bluuebunny/crossref_metadata_2025_split huggingface dataset:
Revisiting U.S. Nocturnal Tornado Vulnerability and Its Influence on Tornado Impacts
Authors: Strader Stephen M. , Ashley Walker S. , Haberlie Alex M. , Kaminski Kristie 
Published: July 2022

Abstract
This research examines tornadoes and their fatalities by light condition (i.e., daytime and nighttime) for the United States. The study has two primary objectives: 1) to catalog and reassess differences in daytime and nighttime, or nocturnal, tornadoes and their fatalities from spatial and temporal perspectives and 2) to employ a spatially explicit Monte Carlo simulation technique to calculate differences in daytime and nocturnal tornado–population impact potential by combining climatological tornado risk data with fine-scale, gridded estimates of day and night population density. Results reveal that nocturnal tornadoes remain a substantial impediment to mitigating tornado casualties despite long-term improvements in detection and warning of these events. Nocturnal tornadoes are nearly 2 times as deadly as daytime events, with fatalities stemming from overnight (i.e., from local midnight to sunrise) tornadoes increasing fourfold since the late nineteenth century. The proportion of all tornado fatalities that occurred during daytime hours has decreased 20% over the last 140 years while the nocturnal fatality proportion has increased 20%. The stall, or even slight growth, in U.S. tornado mortality rates over the last 30 years has, at least in part, been driven by increasing nocturnal tornado fatalities. Overall, nocturnal tornadoes affect 13% more people on average than daytime tornadoes, revealing the importance of time of day in mitigating tornado–population impacts and disasters. Emergency managers, forecasters, first responders, policy makers, and researchers should continue to focus efforts on understanding nocturnal tornadoes, especially with regard to how populations receive warnings and respond to these nocturnal threats.
“Death is as Much Part of Life as Living”: Attitudes and Experiences Preparing for Death from Older Adults with Sickle Cell Disease
Authors: Oyedeji Charity I. , Strouse John J. , Masese Rita , Gray Nathan , Oyesanya Tolu O. 
Published: July 2022

The life-limiting and unpredictable nature of sickle cell disease (SCD) is well-established, yet there is limited literature on end-of-life planning. The purpose of this study was to describe perspectives about preparing for death for older adults with SCD. We enrolled 19 older adults with SCD (age ≥ 50 years) into this qualitative descriptive study. Theme 1 was “anticipation of early death,” with sub-themes: (a) informed of early death and (b) making plans for death. Theme 2 was “near death experiences.” Theme 3 was “differences in level of comfort with death” with subthemes: (a) death as a part of life and (b) differences in level of comfort discussing death. Theme 4 was “influence of spirituality” with subthemes: (a) God controls the timing of death and (b) belief in the afterlife. These results will inform interventions to improve the quality of patient-provider communication to provide goal-concordant end-of-life care for adults with SCD.
Open Access Exercise Electrocardiography: A Service to Improve Management of Ischaemic Heart Disease by General Practitioners
Authors: Sulke A N , Paul V E , Taylor C J , Roberts R H , Norris ADC 
Published: July 2022

An initial study of the use of open access exercise electrocardiography by general practitioners (GPs) in South East Kent showed that patient selection and interpretation of test results was frequently incorrect. After issuing guidelines, modifying the request form and instituting registrar review of all requests, significant improvements in both referral pattern, result interpretation and patient management have resulted. Forty-nine GPs requested 110 exercise tests during 1988/89. Twelve per cent were not undertaken after discussion with the referring practitioner. Eighty-four per cent of those tested would have been referred to the district general hospital cardiology outpatient department in the absence of open access exercise electrocardiography service. Six per cent of patients were referred directly for invasive investigation. Thirty-five per cent were referred to the district general hospital cardiology outpatient department, whilst 42% were spared hospital referral based on the result of the investigation. Better use of the modified service was suggested by: Referral of fewer patients with non-cardiac chest pains (P= 0.002); more patients with a moderate pre-test probability of ischaemic heart disease (P<0.05); fewer inappropriate requests (P<0.01); and fewer inappropriately undertaken tests (P< 0.001) than in the previous study. All patients with strongly positive test results were appropriately managed. Open access exercise electrocardiography in the format investigated is potentially a cost-effective and useful tool to improve diagnosis and management of heart disease bv GPs.
Fluctuations in Perceived Energy and Mood among Patients with Chronic Fatigue Syndrome
Authors: Wood C , Magnello M E , Sharpe M C 
Published: July 2022

Patients currently suffering or recently recovered from chronic fatigue syndrome (CFS) were compared with each other and with a group of well-matched controls in a study of diurnal variation in levels of perceived mental and physical energy and positive and negative affect. Patients who were currently ill showed diurnal variation in patterns of energy, with maximum levels being recorded between 10.00 h and 12.00 h which were significantly higher (P< 0.05) than energy levels recorded on rising or retiring. This pattern was similar to the controls but average energy levels at each time point were lower (P< 0.05) among the ill patients. Recovered patients showed the same pattern, with mean energy levels falling between those of the ill patients and controls. Similar diurnal patterns were found for perceptions ofpositive, though not negative affect. Correlations between physical and mental energy and between both of these energy variables and positive affect were high (r=0.75 to 0.85) in both controls and CFS patients. However, correlations with negative affect were low (eg r=-0.10) and non-significant. Total scores on the Hospital Anxiety and Depression Scale (HAD) were significantly higher (P< 0.05) among patients who were still ill than those who had recovered. Scores on the HAD Depression (but not Anxiety) subscale were also significantly higher among those who were still ill (P< 0.01). These findings may be of value in facilitating programmes of cognitive-behavioural modification intended to aid the recovery of patients with CFS.
Assessment of the Impact of Cancer on Work, Recreation, Home Management and Sleep Using a General Health Status Measure
Authors: Malone Margaret , Harris Adrian L , Luscombe David K 
Published: July 2022

A general health status measure (the UK Sickness Impact Profile) was used to assess health-related quality of life in 212 cancer patients [143 women, mean (SD - standard deviation) age 55.3 (11.7) years] compared to 105 age-sex matched control subjects [71 women, mean (SD) age 54.7 (12.2) years]. The four main areas of impairment in the cancer patient group were work, recreation and pastimes, home management and sleep and rest. The majority of patients were unable to work or working shorter hours due to their disease. A diagnosis of cancer was likewise found to have a major impact on active leisure pursuits and led to reduced participation in social and community activities. Patients had particular problems in carrying out household chores and maintenance or repair work in the house. Many patients had difficulty sleeping at night and tended to sleep during the day or rest for much of the day. The majority of studies of quality of life in oncology patients concentrate upon alterations in symptoms, such measures would fail to detect impairment in the aspects described above. Greater attention should be directed towards addressing issues such as changes in employment status and the need for help in the home to improve the overall care of cancer patients.
High-dose methotrexate-related pneumonitis in a child with acute lymphoblastic leukemia
Authors: Rakez Rim , Boufrikha Wiem , Cheffaï Areej , Boukhriss Sarra , Laatiri Mohamed Adnene 
Published: July 2022

Introduction Methotrexate is administered through different routes to treat childhood acute lymphoblastic leukemia. Toxicities of low, intermediate, or high doses of methotrexate have been described in the literature. Methotrexate-induced or related pneumonitis is a rare complication that leads, in most cases, to discontinuing this drug. Case report We report a case of a 17-year-old female patient with newly diagnosed B-acute lymphoblastic leukemia who received a high-dose methotrexate on an induction course. Eight days after methotrexate infusion, she developed fever, dyspnea, hypoxemia, and dry cough. Chest computed tomography showed mosaic attenuation of lung parenchyma and bilateral interstitial infiltrate in favor of hypersensitivity pneumonitis with no evidence of bacterial or fungal infections. Management and outcome Methotrexate-related pneumonitis was diagnosed and corticosteroids were prescribed. Improvement of the symptomatology was noted within four days. Given the importance of methotrexate in the treatment of acute lymphoblastic leukemia, intrathecal methotrexate was administered without incident and high-dose methotrexate was re-introduced successfully two and a half months after the pneumonitis episode while using corticosteroids. According to Naranjo's algorithm, the reaction to the drug was found to be probable with a score of 6. Discussion Methotrexate is the backbone of acute lymphoblastic leukemia treatment, but numerous adverse reactions have been published of which methotrexate pneumonitis can be fatal in some cases. In this case, we concluded that this drug can be successfully reintroduced after methotrexate-related pneumonitis.
Level of Hand Hygiene Compliance and Its Associated Factors Among Health Care Workers at Eka Kotebe General Hospital, Addis Ababa, Ethiopia
Authors: Tadesse Muluken , Shimelash Alebachew , Tegegne Eniyew 
Published: July 2022

Background: Poor hand hygiene is an important source of infection, but maintaining hand hygiene is the most important measure to prevent infections. Hand hygiene compliance and its associated factors are not well recognized in Ethiopia. Therefore, this study was intended to determine hand hygiene compliance and its associated factors among health care workers in Eka Kotebe General Hospital. Methods: A cross-sectional study was conducted among health care workers at Eka Kotebe General Hospital. A self-administered questionnaire supplemented by a World Health Organization Hand Hygiene Technical Reference Manual was used to collect data. Data was entered using Epi Info 7.2.0.1 and exported to SPSS 23 for analysis. The data were analyzed using descriptive and inferential statistics. Statistical significance was determined using a P-value of ⩽.05 with a 95% confidence interval. Results: Hand hygiene compliance among healthcare workers was 22.2%. Hand hygiene training (AOR = 2.9, 95% CI: 1.13-7.52), presence of hand hygiene indication poster (AOR = 3.38, 95% CI: 1.18-9.66), hand hygiene promotion by IPC team (AOR = 4.2, 95% CI: 2.53-8.58)), working experience ⩾5 years of a health care providers (AOR = 3.96, 95% CI: 1.12-13.9), being midwife (AOR = 17.1, 95% CI: 2.8-10), being nurse (AOR = 5.3, 95% CI: 2.09-7.8) by profession, and presence of water (AOR = 2.50, 95% CI: 2.20-11.78) were significantly associated factors to hand hygiene compliance. Conclusion: The level of hand hygiene compliance among health care providers was found to be low. Training about hand hygiene, the presence of hand hygiene indication posters, hand hygiene promotion by the IPC team, working experience of health care providers, being a nurse and midwife, and the presence of water were independent predictors of hand hygiene compliance. Health care workers need to be given training on hand hygiene as well as hand hygiene facilities shall be installed and supplied by the hospital in a sustained manner.
No increase of serum neurofilament light in relapsing-remitting multiple sclerosis patients switching from standard to extended-interval dosing of natalizumab
Authors: Johnsson Magnus , Farman Helen H , Blennow Kaj , Zetterberg Henrik , Malmeström Clas , Axelsson Markus , Lycke Jan 
Published: July 2022

Background: Accumulating evidence supports the efficacy of administering natalizumab (NZ) with extended-interval dosing (EID) in patients with relapsing-remitting multiple sclerosis (RRMS). Objectives: We switched NZ dosing from 4-week to 6-week intervals in patients with RRMS, and investigated the effect on serum neurofilament light chain (sNfL) concentrations. Methods: We included two cohorts of patients with RRMS treated with NZ: one received the standard-interval dosing (4 weeks) at baseline, and were switched to 6-week intervals (EID4–6, N = 45). The other cohort received EID (5- or 6-week intervals) both at baseline and during follow-up (EID5/6, N = 25). Serum samples were collected in the EID4–6 cohort at every NZ infusion, for 12 months. The primary outcome was the change in sNfL concentrations after switching to EID. Results: The baseline mean sNfL concentration in the EID4–6 cohort was 10.5 ng/L (standard deviation (SD) = 6.1), and it remained unchanged at 12 months. Moreover, individual sNfL concentrations did not change significantly after extending the NZ dosing intervals. In addition, the EID4–6 and EID5/6 cohorts had similar baseline sNfL concentrations. Conclusion: We concluded that extending the NZ dosing interval did not increase axonal damage, as determined with sNfL, in patients with RRMS.
Ruination in the ring: Habitus in the making of a professional “opponent”
Authors: Wacquant Loïc 
Published: July 2022

Backed by 3 years of apprenticeship in a boxing gym of Chicago’s hyperghetto and in-depth life-story interviews with fifty professional boxers, this article reconstructs the social biography and ring career of a professional “opponent” as a living analyzer of the social, economic, mental, and emotional wheels and cogs of prizefighting careers. An “opponent” like Jake “The Snake” Valliance is a boxer determined and skilled enough to give a good account of himself in the ring, but willing to travel for quick money and be overmatched to serve as a stepping stone in the careers of rising fighters. He fights often, loses nearly as often, but maintains enough occupational pride that he keeps going, always hoping to turn his ship around, thus playing a key role in the pugilistic market. The article dissects the genesis, feeding, and fading of the libido pugilistica that explains the opponent's continued investment in the economy of pain, love, and deceit that is professional boxing. It throws light on the material and symbolic logics of a skilled bodily craft and, beyond it, on the workings of habitus as cognitive cog, trained capacity and socialized desire driving social action.
Epidemiology of Distal Forearm Fracture: A Population-Based Study of 5426 Fractures
Authors: Soerensen Soeren , Larsen Peter , Korup Lærke R. , Ceccotti Adriano A. , Larsen Mia B. , Filtenborg Jonas T. , Weighert Karen P. , Elsoe Rasmus 
Published: July 2022

Background: Despite intensive research into the epidemiology of adult distal forearm fractures, the literature is limited. This study aimed to provide a full overview of adult distal forearm fracture epidemiology, including incidence, fracture classification, mode of injury, and trauma mechanism in patients sustaining a distal forearm fracture, based on an accurate at-risk population with manually validated data leading to a high quality in data. Methods: This was a population-based cohort study with a manual review of X-rays and charts. The primary outcome measure was the incidence of adult distal forearm fractures. The study was based on an average at-risk population of 522 607 citizens. A total of 5426 adult distal forearm fractures were included during the study period. Females accounted for 4199 (77%) and males accounted for 1227 (23%) of fractures. Results: The overall incidence of adult distal forearm fractures was 207.7/100 000/year. Female incidence was 323.4/100 000/year, and male incidence was 93.3/100 000/year. A marked increase in incidence with increasing age was observed for females after 50 years of age. The incidence of distal radius fractures was 203.0/100 000/year, and the incidence of isolated ulna fractures was 3.8/100 000/year. The most common fracture type was an extra-articular AO type 2R3A (69%), and the most common mode of injury was a fall from own height (76%). A small non-trending year-to-year variation was observed during the 5-year study period. Conclusion: Results show that adult distal forearm fractures are very common in women after the postmenopausal period. The overall incidence of adult distal forearm fractures was 207.8/100 000/year. Female incidence was 323.4/100 000/year.
Histidine-rich glycoprotein as a novel predictive biomarker of postoperative complications in intensive care unit patients: a prospective observational study
Authors: Oiwa Masahiko , Kuroda Kosuke , Kawanoue Naoya , Morimatsu Hiroshi 
Published: July 2022

Abstract
Background
Decrease in histidine-rich glycoprotein (HRG) was reported as a cause of dysregulation of the coagulation-fibrinolysis and immune systems, leading to multi-organ failure, and it may be a biomarker for sepsis, ventilator-associated pneumonia, preeclampsia, and coronavirus disease 2019. However, the usefulness of HRG in perioperative management remains unclear. This study aimed to assess the usefulness of HRG as a biomarker for predicting postoperative complications.

Methods
This was a single-center, prospective, observational study of 150 adult patients who were admitted to the intensive care unit after surgery. Postoperative complications were defined as those having a grade II or higher in the Clavien–Dindo classification, occurring within 7 days after surgery. The primary outcome was HRG levels in the patients with and without postoperative complications. The secondary outcome was the ability of HRG, white blood cell, C-reactive protein, procalcitonin, and presepsin to predict postoperative complications. Data are presented as number and median (interquartile range).

Results
The incidence of postoperative complications was 40%. The HRG levels on postoperative day 1 were significantly lower in patients who developed postoperative complications (n = 60; 21.50 [18.12–25.74] µg/mL) than in those who did not develop postoperative complications (n = 90; 25.46 [21.05–31.63] µg/mL). The Harrell C-index scores for postoperative complications were HRG, 0.65; white blood cell, 0.50; C-reactive protein, 0.59; procalcitonin, 0.73; and presepsin, 0.73. HRG was independent predictor of postoperative complications when adjusted for age, the presence of preoperative cardiovascular comorbidities, American Society of Anesthesiologists Physical Status Classification, operative time, and the volume of intraoperative bleeding (adjusted hazard ratio = 0.94; 95% confidence interval, 0.90–0.99).

Conclusions
The HRG levels on postoperative day 1 could predict postoperative complications. Hence, HRG may be a useful biomarker for predicting postoperative complications.
How does safety netting for lung cancer symptoms help patients to reconsult appropriately? A qualitative study
Authors: Black Georgia B. , van Os Sandra , Renzi Cristina , Walter Fiona M. , Hamilton Willie , Whitaker Katriina L. 
Published: July 2022

Abstract
Background
Safety netting in primary care is considered an important intervention for managing diagnostic uncertainty. This is the first study to examine how patients understand and interpret safety netting advice around low-risk potential lung cancer symptoms, and how this affects reconsultation behaviours.

Methods
Qualitative interview study in UK primary care. Pre-covid-19, five patients were interviewed in person within 2–3 weeks of a primary care consultation for potential lung cancer symptom(s), and again 2–5 months later. The general practitioner (GP) they last saw was interviewed face-to-face once. During the covid-19 pandemic, an additional 15 patients were interviewed only once via telephone, and their GPs were not interviewed or contacted in any way. Audio-recorded interviews were transcribed verbatim and analysed using inductive thematic analysis.

Results
The findings from our thematic analysis suggest that patients prefer active safety netting, as part of thorough and logical diagnostic uncertainty management. Passive or ambiguous safety netting may be perceived as dismissive and cause delayed reconsultation. GP safety netting strategies are not always understood, potentially causing patient worry and dissatisfaction. Telephone consultations and the diagnostic overshadowing of COVID-19 on respiratory symptoms impacted GPs’ safety netting strategies and patients’ appetite for active follow up measures.

Conclusions
Safety netting guidelines do not yet offer solutions that have been proven to promote symptom vigilance and timely reconsultation for low-risk lung cancer symptoms. This may have been affected by primary care practices during the COVID-19 pandemic. Patients prefer active or pre-planned safety netting coupled with thorough consultation techniques and a comprehensible diagnostic strategy, and may respond adversely to passive safety netting advice.
Uses and perceptions of medications among French older adults: results from the 2020 French Health Barometer survey
Authors: Tran Anh Thi-Quynh , Soullier Noémie , Ankri Joël , Herr Marie , