bluuebunny/crossref_metadata_2025_split huggingface dataset:
Changes in self-harm- and violence-related urgent psychiatric consultation in the emergency department during the different stages of the COVID-19 pandemic
Authors: Liu Chun-Hao , Chen Po-Cheng , Chen Jian-Hong , Yeh Chung-Cheng 
Published: June 2022

Abstract
Background
The coronavirus disease 2019 pandemic significantly affected emergency department (ED) visits and urgent psychiatric consultation (UPC) seeking behavior in EDs. Our study explored the changes in UPCs during and after the pandemic peak.

Methods
This retrospective observational study evaluated UPCs in the ED of a referral medical center in Taiwan, where treated both physical and psychiatric complaints. We defined the COVID-19 pandemic peak period as calendar week 4–18, 2020. The corresponding baseline as calendar week 4–18, 2019, and the slack period as week 4–18, 2021. The total number of UPCs, patient demographic data such as sex and age of the patients seen, the referral system (whether police or emergency medical service [EMS] or other sources), and the chief complaint (self-harm or violence) were recorded.

Results
Compared with the baseline period, a significant decline in UPCs was observed in the pandemic peak period, and a rebound was observed in the slack period, with the median [IQR] Q1, Q3 values of 22 [18, 26], 12 [10, 17]), and 16 [15, 23], respectively. We observed significantly few men (34.9% vs 45.2%) and less violence (10.2% vs 17.6%) in the peak period compared with in the baseline period, but no significant difference was found compared with the slack period. Throughout the pandemic, younger patients (41.8 ± 17.4 in 2019, 39.2 ± 18.5 [p = 0.121] in 2020, and 35.6 ± 17.2 [p < 0.001] in 2021), higher proportions of police/EMS referral (38.7% in 2019, 41.9% [p = 0.473] in 2020, and 51.9% [p = 0.001] in 2021) and self-harm–related complaints (57% in 2019, 62.4% [p = 0.233] in 2020, and 64.9% [p = 0.049] in 2021) was noted among UPC seekers during the pandemic. However, the proportion of violence-related UPCs (17.6% in 2019, 10.2% [p = 0.023] in 2020, and 12.3% [p = 0.072] in 2021) declined.

Conclusions
This study found that UPCs changed throughout the pandemic. This result raises the concern that mental health needs are masked during the pandemic.
Safety and efficacy of vacuum bottle plus catheter for drainage of iatrogenic pneumothorax
Authors: Chen Shih-Yu , Kuo Yao-Wen , Ho Chao-Chi , Wu Huey-Dong , Wang Hao-Chien 
Published: June 2022

Abstract
Background
Iatrogenic pneumothorax is common after thoracic procedures. For patients with pneumothorax larger than 15%, simple aspiration is suggested. Although vacuum bottle plus non-tunneled catheter drainage has been performed in many institutions, its safety and efficacy remain to be assessed.

Methods
Through this prospective cohort study (NCT03724721), we evaluated the safety and efficacy of vacuum bottle plus non-tunneled catheter drainage. Patients older than 20 years old who developed post-procedural pneumothorax were enrolled. A non-tunneled catheter was placed at the intersection of the midclavicular line and the second intercostal space. A 3-way stopcock, a drainage set, and a digital pressure gauge were connected. The stopcock was manipulated to connect the pleural space to the pressure gauge for measurement of end-expiration intrapleural pressure or to the vacuum bottle for air drainage. The rate of successful drainage, the end-expiration intrapleural pressure before, during, and after the procedure and the duration of hospitalization were recorded.

