bluuebunny/crossref_metadata_2025_split huggingface dataset:
A virtual breakthrough series collaborative to support deprescribing interventions across Veterans Affairs healthcare settings
Authors: Phillips Kristin K. , Mecca Marcia C. , Baim‐Lance Abigail M. , Schiller Gabrielle S. , Pruskowski Jennifer A. , Ellis Elizabeth C. , Aponte‐Rosario Deylen S. , Federovich‐Hogan Amanda L. , Kossifologos Annette C. , Martinez Erica D. , Boockvar Kenneth S. 
Published: June 2023

AbstractBackgroundVirtual collaborative models are a practical way to implement a supportive environment for multi‐team learning. In this project, we aimed to describe the processes and outcomes of a virtual deprescribing collaborative that facilitated implementation of deprescribing interventions around the country.MethodsTwo successive cohorts comprised of multidisciplinary teams from geographically diverse veterans affairs (VA) sites were selected via an application process to participate in a virtual deprescribing collaborative. Each site developed its own deprescribing protocol and took part in regular meetings, mentoring groups, monthly data reporting, and other learning activities over an approximate 9 month period, per cohort. Standard measures were number of veterans served and medications deprescribed. Descriptive and qualitative analyses were utilized.ResultsTwenty‐one total VA sites were selected to participate in the deprescribing collaborative in two cohorts (Cohort 1, n = 12 sites; Cohort 2, n = 9 sites). The majority of sites' practice areas directly served the older adult population, and the majority of site leads were pharmacists. The most utilized tool used by the collaborative sites was the VA VIONE decision support tool (n = 14) and the most common strategy was individualized medication review. Combining outcomes from both Cohorts 1 and 2, a total of n = 4770 veterans were served, with 8332 medications deprescribed. Eighty‐two percent of Cohort 1 sites surveyed reported their deprescribing program was still being utilized after 1 year follow up.ConclusionsThis virtual deprescribing collaborative aided in the successful implementation of both established and novel deprescribing practices across a variety of VA practice sites that care for older adults. The shared learning experience enhanced problem solving and allowed for interdisciplinary teamwork. Overall the collaborative was successful in improving polypharmacy for several thousand older adults.
Exacerbated inequalities: A scoping review of the experiences of older persons during conflict situations
Authors: Kokorelias Kristina M. , Grosse Anna , Kazberouk Alexander , Sinha Samir K. 
Published: June 2023

AbstractBackgroundWe conducted the first known comprehensive literature review to (1) identify, categorize, and summarize the existing knowledge about the experiences of older persons and their caregivers during conflict situations; (2) identify the support needs of older persons and their caregivers, and; (3) identify gaps in the literature and understanding that may inform future research.MethodsA scoping review methodology of academic peer‐reviewed and gray English language literature was employed using six academic literature databases and one gray literature database. We further performed comprehensive searches of relevant search engines and organization websites and bibliographic hand searches to identify additional academic and gray literature. Two authors screened for eligibility of identified studies and documents. One reviewer extracted data regarding authors, article type, geographic origin, key participant characteristics, aims, study design and data collection method, results, conclusions and limitations. Data were analyzed thematically.Results83 documents met this review's inclusion criteria, including 21 academic documents and 62 from the gray literature. Thematic analysis revealed that conflict situations exacerbate existing inequalities experienced by older persons. Within this overarching theme were three interconnected sub‐themes: (1) Older adults are particularly vulnerable during conflict situations; (2) Older persons are inadequately supported in conflict situations; (3) In the face of great challenges, many older adults still manage to endure through conflict situations. We identified 15 recommendations from the reviewed documents to better support older adults in conflict situations.ConclusionsExisting inequalities, such as ageism and ableism, targeted discrimination, and poor health outcomes, become exacerbated during conflict situations, resulting in older persons being less able to flee and meet their daily needs with sufficient access to necessities and healthcare. Little is known of the experiences and needs of family caregivers during conflict situations. We identified several opportunities to improve the experience and support of older persons in conflict situations.
Three‐dimensional analysis for measuring volumetric changes after a noninvasive treatment performed with a new system delivering microwave energy for unwanted abdominal fat reduction
Authors: Clementoni Matteo Tretti , Bonan Paolo , Pedrelli Valerio , Fusco Irene 
Published: June 2023

