values or discussion about harms or benefits. Limitations The probability of successful CPR in our sample is unknown. Findings may be different in a population who is imminently dying but still requesting CPR. Conclusions Participants chose CPR because they perceived life as worth living and CPR as a chance worth taking. Participants did not want to be left in a severely debilitated state but did not have accurate information about this risk. Implications Decision making about CPR in-hospital can be improved if it is grounded in accurate risk understanding and the patient’s values and wishes.
Online Infectious Diseases Subspecialty Supplementary Curriculum for Medical Students and Residents: Moving Beyond “You Get What You Get”
Authors: Miller Nikki , Wick Jo , Luther Vera P , Newman Jessica R 
Published: April 2023

OBJECTIVES Students and residents rotating through infectious diseases (ID) electives are instructed primarily by participation in rounds and clinics, with teaching focused on diseases encountered. This “you get what you get” approach allows learners to apply knowledge directly to patient care, however, may miss topics encountered in standardized testing. This multisite study investigates the use of asynchronous web-based learning modules and its impact on student and resident knowledge. METHODS Students and residents rotating through an ID elective were assigned to their standard elective (old) or asked to complete asynchronous web-based learning modules in addition to the standard curriculum (new). Learners submitted pre- and post-tests and scores were tabulated. In the following academic year, learners at the host site were provided the learning modules and a post-elective survey. RESULTS Nine learners (100%) completed the pre-test and 5 (55.6%) completed the post-test in the standard (old) curriculum group, while 15 (100%) completed the pre-test and post-test in the new curriculum group. The mean percentage change in accuracy was 9% and 5.3% in the old and new curricula, respectively. Most (94%) survey respondents recommended continued use of the curriculum and expansion to other subspecialty electives. CONCLUSIONS Subspecialty electives have multiple purposes including assisting learners in exploring careers, providing a well-rounded medical experience, or preparing learners for content in standardized tests. Consistent curricula are not always provided with electives to supplement the clinical experience. Our web curriculum was well-received with perceived knowledge gain, though with very small pre-post-test groups a score improvement could not be determined. An asynchronous online curriculum for learners in ID was feasible and well-received among faculty, and learners felt their knowledge was enhanced. Content areas supplemented those encountered during the ID elective. While an improvement in post-test scores was not demonstrated, learners and faculty felt modules were beneficial.
Drug Counseling: The Need for a Systematic Approach
Authors: Sarriff Azmi 
Published: April 2023

Objective An approach to drug counseling that helps organize and standardize the documentation of a patient's specific drug-taking problem is presented. Background Patient counseling on the proper use of prescribed medications should be treated as a problem-solving session. The patient's underlying drug-taking problems may be complicated and deep-seated and may not be apparent unless specifically sought. This article introduces an approach that is intended to provide a systematic process for drug counseling: (1) establish a comprehensive, patient-specific database; (2) list patient-specific drug-taking problems; (3) provide counseling information and promote compliance; and (4) assess and monitor compliance. An important attribute of this approach is that it facilitates the dynamic nature of the counseling process. Conclusions This approach to drug counseling serves as a guideline for patient counseling. Additional experience with this system is necessary to determine its effectiveness at achieving the desired counseling outcomes.
Reducing Outpatient Costs of Nonsteroidal Antiinflammatory Drugs at a Department of Veterans Affairs Teaching Hospital
Authors: Drexler Paul G. , Lambdin Charles S. 
Published: April 2023

Objective To determine how formulary changes, based on the recommendations of a clinical pharmacy specialist, affected outpatient nonsteroidal antiinflammatory drug (NSAID) prescribing patterns and drug costs in a Department of Veterans Affairs (VA) teaching hospital. Design Cost-benefit analysis. Setting VA teaching hospital. Patients Outpatient veterans. Interventions Sulindac, piroxicam, and diflunisal were removed from the formulary and made available only on a case-by-case review process. Buffered aspirin and phenylbutazone also were removed from the formulary; these drugs were made unavailable altogether. Ibuprofen, indomethacin, salsalate, enteric-coated aspirin, and plain aspirin retained their formulary status and were available for routine prescribing. Main Outcome Measures Changes in the number of prescriptions dispensed and in prescription costs for each NSAID were measured 3 months before and 5 and 21 months after implementation of formulary changes. Results No prescriptions were dispensed for diflunisal, buffered aspirin, and phenylbutazone 21 months after implementation of the formulary changes. During this same period, prescriptions for sulindac and piroxicam declined 95.7 and 97.1 percent, respectively. The average cost per outpatient NSAID prescription declined from $14.78 to $4.75 (67.9 percent) after 21 months. An extrapolated yearly savings of $137,704 was calculated. Conclusions Formulary changes based on recommendations of a clinical pharmacy specialist resulted in altered physician prescribing patterns and reduced outpatient drug costs for NSAIDs in a VA teaching hospital.
Educating Patients’ Families on Their Level
Authors: Knapp Judy A. , Hyde Victoria S. 
Published: April 2023

