bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy of Zinc to Control Diarrhea in Developing Nations
Authors: Keough Colleen 
Published: July 2023

Abstract
Acute diarrhea remains a leading cause of childhood deaths, with up to 2.5 million deaths estimated annually among children below 5 years of age. Zinc likely plays an important role in modulating the host resistance to infectious agents. This double-blind randomized controlled trial conducted in New Delhi, India, demonstrates that in pediatric populations likely to have a high prevalence of zinc deficiency and malnutrition, zinc supplementation during episodes of diarrhea results in a 39% reduction in the mean number of watery stools per day and a 21% reduction in the number of days with watery stools. The number of emesis was same both groups.
Bubble CPAP as a Cost-Effective Technology to Reduce Need for Mechanical Ventilation in Neonates
Authors: Walker Andrea 
Published: July 2023

Abstract
This observational study looks at the introduction of an alternative technique for ventilatory support, bubble CPAP, in a referral hospital in a developing nation. The use of bubble CPAP was associated with a 50% reduction in the need for mechanical ventilation with no difference in mortality. Importantly, bubble CPAP could be initiated and administered by nurses after only 1–2 months of on-the-job training, and the cost of the machine is significantly cheaper, it requires less expertise to administer, and it has fewer risks than mechanical ventilation. This makes bubble CPAP an excellent option for higher-level neonatal care in resource-limited areas.
What Is a Cost-Effective Way to Screen for Cervical Cancer in Resource-Denied Settings?
Authors: Sirna Stephanie 
Published: July 2023

Abstract
As a result of resource-intensive cytology-based cervical cancer screening programs, cervical cancer incidence has decreased substantially in high-income countries, with 85% of cases now occurring in low- and middle-income countries (LMICs). This is largely due to lack of screening and lack of human papillomavirus (HPV) vaccine access. Alternative screening with visual inspection with acetic acid (i.e., vinegar [VIA]) has been utilized as a method to detect and treat cervical dysplasia with fewer visits and resources. This randomized cohort study showed that VIA screening is an effective method to prevent cervical cancer in developing countries, resulting in a 25% reduction in cervical cancer incidence and a 35% reduction in cervical cancer mortality in the intervention group.
Unavailability of Cardiac Catheterization
Authors: Olds Peter 
Published: July 2023

Abstract
Ischemic heart disease is one of the most common causes of mortality across the globe. The standard of care for acute myocardial infarction (MI) is percutaneous coronary intervention (PCI), which remains woefully unavailable to the majority of the population in the Global South due to structural and economic inequities. Hence, the ISIS-2 study, which was done in 1988, remains relevant in locations where PCI is unavailable. This study was done to assess the efficacy of streptokinase and aspirin, alone and in combination, on vascular mortality in patients with acute MI. Streptokinase and aspirin reduced the odds of 5-week mortality by 25% and 23%, respectively, compared with those receiving placebo. The combination of streptokinase and aspirin led to a 42% reduction in the odds of mortality at 5 weeks, compared with those receiving placebo. Hence, in patients who present with acute MI, the combination of streptokinase and aspirin is safe and effective and remains the cornerstone of ST Elevation Myocardial Infarction (STEMI) care in regions where PCI is unavailable.
Do Checklists Improve Surgical Outcomes in Under-Resourced Settings?
Authors: Shah Priyansh , Mohan Monali , Gadgil Anita , Roy Nobhojit 
Published: July 2023

Abstract
Surgery is a vital medical service that can prevent loss of life or limb but is also associated with risk of death and complications—half of which are likely to be avoidable. The World Health Organization (WHO) published guidelines identifying multiple best practices to ensure the safety of surgical patients worldwide. This study performed across 8 hospitals in 8 cities across 5 continents by the Safe Surgery Saves Lives Study Group shows the implementation of the checklist reduced the overall death rate by 47% and complications by 36% after introduction of the checklist. The overall rates of surgical-site infection declined from 6.2% to 3.4% (p &lt;0.001).
Powerful Doctors and Underfunded Public Health
Authors: Navin Mark C. , Attwell Katie 
Published: July 2023