AbstractBackgroundA growing demand for aesthetic treatments for localized abdominal unwanted fat has developed as a healthy lifestyle is not always able to improve abdomen appearance.AimsThe purpose of this retrospective nonrandomized observational study was to evaluate the efficacy and safety of a new device delivering microwaves energy for unwanted fat reduction, using three‐dimensional (3D) imaging analysis.MethodsTwenty patients (both female and male) were treated in the abdominal area. Subjects received 4 treatments with the study device. Follow‐up evaluations were conducted to estimate safety and efficacy. A Numerical Rating Scale (NRS) was used for pain assessment. Patient's 3D imaging analysis was performed at baseline and at 3 months follow‐up. Finally, a satisfaction questionnaire was filled in by all the patients.ResultsAll subjects completed the whole cycle of treatments and presented for the follow‐up visits. Analysis of 3D imaging yielded a significantly reduction in circumference (cm) and volume (cm3), passing, respectively, from 85.2 ± 8.1 cm and 1950.6 ± 471.0 cm3at baseline to 80.8 ± 8.2 cm and 1728.9 ± 490.9 cm3(p < 0.001) at 3‐months follow‐up after the last treatment. According to the NRS results, the treatment was well tolerated. From the analysis of the satisfaction questionnaire the 90% of patients are interested in carrying out the same treatment in other body areas.ConclusionWith the use of three‐dimensional imaging techniques, the efficacy of a new system delivering microwaves energy for the reduction of abdominal volume correlated to a subdermal fat reduction while preserving/improving skin tightening, was quantitatively and objectively demonstrated.
Unplanned costs and benefits: Gender and spousal spillover effects of retirement on health
Authors: Newmyer Lauren , Lowrey Kendal L. , Levchenko Yuliana 
Published: June 2023

AbstractObjectiveOur study assesses how women and men's health indicators are shaped by their spouse's retirement.BackgroundThe retirement process can reshape the health of a retiree, but these effects can also extend onto the health of spouses. Although past research has largely focused on how men's retirement might negatively shape their wife's health outcomes, it is possible that wives' retirement has detrimental effects on their husband's health as well.MethodUsing data from the Health and Retirement Study (HRS), we employ a fuzzy regression discontinuity design to identify the causal effects of spousal retirement on indicators of physical and mental health in married older adults.ResultsOur results suggested that men, not women, experience the most negative spousal spillover effects of retirement on their health outcomes. We found the most support for spillover effects on spouses' physical health outcomes. Additionally, men who are not working when their spouse retires experienced the most negative health effects.ConclusionWomen and men's health is differentially affected by spousal retirement, where men might be the most negatively affected by their spouses' transition in the US context. These results contradict conventional wisdom that undergirds numerous untested assumptions underlying prior research on this significant life transition.
Top Manager Heuristics Under Knightian Uncertainty: Control Versus Prediction and the Moderating Impact of Framing
Authors: Smit Willem 
Published: June 2023

AbstractIn line with recent conceptual developments that take Knightian uncertainty seriously in the management literature, we investigate the heuristics employed by top managers confronted with an influx of uncertainty. Using an instrument specifically designed to examine heuristic transition from prediction to control in response to uncertainty, we gather data from 147 executive managers and obtain a counterintuitive result. Top managers persist in, and even increase the use of predictive heuristics as uncertainty mounts. But the effect is moderated. Framing uncertainty as a threat enhances the preference for prediction, while framing uncertainty as an opportunity enables managers to shift to control. Post‐hoc analyses indicate that experience may offer managers a stock of control heuristics that also facilitate a shift as they face uncertainty. Our research offers new insights into attribute substitution related to environmental framing and thereby aims to advance the conversation regarding top manager heuristics and biases and the management of uncertainty.
Coffee quality: Insights of Brazilian consumers from different sociodemographic levels combining modified Word Association and Maximum Difference Scaling (MaxDiff)
Authors: Soares Paula T. S. , Tavares Filho Elson R. , Pagani Mônica M. , Mársico Eliane T. , Cruz Adriano G. , Esmerino Erick A. 
Published: June 2023

AbstractThe coffee market is dynamic and offers several products (e.g., powder, capsule, instant, and grain) distributed in different quality categories, such as traditional, extra strong, special, gourmet, and premium. However, despite the diversity of products, there is little information about how consumers with different sociodemographic characteristics perceive and idealize high‐quality coffees. This study used a modified Word Association task (n = 142) to determine the attributes of high‐quality coffee and the Maximum Difference Scale (n = 330) to organize the attributes concerning their importance between groups of consumers from different sociodemographic levels. Consumers considered flavor, aroma, and intensity as the most important attributes of high‐quality coffees, regardless of gender or socioeconomic class. In addition, price and sweetness were important attributes for class C consumers, while temperature and roasting were more important for class A.Practical ApplicationKnowing the specificities of coffee consumers allows the manufacturer to direct their products to different niches that perceive the product differently.
Clinical presentation, diagnosis, treatment, and outcome in 8 dogs and 2 cats with global hypoxic‐ischemic brain injury (2010‐2022)
Authors: Crawford Abbe Harper , Beltran Elsa , Danciu Cecilia‐Gabriella , Yaffy Dylan 
Published: June 2023

AbstractBackgroundGlobal hypoxic‐ischemic brain injury (GHIBI) results in variable degrees of neurological dysfunction. Limited data exists to guide prognostication on likelihood of functional recovery.HypothesisProlonged duration of hypoxic‐ischemic insult and absence of neurological improvement in the first 72 hours are negative prognostic indicators.AnimalsTen clinical cases with GHIBI.MethodsRetrospective case series describing 8 dogs and 2 cats with GHIBI, including clinical signs, treatment, and outcome.ResultsSix dogs and 2 cats experienced cardiopulmonary arrest or anesthetic complication in a veterinary hospital and were promptly resuscitated. Seven showed progressive neurological improvement within 72 hours of the hypoxic‐ischemic insult. Four fully recovered and 3 had residual neurological deficits. One dog presented comatose after resuscitation at the primary care practice. Magnetic resonance imaging confirmed diffuse cerebral cortical swelling and severe brainstem compression and the dog was euthanized.Two dogs suffered out‐of‐hospital cardiopulmonary arrest, secondary to a road traffic accident in 1 and laryngeal obstruction in the other. The first dog was euthanized after MRI that identified diffuse cerebral cortical swelling with severe brainstem compression. In the other dog, spontaneous circulation was recovered after 22 minutes of cardiopulmonary resuscitation. However, the dog remained blind, disorientated, and ambulatory tetraparetic with vestibular ataxia and was euthanized 58 days after presentation. Histopathological examination of the brain confirmed severe diffuse cerebral and cerebellar cortical necrosis.Conclusions and Clinical ImportanceDuration of hypoxic‐ischemic insult, diffuse brainstem involvement, MRI features, and rate of neurological recovery could provide indications of the likelihood of functional recovery after GHIBI.
Clotted blood samples in the neonatal intensive care unit: A retrospective, observational study to evaluate interventions to reduce blood sample clotting
Authors: van Rens Matheus F. P. T. , Hugill Kevin , Francia Airene L. V. , Macaraig Abraham Victor , van Loon Fredericus H. J. , Spencer Timothy R. , Bayoumi Mohammad A. A. 
Published: June 2023

AbstractBackgroundBlood draws for laboratory investigations are essential for patient management in neonatal intensive care units (NICU). When blood samples clot before analysis, they are rejected, which delays treatment decisions and necessitates repeated sampling.AimTo decrease the incidence of rejected blood samples taken for laboratory investigation as a result of clotted sample.Study DesignThis retrospective observational study used routine data on blood draws from preterm infants collected between January 2017 and June 2019 in a 112‐cot NICU in Qatar. Quality improvement interventions to reduce the rate of clotted blood samples included: awareness raising and safe sampling workshops with NICU staff, involvement of the neonatal vascular access team, development of a complete blood count (CBC) sample collection pathway, review of sample collection equipment, introducing the Tenderfoot® heel lance, establishment of benchmarks and provision of dedicated blood extraction equipment.ResultsFirst attempt blood draw occurred in 10 706 cases, representing a 96.2% success rate. In 427 (3.8%) cases, the samples were clotted requiring repeat collection. The overall rate of clotted specimens decreased from 4.8% in 2017 and 2018 to 2.4% in 2019, with odds ratios of 1.42 (95% confidence interval [CI] 1.13–1.78, p = .002), 1.46 (95% CI 1.17–1.81, p < .001) and 0.49 (95% CI 0.39–0.63, p < .001), respectively. The majority (87%–95%) of blood samples were by venepuncture using an intravenous (IV) catheter or the NeoSafe™ blood sampling device. Heel prick sampling was the second (2%–9%) most common method. Clotted samples were most frequently associated with needle use, 228 of 427 (53%), and IV cannula, 162 of 427 (38%), with odds ratios of 4.14 (95% CI 3.34–5.13, p < .001) and 3.11 (95% CI 2.51–3.86, p < .001), respectively.ConclusionsOur interventions over 3 years were associated with reduced rates of sample rejection due to clotting, and this led to improved patient experience through fewer repeated samplings.Relevance to Clinical PracticeThe insights gained from this project can help to improve patient care. Interventions that reduce the rate of blood sample rejection by clinical laboratories can lead to economic savings, timelier diagnostic and treatment decisions, and contribute to an improved quality care experience for all critical care patients, irrespective of age, by reducing the need for repeated phlebotomy and the risk of related complications.
Alveolar bone morphology in patients with palatally‐displaced maxillary lateral incisors before and after orthodontic treatment: A cone‐beam computed tomography study
Authors: Tang Yao , Lu Wenhsuan , Wu Weiqiang , Sun Qiannan , Zhang Yunfan , Xu Tianmin , Chen Si , Liang Wei , Han Bing 
Published: June 2023

AbstractIntroductionPalatal displacement of maxillary anterior teeth is common in clinical practice. Previous studies have reported that the labial bone around palatally‐displaced incisors is thinner than that around normally‐placed teeth. Therefore, it is necessary to elucidate alveolar bone changes after alignment to guide orthodontic treatment. In this study, we investigated the alveolar bone changes around palatally‐displaced maxillary lateral incisors before and after treatment, and the effects of extraction and age using cone‐beam computed tomography.MethodsIn this retrospective study, 55 patients with unilateral palatally‐displaced maxillary lateral incisors were included. Three‐dimensional alveolar bone changes were measured at three levels (25%, 50% and 75% of the root length) using cone‐beam computed tomography. Group comparisons were made between displaced and control teeth, extraction and non‐extraction groups, and adult and minor groups.ResultsAfter orthodontic treatment, labiopalatal and palatal alveolar bone widths decreased at all measured levels. Labial alveolar bone width increased significantly at P25, but decreased at P75. Concavity decreased, while tooth‐axis angle, tooth length, B‐CEJ and P‐CEJ increased. Changes in LB and LP at P75, B‐CEJ and P‐CEJ were statistically significant. After treatment, the tooth‐axis angle on the PD side increased by 9.46°. The change in tooth‐axis angle on the PD side was significantly smaller, and LB and LP decreased more at P75, in the extraction group.ConclusionsCompared to the control teeth, alveolar bone thickness and height for the displaced teeth decreased more significantly after treatment. Tooth extraction and age also influenced alveolar bone changes.
The use of ketamine infusion to dramatically reduce opioid requirements in a patient whose high‐dose intrathecal opioid pump was inadvertently cut during surgery
Authors: McDonald William M. , Wilkinson Michael M. , Jain Ankush , Cohen Steven P. 
Published: June 2023

AbstractBackgroundChronic opioid therapy may lead to high level tolerance development, hyperalgesia, and central sensitization, which further complicates long‐term therapeutic management of chronic pain patients. In this case, we encounter a patient who was receiving over 15,000 morphine milligram equivalents through their intrathecal pain pump. Unfortunately, the intrathecal pump was inadvertently cut during a spinal surgery. It was deemed unsafe to delivery IV equivalent opioid therapy in this case; instead, the patient was admitted to the ICU and given a four‐day ketamine infusion.MethodThe patient was started on a ketamine infusion at a rate of 0.5mg/kg/h, which was continued for three days. On the fourth day, the infusion rate was tapered over 12 h before being completely stopped. No coinciding opioid therapy was given during this time, which was only restarted in the outpatient setting.ResultsDespite chronic high levels of opioid therapy immediately prior to the ketamine infusion, the patient did not experience florid withdrawals during the infusion period. Additionally, the patient experienced remarkable improvement in their subjective pain rating, which decreased from 9 to 3–4 on an 11‐point Number Rating Scale, while simultaneously being managed on an MME <100. These results were sustained through a 6‐month follow‐up period.ConclusionKetamine may play an important role in attenuating not only tolerance but also acute withdrawal in a setting where rapid or instant weaning from high dose chronic opioid therapy is needed.
Histological damage characteristics and quantitive analysis of porcine skin with non‐insulated microneedle radiofrequency
Authors: Feng Jiayi , Zhang Ling , Qi Jun , Huang Lvping 
Published: June 2023

AbstractObjectiveIn recent years, the microneedle radiofrequency (MRF) has been widely used for skin rejuvenation, but histological studies on the immediate trauma caused by different parameters of non‐insulated RF microneedlesMethodsThe skin of three pigs was treated with different needle depths, pulse widths and energy levels of non‐insulated microneedle RF. Samples were collected before, immediately, and 2 weeks after treatment. The immediate histological response of each group was assessed and quantified by hematoxylin and eosin staining, Masson staining and Victoria Blue staining.ResultsIn the treatment of non‐insulated microneedle RF, different energy levels affected mainly the range of thermal damage (p = 0.044), and different needle depths affected mainly the depth of the cavity (p = 0.022). But the width of the coagulation zone width was determined by different factors. There was no significant difference in the histology of immediate damage caused by different pulse widths. Reepithelialization of the epidermis and basic wound repair can be completed within 2 weeks.ConclusionNon‐insulated RF microneedle therapy is an effective and safe treatment that can stimulate dermal wound healing with less thermal coagulation and a wide range of reversible thermal damage. However, it should be noted that the set needle depth may not correspond to the actual penetration depth, nor to the actual depth of histologic trauma.
Cancer Loyalty Card Study (CLOCS): feasibility outcomes for an observational case–control study focusing on the patient interval in ovarian cancer
Authors: Brewer Hannah R , Chadeau-Hyam Marc , Johnson Eric , Sundar Sudha , Flanagan James , Hirst Yasemin 
Published: June 2023

ObjectivesOvarian cancer symptoms are often non-specific and can be normalised before patients seek medical help. The Cancer Loyalty Card Study investigated self-management behaviours of patients with ovarian cancer prior to their diagnosis using loyalty card data collected by two UK-based high street retailers. Here, we discuss the feasibility outcomes for this novel research.DesignObservational case–control study.SettingControl participants were invited to the study using social media and other sources from the general public. Once consented, control participants were required to submit proof of identification (ID) for their loyalty card data to be shared. Cases were identified using unique National Health Service (NHS) numbers (a proxy for ID) and were recruited through 12 NHS tertiary care clinics.ParticipantsWomen in the UK, 18 years or older, with at least one of the participating high street retailers’ loyalty cards. Those with an ovarian cancer diagnosis within 2 years of recruitment were considered cases, and those without an ovarian cancer diagnosis were considered controls.Primary outcome measuresRecruitment rates, demographics of participants and identification of any barriers to recruitment.ResultsIn total, 182 cases and 427 controls were recruited with significant differences by age, number of people in participants’ households and the geographical region in the UK. However, only 37% (n=160/427) of control participants provided sufficient ID details and 81% (n=130/160) matched retailers’ records. The majority of the participants provided complete responses to the 24-Item Ovarian Risk Questionnaire.ConclusionsOur findings show that recruitment to a study aiming to understand self-care behaviours using loyalty card data is challenging but feasible. The general public were willing to share their data for health research. Barriers in data sharing mechanisms need to be addressed to maximise participant retention.Trial registration numberISRCTN14897082, CPMS 43323,NCT03994653.