bluuebunny/crossref_metadata_2025_split huggingface dataset:
Contrast Agent Pooling (C.A.P.) sign and imminent cardiac arrest: a retrospective study
Authors: Lee Yu-Hsuan , Chen Jiashan , Chen Po-An , Sun Jen-Tang , Kang Bo-Hwi , Chu Sheng-En , Fan Chieh-Min , Tsai Kuang-Chau , Sim Shyh-Shyong 
Published: May 2022

Abstract
Background
The sign of contrast agent pooling (C.A.P.) in dependent part of the venous system were reported in some case reports, which happened in the patients before sudden cardiac arrest. Until now, there is no solid evidence enough to address the importance of the sign. This study aimed to assess the accuracy of the C.A.P. sign in predicting imminent cardiac arrest and the association of the C.A.P. sign with patient’s survival.

Methods
This is a retrospective cohort study. The study included all patients who visited the emergency department, who received contrast computed tomography (CT) scan and then experienced cardiac arrest at the emergency department (from January 1, 2016 to December 31, 2018). We evaluated the occurrence of the C.A.P. sign on the chest or abdominal CT scan, patients with ECMO were excluded. With positive C.A.P. sign, the primary outcome is whether in-hospital cardiac arrest happens within an hour; the accuracy of C.A.P. sign was calculated. The secondary outcome is survival to discharge.

Results
In the study, 128 patients were included. 8.6% (N = 11) patients had positive C.A.P. sign and 91.4% (N = 117) patients did not. The accuracy of C.A.P. sign in predicting cardiac arrest within 1 h was 85.94%. The C.A.P. sign had a positive association with IHCA within 1 h after the CT scan (adjusted odds ratio 7.35, 95% confidence interval [CI] 1.27 – 42.69). The relative risk (RR) of survival to discharge was 0.90 with positive C.A.P. sign (95% CI 0.85 – 0.96).

Conclusions
The C.A.P. sign can be considered as an alarm for imminent cardiac arrest and poor prognosis. The patients with positive C.A.P. sign were more likely to experience imminent cardiac arrest; in contrast, less likely to survive.

Trial registration
IRB No.108107-E.
Adequacy of compression positioning using the feedback device during chest compressions by medical staff in a simulation study
Authors: Koyama Yasuaki , Matsuyama Tasuku , Kaino Takako , Hoshino Tetsuya , Nakao Junzo , Shimojo Nobutake , Inoue Yoshiaki 
Published: May 2022

Abstract
Background
The 2020 American Heart Association guidelines recommend the use of a feedback device during chest compressions (CCs). However, these devices are only placed visually by medical personnel on the lower half of the sternum and do not provide feedback on the adequacy of the pressure-delivery position. In this study, we investigated whether medical staff could deliver CCs at the adequate compression position using a feedback device and identified where the inadequate position was compressed.

Methods
This simulation-based, prospective single-centre study enrolled 44 medical personnel who were assigned to four different groups based on the standing position and the hand in contact with the feedback device as follows: right–left (R–l), right–right (R–r), left–right (L–r), and left–left (L–l), respectively. The sensor position where the maximal average pressure was applied during CCs using the feedback device were ascertained with a flexible capacitive pressure sensor. We determined if this position is the adequate compression position or not. The intergroup differences in the frequency of the adequate compression position, the maximal average pressure, compression rate, depth and recoil were determined.

Results
The frequencies of adequate compression positioning were 55, 50, 58, and 60% in the R–l, R–r, L–r, and L–l groups, respectively, with no significant intergroup difference (p = 0.917). Inadequate position occurred in the front, back, hypothenar and thenar sides. The maximal average pressure did not significantly differ among the groups (p = 0.0781). The average compression rate was 100–110 compressions/min in each group, the average depth was 5–6 cm, and the average recoil was 0.1 cm, with no significant intergroup differences (p = 0.0882, 0.9653, and 0.2757, respectively).

