bluuebunny/crossref_metadata_2025_split huggingface dataset:
Whole Blood Resuscitation is Safe in Pediatric Trauma Patients: A Multicenter Study
Authors: Perea Lindsey L. , Moore Kate , Docherty Courtney , Nguyen Uyen , Seamon Mark J. , Byrne James P. , Jenkins Donald H. , Braverman Maxwell A. , Porter John M. , Armento Isabella G. , Mentzer Caleb , Leonard Guy C. , Luis Alejandro J. , Noorbakhsh Matthew R. , Babowice James E. , Kaafarani Haytham M. A. , Mokhtari Ava , Martin Matthew J. , Badiee Jayraan , Mains Charles , Madayag Robert M. , Moore Sarah A. , Madden Kathleen , Hazelton Joshua P. 
Published: February 2023

Introduction Whole blood (WB) resuscitation has been associated with a mortality benefit in trauma patients. Several small series report the safe use of WB in the pediatric trauma population. We performed a subgroup analysis of the pediatric patients from a large prospective multicenter trial comparing patients receiving WB or blood component therapy (BCT) during trauma resuscitation. We hypothesized that WB resuscitation would be safe compared to BCT resuscitation in pediatric trauma patients. Methods This study included pediatric trauma patients (0-17 y), from ten level-I trauma centers, who received any blood transfusion during initial resuscitation. Patients were included in the WB group if they received at least one unit of WB during their resuscitation, and the BCT group was composed of patients receiving traditional blood product resuscitation. The primary outcome was in-hospital mortality with secondary outcomes being complications. Multivariate logistic regression was performed to assess for mortality and complications in those treated with WB vs BCT. Results Ninety patients, with both penetrating and blunt mechanisms of injury (MOI), were enrolled in the study (WB: 62 (69%), BCT: 28 (21%)). Whole blood patients were more likely to be male. There were no differences in age, MOI, shock index, or injury severity score between groups. On logistic regression, there was no difference in complications. Mortality was not different between the groups ( P = .983). Conclusion Our data suggest WB resuscitation is safe when compared to BCT resuscitation in the care of critically injured pediatric trauma patients.
Symptom Management and Support in Dying Patients with Cancer and Coronavirus Disease-19—A Register-Based Study
Authors: Hedman Christel , Strang Peter , Lundström Staffan , Martinsson Lisa 
Published: February 2023

Objective Little is known to what extent access to specialist palliative care (SPC) for cancer patients dying with coronavirus disease-2019 (COVID-19) affects the occurrence of breakthrough symptoms, symptom relief, and overall care, compared to hospital deaths. Our aim was to include patients with both COVID-19 and cancer and compare those dying in hospitals with those dying in SPC with reference to the quality of end-of-life care. Methods Patients with both cancer and COVID-19 who died in hospitals ( n = 430) and within SPC ( n = 384) were identified from the Swedish Register of Palliative Care. The hospital and SPC groups were compared regarding the quality of end-of-life care, including the occurrence of 6 breakthrough symptoms during the last week in life, symptom relief, end-of-life care decisions, information, support, and human presence at death. Results Breakthrough of breathlessness was more common in the hospital patients compared to the SPC patients (61% and 39%, respectively; p < .001), while pain was less common (65% and 78%, respectively; p < .001). Breakthrough of nausea, anxiety, respiratory secretions, or confusion did not differ. All 6 symptoms, except for confusion, were more often completely relieved in SPC ( p = .014 to p < .001 in different comparisons). In SPC, a documented decision about the goal being end-of-life care and information about this were more common than in hospitals ( p < .001). Also, to have family members present at the time of death and for family members to be offered a follow-up talk afterward was more common in SPC ( p < .001). Conclusion More systematic palliative care routines may be an important factor for better symptom control and higher quality of end-of-life care in hospitals.
Rapid triage and transition to telehealth for heart transplant patients in the COVID-19 pandemic setting
Authors: Bart Nicole K , Emmanuel Sam , Friits-Lamora Rodrigo , Larkins Emily , Kotlyar Eugene , Muthiah Kavitha , Jabbour Andrew , Hayward Christopher , Jansz Paul C , Keogh Anne M , Thomas Emma E , Macdonald Peter S 
Published: February 2023

