bluuebunny/crossref_metadata_2025_split huggingface dataset:
Emergency department visits and trends related to cocaine, psychostimulants, and opioids in the United States, 2008–2018
Authors: Suen Leslie W. , Davy-Mendez Thibaut , LeSaint Kathy T. , Riley Elise D. , Coffin Phillip O. 
Published: February 2022

Abstract
Background
Drug-related emergency department (ED) visits are escalating, especially for stimulant use (i.e., cocaine and psychostimulants such as methamphetamine). We sought to characterize rates, presentation, and management of ED visits related to cocaine and psychostimulant use, compared to opioid use, in the United States (US).

Methods
We used 2008–2018 National Hospital Ambulatory Medical Care Survey data to identify a nationally representative sample of ED visits related to cocaine and psychostimulant use, with opioids as the comparator. To make visits mutually exclusive for analysis, we excluded visits related to 2 or more of the three possible drug categories. We estimated annual rate trends using unadjusted Poisson regression; described demographics, presenting concerns, and management; and determined associations between drug-type and presenting concerns (categorized as psychiatric, neurologic, cardiopulmonary, and drug toxicity/withdrawal) using logistic regression, adjusting for age, sex, race/ethnicity, and homelessness.

Results
Cocaine-related ED visits did not significantly increase, while psychostimulant-related ED visits increased from 2008 to 2018 (2.2 visits per 10,000 population to 12.9 visits per 10,000 population; p < 0.001). Cocaine-related ED visits had higher usage of cardiac testing, while psychostimulant-related ED visits had higher usage of chemical restraints than opioid-related ED visits. Cocaine- and psychostimulant-related ED visits had greater odds of presenting with cardiopulmonary concerns (cocaine adjusted odds ratio [aOR] 2.95, 95% CI 1.70–5.13; psychostimulant aOR 2.46, 95% CI 1.42–4.26), while psychostimulant-related visits had greater odds of presenting with psychiatric concerns (aOR 2.69, 95% CI 1.83–3.95) and lower odds of presenting with drug toxicity/withdrawal concerns (aOR 0.47, 95%CI 0.30–0.73) compared to opioid-related ED visits.

Conclusion
Presentations for stimulant-related ED visits differ from opioid-related ED visits: compared to opioids, ED presentations related to cocaine and psychostimulants are less often identified as related to drug toxicity/withdrawal and more often require interventions to address acute cardiopulmonary and psychiatric complications.
Quantifying population level hypertension care cascades in India: a cross-sectional analysis of risk factors and disease linkages
Authors: Kothavale Ajinkya , Puri Parul , Sangani Purvi G. 
Published: February 2022

AbstractBackgroundHypertension is associated with higher morbidity and mortality burden, and is reported to pose severe repercussions on those above the age of 60 years. Despite the growing concern, empirical evidence providing nationally representative estimates of hypertension care cascades for the elderly population are inadequate in India. Therefore, the present study aims to quantify the magnitude of hypertension care cascades, identify the co-morbidities attributed to hypertension and recognize lifestyle modifications to reduce the instances of uncontrolled blood pressure among the elderly population in India.MethodThis study employed data on 28,109 elderly individuals from the Longitudinal Ageing Study in India, 2017-18. Descriptive and multivariable analyses were performed to identify the burden and correlates of hypertension and uncontrolled blood pressure levels. Population Attributable Risk was computed to identify deteriorating health implications and recognize viable solutions to improve the situation.ResultsThe findings suggest that elderly experiences loss at all stages of hypertension care, namely, at the level of measured hypertension (72.5%), diagnosis/awareness (57.3%), treatment (50.5%), and control (27.5%). The highest dip was observed at the level of blood pressure control. The findings hint towards the linkages between socio-economic, demographic, and lifestyle factors with hypertension and uncontrolled blood pressure levels. Caste, religion, living arrangement, MPCE quintile, residence, family history of hypertension, working status, and alcohol consumption were the significant predictors of uncontrolled hypertension. The findings quantified the proportion of diseased cases attributed to hypertension, and highlighted essential contributors of overall and uncontrolled hypertension.ConclusionsThere is an urgent need to improve access to cost-effective anti-hypertensive prescriptions to curtail the increasing burden of uncontrolled blood pressure and some other co-morbid diseases. Thus, if apprehended cautiously, findings from this study can serve to design practical approaches aimed at control, prevention, and management of hypertension among the elderly population of India.
Trends in utilisation of plain X-rays by older Australians (2010–2019)
Authors: Gaget Virginie , Inacio Maria C. , Tivey David R. , Jorissen Robert N. , Babidge Wendy , Visvanathan Renuka , Maddern Guy J. 
Published: February 2022