Conclusions
We found that only approximately half of the medical staff could deliver CCs using the feedback device at an adequate compression position and the inadequate position occurred in all sides. Resuscitation courses should be designed to educate trainees about the proper placement during CCs using a feedback device while also evaluating the correct compression position.
A flexible approach for variable selection in large-scale healthcare database studies with missing covariate and outcome data
Authors: Lin Jung-Yi Joyce , Hu Liangyuan , Huang Chuyue , Jiayi Ji , Lawrence Steven , Govindarajulu Usha 
Published: May 2022

AbstractBackgroundPrior work has shown that combining bootstrap imputation with tree-based machine learning variable selection methods can provide good performances achievable on fully observed data when covariate and outcome data are missing at random (MAR). This approach however is computationally expensive, especially on large-scale datasets.MethodsWe propose an inference-based method, called RR-BART, which leverages the likelihood-based Bayesian machine learning technique, Bayesian additive regression trees, and uses Rubin’s rule to combine the estimates and variances of the variable importance measures on multiply imputed datasets for variable selection in the presence of MAR data. We conduct a representative simulation study to investigate the practical operating characteristics of RR-BART, and compare it with the bootstrap imputation based methods. We further demonstrate the methods via a case study of risk factors for 3-year incidence of metabolic syndrome among middle-aged women using data from the Study of Women’s Health Across the Nation (SWAN).ResultsThe simulation study suggests that even in complex conditions of nonlinearity and nonadditivity with a large percentage of missingness, RR-BART can reasonably recover both prediction and variable selection performances, achievable on the fully observed data. RR-BART provides the best performance that the bootstrap imputation based methods can achieve with the optimal selection threshold value. In addition, RR-BART demonstrates a substantially stronger ability of detecting discrete predictors. Furthermore, RR-BART offers substantial computational savings. When implemented on the SWAN data, RR-BART adds to the literature by selecting a set of predictors that had been less commonly identified as risk factors but had substantial biological justifications.ConclusionThe proposed variable selection method for MAR data, RR-BART, offers both computational efficiency and good operating characteristics and is utilitarian in large-scale healthcare database studies.
Todani type III: like biliary dilatation with duodenal prolapse—a case report
Authors: Meng Yunpeng , Guo Kangli , Jiang Yu , Wei Shaohua 
Published: May 2022

Abstract
Background
Biliary dilatation is a rare disease involving intrahepatic and extrahepatic biliary tract abnormalities. With the development of imaging technology, an increasing number of special cases have been diagnosed, which poses a challenge to the traditional classification method.

Case presentation
A 50-year-old woman was admitted to the hospital due to right upper quadrant pain for more than 10 days. The patient had previous episodes of similar symptoms, which were relieved after symptomatic treatment at a local community hospital. After the symptoms developed, she underwent a computed tomography scan at the local hospital, which showed biliary dilatation; thus, she was referred to our hospital for further treatment. After admission, her magnetic resonance imaging examination also suggested biliary dilatation, but abnormal signals were found in her duodenum. First, a duodenal diverticulum was considered. Later, endoscopic ultrasonography was conducted, and the results suggested that the dilated biliary tract had herniated into the duodenum. This type of lesion is most closely classified as a Todani type III lesion. The patient finally underwent choledochectomy and Roux‑en‑Y hepaticojejunostomy, and the postoperative pathology was consistent with our preoperative diagnosis. The patient was followed up for approximately 2 years, and no obvious postoperative complications were found.

Conclusions
The manifestations of this case are relatively rare and involve one of the undiscussed categories of the Todani classification system; therefore, this case has certain clinical value. Moreover, there is no report similar to this experience in the previous literature.
Review of recent evidence on the management of heartburn in pregnant and breastfeeding women
Authors: Ali Raja Affendi Raja , Hassan Jamiyah , Egan Laurence J. 
Published: May 2022

AbstractGastroesophageal reflux disease (GERD) is one the most common medical complaints in pregnant women. Some women continue to experience GERD symptoms after delivery. Effective management of GERD symptoms is important to improve productivity and quality of life. Management of heartburn in pregnant and breastfeeding women involves lifestyle modifications, dietary modifications, non-pharmaceutical remedies and pharmaceutical drugs. For most patients, lifestyle/dietary modifications are helpful in reducing GERD symptoms. For patients who require a more intense intervention, various types of pharmaceutical drugs are available. However, the suitability of each treatment for use during pregnancy and lactation must be taken into consideration. This article explores the reported efficacy and safety of these treatment options in pregnant and breastfeeding women. Recommended treatment algorithm in pregnant and breastfeeding women have been developed.
Obstetrics care providers attitude and utilization of non-pharmacological labor pain management in Harari regional state health facilities, Ethiopia
Authors: Eyeberu Addis , Debela Adera , Getachew Tamirat , Dheresa Merga , Alemu Addisu , Dessie Yadeta 
Published: May 2022

Abstract
Background
In a woman’s life, labor pain is the most severe pain that they have ever faced. In Ethiopia, the provision of pain relief in labor is often neglected. Furthermore, evidence strongly urged that further research is needed on non-pharmacological labor pain management. Therefore, obstetrics care providers’ attitudes and utilization of non-pharmacological labor pain management need to be assessed.

Method
A facility-based cross-sectional study was conducted from May 20 to June 10, 2021, in Harari regional state health facilities, Ethiopia. All obstetric caregivers in Harari regional state health facilities were included in the study. A structured questionnaire adapted from the previous studies was used to collect data. The data was entered into Epi-data version 3.1 statistical software. Statistical analysis was carried out by using SPSS for windows version 22. Multivariate linear regression analysis was employed to determine the association between independent variables and the outcome variable.

Result
The overall utilization of non-pharmacological labor pain relief methods was 59.3% [(95% CI (53.9,63.4)]. Three hundred five (65.5%) of the study participants had unfavorable attitudes. Females compared to males (β = − 0.420; 95% CI: − 0.667, − 0.173), clinical experience (β = − 0.201; 95% CI: − 0.268, − 0.134), knowledge sum score (β =0.227: 95%; CI: 0.18,0.247), and attitude sum score (β = 0.376; 95% CI: 0.283, 0.47) were showed significantly association with utilization of non-pharmacological labor pain management.

Conclusion
The overall utilization of non-pharmacological labor pain relief methods was relatively good compared to other studies done in Ethiopia but all women’s need for labor relief methods should not be ignored. In this study sex of the respondents, clinical experience, individual preference, attitude and knowledge were factors associated with the utilization of non-pharmacological labor pain management. All stake holds need to work together to improve the attitude of health providers and to increase the utilization of non-pharmacologic labor pain management.
Increasing harms for bingo players: digitisation, commercialisation and regulatory inadequacy: a multi-site case study
Authors: Maltzahn Kathleen , Whiteside Mary , Lee Helen , Cox John , MacLean Sarah 
Published: May 2022

Abstract
Background
Bingo is often understood as a low-harm form of gambling. This view has been challenged by a growing body of literature identifying gambling harm to bingo players in a range of countries. In this study, we aimed to identify which conditions enabled, facilitated, intensified or mitigated gambling harm for bingo players in three populations in Victoria in the context of corporate, technological and regulatory changes.

Methods
Our qualitative study investigated experiences of bingo-related gambling harm in three populations in Victoria, Australia where bingo was popular and structural disadvantage common: Indigenous people in the east, Pacific people in the state’s north and older people on low or fixed incomes in the capital. Data was generated through interviews with 53 bingo players and 13 stakeholders as well as 12 participant observations of bingo sessions.

Results
We found that while bingo is overwhelmingly positive for many players, a minority of bingo players and their families experience notable harm. Harm was generated through traditional paper-based bingo games, new technologies such as tablet-based bingo and by the widespread tactic of placing bingo sessions in close proximity to harmful electronic gambling machines. Overall, the risk of harm to bingo players appears to be escalating due to commercial, technological and regulatory changes.

Conclusions
These changes can be better managed by regulators: reforms are needed to safeguard bingo’s distinct character as a lower-risk form of gambling at a time when it, and its players, are under threat. Significantly, we found that harm to bingo players is intensified by factors external to gambling such as racialised poverty and adverse life events. Strategies that recognise these factors and grapple with gambling harm to bingo players are needed.
Worksite tobacco control – a qualitative study on perspectives from employers and employees at small worksites
Authors: Kava Christine M. , Ruiz Raymond A. , Harris Jeffrey R. , Hannon Peggy A. 
Published: May 2022

Abstract
Background
Evidence-based interventions (EBIs) for tobacco control can be implemented in worksite settings to reduce tobacco use. Small worksites are less likely to adopt tobacco control EBIs than large worksites. The purpose of this qualitative study was to 1) explore factors that impact small employers’ decisions to offer tobacco control EBIs, and 2) understand employees’ perceptions of tobacco control at small worksites.

Methods
Working with staff from small worksites (20–250 employees), we analyzed data from 12 semi-structured interviews with employers (via key informants) and four focus groups with employees. We recruited employers and employees through a purchased business list and market research company, respectively. Interview and focus group topics included perceptions of worksite tobacco control; internal and external forces shaping worksite tobacco control implementation; and perceived worksite support for cessation. We conducted thematic data analysis.

Results
Key themes from the employer interviews included: the local environment played an important role in implementation of tobacco control EBIs; tobacco control was perceived as important but not a priority; and tobacco control decisions were driven by worksite culture. Key themes from the employee focus groups included: perceived employer support for tobacco cessation was limited although there was interest from employees; employees who currently used tobacco were stigmatized for their behavior; and incentives and coaching were considered ideal tobacco control EBIs.

Conclusions
Tobacco control has not been prioritized at small worksites, despite employees welcoming additional cessation support. This study contributes important information on contextual factors and employee preferences that could be targeted to improve tobacco control EBI implementation. Worksites should implement comprehensive tobacco-free policies, minimize stigma when promoting cessation, establish equitable break policies, and involve employees in decision-making related to tobacco control.
Pulmonary invasive mucinous adenocarcinoma mimicking pulmonary actinomycosis
Authors: Zhu Dongyi , Zhang Qian , Rui Zhuanghua , Xu Shengbao 
Published: May 2022

Abstract
Background
Primary pulmonary invasive mucinous adenocarcinoma is a rare and distinct subtype of lung adenocarcinoma.

Case presentation
A 72-year-old woman presented with productive cough for two months and fever for six days. Chest computed tomography (CT) showed a mass in the left lower lobe. Sputum culture tested negative for bacteria, but the sequence of Actinomyces meyeri was detected by metagenomic next generation sequencing from the bronchoalveolar lavage fluid. It was considered a pathogenic bacterium as the normalized number of DNA sequencing reads was 10 times higher than the normal level. The patient’s symptoms alleviated quickly, and the chest CT lesion shrank to a third of the original size following treatment with penicillin for two months. However, a repeat chest CT performed after four months of treatment revealed that the lesion had expanded. Positron emission tomography/CT revealed that fluorodeoxyglucose metabolism was increased in the mass with surrounding ground glass density of the left lower lobe. Furthermore, CT-guided percutaneous lung biopsy was performed, and hematoxylin–eosin staining showed columnar tumor cells with abundant mucin in the cytoplasm with a basal nucleus. Finally, the patient was diagnosed with pulmonary invasive mucinous adenocarcinoma and agreed to undergo a thoracoscopic surgery.