Background In the setting of the COVID-19 pandemic, a rapid uptake of telehealth services was instituted with the aim of reducing the spread of disease to vulnerable patient populations including heart transplant recipients. Methods Single-center, cohort study of all heart transplant patients seen by our institution's transplant program during the first 6 weeks of transition from in-person consultation to telehealth (23 March – 5 June 2020). Results Face-to-face consultation allocation strongly favored patients in the early post-operative period (34 vs. 242 weeks post-transplant; p < 0.001). Telehealth consultation dramatically reduced patient travel and wait times (80 min per visit saved in telehealth patients). No apparent excess re-hospitalization or mortality was seen in telehealth patients. Conclusions With appropriate triage, telehealth was feasible in heart transplant recipients, with videoconferencing being the preferred modality. Patients seen face-to-face were those triaged to be higher acuity based on time since transplant and overall clinical status. These patients have the expected higher rates of hospital re-admission, and therefore should continue to be seen in person.
Remote cognitive behavioral therapy for older adults with anxiety symptoms: A systematic review and meta-analysis
Authors: Ando Mariko , Kao Ying-Chia , Lee Yu-Chien , Tai Sung-An , Mendez Samuel R , Sasaki Kosuke , Tang Wenze , Papatheodorou Stefania 
Published: February 2023

Introduction In-person cognitive behavioral therapy (CBT) can reduce self-reported anxiety in older adults. However, studies are limited for remote CBT. We assessed the effectiveness of remote CBT in mitigating self-reported anxiety in older adults. Methods We conducted a systematic review and meta-analysis based on a literature search of PubMed, Embase, PsycInfo, and Cochrane databases up to March 31, 2021, for randomized controlled clinical trials comparing the effectiveness of remote CBT versus non-CBT controls on mitigating self-reported anxiety in older adults. We calculated within-group pre-to-post-treatment standardized mean difference using Cohen's d, obtained the difference between a remote CBT group and a non-CBT control group as our effect size for cross-study comparison, and conducted a random-effects meta-analysis. Changes in scores on self-reported anxiety symptoms (Generalized Anxiety Disorder-7 item Scale, Penn State Worry Questionnaire, or Penn State Worry Questionnaire – Abbreviated), and self-reported depressive symptoms (Patient Health Questionnaire-9 item Scale or Beck Depression Inventory) were primary and secondary outcomes, respectively. Results Six eligible studies, containing 633 participants with a pooled mean age of 66.6 years, were included in the systematic review and meta-analysis. There was a significant mitigating effect of intervention on self-reported anxiety, favoring remote CBT over non-CBT controls (between-group effect size: −0.63; 95% CI: −0.99 to −0.28). We also found a significant mitigating effect of intervention on self-reported depressive symptoms (between-group effect size: −0.74; 95% CI: −1.24 to −0.25). Discussion Remote CBT is more effective in reducing self-reported anxiety and depressive symptoms than non-CBT control in older adults.
Design and Performance Evaluation of a Novel Automatic Stapling Device for Knotless Barbed Suture in Laparoscopic Surgery
Authors: Zhou Qing , Li Zheng , Zhu Mingyue , Ding Bo , Xu Jingyun , Shen Yang 
Published: February 2023

Need This study developed a novel automatic stapling device for improving the speed and stability of suturing in laparoscopic surgery. Technical Solution The stapling device included 3 components: driver module, actuator module, and transmission module. Proof of concept A negative water leakage test of the in vitro intestinal defect model preliminarily demonstrated the safety of the new automatic stapling device. The suturing time for skin and peritoneal defects through the automatic stapling device was significantly shorter than that through the ordinary needle-holder suture ( P < .05). These 2 suture methods had good tissue alignment. The automatic suture showed less inflammatory cell infiltration and lower inflammatory response scores at the tissue incision on days 3 and 7 after surgery compared with the ordinary needle-holder suture, with statistically significant differences ( P < .05). Next steps In the future, the device needs to be further optimized and the experimental needs to be supplemented to provide some evidence for clinical use. Conclusion This novel automatic stapling device for knotless barbed suture designed in this study has advantages of shorter suturing time and milder inflammatory responses than the ordinary needle-holder suture, safe and feasible in laparoscopic surgery.
The Feasibility and Efficacy of a Novel Nano Filter in Reducing the Hazards of Surgical Smoke Exposure During Gynecological Laparoscopic Surgery
Authors: Feng Xiaoxiao , Ding Bo , Shen Yang 
Published: February 2023