Objective To provide well-written, easy-to-read, comprehensible education materials without losing sight of their medical accuracy. Participants and Their Duties Employees from all hospital departments develop first drafts. A multidisciplinary committee, patient-education program (PEP), composed of a pharmacist, dietitian, respiratory therapist, radiology technician, medical illustrator, and inpatient and outpatient nurses facilitate these handouts. Laypeople critique the readability and experts evaluate content. Method Patient-education handouts are coded into one of seven divisions and tracked through the stages of writing, word processing, proofing by experts, proofing for readability, illustrating, printing, and distribution. Pharmacy PEP Design A medication template is used to standardize the format and general information that needs to be included in all medication education materials. Conclusions Through better-written and more comprehensible educational materials, patients’ families are able to understand the medical treatment being rendered, thereby easing stress and encouraging their participation in total care.
Issues in Contemporary Drug Delivery
Authors: DeSimone Edward M. , Banakar Umesh V. 
Published: April 2023

Objective To provide an overview of the selection criteria for and proper use of sunscreen products. The effects of ultraviolet (UV) radiation on the skin are also discussed. Data Sources References were selected from published bibliographies of books and articles dealing with UV radiation and sunscreen agents, manufacturers’ product information, and topical searches in MEDLINE computerized database (English language, through 1991). Study Selection Studies that investigated the short- and long-term effects of UV radiation (UVA and UVB) on human skin were reviewed. Equal weight was given to information published in authoritative textbooks by prominent photobiologists and dermatologists. Data relating to human skin were selected in preference to animal data, and data involving ingredients approved for use in the US were used in preference to those of products approved in foreign countries. Data Synthesis The literature describing the effects of both UVA and UVB on human skin is substantial. However, there is considerably less information on UVA in terms of how its effects impact the formulation and use of commercially produced sunscreen products. Information regarding the proper use of currently available sunscreen products and the appropriate patient counseling information for pharmacists is both considerable and consistent. Conclusions In recent years, the concerns about UV radiation have shifted from the short-term hazards of sunburn to the long-term hazards of skin cancer and premature aging of the skin. Available data suggest that a life-long approach to minimizing exposure to UV radiation including the use of sunscreens with a minimum sun protection factor of 15 will reduce overall morbidity and mortality. Authorities in the field are calling for the continuing development of commercial sunscreen products that provide a broad spectrum of protection against both UVA and UVB and their proper use by the public.
Retrospective Analysis of Neuropathic Pain Control in Patients with Advanced Cancer
Authors: Snare Alison J. , Tett Susan E. , Kaye Karen , Lickiss Norelle 
Published: April 2023

Objective To describe the use of sodium valproate in patients with advanced cancer for the relief of neuropathic pain. Design Case series. A retrospective, descriptive review using medical records. Setting Ambulatory and hospitalized patients referred to the Central Sydney Palliative Care Service, based at the Royal Prince Alfred Hospital, an 800-bed teaching hospital, in Sydney, Australia. Patients Of all the 364 patients who were referred to the Service in 1987, 64 received sodium valproate for neuropathic pain and were eligible for inclusion in the study. Main Outcome Measures Documentation by physicians of pain control and the dose of sodium valproate. Results Forty-three of the 64 patients (67 percent) had an indication of efficacy noted on their record. In 26 of these 43 patients (60 percent), sodium valproate was the only therapy introduced or the dosage was increased immediately prior to the documentation of pain relief. Only 3 patients totally discontinued sodium valproate. The 1 patient who experienced an adverse effect of sedation temporally related to institution of sodium valproate had therapy successfully reintroduced at a lower dosage. The dosages used for analgesia were much lower than those used for epilepsy. The mode and median doses were 400 mg/d (interquartile range 200–600 mg). Conclusions This medical record review raises the hypothesis that sodium valproate may be useful therapy in the management of cancer-related neuropathic pain.
Epidural, Intrathecal, and Patient-Controlled Analgesic Use in a University Medical Center
Authors: Erstad Brian L. , Snyder Beth A. , Kramer Thomas H. 
Published: April 2023

Objective To determine the number and profile of surgical patients receiving epidural, intrathecal, and patient-controlled analgesia. Design Two-month audit of epidural, intrathecal, and patient-controlled analgesia. Setting A 300-bed, tertiary care, university medical center. Patients All patients undergoing surgery and receiving epidural, intrathecal, or patient-controlled analgesia. Results Of 1123 operations performed during the two-month audit, 185 patients (16 percent) received one of the three forms of analgesia studied. Sixty-three percent of the 185 patients received patient-controlled analgesia and 33 percent received epidural injections for pain control. The most common types of surgery associated with the use of these specialized pain-control techniques were obstetric/gynecologic, orthopedic, general, urologic, and cardiothoracic. Conclusions Specialized forms of analgesia are becoming increasingly common. Our audit defined the number of patients receiving such therapies according to type of surgery. Collection of such information by other institutions should allow for targeted evaluations of cost-effectiveness (e.g., drug use evaluations).