Abstract
Background
Older Australians are major health service users and early diagnosis is key in the management of their health. Radiological services are an important component of diagnosis and disease management planning in older Australians, but their national utilisation of diagnostic services has never been investigated in Australia.

Purpose
This study aims to evaluate the utilisation of major plain X-rays by Australians ≥ 65 years old.

Methods
A population-based epidemiological evaluation and yearly cross-sectional analyses of X-ray examinations per 1,000 Australians aged ≥ 65 years old between 2009 and 2019 were conducted using publicly available Medicare Benefits Schedule and Australian Bureau of Statistics data sources. Age and sex specific incidence rate (IR) of plain X-rays per 1,000 Australians, adjusted incidence rate ratios (IRR) and 95% confidence intervals (CI) were estimated using a negative binomial regression model.

Results
During the study period, the Australian population over 65 years old increased by 39% while the crude plain X-ray utilisation by this population increased by 63%. Most X-rays were conducted on extremities or the chest. Men used chest radiography more than women, and particularly for lungs, where the incidence increased the most in those ≥ 85 years old. There was an increase in X-rays of extremities and the hip joint between 2009–10 and 2013–14 in people ≥ 85 years old.

Conclusion
The utilisation of plain X-rays of the chest, the gastro-intestinal tract and extremities was high and has increased among older Australians between 2009–10 and 2018–19. Plain X-rays remain a commonly used diagnostic tool for conditions affecting the older population.
Performance and utility of more highly sensitive malaria rapid diagnostic tests
Authors: Slater Hannah C. , Ding Xavier C. , Knudson Sophia , Bridges Daniel J. , Moonga Hawela , Saad Neil J. , De Smet Martin , Bennett Adam , Dittrich Sabine , Slutsker Laurence , Domingo Gonzalo J. 
Published: February 2022

AbstractBackgroundA new more highly sensitive rapid diagnostic test (HS-RDT) forPlasmodium falciparummalaria (Alere™/Abbott Malaria Ag P.f RDT [05FK140], now calledNxTek™Eliminate Malaria Ag Pf) was launched in 2017. The test has already been used in many research studies in a wide range of geographies and use cases.MethodsIn this study, we collate all published and available unpublished studies that use the HS-RDT and assess its performance in (i) prevalence surveys, (ii) clinical diagnosis, (iii) screening pregnant women, and (iv) active case detection. Two individual-level data sets from asymptomatic populations are used to fit logistic regression models to estimate the probability of HS-RDT positivity based on histidine-rich protein 2 (HRP2) concentration and parasite density. The performance of the HS-RDT in prevalence surveys is estimated by calculating the sensitivity and positive proportion in comparison to polymerase chain reaction (PCR) and conventional malaria RDTs.ResultsWe find that across 18 studies, in prevalence surveys, the mean sensitivity of the HS-RDT is estimated to be 56.1% (95% confidence interval [CI] 46.9–65.4%) compared to 44.3% (95% CI 32.6–56.0%) for a conventional RDT (co-RDT) when using nucleic acid amplification techniques as the reference standard. In studies where prevalence was estimated using both the HS-RDT and a co-RDT, we found that prevalence was on average 46% higher using a HS-RDT compared to a co-RDT. For use in clinical diagnosis and screening pregnant women, the HS-RDT was not significantly more sensitive than a co-RDT.ConclusionsOverall, the evidence presented here suggests that the HS-RDT is more sensitive in asymptomatic populations and could provide a marginal improvement in clinical diagnosis and screening pregnant women. Although the HS-RDT has limited temperature stability and shelf-life claims compared to co-RDTs, there is no evidence to suggest, given this test has the same cost as current RDTs, it would have any negative impacts in terms of malaria misdiagnosis if it were widely used in all four population groups explored here.
Associations between daily steps and cognitive function among inpatients with schizophrenia
Authors: Chen Li-Jung , Stubbs Brendon , Chien I-Chia , Lan Tsuo-Hung , Chung Ming-Shun , Lee Hui-Ling , Hsu Wan-Chi , Ku Po-Wen 
Published: February 2022

Abstract
Background
Walking is the fundamental component of taking steps and is the main form of physical activity among individuals with schizophrenia; it also offers a range of health benefits. This study aimed to examine the associations between daily steps and cognitive function and further explored how many steps were related to better cognitive function among inpatients with schizophrenia.