Need This study developed a nano-filter to reduce the concentration of hazardous substances in surgical smoke. Methodology and device description The nano-filter consists of nanomaterials and hydrophilic materials. Smoke was collected before and after using the new nano-filter during the surgery. Preliminary results The concentration of PM2.5 and PAHs produced by the monopolar device was the highest ( P < .05). The concentration of PM2.5 and PAHs after using a nano-filter was less than the non-filter group ( P < .05). Current status Surgical smoke generated by monopolar and bipolar devices pose a potential cancer risk to health staff in the operational room. The concentration of PM and PAHs were reduced and the cancer risk was not obvious by using the nano-filter.
Exploring the well-being of community pharmacy professionals, turnover intention and patient safety: Time to include operational responsibility
Authors: Etezad Seyedehsan , Fleming Mark , Weigand Heidi A. , Hartt Christopher M. , Dutton Daniel J. , Barker James R. , Brunt Keith R. 
Published: February 2023

Background: The COVID-19 pandemic added significant occupational pressures on community pharmacists. The objective of this research project was to investigate the level of distress and burnout among community pharmacy professionals and its association with their retention within their occupation as well as patient safety outcomes. Method: We conducted a cross-sectional study on 722 community pharmacy professionals from all Canadian provinces using an online survey, including scientifically validated measures. The data were analyzed using multiple regression analysis. Results: In Canada, 85% of community pharmacy professionals reported their mental health had suffered since the COVID-19 pandemic. Younger pharmacy professionals and those paid hourly reported a worsening level of mental health and an increasing level of turnover intention. Pharmacists with more dynamic/disrupted work schedules and those working for a large pharmacy chain (more than 25 pharmacies in Canada) reported lower levels of mental health quality. Pharmacy professionals working in pharmacies that are open more than 70 hours a week reported a lower level of patient safety culture. Pharmacists’ mental health was the significant predictor of their turnover intention, implying a heightened risk to professional effectiveness and retention. Compassion satisfaction was positively associated with patient safety culture and safety behaviour, while compassion fatigue and secondary traumatic stress were significantly associated with pharmacists’ level of risk-taking behaviours. Conclusion: This study emphasized the importance of prioritizing the mental health and well-being of community pharmacy professionals and demonstrated individual and systemic factors predicting the well-being and turnover intention of community pharmacists, as well as patient safety culture within their pharmacy. This research makes a case to consider actions to shift the monitoring focus from community pharmacists (also known as “individual responsibility”) to community pharmacies (also known as “operational responsibility”) for managing patient safety. Additionally, community pharmacists should be provided with the professional autonomy to affect their working conditions and alleviate the stress that has the potential to negatively affect the delivery of care.
Glycemia Risk Index Assessment in a Pediatric and Adult Patient Cohort With Type 1 Diabetes Mellitus
Authors: Díaz-Soto Gonzalo , Pérez-López Paloma , Férnandez-Velasco Pablo , Nieto de la Marca María de la O , Delgado Esther , del Amo Sofia , de Luis Daniel , Bahillo-Curieses Pilar 
Published: February 2023

