bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tradeoffs in Triage of Motor Vehicle Trauma by Rural 911 Emergency Medical Services Practitioners
Authors: Benson Jamie , Wolfson Daniel , van den Broek-Altenburg Eline 
Published: January 2023

Purpose Identification and triage of severely injured patients to trauma centers is paramount to survival. Many patients are undertriaged in rural areas and do not receive proper care. The decision-making processes involved in triage are not well understood and should be assessed to improve the triage process and outcomes. Methods Triage decision-making processes were explored through emergency medical services (EMS) practitioner focus groups and a discrete choice experiment (DCE). Attributes of trauma determined from focus groups and the literature included patient demography, injury mechanism, and trauma center distance. DCE data were analyzed using mixed logit models. Results High-risk mechanism, decreased age, multiple comorbidities, and pregnancy were found to increase the preference for triage. Greater trauma center distance was found to decrease preference for triage, but practitioners were willing to trade off up to 2 h of travel time to transport a third-trimester pregnancy and 48 min of travel time to transport a 25-y-old than they would a 50-y-old with the same comorbidities, injuries, and stability. Conclusions Our findings suggest that current forms of EMS protocols may not be appropriately tailored to support the mechanisms underlying practitioner decision making. Public health professionals and researchers should consider using DCEs to better understand EMS practitioner decision making and identify structures and incentives that may improve patient outcomes and optimally guide appropriate triage decisions. Highlights Discrete choice experiments are an effective method to elicit prehospital practitioners’ preferences around transport of the traumatized patient. Practitioner biases observed in EMS transport data are recovered in stated preference models incorporating individual preference heterogeneity. There is a discrepancy between the triage priorities recommended by protocol and those measured from prehospital practitioners’ decisions—this may have implications in over- and undertriage rates and prehospital protocol design.
Comparative analysis of three common imaging modalities for nasolabial cysts
Authors: Liu Shengyang , Hao Dingqian , Yu Liang , Ma Hui , Zhao Hui , Sun Shujuan , Yu Peng , Ji Hongzhi , Shi Li , Wan Yuzhu , Chen Aiping 
Published: January 2023

Objective To compare the clinical diagnostic value of ultrasonography (USG), computed tomography (CT), and magnetic resonance imaging (MRI) for nasolabial cysts. Methods The clinical and imaging data of 20 patients with 21 nasolabial cysts confirmed surgically and histopathologically were retrospectively analyzed. Results The largest cyst was 3.4 × 2.7 × 2.3 cm, and the smallest cyst was 1.1 × 0.7 × 0.5 cm. All cysts were located in the soft tissue between the nasolabial fold and maxillary bone. USG showed sensitivity of 95%, accuracy of 95%, and a missed diagnosis rate of 5%; CT showed sensitivity of 80%, accuracy of 80%, and a missed diagnosis rate of 20%; and MRI showed sensitivity of 85%, accuracy of 85%, and a missed diagnosis rate of 15%. Conclusions USG showed higher sensitivity and accuracy and a lower missed diagnosis rate than CT and MRI. Therefore, USG is worth popularizing on a large scale for the diagnosis of nasolabial cysts.
Understanding Shifts in US Policies towards the Taliban: A Critical Analysis
Authors: Ibrahimi Niamatullah , Farasoo Abbas 
Published: January 2023

The ‘war on terror’ produced discourses, which elevated terrorism as a primary threat to international peace and security and justified the overthrow of regimes that were suspected of supporting terrorism. After two decades, the United States (US) seeks to wind down the war, including through negotiations with groups that it once regarded as terrorist or complicit in terrorism. This article takes a critical approach to examine these shifts in US policy in relation to the Taliban in Afghanistan. It conceives the Taliban as a networked movement that consisted of local roots, transnational jihadist ties and connections to Pakistan’s proxy war in Afghanistan. The article then identifies and problematises key assumptions of American discourses by assessing them against local patterns of terrorism and (in)security and the Taliban’s violent tactics. Drawing on US sources, it finds that the US discourses shifted over time between various aspects of the Taliban movement as signifiers of its identity to justify shifting Washington’s priorities in Afghanistan. These discursive shifts, which reflected US policy priorities, introduced uncertainties and contradictions that contributed to the failure of the war efforts in Afghanistan. Analyse critique des changements survenus dans la politique américaine à l’égard des talibans
Neutrophil–lymphocyte ratios in blood to distinguish children with asthma exacerbation from healthy subjects
Authors: Pan Ruilin , Ren Yaning , Li Qingqing , Zhu Xuming , Zhang Jian , Cui Yubao , Yin Hao 
Published: January 2023

Objective Airway inflammation is a prominent feature of asthma and may play an important role in disease pathophysiology. Despite the increasing incidence of asthma worldwide, reliable diagnostic biomarkers are lacking and widely lead to asthma misdiagnosis. Neutrophil–lymphocyte ratio (NLR) is a biomarker of systemic inflammation, in addition to NLR–alanine aminotransferase ratio (NAR) and NLR–albumin ratio (NBR). The aim of this study was to evaluate associations of NLR, NAR, and NBR with diagnosis of childhood asthma to determine if they can aid clinical childhood asthma diagnosis. Methods This retrospective case-control study included 89 children with asthma and 53 healthy children from the Wuxi Children’s Hospital affiliated with Nanjing Medical University. We applied various statistical tests to the dataset: Mann–Whitney U test to compare characteristics of the case and control groups; chi-squared test to compare categorical variables; Kruskal–Wallis test to compare statistical differences of asthma indicators among groups; receiver operating characteristic (ROC) curves to assess the diagnostic value of indices; and Spearman correlation analysis to evaluate relationships between NLR and lactate dehydrogenase, albumin, aspartate transaminase, and alanine transaminase levels. Results Compared with controls, the asthma case group had significantly higher white blood cell ( p < 0.01), neutrophil, lactate dehydrogenase, C-reactive protein, and NLR levels ( p < 0.01) and significantly lower lymphocyte ( p = 0.001), platelet ( p = 0.039), and albumin levels ( p = 0.04). We determined optimal cutoff levels for several metrics: 1.723 for NLR, with sensitivity of 0.73 and specificity of 0.906; 0.135 for NAR, with sensitivity of 0.685 and specificity of 0.887; and 0.045 for NBR, with sensitivity of 0.674 and specificity of 0.906. The areas under the curve (AUCs) were 0.824 for NLR, 0.788 for NAR, 0.818 for NBR, and 0.83 for the combination of NLR + NAR + NBR. Conclusion The combination of NLR, NAR, and NBR biomarkers distinguished asthmatic ones suffering from exacerbation of the condition from healthy children. Thus, our results indicate NLR + NAR + NBR could be used as a clinical biomarker for asthma in children.
The potential causal association of systemic lupus erythematosus with congestive heart failure in the East Asian population: A two-sample mendelian randomization study
Authors: Song Euijun 
Published: January 2023

Objective Systemic lupus erythematosus (SLE) is a systemic autoimmune disease that increases the risk of cardiovascular disease, but the causal relationship has remained unknown in the East Asian population. We aim to determine the causal relationship between SLE and congestive heart failure (CHF) in the East Asian population. Methods We conducted a two-sample Mendelian randomization MR study to examine the potential causal association of SLE with CHF, using the East Asian genome-wide association study datasets for SLE (4222 cases, 8431 controls) and CHF (9413 cases, 203,040 controls). Results The MR analysis showed that genetic susceptibility to SLE was associated with the increased risk of CHF (odds ratio [OR] 1.032, 95% confidence interval [CI] 1.004–1.061, p = .023). After excluding the human leukocyte antigen (HLA) regions, SLE was also associated with a higher risk of CHF (OR 1.034, 95% CI 1.007–1.062, p = .015). The multiple MR sensitivity analyses confirmed that this potential causal association was unlikely to be biased by horizontal pleiotropy. Conclusions The findings of this MR study suggest that SLE potentially increases the risk of CHF in the East Asian population. Genetic predisposition to SLE may play a significant role in developing CHF in the East Asian population.
Scleral suture fixation of a custom, flexible iris prosthesis
Authors: Amaral Henryque L , Snyder Michael E. 
Published: January 2023