AbstractPhysicians and their professional societies have played an important but often troubling role in the governance of immunization in America. Throughout the 20th century, physician professional organizations often derailed attempts to build a functional American public health system. If such a system had been created, it could have delivered free vaccines and effective health promotion to the public. More recently, the American Medical Association and the American Academy of Pediatrics have called for more coercive mandatory vaccination policies. America’s immunization governance has an unfortunate history of seeking to punish rather than provide, and the political activities of physicians have been a significant driver of that dynamic.
Conclusion
Authors: Navin Mark C. , Attwell Katie 
Published: July 2023

AbstractAmerica possesses the vaccines it needs to protect the community, but the country’s immunization social order appears to be breaking down. Decreased public trust erodes the potential for vaccination to be a consensus public project, and the decline of liberal democratic government undermines the legitimacy of vaccine mandates. Furthermore, even as voluntary vaccination programs may not achieve sufficiently high vaccination rates to prevent outbreaks, coercive measures will create backfire effects, reduce public trust, and fuel political polarization. In the face of failing governance, America’s public health institutions—and individual Americans—should prepare for a world in which outbreaks of vaccine-preventable diseases are more common. Drawing parallels with the current climate crisis, this chapter lays out a future of adaptation and mitigation for dealing with resurgent vaccine-preventable diseases.
The co-evolution of strong AGN and central galaxies in different environments
Authors: Sampaio V M , Aragón-Salamanca A , Merrifield M R , de Carvalho R R , Zhou S , Ferreras I 
Published: July 2023

ABSTRACTWe exploit a sample of 80 000 Sloan Digital Sky Survey central galaxies to investigate the effect of active galactic nucleus (AGN) feedback on their evolution. We trace the demographics of optically selected AGN (Seyferts) as a function of their internal properties and environment. We find that the preeminence of AGN as the dominant ionizing mechanism increases with stellar mass, overtaking star formation for galaxies with Mstellar ≥ 1010 M⊙. The AGN fraction changes systematically with the galaxies’ star formation activity. Within the blue cloud, this fraction increases as star formation activity declines, reaching a maximum near the green valley (${\sim} 17 \pm 4~{{\ \rm per\ cent}}$), followed by a decrease as the galaxies transition into the red sequence. This systematic trend provides evidence that AGN feedback plays a key role in regulating and suppressing star formation. In general, Seyfert central galaxies achieve an early-type morphology while they still host residual star formation. This suggests that, in all environments, the morphology of Seyfert galaxies evolves from late- to early-type before their star formation is fully quenched. Stellar mass plays an important role in this morphological transformation: while low-mass systems tend to emerge from the green valley with an elliptical morphology (T-Type ∼ −2.5 ± 0.7), their high-mass counterparts maintain a spiral morphology deeper into the red sequence. In high-stellar mass centrals, the fraction of Seyferts increases from early- to late-type galaxies, indicating that AGN feedback may be linked with the morphology and its transformation. Our analysis further suggests that AGN are fuelled by their own host halo gas reservoir, but when in group centrals can also increase their gas reservoir via interactions with satellite galaxies.
Clash of Titans: the impact of cluster mergers in the galaxy cluster red sequence
Authors: Aldás Franklin , Zenteno Alfredo , Gómez Facundo A , Hernandez-Lang Daniel , Carrasco Eleazar R , Vega-Martínez Cristian A , Nilo Castellón J L 
Published: July 2023

ABSTRACT
Merging of galaxy clusters are some of the most energetic events in the Universe, and they provide a unique environment to study galaxy evolution. We use a sample of 84 merging and relaxed SPT galaxy clusters candidates, observed with the Dark Energy Camera in the 0.11 &lt; z &lt; 0.88 redshift range, to build colour–magnitude diagrams to characterize the impact of cluster mergers on the galaxy population. We divided the sample between relaxed and disturbed, and in two redshifts bin at z = 0.55. When comparing the high-z to low-z clusters we find the high-z sample is richer in blue galaxies, independently of the cluster dynamical state. In the high-z bin, we find that disturbed clusters exhibit a larger scatter in the red sequence, with wider distribution and an excess of bluer galaxies compared to relaxed clusters, while in the low-z bin we find a complete agreement between the relaxed and disturbed clusters. Our results support the scenario in which massive cluster halos at z &lt; 0.55 galaxies are quenched as satellites of another structure, i.e. outside the cluster, while at z ≥ 0.55 the quenching is dominated by in situ processes.
Revisiting the mass of open clusters with Gaia data
Authors: Almeida Anderson , Monteiro Hektor , Dias Wilton S 
Published: July 2023