Conclusions
Pulmonary invasive mucinous adenocarcinoma is a subset of lung adenocarcinoma with low incidence rate. The clinical features and CT findings are non-specific. A histopathological diagnosis is of fundamental importance in preventing misdiagnosis.
Do the three-dimensional parameters of brace-wearing patients with AIS change when transitioning from standing to sitting position? A preliminary study on Lenke I
Authors: Zhang Xiaohui , Yang Daoyang , Zhang Shuo , Wang Jun , Chen Yuan , Dou Xiaoran , Liu Yanan , Li Xianglan , Liao Bagen 
Published: May 2022

Abstract
Background
Bracing is the most common conservative treatment for preventing the progression of adolescent idiopathic scoliosis (AIS) in patients with a curve of 25°–40°. X-ray examinations are traditionally performed in the standing position. However, school-age teenagers may take more time to sit. Thus far, little is known about three-dimensional (3D) correction in the sitting position. Hence, this study aimed to determine the effects of standing and sitting positions on 3D parameters during brace correction.

Methods
We evaluated a single-center cohort of patients receiving conservative treatment for thoracic curvature (32 patients with AIS with a Lenke I curve). The 3D parameters of their standing and sitting positions were analyzed using the EOS imaging system during their first visit and after bracing.

Results
At the patients’ first visit, sagittal plane parameters such as thoracic kyphosis (TK), lumbar lordosis (LL), and sacral slope decreased when transitioning from the standing position to the sitting position (standing 29° ± 6°, 42° ± 8°, and 42° ± 8° vs. sitting 22° ± 5°, 27° ± 6°, and 24° ± 4°; p < 0.001), whereas pelvic tilt (PT) increased and sagittal vertical axis shifted forward (standing 9° ± 6° and 1.6 ± 2.7 cm vs. sitting 24° ± 4° and 3.8 ± 2.3 cm; p < 0.001). After bracing, TK and LL decreased slightly (from 29° ± 6° and 42° ± 8° to 23° ± 3° and 38° ± 6°; p < 0.001), whereas the thoracolumbar junction (TLJ) value increased (from 3° ± 3° to 11° ± 3°; p < 0.001). When transitioning to the sitting position, similar characteristics were observed during the first visit, except for a subtle increase in the TLJ and PT values (standing 11° ± 3° and 9° ± 4° vs. sitting 14° ± 3° and 28° ± 4°; p < 0.001). Moreover, the coronal and axial parameters at different positions measured at the same time showed no significant change.

Conclusions
In brace-wearing patients with thoracic scoliosis, compensatory sagittal plane straightening may be observed with a slight increase in thoracolumbar kyphosis, particularly when transitioning from the standing position to the sitting position, due to posterior rotation of the pelvis. Our results highlight that sagittal alignment in AIS with brace treatment is not completely analyzed with only standing X-Ray.

Trial registration
The study protocol was registered with the Chinese Clinical Trial Registry (ChiCTR1800018310).
Family systems nursing conversations: influences on families with stroke
Authors: Pusa Susanna , Saveman Britt-Inger , Sundin Karin 
Published: May 2022

Abstract
Background
Since a family member’s stroke affects the entire family, family systems nursing conversations (FSNCs) may be an appropriate intervention to support the family as a whole. The purpose of our study was to illuminate family members’ experiences within their family situations 6 months after participating in FSNCs when a family member under 65 years of age had suffered a stroke.

Methods
Fourteen semi-structured follow-up interviews were conducted with family members 6 months after they had completed a series of 3 FSNCs. The interview transcripts were subjected to qualitative content analysis.

Results
Family members experienced that the FSNCs had contributed to greater understanding of each other and greater closeness in the family. The FSNCs had also facilitated a mutual understanding of the family’s situation, which they could better manage and move forward with together.

Conclusions
FSNCs can support relational aspects and healthy transitions within families. However, long-term follow-up research is needed to generate sound evidence and inform education about FSNCs, as well as to facilitate their implementation. As a result, families may become better able to prevent the negative outcomes of illness in the family.