bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors associated with oxygen requirement and persistent symptoms 1 year after severe COVID-19 infection
Authors: Serrano María Natalia , Muñoz Oscar Mauricio , Rueda Camilo , Arboleda Alejandra Cañas- , Botero Juan David , Bustos Marlon Mauricio 
Published: May 2023

ObjectiveWe aimed to describe the prevalence and factors associated with the need for supplemental oxygen and persistent symptoms 1 year after severe SARS-CoV-2 infection.MethodsIn this historical cohort and nested case–control study, we included adults with severe COVID-19 (requiring admission to the intensive care unit or invasive mechanical ventilation). We evaluated factors associated with a need for supplemental oxygen and persistent symptoms 1 year after severe infection.ResultsWe included 135 patients (median age 62 years, 30% women). At 1-year follow-up, the main symptoms were dyspnea (32%), myalgia (9%), cough (7%), anxiety (4%), and depression (5%); 12.59% of patients had prolonged requirement for supplemental oxygen. Factors associated with a persistent requirement for supplemental oxygen were female sex (odds ratio 3.15, 95% confidence interval 1.11–8.90) and Charlson Comorbidity Index > 4 (odds ratio 1.60, 95% confidence interval 1.20–2.12).ConclusionsWe found that a high prevalence of supplemental oxygen requirement 1 year after severe COVID infection was associated with female sex and a baseline high rate of comorbidities. It is unknown whether this prevalence was related to other factors, such as the altitude at which patients lived. More than half of patients had prolonged post-COVID syndrome.
Measuring the Change in Soft Palate Length and Shape Following Maxillary Advancement: A Cohort Study in Patients with Orofacial Clefts
Authors: May Andrew , Richards Christina , Moore Mark 
Published: May 2023

Objective To evaluate a method of measuring the change in palatal length and shape following maxillary advancement using synchronous lateral videofluoroscopy and voice recording in order to understand how movement of the maxilla may affect VPI risk in patients with cleft lip and/or palate (CL/P). Design Retrospective cohort study of children with cleft lip and/or palate. Setting Single center, tertiary children's hospital. Participants Patients with cleft lip and/or palate who underwent maxillary advancement between 2016–21 inclusive. Interventions Maxillary advancement surgery, including those who underwent concurrent mandibular procedures. Main outcome measures The length of the soft palate and the genu angle were measured throughout palatal dynamic range. Pre- and post-operative measurements were compared using a one sided T-test, with subgroup analysis for patients with clinical VPI. Results Ten patients were examined. The mean distance of maxillary advancement was 10.5 mm. The average increase in pre-genu soft palate length was 2.8 mm in the resting position and 2.9 mm in the closed position. The genu angle decreased in the closed position by 16.3 degrees. Conclusions The soft palate showed limited ability to lengthen following maxillary advancement and this may explain the risk of VPI. There was partial compensation by the muscle sling of the palate as demonstrated by a more acute post-operative genu angle and this suggests one reason for the variability of VPI reported. Future research is required to investigate how length and shape changes measured using this method can predict VPI risk.
Effect of Buffalo Milk Consumption on the Growth of 10 to 12 years Old Schoolgirls in Magdalena, Laguna, Philippines
Authors: Samson Marivic S , Barba Corazon VC , Africa Leila S , Aguilar Juliet S , Paunlagui Merlyene M , Rola Agnes C , Vigilla-Montecillo Kristine R. , Saludes Thelma A , Barrio Arnel N Del 
Published: May 2023