Background: To evaluate the glycemia risk index (GRI) as a new glucometry in pediatric and adult populations with type 1 diabetes (T1D) in clinical practice. Methods: A cross-sectional study of 202 patients with T1D receiving intensive treatment with insulin (25.2% continuous subcutaneous insulin infusion [CSII]) and intermittent scanning (flash) glucose monitoring (isCGM). Clinical and glucometric isCGM data were collected, as well as the component of hypoglycemia (CHypo) and component of hyperglycemia (CHyper) of the GRI. Results: A total of 202 patients (53% males and 67.8% adults) with a mean age of 28.6 ± 15.7 years and 12.5 ± 10.9 years of T1D evolution were evaluated. Adult patients (>19 years) presented higher glycated hemoglobin (HbA1c) (7.4 ± 1.1 vs 6.7 ± 0.6%; P < .01) and lower time in range (TIR) (55.4 ± 17.5 vs 66.5 ± 13.1%; P < .01) values than the pediatric population, with lower coefficient of variation (CV) (38.6 ± 7.2 vs 42.4 ± 8.9%; P < .05). The GRI was significantly lower in pediatric patients (48.0 ± 22.2 vs 56.8 ± 23.4; P < .05) associated with higher CHypo (7.1 ± 5.1 vs 5.0 ± 4.5; P < .01) and lower CHyper (16.8 ± 9.8 vs 26.5 ± 15.1; P < .01) than in adults. When analyzing treatment with CSII compared with multiple doses of insulin (MDI), a nonsignificant trend to a lower GRI was observed in CSII (51.0 ± 15.3 vs 55.0 ± 25.4; P= .162), with higher levels of CHypo (6.5 ± 4.1 vs 5.4 ± 5.0; P < .01) and lower CHyper (19.6 ± 10.6 vs 24.6 ± 15.2; P < .05) compared with MDI. Conclusions: In pediatric patients and in those with CSII treatment, despite a better control by classical and GRI parameters, higher overall CHypo was observed than in adults and MDI, respectively. The present study supports the usefulness of the GRI as a new glucometric parameter to evaluate the global risk of hypoglycemia-hyperglycemia in both pediatric and adult patients with T1D.
Remote maintenance cardiac rehabilitation (MAINTAIN): A protocol for a randomised feasibility study
Authors: Denton Francesca , Waddell Alexander , Kite Chris , Hesketh Katie , Atkinson Lou , Cocks Matthew , Jones Helen , Randeva Harpal , Davenport Nathan , Powell Richard , Clark Cain , Kyrou Ioannis , Harwood Amy E , McGregor Gordon 
Published: February 2023

Background Long-term adherence to exercise is often poor for people with coronary heart disease (CHD) who have completed supervised, centre-based cardiac rehabilitation. The aim of this study is to assess the feasibility of a remotely prescribed, delivered and monitored cardiac rehabilitation intervention using a wearable device to support long-term adherence to exercise and physical activity during maintenance of cardiac rehabilitation. Methods After completing cardiac rehabilitation, 30 participants with CHD, will be randomised (1:1) to an intervention ( n = 15) or a usual care group ( n = 15) in a 12-month feasibility randomised controlled trial (RCT). The intervention will comprise of an exercise consultation, personalised exercise prescription delivered via a wearable activity monitor using biometric feedback, regular monitoring via check-ins, and feedback text-messages for 6-months. Participants will be assessed at baseline (following completion of cardiac rehabilitation) and at three-, six-, and 12-months post-randomisation. The primary outcome will be feasibility, including assessment of eligibility, recruitment, adherence, and acceptability. Secondary outcomes will include exercise capacity, physical activity behaviours, cardiovascular disease risk and quality of life. Semi-structured interviews will be conducted at three-, six-, and 12-months post-randomisation (and with those who drop-out) to explore the acceptability of the study intervention and procedures. A questionnaire will be offered to those who decline participation. Discussion The MAINTAIN study will evaluate the feasibility of conducting a future definitive multi-centre RCT testing a remotely prescribed and monitored long-term mHealth maintenance exercise programme, versus usual care, for people with CHD who have completed cardiac rehabilitation. Trial registration number ClinicalTrials.gov, NCT05292287. Registered on 22/03/2022
Proportion and characteristics of secondary progressive multiple sclerosis in five European registries using objective classifiers
Authors: Forsberg Lars , Spelman Tim , Klyve Pernilla , Manouchehrinia Ali , Ramanujam Ryan , Mouresan Elena , Drahota Jiri , Horakova Dana , Joensen Hanna , Pontieri Luigi , Magyari Melinda , Ellenberger David , Stahmann Alexander , Rodgers Jeff , Witts James , Middleton Rod , Nicholas Richard , Bezlyak Vladimir , Adlard Nicholas , Hach Thomas , Lines Carol , Vukusic Sandra , Soilu-Hänninen Merja , van der Walt Anneke , Butzkueven Helmut , Iaffaldano Pietro , Trojano Maria , Glaser Anna , Hillert Jan ,   on behalf of the SPMS Research Collaboration Network
Published: February 2023