Methods
Inpatients with schizophrenia were recruited from long-stay psychiatric wards across two hospitals (n=199 at site 1 and n=195 at site 2). Daily steps were collected with an accelerometer for 7 days. Four cognitive domains (attention, processing speed, reaction time, and motor speed) were tested at site 1, and two cognitive domains (attention and processing speed) were tested at site 2. The associations of daily steps and levels of steps/day with cognitive function were tested using multivariable linear regressions separated by site. Covariates included demographic variables, weight status, metabolic parameters, and clinical state.

Results
Participants took an average of 7445 (±3442) steps/day. More steps were related to better attention, processing speed, reaction time, and motor speed after multivariable adjustments. Compared with participants taking <5000 steps/day, those taking ≥5000 steps/day showed significantly better processing speed. Participants taking ≥7500 steps/day were associated with better attention, better reaction time, and better motor speed than those taking <5000 steps/day.

Conclusion
Daily steps are associated with better cognitive function among inpatients with schizophrenia. The optimal benefit for cognitive function among this clinical population is achieving 7500 steps/day or more.
Tick bites in different professions and regions: pooled cross-sectional study in the focus area Bavaria, Germany
Authors: Schielein Louisa , Tizek Linda , Biedermann Tilo , Zink Alexander 
Published: February 2022

Abstract
Background
As the vector-borne diseases tick-borne encephalitis (TBE) and Lyme borreliosis (LB) are common in Germany and transmitted by tick bites, the aim of this study was to assess differences in the number of tick bites in various professions and regions across southern Germany to evaluate the differences in tick-associated risk.

Materials and methods
The analysis is based on three cross-sectional studies that were conducted in 2016 and 2017 in two real-life settings and in one medical setting in Bavaria. All participants filled in a paper-based questionnaire about their history with tick bites. Only adult participants (≥ 18 years) were included in this study.

Results
Overall, 3503 individuals (mean age 50.8 ± 15.2 years, median age 53.0 ± 12.2 years, 54.0% female) were included. Of these, 50% worked in an outdoor profession and 56% lived in environs. Around 70% of participants reported at least one previous tick bite. In comparison to indoor workers, forestry workers (OR = 2.50; 95% CI: 1.10–5.68) had the highest risk for a tick bite followed by farmers (OR = 1.22; 95% CI: 1.01–1.47). Furthermore, people living in rural areas (OR = 1.97, 95% CI:1.49–2.59) and environs (OR = 1.98, 95% CI: 1.54–2.55) were twice as likely to have a previous tick bite than people living in urban areas. In general, slightly more tick bites were reported by people living in eastern Bavaria.

Conclusion
Rising numbers of TBE and LB indicate the need for further prevention strategies, which should focus on outdoor professions with a higher risk and people living in environs and rural areas.
Impact of the Norwegian Agreement for a More Inclusive Working Life on diagnosis-specific sickness absence in young adults: a difference-in-difference analysis
Authors: Hasting Rachel L. , Merkus Suzanne L. , Hanvold Therese N. , Kristensen Petter , Gran Jon Michael , Mehlum Ingrid S. 
Published: February 2022

Abstract
Background
The Norwegian Agreement for a More Inclusive Working Life (the IA Agreement) aims to reduce sickness absence (SA) and increase work participation. Potential impacts of the IA Agreement have not been thoroughly evaluated. The study aimed to estimate the impact of the IA Agreement on musculoskeletal and psychological SA prevalence and duration among young adult men and women, and to identify whether the impact was modified by economic activity or SA grade.