Results
From August 2018 to February 2020, 21 patients underwent vacuum bottle plus catheter drainage (intervention group) and 31 patients received conservative treatment (control group). The end-expiration intrapleural pressure of all patients remained less than − 20 cmH2O during drainage. No procedure related complication was observed. Large pneumothorax (≥ 15%) was associated with higher risk of persistent air leak (Odds ratio 12, 95% CI 1.2–569.7). Vacuum bottle assisted air drainage yielded shorter event-free duration than that of conservative treatment (2 days vs 5 days [interquartile range 1–4 days vs 3–7 days], p < .05). Vacuum bottle assisted air drainage also help identifying patients with persistent pneumothorax and necessitate the subsequent management. The event-free duration of persistent air leak in the intervention group was also comparable with that of conservative treatment (5 days vs 5 days [interquartile range 5–8 days vs 3–7 days], p = .45).

Conclusions
Vacuum bottle plus catheter drainage of iatrogenic pneumothorax is a safe and efficient procedure. It may be considered as an alternative management of stable post-procedural pneumothorax with size larger than 15%.
Trial registration The study protocol was approved by the Research Ethics Committee of National Taiwan University Hospital (No. 201805105DINA) on 6th August, 2018. The first participant was enrolled on 23rd August, 2018 after Research Ethics Committee approval. This clinical trial complete registration at U.S. National Library of Medicine clinicaltrials.gov with identifier NCT03724721 and URL: https://clinicaltrials.gov/ct2/show/NCT03724721 on 30th October, 2018.
Modelling vulnerability: qualitative study of the Balint process for medical students
Authors: Ng Lillian , Seu Chris , Cullum Sarah 
Published: June 2022

AbstractBackgroundHealth professionals in training may be overwhelmed by the emotional dimensions of their work. Balint groups have been proposed as an intervention to support students to process emotional aspects their encounters with patients. The aim of this study was to explore medical students’ emotional experiences of a Balint group during their psychiatry attachment.MethodsMedical students completing a six week clinical attachment in psychiatry took part in weekly Balint group sessions. Five sessions were audio-recorded, transcribed and coded by members of the research team and an independent researcher co-coded all transcripts. Themes were discussed and refined over three rounds of coding.ResultsFour themes were identified: the Balint process as a container to enable vulnerability; becoming attuned to clinical and professional encounters; an evolving sense of identity within the medical hierarchy; and, the need for self-preservation to retain empathy for others.ConclusionThe Balint structure provides medical students with a secure and emotionally resonant experience. Medical students’ engagement with the Balint process, even over a relatively short time period, teaches them how to reflect on difficult emotions associated with clinical encounters. Early exposure during a psychiatry placement may benefit students in terms of understanding relationship dynamics and the need for self-integration and lifelong reflection over the course of their medical career.
Decision algorithm for when to use the ICD-11 3-part model for healthcare harms
Authors: Eastwood Cathy A. , Khair Shahreen , Southern Danielle A. 
Published: June 2022

AbstractAccurate data collection of healthcare-related adverse events provides a foundation for quality and health system improvement. The International Classification of Diseases for Mortality and Morbidity Statistics, 11th revision (ICD-11 MMS) includes new codes to identify harm or injury and the events or actions leading to the adverse events. However, it is difficult to choose the correct codes without in-depth understanding of which event may be classified as an injury or harm. A 3-part model will be available in the ICD-11 MMS to cluster the codes for the harm or injury that occurred, the causal factors, and the mode (mechanism) involved. While field testing coding of adverse events, our team developed a decision tree (algorithm), which guides when to use the 3-part model. The decision tree now resides in the ICD-11 Reference Guide. This paper is part of a special ICD-11 paper series and outlines the steps used in the decision-tree (algorithm) and provides examples to help understand the process.While it may take coders some time to gain experience to use the 3-part model and decision-tree, the ICD-11 Reference Guide and this paper can be helpful resources to help clarify the process.
Daily surgery caseload prediction: towards improving operating theatre efficiency
Authors: Hassanzadeh Hamed , Boyle Justin , Khanna Sankalp , Biki Barbara , Syed Faraz 
Published: June 2022

Abstract
Background
In many hospitals, operating theatres are not used to their full potential due to the dynamic nature of demand and the complexity of theatre scheduling. Theatre inefficiencies may lead to access block and delays in treating patients requiring critical care. This study aims to employ operating theatre data to provide decision support for improved theatre management.