Introduction Iris prostheses are an integral tool for the management of symptoms in the setting of damaged, insufficient, or absent irides. Fixation of a custom iris prosthesis in the absence of capsular support raises similar challenges to the fixation of an intraocular lens (IOLs) without capsular support. Centration and planar orientation of these larger iris devices are perhaps even more important than with IOLs. Methods We describe two variations of a reliably reproducible suture fixation technique for securing these special devices using a modification of the tiltless, centration-adjustable suture technique for sclerally-fixated posterior chamber IOLs. Results We described a few techniques that are safe and reproductible. That have been used in more than 300 cases in our co-hort with success and follow-ups of over 10 year. Conclusion We go over the technique step-by-step, highlighting the critical steps and pitfalls to avoid complications and achieve satisfactory results and aiming to get more surgeons to use these techniques and help facilitate the steep learning curve some of the steps might have.
Review of glaucoma management in France
Authors: Prud’homme Léo , Knoeri Juliette , Chamard Chloé , Bennedjai Amin , Bensmail Djawed , Lachkar Yves 
Published: January 2023

Purpose To conduct a review of glaucoma management in France Method A 15-question survey was sent to ophthalmologists listed in the journal Réalités Ophtalmologiques and the Syndicat National des Ophtalmologues de France. Results 459/471 responses were analyzed. Gonioscopy was performed by 64.7% of respondents with a Goldmann three-mirror lens, by 51.4% with a four-mirror lens, and 8.2% preferred to perform the procedure with anterior segment imaging. The visual field was reported to be interpreted without difficulty by 87.8% of the practitioners, and 54.0% utilize a progression software. Ultrasound biomicroscopy was reported to be interpreted without difficulty by 20.0% of practitioners. In cases of severe ocular hypertonia with flat bleb in early postoperative trabeculectomy, 61.7% chose ocular massage as a first-line treatment, 52.9% chose laser suture lysis, 50.5% utilized needling, and 24.8% employed hypotonizing eyedrops. In case of severe ocular hypertonia with flat bleb in early postoperative deep sclerectomy, 53.2% chose goniopuncture as their first treatment, 34.4% employed needling, 31.8% utilized ocular massage, and 23.3% chose hypotonizing eyedrops. The selective laser trabeculoplasty is used as soon as the diagnosis is made by 37.5%, in association with a mono or dual therapy by 93.2%, after trying different combinations of eyedrops by 45.5%, when the visual field deteriorates despite a normalized intraocular pressure by 46.6%, and in cases of hypertonia after filtering surgery by 19.2%. Concerning management for primary angle-closure glaucoma, 80.8% considered peripheral iridotomy, and 18.7% utilized cataract surgery. Conclusion The diversity of responses concerning glaucoma management should draw attention to the need for standardized practices.
Neighborhood characteristics and arterial stiffness among Black adults – Results from the Jackson Heart Study and Morehouse-Emory Cardiovascular Center for Health Equity
Authors: Islam Shabatun J , Kim Jeong Hwan , Li Xiaona , Ko Yi-An , Baltrus Peter , Mitchell Gary F , Fox Ervin R , Mujahid Mahasin S , Vaccarino Viola , Lewis Tené T , Taylor Herman A , Sims Mario , Quyyumi Arshed A 
Published: January 2023

Introduction: Poor quality neighborhood environments are independent risk factors for cardiovascular disease (CVD) but are understudied in Black adults, who face large CVD health disparities. Arterial stiffness, a marker of early vascular aging, precedes development of hypertension and adverse CVD events but the effect of neighborhood on arterial stiffness among Black adults remains unknown. Objective: We compared the association between neighborhood environment and arterial stiffness among Black adults in Jackson, MS and Atlanta, GA. Methods: We studied 1582 Black adults (mean age 53 ± 10, 35% male) living in Jackson, MS from the Jackson Heart Study (JHS) and 451 Black adults (mean age 53 ± 10, 39% male) living in Atlanta, GA from the Morehouse-Emory Cardiovascular Center for Health Equity (MECA) study, without known CVD. Neighborhood problems (includes measures of aesthetic quality, walking environment, food access), social cohesion (includes activity with neighbors), and violence/safety were assessed using validated questionnaires. Arterial stiffness was measured as pulse wave velocity (PWV) using magnetic resonance imaging in JHS and as PWV and augmentation index (AIx) using applanation tonometry (SphygmoCor, Inc.) in MECA. Multivariable linear regression models were used to examine the association between neighborhood characteristics and arterial stiffness, adjusting for potential confounders. Results: Improved social characteristics, measured as social cohesion in JHS (β = −0.32 [−0.63, −0.02], p = 0.04) and activity with neighbors (β = −0.23 [−0.40, −0.05], p = 0.01) in MECA, were associated with lower PWV in both cohorts and lower AIx (β = −1.74 [−2.92, − 0.56], p = 0.004) in MECA, after adjustment for CVD risk factors and income. Additionally, in MECA, better food access (β = −1.18 [−2.35, − 0.01], p = 0.05) was associated with lower AIx and, in JHS, lower neighborhood problems (β = −0.33 [−0.64, − 0.02], p = 0.04) and lower violence (β = −0.30 [−0.61, 0.002], p = 0.05) were associated with lower PWV. Conclusion: Neighborhood social characteristics show an independent association with the vascular health of Black adults, findings that were reproducible in two distinct American cities.
Development of stigma-related support for autistic adults: Insights from the autism community
Authors: Han Emeline , Scior Katrina , Heath Eric , Umagami Kana , Crane Laura 
Published: January 2023

Many autistic adults experience public stigma and some internalise this stigma with negative effects on their mental health. While efforts to reduce public stigma are paramount, change can be slow, and interventions to prevent internalised stigma may also be needed. Using a mixed methods online survey, we gathered the views of 144 autistic adults and parents/caregivers of autistic people in the United Kingdom on whether a stigma-related support programme for autistic adults is needed and, if so, what it should ‘look’ like. Quantitative data (summarised descriptively) showed that most participants felt it was important for autistic adults to have support in managing stigma and revealed diverse preferences in terms of programme delivery, underscoring the need for flexibility. Using reflexive thematic analysis, four main themes were identified from the qualitative data: (1) ‘We need to change society not autistic people’, (2) ‘Stigma is difficult to manage alone’, (3) ‘Focus on positive, practical support’, and (4) ‘There is no one size fits all approach’. We discuss the important implications our findings have for how future interventions in this area are framed and delivered. Lay Abstract Many autistic adults experience public stigma, which refers to negative attitudes and treatment from others. Because of that, some autistic adults may also apply unhelpful beliefs to themselves, which is known as internalised stigma. There is some evidence that both public stigma and internalised stigma are linked to poorer mental health in autistic adults. Clearly, it is crucial to change how society thinks and acts towards autistic people. There are several programmes that are trying to do this. But as change can be slow, support may also be needed to help autistic people cope with and challenge stigma. Using an online survey, we gathered the views of 144 autistic adults and parents/caregivers of autistic people in the United Kingdom on whether a stigma support programme for autistic adults is needed and, if so, what it should ‘look’ like. Most participants felt it was important for autistic adults to have support in managing stigma because of the harmful effects that stigma has on mental health and the challenges that autistic adults face in disclosing their diagnosis. However, participants were also concerned that such a programme could convey the message that autistic people, rather than society, need to change. Participants suggested that the programme should be positive and practical, helping autistic adults to understand and accept themselves, as well as learn context-specific strategies for responding to stigma and/or disclosing their diagnosis. They also stressed that the programme should be flexible and inclusive, recognising that autistic adults have very different needs and preferences.
Mental health–related hospitalizations among adolescents and emerging adults with autism in the United States: A retrospective, cross-sectional analysis of national hospital discharge data
Authors: McMaughan Darcy Jones (DJ) , Imanpour Sara , Mulcahy Abigail , Jones Jennifer , Criss Michael M 
Published: January 2023