Methods
Data from national registries were combined for 372,199 individuals born in Norway 1967–1976. ICPC-2 codes identified musculoskeletal (L) and psychological (P) diagnoses. A difference-in-difference method compared prevalence and mean duration of first SA > 16 days between 2000 and 2005 separately for men and women working in IA companies relative to non-IA companies. Analyses were adjusted for mean company size and stratified by economic activity and SA grade (full/graded). Average marginal change was calculated with 95% confidence intervals (CI).

Results
The impacts of the IA Agreement on SA prevalence were mixed as the direction and size of marginal changes varied according to diagnosis, gender, and economic activity. However, there was a general tendency towards reduced mean SA duration for both diagnosis groups, and in particular men with musculoskeletal SA (− 16.6 days, 95% CI -25.3, − 7.9). Individuals with full SA in IA companies had greater reductions in mean SA duration. Only the wholesale and retail economic activity indicated a beneficial contribution of the IA Agreement for both SA prevalence and duration, in both diagnoses and genders.

Conclusions
Potential impacts of the IA Agreement on SA in young men and women varied according to diagnosis and economic activity. However, results indicated that the IA Agreement could reduce SA duration. Further research should identify reasons for gender and economic activity differences.
Trajectories of hypoxemia and pulmonary mechanics of COVID-19 ARDS in the NorthCARDS dataset
Authors: Jafari Daniel , Gandomi Amir , Makhnevich Alex , Qiu Michael , Rolston Daniel M. , Gottesman Eric P. , Tsegaye Adey , Mayo Paul H. , Stewart Molly E. , Zhang Meng , Hajizadeh Negin 
Published: February 2022

Abstract
Background
Understanding heterogeneity seen in patients with COVIDARDS and comparing to non-COVIDARDS may inform tailored treatments.

Methods
A multidisciplinary team of frontline clinicians and data scientists worked to create the Northwell COVIDARDS dataset (NorthCARDS) leveraging over 11,542 COVID-19 hospital admissions. The data was then summarized to examine descriptive differences based on clinically meaningful categories of lung compliance, and to examine trends in oxygenation.

Findings
Of the 1536 COVIDARDS patients in the NorthCARDS dataset, there were 531 (34.6%) who had very low lung compliance (< 20 ml/cmH2O), 970 (63.2%) with low-normal compliance (20–50 ml/cmH2O), and 35 (2.2%) with high lung compliance (> 50 ml/cmH2O). The very low compliance group had double the median time to intubation compared to the low-normal group (107.3 h (IQR 25.8, 239.2) vs. 39.5 h (IQR 5.4, 91.6)). Overall, 68.8% (n = 1057) of the patients died during hospitalization. In comparison to non-COVIDARDS reports, there were less patients in the high compliance category (2.2% vs. 12%, compliance ≥ 50 mL/cmH20), and more patients with P/F ≤ 150 (59.8% vs. 45.6%). There is a statistically significant correlation between compliance and P/F ratio. The Oxygenation Index is the highest in the very low compliance group (12.51, SD(6.15)), and lowest in high compliance group (8.78, SD(4.93)).

Conclusions
The respiratory system compliance distribution of COVIDARDS is similar to non-COVIDARDS. In some patients, there may be a relation between time to intubation and duration of high levels of supplemental oxygen treatment on trajectory of lung compliance.
Treatment of type III dens invaginatus in bilateral immature mandibular central incisors: a case report
Authors: Zhang Jie , Wang Yuan , Xu Lei , Wu Zhifang , Tu Yan 
Published: February 2022

Abstract
Background
Dens invaginatus (DI) is a developmental anomaly, Oehlers Type III DI is the most complex type and early diagnosis and treatment is complicated and challenging. This report presents a rare case of a type IIIb DI associated with a periapical lesion in bilateral immature permanent mandibular central incisors.

Case presentation
An eight-year-old boy referred to our clinic manifesting with pain along with swelling in the mandibular incisors for the past one month. Radiographic examination showed periapical radiolucency exhibiting a scantly defined border, as well as an invagination which had a central invaginated canal extending from the pulp chamber throughout the apical foramen in both mandibular central incisors. We performed two different treatment procedures on the basis of the condition of the main pulp of the mandibular central incisors. in which only the invagination root canal was treated in the right mandibular central incisor, while the invagination and main root canals were treated in the left mandibular central incisor. During the 18-month follow-up period, the teeth were clinically asymptomatic. Imaging examinations indicated complete healing of the periapical lesion and revealed that the wall of the root canal was thickened and the open apex was closed.