Method
Historical observations are used to predict long-term daily surgery caseload in various levels of granularity, from emergency versus elective surgeries to clinical specialty-level demands. A statistical modelling and a machine learning-based approach are developed to estimate daily surgery demand. The statistical model predicts daily demands based on historical observations through weekly rolling windows and calendar variables. The machine learning approach, based on regression algorithms, learns from a combination of temporal and sequential features. A de-identified data extract of elective and emergency surgeries at a major 783-bed metropolitan hospital over four years was used. The first three years of data were used as historical observations for training the models. The models were then evaluated on the final year of data.

Results
Daily counts of overall surgery at a hospital-level could be predicted with approximately 90% accuracy, though smaller subgroups of daily demands by medical specialty are less predictable. Predictions were generated on a daily basis a year in advance with consistent predictive performance across the forecast horizon.

Conclusion
Predicting operating theatre demand is a viable component in theatre management, enabling hospitals to provide services as efficiently and effectively as possible to obtain the best health outcomes. Due to its consistent predictive performance over various forecasting ranges, this approach can inform both short-term staffing choices as well as long-term strategic planning.
Healthcare service utilization patterns and patient experience in persons with spinal cord injury: a comparison across 22 countries
Authors: Bychkovska Olena , Tederko Piotr , Engkasan Julia Patrick , Hajjioui Abderrazak , Gemperli Armin 
Published: June 2022

Abstract
Background
Persons with spinal cord injury frequently visit numerous clinical settings. Such all-around experience of the system may serve as a comprehensive experience indicator. This study compared the patient experience of persons with chronic SCI in relation to healthcare service utilization patterns in 22 countries, hypothesizing that primary-care oriented patterns would offer a better experience.

Methods
This study was based on International Spinal Cord Injury Survey with 12,588 participants across 22 countries worldwide. Utilization patterns/clusters were identified by cluster analysis and experience score – by the partial credit model. The association between healthcare utilization and experience at the provider and cluster level was explored by regression analysis.

Results
The highest share of visits was to primary care physicians (18%) and rehabilitation physicians (16%). Utilization patterns had diverse orientations: from primary care to specialized and from inpatient to outpatient. The experience was reported as very good and good across different dimensions: 84% reported respectful treatment; 81% – clear explanations; 77% – involvement in decision making; 65% – satisfaction with care. The average experience score (0–100) was 64, highest – 74 (Brazil) and the lowest – 52 (Japan, South Korea). Service utilization at provider and at cluster levels were associated with patient experience, but no utilization pattern resulted in uniformly better patient experience.

Conclusion
While there are distinct patterns between countries on how persons with chronic SCI navigate the healthcare system, we found that different utilization patterns led to similar patient experience. The observed difference in patient experience is likely determined by other contextual factors than service utilization.
Self-care interventions for sexual and reproductive health in humanitarian and fragile settings: a scoping review
Authors: Dawson Angela , Tappis Hannah , Tran Nguyen Toan 
Published: June 2022

Abstract
Background
Self-care is the ability of individuals, families, and communities to promote health, prevent disease, maintain health, and manage illness and disability with or without a health care provider. In resource-constrained settings with disrupted sexual and reproductive health (SRH) service coverage and access, SRH self-care could play a critical role. Despite SRH conditions being among the leading causes of mortality and morbidity among women of reproductive age in humanitarian and fragile settings, there are currently no reviews of self-care interventions in these contexts to guide policy and practice.

Methods
We undertook a scoping review to identify the design, implementation, and outcomes of self-care interventions for SRH in humanitarian and fragile settings. We defined settings of interest as locations with appeals for international humanitarian assistance or identified as fragile and conflict-affected situations by the World Bank. SRH self-care interventions were described according to those aligned with the Minimum Initial Services Package for Reproductive Health in Crises. We searched six databases for records using keywords guided by the PRISMA statement. The findings of each included paper were analysed using an a priori framework to identify information concerning effectiveness, acceptability and feasibility of the self-care intervention, places where self-care interventions were accessed and factors relating to the environment that enabled the delivery and uptake of the interventions.

Results
We identified 25 publications on SRH self-care implemented in humanitarian and fragile settings including ten publications on maternal and newborn health, nine on HIV/STI interventions, two on contraception, two on safe abortion care, one on gender-based violence, and one on health service provider perspectives on multiple interventions. Overall, the findings show that well-supported self-care interventions have the potential to increase access to quality SRH for crisis-affected communities. However, descriptions of interventions, study settings, and factors impacting implementation offer limited insight into how practical considerations for SRH self-care interventions differ in stable, fragile, and crisis-affected settings.

Conclusion
It is time to invest in self-care implementation research in humanitarian settings to inform policies and practices that are adapted to the needs of crisis-affected communities and tailored to the specific health system challenges encountered in such contexts.
Observational study of population genomic screening for variants associated with endocrine tumor syndromes in a large, healthcare-based cohort
Authors: Savatt Juliann M. , Ortiz Nicole M. , Thone Gretchen M. , McDonald Whitney S. , Kelly Melissa A. , Berry Alexander S. F. , Alvi Madiha M. , Hallquist Miranda L. G. , Malinowski Jennifer , Purdy Nicholas C. , Williams Marc S. , Sturm Amy C. , Buchanan Adam H. 
Published: June 2022

AbstractBackgroundIn current care, patients’ personal and self-reported family histories are primarily used to determine whether genetic testing for hereditary endocrine tumor syndromes (ETS) is indicated. Population genomic screening for other conditions has increased ascertainment of individuals with pathogenic/likely pathogenic (P/LP) variants, leading to improved management and earlier diagnoses. It is unknown whether such benefits occur when screening broader populations for P/LP ETS variants. This manuscript assesses clinical utility outcomes of a large, unselected, healthcare-based genomic screening program by describing personal and family history of syndrome-related features, risk management behaviors after result disclosure, and rates of relevant post-disclosure diagnoses in patient-participants with P/LP ETS variants.MethodsObservational study of individuals informed of a P/LP variant inMEN1,RET,SDHAF2,SDHB,SDHC,SDHD, orVHLthrough Geisinger’s MyCode Community Health Initiative between June 2016 and October 2019. Electronic health records (EHRs) of participants were evaluated for a report of pre-disclosure personal and self-reported family histories and post-disclosure risk management and diagnoses.ResultsP/LP variants in genes of interest were identified in 199 of 130,490 (1 in 656) adult Geisinger MyCode patient-participants, 80 of which were disclosed during the study period. Eighty-one percent (n= 65) did not have prior evidence of the result in their EHR and, because they were identified via MyCode, were included in further analyses. Five participants identified via MyCode (8%) had a personal history of syndrome-related features; 16 (25%) had a positive self-reported family history. Time from result disclosure to EHR review was a median of 0.7 years. Post-disclosure, 36 (55.4%) completed a recommended risk management behavior; 11 (17%) were diagnosed with a syndrome-related neoplasm after completing a risk management intervention.ConclusionsBroader screening for pathogenic/likely pathogenic variants associated with endocrine tumor syndromes enables detection of at-risk individuals, leads to the uptake of risk management, and facilitates relevant diagnoses. Further research will be necessary to continue to determine the clinical utility of screening diverse, unselected populations for such variants.
A cross-sectional questionnaire survey on knowledge of anti-protozoal drug use and resistance among AHPs in Kwara State, Nigeria
Authors: Elelu Nusirat , Agene Grace , Sanusi Fatima , Al-Mustapha Ahmad Ibrahim 
Published: June 2022

AbstractAntimicrobial resistance is a global public health crisis. However, there is a paucity of data on anti-protozoal resistance (APR), especially in animals. Hence, we assessed the knowledge of prudent antiprotozoal drug usage (APU) and resistance among animal health practitioners (AHPs) in Kwara State, Nigeria.A cross-sectional survey of 435 AHPs was performed in Kwara State from the 5th of March to the 31st of July 2020 using a structured and validated questionnaire. We used logistic regression analysis to identify socio-demographic factors that are associated with the satisfactory perception of prudent APU and good knowledge of APR among AHPs.Our findings showed that 80.2% (n = 349) of the AHPs in Kwara state had a good knowledge of APR with a mean knowledge score of 5.8 ± 1.2. In the same vein, 75.6% (n = 329) of the AHPs had a satisfactory perception of prudent APU with a mean score of 3.84 ± 1.21. Only 10.1% of the AHPs had observed treatment failures after the use of anti-protozoal drugs. Most of the AHPs (75.6%) believed that APR poses a significant threat to animal production and health globally. Logistic regression analysis showed that female AHPs were more likely (OR: 2.17; 95% CI: 0.91, 5.20;p < 0.005) to have better knowledge of APR than their male counterparts. AHPs with tertiary education were likely (OR: 2.77; 95% CI: 0.96, 4.99;p < 0.05) to be more knowledgeable about APR and have satisfactory perceptions of APU (OR: 1.57; 95% CI: 1.16, 2.99;p = 0.07) respectively. Finally, veterinarians were 3.76 times (95% CI:1.26, 9.25;p < 0.001) more likely to have good knowledge of APR and better perceptions of APU (OR: 3.28; 95% CI: 1.89, 5.68;p < 0.001) than other AHPs respectively.To control antimicrobial resistance, continuous training of AHPs especially para-veterinary officers is essential to update their knowledge on prudent antimicrobial usage and prevent the emergence of resistant protozoan parasites.
A microfluidic paper analytical device using capture aptamers for the detection of PfLDH in blood matrices
Authors: Ogunmolasuyi Adewoyin Martin , Fogel Ronen , Hoppe Heinrich , Goldring Dean , Limson Janice 
Published: June 2022

Abstract
Background
The prevalence and death rate arising from malaria infection, and emergence of other diseases showing similar symptoms to malaria require the development of malaria-specific and sensitive devices for its diagnosis. To address this, the design and fabrication of low-cost, rapid, paper-based analytical devices (µPAD) using surface-immobilized aptamers to detect the presence of a recombinant malarial biomarker—Plasmodium falciparum lactate dehydrogenase (rPfLDH)—is reported in this study.

Methods
Test zones on paper surfaces were created by covalently immobilizing streptavidin to the paper, subsequently attaching biotinylated aptamers to streptavidin. Aptamers selectively bound rPfLDH. The measurement of captured rPfLDH enzyme activity served as the means of detecting this biomarker. Enzyme activity across three replicate sensors was digitally quantified using the colorimetric Malstat assay.

Results
Screening of several different aptamers reported in the literature showed that aptamers rLDH7 and 2008s immobilized in this manner specifically recognised and captured PfLDH. Using rLDH7, the sensitivity of the µPAD sensor was evaluated and the µPAD sensor was applied for preferential detection of rPfLDH, both in buffered solutions of the protein and in spiked serum and red blood cell lysate samples. In buffered solutions, the test zone of the µPAD sensor exhibited a KD of 24 ± 11 nM and an empirical limit of detection of 17 nM, respectively, a limit similar to commercial antibody-based sensors exposed to rPfLDH. The specific recognition of 133 nM rPfLDH in undiluted serum and blood samples was demonstrated by the µPAD.

Conclusion
The reported µPAD demonstrates the potential of integrating aptamers into paper-based malarial rapid diagnostic tests.

Graphical Abstract