Background: Milk contains essential nutrients that help can improve the growth and development of adolescent girls. Objectives: The study determined the effect of milk consumption on the nutritional status of schoolgirls ages 10 to 12 years old in Magdalena, Laguna, Philippines. Methodology: A quasi-experimental study design was used to determine the impact of daily consumption of 200 ml buffalo milk on the prevalence of undernutrition among the 57 schoolgirl participants before and after 160 days. One sample t-test and paired t-test were used to compare the actual and expected total increment and monthly changes in the height and body mass index (BMI) of the participants, while a one-way analysis of variance was used to compare the actual total changes in height and BMI by age. Factors that are correlated with these measurements were identified based on Spearman’s correlation coefficients. Results: The percentage of stunting (31.6%-22.8%) and thinness (21.1%-15.8%) decreased after the milk feeding. Significant differences were observed in the means of total actual and expected changes in height ( P < .00) and BMI ( P < .00). While there were significant differences in the means of actual and expected monthly changes in height every month, this was only observed in the first 2 months for BMI. Only the mean actual changes in height had significant differences when compared by age ( P = .04). Lastly, the age and education of the father were found to be correlated with the height of the schoolgirls. Conclusion: Buffalo milk consumption can improve the growth outcomes of schoolgirls
Long-term mechanical ventilation and transitions in care: A narrative review
Authors: Xiao Lena , Amin Reshma , Nonoyama Mika Laura 
Published: May 2023

Objectives Individuals dependent on long-term mechanical ventilation (LTMV) for their day-to-day living are a heterogenous population who go through several transitions over their lifetime. This paper describes three transitions: 1) institution/hospital to community/home, 2) pediatric to adult care, and 3) active treatment to end-of-life for ventilator-assisted individuals (VAIs). Methods A narrative review based on literature and the author’s collective practical and research experience. Four online databases were searched for relevant articles. A manual search for additional articles was completed and the results are summarized. Results Transitions from hospital to home, pediatric to adult care, and to end-of-life for VAIs are complex and challenging processes. Although there are several LTMV clinical practice guidelines highlighting key components for successful transition, there still exists gaps and inconsistencies in care. Most of the literature and experiences reported to date have been in developed countries or geographic areas with funded healthcare systems. Conclusions For successful transitions, the VAIs and their support network must be front-and-center. There should be a coordinated, systematic, and holistic plan (including a multi-disciplinary team), life-time follow-up, with bespoke consideration of jurisdiction and individual circumstances.
Flow diversion jet: A dangerous mechanism in the flow diversion treatment of giant intracranial aneurysms
Authors: Brake Aaron , Fry Lane , Heskett Cody , De Stefano Frank A , Lei Catherine , Ebersole Koji 
Published: May 2023

Background Cerebral hyperperfusion syndrome (CHS) occurs after the restoration of blood flow to a previously low-flow, low-pressure region of the cerebral vasculature, which subsequently responds with chronic compensatory vasodilation, leading to a dysregulated state. Sudden restoration of normal blood flow can overwhelm the vasculature leading to intracranial hemorrhage (ICH). Separately, the Windkessel phenomenon describes the capacity for elastic vessels to expand with systolic pressure and decompress with diastole, thereby suppressing distal pulse pressure. We encountered a case involving giant basilar aneurysms in which we believe the Windkessel phenomenon precipitated a catastrophic manifestation of CHS at treatment. Observation We present a 60-year-old female found to have marked dolichoectasia of the right cervical internal carotid, vertebral, and basilar arteries concurrent with two large vertebrobasilar dissecting-type fusiform aneurysms. Managed conservatively for ten years before developing gait ataxia, new imaging revealed dramatic interval growth of the larger aneurysm. Flow diversion with partial coiling of the aneurysms was pursued. The patient suffered intra-procedural catastrophic thalamic and midbrain hemorrhage with intraventricular extension. A meticulous review of the case data was undertaken. Our findings suggest that giant aneurysms can act as a Windkessel reservoir, depressing the distal pulse pressure. Flow diversion bypasses the reservoir, increasing the distal pulse pressure beyond the autoregulatory capacity, resulting in ICH analogous to CHS. Lessons CHS and Windkessel phenomenon can contribute to catastrophic sequelae in the treatment of giant intracranial aneurysms with flow diversion. Awareness of this mechanism can protect future patients from harm.
A comprehensive review of the epidemiology and clinical features of 91 cases with Buerger’s disease
Authors: Modaghegh Mohammad Hadi Saeed , Kamyar Mohammad Mahdi , Shafiei Ali , Shariatmaghani Somayeh Sadat , Saremi Elena , Sadeghipour Kermani Fatemeh 
Published: May 2023