Conclusion
For young permanent teeth with type III Dens invaginatus, it is particularly important to keep pulp vitality, which could maintain root development and allow a good long-term prognosis.
COMPANION: development of a patient-centred complexity and casemix classification for adult palliative care patients based on needs and resource use – a protocol for a cross-sectional multi-centre study
Authors: Hodiamont Farina , Schatz Caroline , Gesell Daniela , Leidl Reiner , Boulesteix Anne-Laure , Nauck Friedemann , Wikert Julia , Jansky Maximiliane , Kranz Steven , Bausewein Claudia 
Published: February 2022

Abstract
Background
A casemix classification based on patients’ needs can serve to better describe the patient group in palliative care and thus help to develop adequate future care structures and enable national benchmarking and quality control. However, in Germany, there is no such an evidence-based system to differentiate the complexity of patients’ needs in palliative care. Therefore, the study aims to develop a patient-oriented, nationally applicable complexity and casemix classification for adult palliative care patients in Germany.

Methods
COMPANION is a mixed-methods study with data derived from three subprojects. Subproject 1: Prospective, cross-sectional multi-centre study collecting data on patients’ needs which reflect the complexity of the respective patient situation, as well as data on resources that are required to meet these needs in specialist palliative care units, palliative care advisory teams, and specialist palliative home care. Subproject 2: Qualitative study including the development of a literature-based preliminary list of characteristics, expert interviews, and a focus group to develop a taxonomy for specialist palliative care models. Subproject 3: Multi-centre costing study based on resource data from subproject 1 and data of study centres. Data and results from the three subprojects will inform each other and form the basis for the development of the casemix classification. Ultimately, the casemix classification will be developed by applying Classification and Regression Tree (CART) analyses using patient and complexity data from subproject 1 and patient-related cost data from subproject 3.

Discussion
This is the first multi-centre costing study that integrates the structure and process characteristics of different palliative care settings in Germany with individual patient care. The mixed methods design and variety of included data allow for the development of a casemix classification that reflect on the complexity of the research subject. The consecutive inclusion of all patients cared for in participating study centres within the time of data collection allows for a comprehensive description of palliative care patients and their needs. A limiting factor is that data will be collected at least partly during the COVID-19 pandemic and potential impact of the pandemic on health care and the research topic cannot be excluded.

Trial registration
German Register for Clinical Studies trial registration number: DRKS00020517.
Conceptualising effective symptom management in palliative care: a novel model derived from qualitative data
Authors: Chapman Emma J. , Pini Simon , Edwards Zoe , Elmokhallalati Yousuf , Murtagh Fliss E. M. , Bennett Michael I. 
Published: February 2022

Abstract
Background
Pain, breathlessness and fatigue are some of the most challenging symptoms to manage in patients with advanced disease. Specialist palliative care leads to better symptom management, but factors contributing to successful symptom management in this context have not been explored. Our aim was to understand what facilitates effective symptom management in specialist palliative care within UK hospices and investigate what barriers are experienced.

Methods
This was a grounded theory study using qualitative semi-structured focus groups and interviews. Participants were recruited from multidisciplinary specialist palliative care teams (doctors, nurses, healthcare assistants, physiotherapists, occupational therapists, complementary therapists, social workers and chaplains) working in inpatient, outpatient and community services provided by five hospices in the United Kingdom.

Results
We present a novel qualitative data-derived model of effective symptom management in specialist palliative care. We describe a co-ordinated, multi-faceted, sequential approach involving a process of engagement, partnership, decision-making, and delivery. Interventions to manage symptoms are less effective in psychologically distressed patients. Our data highlights that families of patients have a key role in determining effectiveness of symptom management interventions A holistic approach by a co-ordinated, multi-disciplinary team, including support to recognise and minimise psychological distress might facilitate more effective symptom management. Barriers to symptom management include team discordance and lack of understanding about symptom management by patient and families.

Conclusions
Shared decision-making between patients and professionals and co-ordination of care by a multi-disciplinary team are key components of effective symptom management. Actions to address psychological distress and evaluate the understanding and expectations of patients and their families would enable more effective symptom management. A more effective multi-disciplinary approach would be facilitated by discussion within teams about role competencies and boundaries.