ABSTRACT
The publication of the Gaia catalogue and improvements in methods to determine memberships and fundamental parameters of open clusters has led to major advances in recent years. However, important parameters such as the masses of these objects, although being studied mostly in some isolated cases, have not been addressed in large homogeneous samples based on Gaia data, taking into account details such as binary fractions. Consequently, relevant aspects such as the existence of mass segregation were not adequately studied. Within this context, in this work, we introduce a new method to determine individual stellar masses, including an estimation for the ones in binary systems. This method allows us to study the mass of open clusters, as well as the mass functions of the binary star populations. We validate the method and its efficiency and characterize uncertainties using a grid of synthetic clusters with predetermined parameters. We highlight the application of the method to the Pleiades cluster, showing that the results obtained agree with the current consensus in the literature as well as recent Gaia data. We then applied the procedure to a sample of 773 open clusters with fundamental parameters determined using Gaia Early Data Release 3 data, obtaining their masses. Subsequently, we investigated the relation between the masses and other fundamental parameters of the clusters. Among the results, we found no significant evidence that clusters in our sample lose and segregate mass with age.
Reducing Tubing and Device Misconnections
Authors: Mazzella Dana 
Published: July 2023

ABSTRACT

Purpose:
The aim of this quality improvement (QI) project was to explore prevention strategies to reduce tubing and device misconnections that cause patient harm and death. Practicing evidence-based techniques can improve rates of nursing-sensitive indicators, such as central line–associated bloodstream infections, and increase patient safety.

Methods:
Our nursing quality management team reviewed internal quality data and found 11 reported misconnections. A literature review was performed to identify recommended prevention strategies that have been used to improve patient outcomes. Recommended strategies included promoting environmental safety, providing adequate education to clinicians on adverse events, performing line tracing and line reconciliation, and reporting all errors in real time.
The nursing quality management team provided education on recommended best practices to prevent misconnection to various stakeholders. Nursing policies and standards of care were revised to include the practice of line tracing and line reconciliation during handoff, admission, transfers, and clinical tests and procedures.

Results:
The nursing quality management team gathered postimplementation data on education and policy changes. Two incidents of misconnection occurred within four months. In their reports, clinicians adopted the language of line tracing and line reconciliation when describing the events and actions performed.

Conclusion:
Implementation of prevention strategies, including adequate education, enabled staff to identify the risk of misconnections and potential adverse events. Clinical staff incorporated line tracing and reconciliation into their practice, improving patient outcomes.
Improving Sickle Cell Disease Care
Authors: Jackson Andrea 
Published: July 2023

ABSTRACT
Research into sickle cell disease (SCD), which disproportionately affects historically underserved ethnic and racial groups, lacks funding and resources. The Centers for Disease Control and Prevention's Sickle Cell Data Collection program is a comprehensive data registry that gathers information about disease prevalence, outcomes, and the type of care patients receive, but it's only currently active in 11 states. This article describes nurses' ethical responsibility to participate in policy work and to advocate for funding for this program, as well as the importance of sharing their perspectives on caring for people who have SCD with legislative representatives.
Compassionate Care for People with Cancer and Opioid Use Disorder
Authors: Jones Katie Fitzgerald , Broglio Kathleen , Ho J. Janet , Rosa William E. 
Published: July 2023

ABSTRACT:
Opioid use disorder (OUD) is an important comorbidity to assess and manage in people with cancer. In this article, the authors discuss strategies for safe opioid management in individuals with OUD and cancer-related pain using a composite case example. They highlight core approaches to pain management, including motivational interviewing, harm reduction, and evidence-based treatments, as well as advocacy for person-centered end-of-life care.
Treatment of chronic migraine with Botox (onabotulinumtoxinA): Development, insights, and impact
Authors: Turkel Catherine C. , Aurora Sheena , Diener Hans-Christoph , Dodick David W. , Lipton Richard B. , Silberstein Stephen D. , Brin Mitchell F. 
Published: July 2023

Chronic migraine (CM) is a neurological disease characterized by frequent migraine attacks that prevent affected individuals from performing daily activities of living, significantly diminish quality of life, and increase familial burden. Before onabotulinumtoxinA was approved for CM, there were few treatment options for these seriously disabled patients and none had regulatory approval.
The terminology and recognition of CM evolved in parallel with the onabotulinumtoxinA clinical development program. Because there were no globally accepted classification criteria for CM when onabotulinumtoxinA was in development, the patient populations for the trials conducted by Allergan were determined by the Allergan migraine team in collaboration with headache scientists and clinicians. These trials and collaborations ultimately led to improvements in CM classifications.
In 2010, onabotulinumtoxinA became the first medication and first biologic approved specifically to prevent headaches in patients with CM. Approval was based on 2 similarly designed phase 3, double-blind, randomized, placebo-controlled, multicenter clinical studies. Both studies showed significantly greater improvements in mean change from baseline in headache-day frequency in patients with CM receiving onabotulinumtoxinA compared with those receiving placebo.
The safety and effectiveness of onabotulinumtoxinA have been established globally in >5000 patients with CM with or without medication overuse treated in clinical and observational studies. Benefits also include improvements in quality of life, fewer psychiatric comorbidities, and reduced healthcare resource utilization. Across studies, onabotulinumtoxinA was well tolerated; adverse events tended to be mild or moderate in severity and to decline over subsequent treatment cycles.
Changing Landscape of Routine Pediatric Surgery for Rural and Urban Children
Authors: Gadepalli Samir K. , Leraas Harold J. , Flynn-O’Brien Katherine T. , Van Arendonk Kyle J. , Hall Matt , Tracy Elisabeth T. , Ricca Robert L. , Goldin Adam B. , Ehrlich Peter F. 
Published: July 2023

Objective:
To describe the changes to routine pediatric surgical care over the past 2 decades for children living in urban and rural environments.

Background:
A knowledge gaps exists regarding trends in the location where routine pediatric surgical care is provided to children from urban and rural environments over time.

Methods:
Children (age 0–18) undergoing 7 common surgeries were identified using State Inpatient Databases (SID, 2002–2017). Rural-Urban Commuting Area codes were used to classify patient and hospital zip codes. Multivariable regression models for distance traveled >60 miles and transfer status were used to compare rural and urban populations, adjusting for year, age, sex, race, and insurance status.

Results:
Among 143,467 children, 13% lived in rural zip codes. The distance traveled for care increased for both rural and urban children for all procedures but significantly more for the rural cohort (eg, 102% vs 30%, P<0.001, cholecystectomy). Transfers also increased for rural children (eg, transfers for appendectomy increased from 1% in 2002 to 23% in 2017, P<0.001). Factors associated with the need to travel >60 miles included year [adjusted odds ratio (aOR)=2.18, 95% CI: 1.94–2.46: 2017 vs 2002], rural residence (aOR=6.55, 95% CI: 6.11–7.01), age less than 5 years (aOR=2.17, 95% CI: 1.92–2.46), and Medicaid insurance (aOR=1.35, 95% CI: 1.26–1.45). Factors associated with transfer included year (aOR=5.77, 95% CI: 5.26–6.33: 2017 vs 2002), rural residence (aOR=1.47, 95% CI: 1.39–1.56), age less than 10 years (aOR=2.34, 95% CI: 2.15–2.54), and Medicaid insurance (aOR=1.49, 95% CI: 1.42–1.46).

Conclusion:
Rural children, younger age, and those on Medicaid disproportionately traveled greater distances and were more frequently transferred for common pediatric surgical procedures.
Stoma-free Survival After Rectal Cancer Resection With Anastomotic Leakage
Authors: Greijdanus Nynke G. , Wienholts Kiedo , Ubels Sander , Talboom Kevin , Hannink Gerjon , Wolthuis Albert , de Lacy Francisco B. , Lefevre Jérémie H. , Solomon Michael , Frasson Matteo , Rotholtz Nicolas , Denost Quentin , Perez Rodrigo O. , Konishi Tsuyoshi , Panis Yves , Rutegård Martin , Hompes Roel , Rosman Camiel , van Workum Frans , Tanis Pieter J. , de Wilt Johannes H.W. ,   TENTACLE-Rectum Collaborative Group
Published: July 2023

Objective:
This study aimed to develop and validate a prediction model (STOMA-score) for one-year stoma-free survival in rectal cancer (RC) patients with anastomotic leakage (AL).

Background:
AL after RC resection often results in a permanent stoma.

Methods:
This international retrospective cohort study (TENTACLE–Rectum) encompassed 216 participating centres, and included patients who developed AL after RC surgery between 2014-2018. Clinically relevant predictors for one-year stoma-free survival were included in uni- and multivariable logistic regression models. The STOMA-score was developed and internally validated in a cohort of patients operated between 2014-2017, with subsequent temporal validation in a 2018 cohort. The discriminative power and calibration of the models’ performance were evaluated.

Results:
This study included 2499 AL patients; 1954 in the development cohort and 545 in the validation cohort. Baseline characteristics were comparable. One-year stoma-free survival was 45.0% in the development cohort and 43.7% in the validation cohort. The following predictors were included in the STOMA-score: sex, age, ASA-classification, body mass index, clinical M-disease, neoadjuvant therapy, abdominal- and transanal approach, primary defunctioning stoma, multivisceral resection, clinical setting in which AL was diagnosed, postoperative day of AL diagnosis, abdominal contamination, anastomotic defect circumference, bowel wall ischemia, anastomotic fistula, retraction and reactivation leakage. The STOMA-score showed good discrimination and calibration (c-index 0.71, 95%CI 0.66-0.76).

Conclusion:
The STOMA-score consists of eighteen clinically relevant factors and estimates the individual risk for one-year stoma-free survival in patients with AL after RC surgery, which may improve patient counselling and give guidance when analyzing efficacy of different treatment strategies in future studies.
Outcomes Associated with Esophageal Perforation Management
Authors: Veziant Julie , Boudis Fabio , Lenne Xavier , Bruandet Amelie , Eveno Clarisse , Nuytens Frederiek , Piessen Guillaume 
Published: July 2023

Objective:
Evaluate outcomes associated with esophageal perforation (EP) management at a national level and determine predictive factors of 90-day mortality (90dM), failure-to-rescue (FTR) and major morbidity (MM, Clavien-Dindo 3-4).

Background:
EP remains a challenging clinical emergency. Previous population based-studies showed rates of 90dM up to 38.8% but were outdated or small-sized.

Methods:
Data from patients admitted to hospitals with EP were extracted from the French medico-administrative database (2012-2021). Etiology, management strategies, short and long-term outcomes were analyzed. A cut-off value of the annual EP management caseload affecting FTR was determined using the Chi Squared Automatic Interaction Detector method. Random effects logistic regression model was performed to assess independent predictors of 90dM, FTR and MM.

Results:
Among 4765 patients with EP, 90dM and FTR rates were 28.0% and 19.4%. Both remained stable during the study period. EP was spontaneous in 68.2%, due to esophageal cancer in 19.7%, iatrogenic post-endoscopy in 7.3% and due to foreign body ingestion in 4.7%. Primary management consisted in surgery (n=1447,30.4%), endoscopy (n=590,12.4%), isolated drainage (n=336,7.0%) and conservative management (n=2392,50.2%). After multivariate analysis, besides age and comorbidity, esophageal cancer was predictive of both 90dM and FTR. An annual threshold of ≥8 EP managed annually was associated with reduced 90dM and FTR rate. In France, only some university hospitals fulfilled this condition. Furthermore, primary surgery was associated with a lower 90dDM and FTR rate despite an increase in MM.

Conclusion:
We provide evidence for the referral of EP to high-volume centers with multidisciplinary expertise. Surgery remains an effective treatment of EP.