Autistic adolescents and emerging adults experience high rates of mental health conditions—a risk factor for hospitalization. Using nationally representative data from the 2016 HCUP KID, we estimated the prevalence and costs of mental health–related hospitalizations for autistic adolescents and emerging adults in the United States. Hospital discharges for ages 10–20 years ( n = 1,346,849) were analyzed using survey-adjusted logistic regression and general linear modeling. Mental health–related hospitalizations among autistic young people ( n = 14,368) were mostly for neurodevelopmental, disruptive, depressive, and bipolar disorders. Mental health–related hospitalizations were almost 11 times more likely (OR = 10.98, 95% CI = 10.00–12.00) for autistic youth compared youth with complex and chronic conditions, and two times (OR = 2.03, 95% CI = 1.88–2.19) more likely compared to population controls. Predicted mean service delivery costs of mental health–related hospitalizations for autistic adolescents and emerging adults were US$7,401.23 per stay, resulting in US$106 million in estimated total service delivery costs in 2016. Mental health–related hospitalizations can indicate poor quality care, be traumatic, and increase suicide risk. Community mental health care for autistic young people is needed. Lay abstract Autistic young people are more likely to have mental health conditions, like depression and bipolar disorder, than people without autism. These mental health issues sometimes lead to hospitalizations, which can be expensive and traumatic. Because of this, we wanted to understand mental health–related hospitalizations among autistic young people aged 10–20. We found that the main mental health reasons for the hospitalization of autistic young people were neurodevelopmental, disruptive, depressive, and bipolar disorders. These hospitalizations cost an average of US$7401.23 per stay, for a total of US$106 million in service delivery costs in 2016. Mental health–related hospitalizations were compared between young people with autism, young people with complex and chronic conditions, and young people with no chronic conditions. Autistic young people were almost 11 times more likely to be hospitalized for mental health reasons than young people with complex and chronic conditions, and two times more likely than young people with no complex and chronic conditions. We believe the United States needs better community-based mental health care for young people with autism.
Examining the COVID-19 pandemic and its impact on social work in health care
Authors: Nicholas David B. , Samson Patricia , Hilsen Leeann , McFarlane Janet 
Published: January 2023

Summary This qualitative study examined the COVID-19 pandemic as experienced by healthcare-based social workers in relation to practice, and personal and professional impacts of providing care in this context, with recommendations for pandemic preparedness and response. A total of 12 focus groups were convened between June 2020 and March 2021, comprising 67 hospital social workers across multiple hospitals and other care facilities in western Canada. Findings Based on an Interpretive Description approach, themes emerged reflecting practice shifts; increased work and changing roles; imposed restrictions; problems in communication and decision-making; distress, fear, and demoralization; and co-existing silver linings amid challenges. Applications The COVID-19 pandemic has substantially impacted social workers and their delivery of service. Addressing concerns through proactive responsiveness, both during and beyond the pandemic, are important in nurturing patient-centered care and a supported workforce. Along with that of interdisciplinary colleagues in health care, social workers’ practice has been profoundly impacted by the COVID-19 pandemic. This article explores the experiences of social workers in healthcare settings during the COVID-19 pandemic.
Cellulose acetate-TiO2 and activated carbon electrospun composite fibre membranes for toluene removal
Authors: Orlando Roberta , Afshari Alireza , Fojan Peter 
Published: January 2023

The VOCs removal from polluted air has been achieved using several different methods but primarily through the use of adsorbent materials or through degradation with photocatalytic oxidation (PCO). Fibres produced by electrospinning have the possibility to easily incorporate additives into the fibres and onto their surface. This can functionalise them for efficient VOCs removal. Cellulose acetate (CA)-based electrospun fibre membranes have been fabricated and doped with activated charcoal (AC) and titanium dioxide (TiO2), either separately or in combination to investigate their toluene removal capacity of the single additive and the synergic effects of adsorption and PCO. Two different methods of functionalisation of the fibres with AC and TiO2 have been used. These methods are air spraying and electro-spraying. Several configurations of the final membranes have been investigated. SEM images indicate that the additives have been successfully distributed on the fibre surface and they affect their morphology by increasing the overall roughness and the thickness of the final membranes. Adsorption with AC achieved 45.5% removal of toluene with a starting concentration of 22.5 ppm. PCO was probably initiated using a blacklight blue UV lamp with a peak wavelength of 365 nm as formation of formaldehyde was recorded. The findings suggest that PCO is affected by the residence time and UV light intensity.