Background Thromboangiitis Obliterans (TAO) is a disease of small and medium-sized arteries with an unclear natural course. This study aims to establish a national registry of the disease to gain a better understanding of its epidemiology and clinical course. Method This study was a cohort study of 242 patients with a high probability of TAO admitted to Mashhad University of Medical Sciences (MUMS) hospitals from 2000 to 2015. Of these, 91 patients with a confirmed diagnosis were included in the study (90 males and 1 female) with a mean age of 35 ± 7.8 years. Results The most common symptom upon onset of the disease was paresthesia (29.7%), followed by cold sensitivity and paresthesia (93.4%) during the progression of the disease and Raynaud syndrome or vasospasm (93.9%) in the active phase. The right lower limb was the most commonly affected limb (46.2%), and presenting ischemic symptoms in 48.4%. Statistics indicated a positive correlation between the duration of Burger’s disease and the number of affected limbs ( p = 0.001). There was no effect of disease duration on the likelihood of amputations ( p = 0.28). Conclusion Some patients may experience mild, subtle symptoms for years before the initial signs and symptoms appear, which can be severe and rapidly progress to the point of requiring amputation. We suggest that the diagnostic criteria for Buerger’s disease should be revised in light of the presence of atherosclerosis and its associated risk factors, which present a challenge in terms of diagnosis and treatment. Clinical experience will be of great importance in this regard.
Does stroke-associated pneumonia play an important role on risk of in-hospital mortality associated with severe stroke? A four-way decomposition analysis of a national cohort of stroke patients
Authors: Gittins Matthew , Lobo Chaves Marco Antonio , Vail Andy , Smith Craig J 
Published: May 2023

Background: Severe strokes and stroke-associated pneumonia (SAP) have long been associated with poorer patient health outcomes, for example, in-hospital mortality. However, it is unclear what role SAP plays in the risk of in-hospital mortality associated with a severe stroke at admission. Methods: Using the Sentinel Stroke National Audit Program data on stroke admissions (2013–2018) in England and Wales, we modeled the “total” effect for severe stroke on risk of in-hospital mortality. Through four-way decomposition methodology, we broke down the “total” observed risk into four components. The direct “severity on outcome only” effect, the pure indirect effect of severity mediated via SAP only, the interaction between severity and SAP when mediation is not present, and when mediation via SAP is present. Results: Of 339,139 stroke patients included, 9.4% had SAP and 15.6% died in hospital. Of SAP patients, 45% died versus 12% of non-SAP patients. The risk ratio for in-hospital mortality associated with severe versus mild/moderate stroke (i.e. total effect) was 4.72 (95% confidence interval: 4.60–4.85). Of this, 43%-increased risk was due to additive SAP interaction, this increased to 50% for “very severe” stroke. The remaining excess relative risk was due to the direct severity on outcome effect only, that is, there was no evidence here for a mediation effect via SAP. Conclusion: SAP was associated with a higher mortality in severe stroke patients. Prioritizing SAP prevention in severe stroke patients may improve in-hospital survival. Our results suggest that in severe stroke patients avoiding SAP might result in an up to 43% reduction in mortality.
“Train as you play”: Improving effectiveness of training in youth soccer players
Authors: Deuker Albert , Braunstein Bjoern , Chow Jia Yi , Fichtl Maximilian , Kim Hyoek , Körner Swen , Rein Robert 
Published: May 2023

Purpose The present study investigates to what extend de-contextualized practice is necessary to acquire technical skills in developmental soccer training. Typically, open play is considered beneficial for acquiring tactical skills, whereas specific drills are used to support the development of technical skills like passing and shooting. Therefore, a field-based study was designed to investigate the effectiveness of a Nonlinear Pedagogy (NP) approach in contrast to a classical Deliberate Practice approach to improve passing performance in young developmental soccer players. Method Forty young male players (age 10 ± 1 years) were randomly assigned to three groups (PLAY, PRACTICE, and CONTROL). The PRACTICE group performed classical passing drills, whereas the PLAY group underwent a NP training regime. Passing skill was assessed before and after a 5-week training program using a standardized passing test according to the German Football Association. Additional retention testing was performed 5 weeks later. Results The results indicated that, although the test design showed no specificity to the learning environment of the PLAY group, both groups improved passing skills after training, but the PLAY group displayed better results during retention testing (PRACTICE: p = 0.004, d = 0.48; PLAY: p = 0.001, d = 0.53) compared to the PRACTICE group. These findings are suggestive of general transfer learning in dynamic learning environments. Conclusion The findings indicate that even when there is an emphasis on “technical skill” enhancement, more effective improvement in young development players may be observed through dynamic learning environments. Consequently, this study encourages coaches to design training regimes that afford players to train as they play.
Scapulothoracic tenodesis using hamstring tendon graft for treatment of problematic scapula winging: A new surgical technique
Authors: Gokaraju Kishan , Mahmoud Ahmed , Williams Daniel , Duke Phillip FR , Ross Mark 
Published: May 2023

Introduction Winging of the scapula occurs due to dysfunction of its stabilising muscles, most commonly serratus anterior and/or trapezius, for example in facioscapulohumeral muscular dystrophy. Resultant loss of scapular control and abnormal kinematics can decrease shoulder function due to glenohumeral joint instability, loss of range of motion and pain. Previously described treatment for cases resistant to physiotherapy includes scapulothoracic arthrodesis which involves risk of non-union and metalwork failure, as well as reduced respiratory function due to immobilisation of a segment of the adjacent chest wall. Technique We present a novel surgical approach to the management of problematic scapular winging by using hamstring graft to achieve a scapulothoracic tenodesis. Discussion We believe this technique provides an adequately stable scapula for improved shoulder movement and function, a sufficiently mobile chest wall for improved lung function and avoidance of complications specifically associated with arthrodesis.
Assessing Spatial User Experience for Design Guidelines: A Comparative Study of Outpatient Waiting Rooms With Conventional Versus Modern Features
Authors: Juliá-Nehme Begoña , Yoon So-Yeon , Cumsille Patricio , Rodríguez Eugenio 
Published: May 2023

Objectives: Identify waiting room design features that are most appreciated by outpatients and their companions in conventional and modern waiting rooms. Evaluate if end users evaluate the environment differently from experts and in what aspects. Provide evidence-based design guidelines that orient designers and healthcare managers. Background: Built environments are relevant in patients’ evaluation of overall healthcare service. For outpatients, waiting frequently consumes the largest amount of time; thus, waiting room interior design has great potential to enhance their experience. Methods: This study compares perceptions of two types of waiting rooms—conventional and modern—based on the spatial user experience (SUE) model. In the first stage of the study, we compared user evaluations of conventional waiting rooms ( n = 137) and modern waiting rooms ( n = 426) with respect to the eight SUE model dimensions using multigroup structural equation modeling. In the second stage, an expert ergonomist and two professional interior designers assessed both types of waiting rooms. Results: Results showed that modern waiting rooms were perceived to be significantly better in all SUE dimensions. We also found experts’ evaluations were overall consistent with users’ perceptions. Discrepancies were only found in temperature perception, signage evaluation, and spatial appreciation. Conclusions: Participants valued modern style waiting room features such as good quality signage, use of armchairs and sofas, a controlled environment, and decoration. We suggest involving end users in the design process to respond to their needs and promote a positive experience. Finally, we provide easy-to-adopt design guidelines to improve patients’ waiting room experience.
Understanding Post-occupancy Evaluation Processes for Public Healthcare Facilities in Australia and Aotearoa New Zealand
Authors: Blanch Shari , Frazer Annabel 
Published: May 2023

Objective:The following research paper seeks to explore how post-occupancy evaluations (POEs) are undertaken in the nine health jurisdictions across Australia and Aotearoa New Zealand and investigate if the process can be strengthened to better inform healthcare design and investment.Background:Healthcare expenditure in both nations is increasing, and the rigorous evaluation of healthcare facilities can provide evidence to improve their return on investment. A POE is a research method used to undertake this analysis, usually 12 months after a facility has been occupied. There is limited information available about how POEs are undertaken in each jurisdiction, and there has never been research conducted to understand these processes across the region.Methods:Focus groups were conducted with participants from the government health organization in each jurisdiction to collect qualitative data regarding various aspects of POE processes and barriers to undertaking POEs.Results:Only five of the nine jurisdictions undertake POEs on healthcare facilities (with varied frequencies), and there is no standardized framework in use. However, every jurisdiction does undertake a “benefits realization” process. There is limited involvement of external consultants in POEs or benefits realization processes. POE benchmarks should be established at project commencement, and POE results should then inform future projects. Top-down support is required for POEs to occur.Conclusions:The primary conclusion is that strengthening any evaluation process requires a nuanced approach in each jurisdiction to account for their unique context and challenges. Regular rigorous evaluations are required to feed results into the Australasian Health Facility Guidelines and encourage innovative facility design.
Improving Access to Specialist Palliative Care for Patients With Catastrophic Strokes Using Best Practice Advisory- a Feasibility Study
Authors: Nagpal Vandana , Osgood Marcey L. , Reidy Jennifer , Healy Rose , Silver Brian 
Published: May 2023

Background and Purpose The American Heart Association and American Stroke Association (AHA/ASA) strongly recommend specialty palliative care (PC) for all patients hospitalized with life-threatening or life-altering strokes to provide expert symptom management, improve communication, promote shared decision-making and relieve suffering. We piloted an intervention to remind physicians about high PC needs of their patients admitted with catastrophic stroke. Methods We worked with colleagues from medical informatics to create a “Best Practice Advisory” (BPA) to recommend a goals-of-care conversation and PC consultation for patients with a National Institutes of Health Stroke Scale (NIHSS) score of 20 or more in our electronic medical record (Epic). We evaluated the impact of this BPA, after implementation, on the number and timing of PC consults and reviewed barriers to this system change. Results The BPA was operational in Jan 2019. Data analysis showed that it fired for all patients with an entered NIHSS score of ≥20. Though a large portion of the BPAs (more than 90%) were acknowledged without documented reason (after selecting “do not order”), PC consultations per 100 patients with triggered BPA increased from the first year of implementation (11.7 in 2019) to the next 2 years (20.7 in 2020, 15.6 in 2021). Also, the providers learned to manage BPA alerts better resulting in more than 30% reduction in the number of BPA alerts fired for each patient encounter in 2020-2021 compared to 2019.
Impact of Pharmacist Integration Into Primary Care on Reimbursement for Hospital Follow-Up Visits
Authors: Meier Mackenzi , Simpson Grace , Patel Megha , Keedy Chelsea A. 
Published: May 2023

Background: The financial and clinical impact of transitional care management (TCM) outcomes through pharmacist integration within primary care is not well described. Objectives: The primary objective of this study was to determine the financial impact of pharmacist conducted post-discharge phone calls. The secondary objectives included readmission rates and number of interventions. Methods: A computer-generated list identified patients discharged from St. Joseph’s/Candler Health System (SJ/C) with a listed primary care provider within the SJ/C Primary Care Medical Group at Eisenhower from November 1, 2019 to April 30, 2020. Eligible patients who received a post-discharge phone call from a pharmacist were compared to those who received a call by another staff member. Data was collected regarding the financial impact of pharmacist conducted post-discharge phone calls. Readmission rates and medication related interventions were also assessed. Results: There were 104 patients discharged meeting criteria. Twenty-four patients were contacted by a pharmacist resulting in 20 subsequent hospital follow up appointments scheduled with the provider. Total amount billed for those appointments was $4220 (average of $211 per visit). Twenty-five calls were made by non-pharmacist staff with 23 appointments scheduled. Total amount billed for those appointments was $2445 (average of $106 per visit). Increased reimbursement was generated by a qualifying 2-way communication by the pharmacist as outlined by Center for Medicaid and Medicare Services enabling providers to bill for a TCM visit versus standard office visit. Pharmacists made 33 clinical interventions including medication reconciliation, medication procurement, referrals, lab orders, and education. One intervention was made by non-pharmacist staff. The 30-day readmission rate for pharmacist contacted patients was 8% versus 12% for non-pharmacist contacted patients. Conclusions: Pharmacist involvement in TCM while integrated into a primary care office is previously not well described. This data highlights an opportunity for pharmacists to demonstrate sustainability and improved outcomes related to TCM.