Background To assign a course of secondary progressive multiple sclerosis (MS) (SPMS) may be difficult and the proportion of persons with SPMS varies between reports. An objective method for disease course classification may give a better estimation of the relative proportions of relapsing–remitting MS (RRMS) and SPMS and may identify situations where SPMS is under reported. Materials and methods Data were obtained for 61,900 MS patients from MS registries in the Czech Republic, Denmark, Germany, Sweden, and the United Kingdom (UK), including date of birth, sex, SP conversion year, visits with an Expanded Disability Status Scale (EDSS) score, MS onset and diagnosis date, relapses, and disease-modifying treatment (DMT) use. We included RRMS or SPMS patients with at least one visit between January 2017 and December 2019 if ≥ 18 years of age. We applied three objective methods: A set of SPMS clinical trial inclusion criteria (“EXPAND criteria”) modified for a real-world evidence setting, a modified version of the MSBase algorithm, and a decision tree-based algorithm recently published. Results The clinically assigned proportion of SPMS varied from 8.7% (Czechia) to 34.3% (UK). Objective classifiers estimated the proportion of SPMS from 15.1% (Germany by the EXPAND criteria) to 58.0% (UK by the decision tree method). Due to different requirements of number of EDSS scores, classifiers varied in the proportion they were able to classify; from 18% (UK by the MSBase algorithm) to 100% (the decision tree algorithm for all registries). Objectively classified SPMS patients were older, converted to SPMS later, had higher EDSS at index date and higher EDSS at conversion. More objectively classified SPMS were on DMTs compared to the clinically assigned. Conclusion SPMS appears to be systematically underdiagnosed in MS registries. Reclassified patients were more commonly on DMTs.
Social Innovation for Sustainability and Social Inclusion
Authors: Kumar Dinesh , Gupta Punam 
Published: February 2023

Companies are realising now that business is not only about selling products to rich consumers but also to serve the underserved bottom-of-the-pyramid (BOP) markets. Serving these customers calls for innovative methods. This had led to reinventing business models to expand the nature of their businesses from mere commercial motives to social ones as well; the understanding that businesses succeed if they go beyond their mandate of making profits. The future rests on three paradigm shifts taking place in BOP approaches: innovation, transformation of companies into social enterprises and technological advancements that bring products closer to BOP consumers. That is to say, companies today re-invent their business models and their very approach of doing business. Such companies stand a greater chance of success and long-term survival. This article describes the concepts of social business, social entrepreneurship and social innovation. We illustrate the concepts with mini case studies or examples of several companies that have achieved innovation in products, business models or processes to serve BOP markets. We describe efforts that solve problems of consumers who are disadvantaged because of distance, education or purchasing power. If this ‘social innovation’ betters the life of consumers, it could result in sustainability and inclusive development. The world is slowly realising that the existing business models that place importance on relentless pursuit of profits are causing immense damage to our society and environment. The objectives of business must change. Milton Friedman’s famous saying, ‘the sole purpose of a business is to generate profits for its shareholders’ is no longer accepted today as businesses find that they must cater to social objectives as well. This article describes that this can well be achieved, as illustrated by several companies who achieve both—financial profits and social good. Drawing from examples of successful initiatives, new business models are being created that provide affordable products and services for disadvantaged consumers. We have taken elements from the business models of these companies to figure out what the future looks like. These companies, we find, found solutions through an action-oriented mindset to solve long-standing problems. Firms that embrace experimentation and rapid prototyping stand to win huge new markets and profits. They invest in distribution and training of local resources, develop innovative products and processes, involve stakeholders and above all, build a social purpose in their objectives. Social innovation and social entrepreneurship shift the focus of governments and companies towards neglected or BOP consumers who are otherwise unapproachable. Examples of social innovation show that it touches the lives of millions of people, empowers them and leads to sustainability. Investments in social innovation that are both sustainable and socially inclusive are the need of the hour.