bluuebunny/crossref_metadata_2025_split huggingface dataset:
Longer-Term Results of a Universal Electronic Consultation Program at the Cardiology Department of a Galician Healthcare Area
Authors: Rey-Aldana Daniel , Mazón-Ramos Pilar , Portela-Romero Manuel , Cinza-Sanjurjo Sergio , Alvarez-Alvarez Belen , Agra-Bermejo Rosa , Rigueiro-Veloso Pedro , Espasandín-Domínguez Jenifer , Gude-Sampedro Francisco , González-Juanatey José R. 
Published: January 2022

Background:
Telemedicine models play a key role in organizing the growing demand for care and healthcare accessibility, but there are no described longer-term results in health care. Our objective is to assess the longer-term results (delay time in care, accessibility, and hospital admissions) of an electronic consultation (e-consultation) outpatient care program.

Methods:
Epidemiological and clinical data were obtained from the 41 258 patients referred by primary care to the cardiology department from January 1, 2010, to December 31, 2019. Until 2012, all patients were attended in an in-person consultation (2010–2012). In 2013, we instituted an e-consultation program (2013-2019) for all primary care referrals to cardiologists that preceded patients’ in-person consultations when considered. We used an interrupted time series regression approach to investigate the impact of the e-consultation on (1) delay time (days) in care and (2) hospital admissions. We also analyzed (3) total number and referral rate (population-adjusted referred rate) in both periods (in-person consultation and e-consultation), and (4) the accessibility was measured as number of consultations and variation according to distance from municipality and reference hospital.

Results:

During the e-consultation, the demand increased (7.2±2.4% versus 10.1±4.8% per 1000 inhabitants,
P
<0.001), and referrals from different areas were equalized. The reduction in delay to consultation during the in-person consultation (−0.96 [95% CI, −0.951 to −0.966],
P
<0.001) was maintained with e-consultations (−0.064 [95% CI, 0.043–0.085],
P
<0.001). After the implementation of e-consultation, we observed that the increasing of hospital admission observed in the in-person consultation (incidence rate ratio, 1.011 [95% CI, 1.003–1.018]), was stabilized (incidence rate ratio, 1.000 [95% CI, 0.985–1.015];
P
=0.874).

Conclusions:
Implementing e-consultations in the outpatient management model may improve accessibility of care for patients furthest from the referral hospital. After e-consultations were implemented, the upward trend of hospital admissions observed during the in-person consultation period was stabilized with a slight downward trend.
Non-Empirical Uncertainties in Evidence-Based Decision Making
Authors: Ongaro Malvina , Andreoletti Mattia 
Published: January 2022

Abstract
The increasing success of the evidence-based policy movement is raising the demand of empirically informed decision making. As arguably any policy decision happens under conditions of uncertainty, following our best available evidence to reduce the uncertainty seems a requirement of good decision making. However, not all the uncertainty faced by decision makers can be resolved by evidence. In this paper, we build on a philosophical analysis of uncertainty to identify the boundaries of scientific advice in policy decision making. We start by introducing a distinction between empirical and non-empirical types of uncertainty, and we explore the role of two non-empirical uncertainties in the context of policy making. We argue that the authority of scientific advisors is limited to empirical uncertainty and cannot extend beyond it. While the appeal of evidence-based policy rests on a view of scientific advice as limited to empirical uncertainty, in practice there is a risk of over reliance on experts beyond the legitimate scope of their authority. We conclude by applying our framework to a real-world case of evidence-based policy, where experts have overstepped their boundaries by ignoring non-empirical types of uncertainty.
What Happens When Coups Fail? The Problem of Identifying and Weakening the Enemy Within
Authors: Woldense Josef 
Published: January 2022

The ruler’s ability to cope with crises is critical for authoritarian durability. Yet, the coping mechanism—the actual management strategies by which rulers confront crises—is largely treated as a black box. This study takes a step in addressing this problem by examining how rulers use their appointment powers to manage the crisis that is the aftermath of failed coups. I argue that the principle challenge of this period is that rulers cannot identify the opposition and to cope, they deliberately infuse the center of the regime with officials from the periphery to dilute and ultimately weaken the invisible enemy they confront. Using a novel dataset on the appointments of mid and high level officials over the course of 34 years in Ethiopia, I find that the ruler relied considerably on outside officials following the failed coup in 1960 in ways he never did before or after the event.
The Political Legacies of Rebel Rule: Evidence from a Natural Experiment in Côte d’Ivoire
Authors: Martin Philip A. , Piccolino Giulia , Speight Jeremy S. 
Published: January 2022

How does exposure to rebel rule affect citizens’ political attitudes after armed conflicts end? We combine original survey data from Côte d’Ivoire with a natural experiment based on the arbitrary location of a ceasefire boundary to estimate the effects of exposure to rebel rule by the Forces Nouvelles (FN) on Ivorians’ sense of democratic citizenship. Our findings show that individuals in communities ruled by the FN held more negative attitudes about local government institutions 7 years after the reunification of the country, held weaker commitments to civic obligations, and were more likely to condone extralegal actions. The effects of rebel rule are larger than the effects of extreme lived poverty and appear among both rebel coethnics and non-coethnics. Using qualitative and survey evidence, we propose three theoretical mechanisms to explain why exposure to rebel rule weakened citizen-state relations: disrupted norms of compliance with state-like authorities, the formation of local self-help institutions leading to negative assessments of the redeployed state, and resentment due to unmet expectations of economic recovery. Our study informs debates about the links between war, citizenship, and statebuilding.
Using the Craniovertebral Angle to Quantify Intraoperative Ergonomic Risk
Authors: Kelly Natalie , Mousset Marike , Althubaiti Abdulrahman , Agarwal Riddhima , Onwuka Amanda , Chiang Tendy 
Published: January 2022

ObjectiveTo measure the craniovertebral angle during tonsillectomy, assess the interrater reliability of our methodology, and investigate the correlations of the Rapid Upper Limb Assessment and the craniovertebral angle to quantify ergonomic risk.Study DesignProspective, observational study.SettingTertiary care pediatric institution.MethodsNeck posture was evaluated for 92 images with 7 surgeons. Lateral images of the surgeon were captured every minute in a standardized method. Images were assessed by 3 raters, measuring the craniovertebral angle, defined as the angle between a horizontal line through the C7 vertebrae and another line through C7 and the tragus of the ear. Interrater reliability of the craniovertebral angle was evaluated using the κ statistic. Per prior publications, reports of neck pain were frequent when the craniovertebral angle value was <50°; thus, we defined an abnormal posture if the craniovertebral angle was <50°.ResultsMean (SD) craniovertebral angle during tonsillectomy was 26.0° (11.3°). One hundred percent of procedures had at least 1 assessment of abnormal posture. The lowest interrater reliability was 0.77 (CI: 0.67‐0.87). Rapid Upper Limb Assessment and craniovertebral angle (CA) correlation was −0.12 (P =. 27) and, therefore, null.ConclusionPoor posture during tonsillectomy places otolaryngologists at intraoperative ergonomic risk. The craniovertebral angle is a predictor of future neck pain, and a pathologic neck position during tonsillectomy was identified. Given the high interrater reliability, our approach to assessing intraoperative surgical ergonomics was validated. Overall, RULA and the CA are not a substitute for one another but complementary.
Prognostic role of preoperative carcinoembryonic antigen level in part-solid lung adenocarcinoma
Authors: Yamanashi Keiji , Hamaji Masatsugu , Murakami Kotaro , Shimada Yoshihisa , Kayawake Hidenao , Yutaka Yojiro , Kawaguchi Yohei , Kudo Yujin , Ikeda Norihiko , Date Hiroshi 
Published: January 2022

Background Part-solid lung adenocarcinoma appears as a heterogeneous subgroup, and its surgical management is controversial. This study aimed to elucidate whether preoperative carcinoembryonic antigen, a time-honored tumor marker, can be used as a prognostic factor that contributes to its management. Methods We retrospectively reviewed consecutive patients with clinical-T1a-cN0M0 part-solid adenocarcinoma who underwent surgical resection between January 2011 and December 2015 at two institutions. Results Overall, 288 patients were identified. The median age was 69 years with 176 patients (61%) being female. The median follow-up time was 5.6 years. Lymph node metastases were found in 6 (15%) of 41 patients with elevated carcinoembryonic antigen levels, while 10 (4.0%) of 247 patients had normal carcinoembryonic antigen levels ( P = 0.016). The 5-year overall survival rates in patients with normal and elevated carcinoembryonic antigen levels were 96.9% and 87.2%, respectively ( P = 0.006), and the 5-year relapse-free survival rates were 91.8% and 62.8%, respectively ( P < 0.001). The multivariable analysis revealed that preoperative carcinoembryonic antigen level was a significant prognostic factor for relapse-free survival (hazard ratio [HR] = 2.92, 95% confidence interval [CI] = 1.63–5.25, P < 0.001). Among the patients with elevated carcinoembryonic antigen levels, the 5-year overall survival rates in those undergoing lobar resection and segmentectomy were 87.0% and 88.9%, respectively ( P = 0.59), and the 5-year relapse-free survival rates were 61.7% and 66.7%, respectively ( P = 0.84). Conclusions Our data suggest that preoperative carcinoembryonic antigen level appears to be an important predictor of postoperative survival outcomes in early-stage part-solid adenocarcinoma. Further studies are required to optimize management of patients with elevated preoperative carcinoembryonic antigen levels, although segmentectomy appeared acceptable in those patients.
The Impact of a Neurocritical Care and Neuropalliative Collaboration on Intensive Care Unit Outcomes
Authors: Shemme Andersen J. , Phillips Joel N. , Bloise Rafael , Koehler Tracy J. , Gorelick Philip B. , Francis Brandon A. 
Published: January 2022

Background: Neurocritical care (NCC) and neuropalliative care (NPC) clinicians provide care in specialized intensive care units (ICU). There is a paucity of data regarding the impact of NCC and NPC collaboration in smaller, community-focused settings. Objective: To determine the clinical impact of introducing a NCC/NPC collaborative model in a mixed ICU community-based teaching hospital. Design: Retrospective pre/post cohort study. Subjects: Patients ≥18 years of age admitted to the ICU who received neurology and palliative care consultations between September 1, 2015 and August 31, 2017 at a 300 bed community-focused hospital were included. Intervention: The addition of a NCC/NPC collaborative model took place in September of 2016. The time periods before (9/1/2015 to 8/31/2016) and after (9/1/2016 to 8/31/2017) the addition were compared. Results: A total of 274 admissions (pre: 130, post: 144) were included. There were significantly more NCC consultations provided in the post-period (44.6% vs 57.6%; P = .03). NPC consultation increased (55.4% vs 66.7%; P = .056) Median LOS was significantly shorter after implementation of the collaborative model (11 vs 8 days; P = .01). Median ICU LOS was also shorter by 1 ICU-day in the post-period, though this was not statistically significant ( P = .23). Mortality rates were similar ( P = .95). Conclusions: Our findings suggest NCC/NPC collaboration in a community-focused teaching hospital was associated with more NCC consultations, as well as shorter LOS without increasing mortality. These data highlight the importance of supporting collaborative models of care in community settings. Further research is warranted.
Olanzapine/Samidorphan: New Drug Approved for Treating Bipolar I Disorder and Schizophrenia
Authors: Monahan Christie , McCoy Lindsey , Powell Jason , Gums John G. 
Published: January 2022

Objective To describe the approval of olanzapine/samidorphan, compare the clinical trial data, and summarize key findings, with a focus on impact to clinical practice. Data Sources A literature search of PubMed was performed (March 2006 to November 2021) using the following search terms: Lybalvi, olanzapine/samidorphan, olanzapine, antipsychotic, bipolar disorder, and schizophrenia. Product monographs, review articles, and randomized control trials were reviewed. Study Selection and Data Extraction Relevant English-language studies conducted in humans were considered. Primary use of Phase III clinical drug approval trials preferred; supplementary trial analysis evaluated to provide context. Data Synthesis In June 2021, the Food and Drug Administration (FDA) approved Lybalvi® (olanzapine/samidorphan) for indications including treatment of adults with schizophrenia and/or bipolar I disorder (acute manic episodes or acute episodes with mixed features) through the multi-stage ENLIGHTEN clinical trials. Participants were enrolled in 4-week, 24-week, and 52-week studies to evaluate the safety and efficacy of olanzapine/samidorphan. Subsequent secondary analysis evaluated metabolic effects. Relevance to Patient Care and Clinical Practice This review details the pharmacologic, pharmacokinetic, associated dosing and indications, and adverse effects for the drug combination olanzapine/samidorphan. Better understanding of novel drug mechanisms will help to expand on the potential role and place for use in clinical practice. Conclusion When treating complex patients with schizophrenia, the olanzapine/samidorphan combination has limited effect on medication-induced weight gain often associated with antipsychotic olanzapine monotherapy. Additional studies are needed to further define the role of olanzapine/samidorphan in bipolar I disorder and clinical practice.
Structural health monitoring on Yangluo Yangtze River Bridge: Implementation and demonstration
Authors: Zhu Ya-Fei , Ren Wei-Xin , Wang Ya-Fei 
Published: January 2022

Long-span cable-supported bridge is one of crucial transportation infrastructures. Structural health monitoring (SHM) system that is used to assess structural service conditions and detect early damage has drawn a growing attention in engineering structural society. It provides a real-time monitoring of various structural changes under operational and extreme conditions. Yangluo Bridge over Yangtze River in Wuhan city of China is a 1280 m central span suspension bridge with an orthotropic steel box girder. Taking the SHM system of Yangluo Yangtze River Bridge as an example, this paper presents an implementation of SHM system on the bridge in terms of sensor layout, data acquisition strategy, data transmission, data processing, and abnormal alarm framework. With such an SHM system, the typical monitoring results are demonstrated such as operational environments, loadings, structural deformation, strains, dynamic properties, and structural responses. The SHM system of Yangluo Yangtze River Bridge is continuously gathering data and monitoring structural behavior. It is anticipated that it will provide either scientific or technological supports to the service comfort and safety of the bridge.
Optimizing quality of care in patients admitted with chronic obstructive pulmonary disease exacerbation
Authors: Tsao Megan , Laikijrung Chananid , Tran Alan , Pon Tiffany , Roach Denise , Liu Bo , Le Kathie 
Published: January 2022

Objectives: Adherence to Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines in acute exacerbation of chronic obstructive pulmonary disease (AECOPD) treatment is variable in the inpatient setting. This study evaluates appropriateness of therapy in patients admitted to an academic medical center for AECOPD. Methods: This was a single-center, retrospective, observational study. The primary endpoint was proportion of patients who received appropriate AECOPD treatment within 24 h. Secondary endpoints included mean length of stay (LOS) and time to administration (TTA) of pharmacotherapy, 30-day readmission rates, and proportions of various ancillary care received. Data were analyzed using descriptive and inferential statistics. Results: Of 533 screened admissions, 163 were included. Of those included, 55% ( n = 90) received guideline-based therapy within 24 h of presentation. This group had significantly shorter mean LOS (3.48 ± 2.61 vs 4.53 ± 3.40 days, p = .026), fewer COPD-related readmissions (7 vs 14, p = .036), and numerically fewer all-cause readmissions (14 vs 19, p = .11). Mean LOS and TTA were 3.95 ± 3.02 days and 8.47 ± 12.77 h, respectively. Discussion: Timely and guideline-based delivery of medications was associated with shorter length of stay and fewer COPD-related readmissions. Establishing a standardized care plan through order set implementation may be one strategy to improve care and outcomes in AECOPD patients.
Arabic translation, cultural adaptation, and pilot-testing of multimorbidity self-management self-efficacy scales
Authors: Khraim Fadi , Munir Sadia , Johnson Jessie , Alqudah Maha , Kan’an Haitham 
Published: January 2022

Objective This study aimed to translate to Arabic language and culturally adapt the Self-Efficacy for Managing Chronic Diseases Scale (SEMCD) and The Perceived Medical Condition Self-Management Scale (PMCSMS). Design The translation of the two scales was conducted according to the framework by Beaton et al. Then, these scales were tested in a cross-sectional correlational study with 85 Arabic-speaking participants with multimorbidities in Qatar. Psychometric tests to assess the reliability and validity of the translated scales were done. Results The internal consistency reliability (α) for the Arabic version of both PMCSMS and SEMCD scales was 0.953 and 0.949, respectively. Correlation coefficient ( r) used to assess convergent validity between the PMCSMS and the SEMCD was 0.76 (p < 0.5). Number of morbidities negatively correlated with scores of self-management self- efficacy scores of the PMCSMS and the SEMCD ( r = −0.50 and −0.51, respectively). Discussion The translated PMCSMS and SEMCD are valid and reliable scales that can be used by researchers and healthcare providers to assess levels of self-efficacy among individuals with multimorbidities. The translated scales can be employed in research or interventional programmes that aim to improve self-management or self-efficacy among individuals with multimorbidities.
Palmar skin elasticity measured by the Cutometer MPA 580 is decreased in mild Dupuytren’s disease compared to healthy controls
Authors: Van Nuffel Maarten , Meulyzer Caroline , Gheysen Britt , Böhrer Arne , Anthonissen Mieke , Van den Kerckhove Eric , Degreef Ilse 
Published: January 2022

Introduction Involvement of the palmar skin is often seen in patients with Dupuytren’s disease (DD) with severe finger contractures. However, skin elasticity may be already decreased earlier in the disease. The Cutometer MPA 580 could provide an objective skin measurement tool to assess this decrease in elasticity. Linking objective skin measurements to functional outcome measures could lead to better prediction of disease progression. We set up a study to investigate if the Cutometer was able to detect differences in skin elasticity between patients with mild Dupuytren’s disease and healthy controls. Methods A cross-sectional analytical study was performed. Three assessors measured skin elasticity (palmar hand) on two sites using the Cutometer on 30 patients with mild DD and 30 healthy controls. Student’s t-test was used to evaluate differences in skin elasticity and a linear model to evaluate interactions between the groups and sites. Results Significant differences in skin elasticity were found between DD patients and controls, as well as differences based on the location examined. Discussion Similar to other skin conditions, the Cutometer MPA 580 was able to demonstrate a significant lower elasticity in the palmar skin in DD patients compared to healthy controls. A decrease in skin elasticity in different locations of the hand correlated with areas that often pose problems in the treatment of more severe DD. The Cutometer could potentially be a tool to identify these areas earlier in the disease.
Ferroptosis-associated DNA methylation signature predicts overall survival in patients with head and neck squamous cell carcinoma
Authors: Xu Yuanyuan , Hong Min , Kong Deyu , Deng Jun , Zhong Zhaoming , Liang Jin 
Published: January 2022

Abstract
Background
Head and neck squamous cell carcinoma (HNSCC) is a common cancer characterized by late diagnosis and poor prognosis. The aim of this study was to identify a novel ferroptosis-related DNA methylation signature as an alternative diagnosis index for patients with HNSCC.

Methods
Methylome and transcriptome data of 499 HNSCC patients, including 275 oral squamous cell carcinoma (OSCC) samples, were obtained from The Cancer Genome Atlas (TCGA). An additional independent methylation dataset of 50 OSCC patients from the NCBI Gene Expression Omnibus (GEO) database was used for validation. As an index of ferroptosis activity, the ferroptosis score (FS) of each patient was inferred from the transcriptome data using single-sample gene set enrichment analysis. Univariate, multivariate, and LASSO Cox regression analyses were used to select CpG sites for the construction of a ferroptosis-related DNA methylation signature for diagnosis of patients.

Results
We initially inferred the FS of each TCGA HNSCC patient and divided the samples into high- and low-FS subgroups. Results showed that the high-FS subgroup displayed poor overall survival. Moreover, 378 differentially methylated CpG sites (DMCs) were identified between the two HNSCC subgroups, with 16 selected to construct a 16-DNA methylation signature for risk prediction in HNSCC patients using the LASSO and multivariate Cox regression models. Relative operating characteristic (ROC) curve analysis showed great predictive efficiency for 1-, 3-, and 5-year HNSCC survival using the 16-DNA methylation signature. Its predictive efficiency was also observed in OSCC patients from the TCGA and GEO databases. In addition, we found that the signature was associated with the fractions of immune types in the tumor immune microenvironment (TIME), suggesting potential interactions between ferroptosis and TIME in HNSCC progression.

Conclusions
We established a novel ferroptosis-related 16-DNA methylation signature that could be applied as an alternative tool to predict prognosis outcome in patients with HNSCC, including OSCC.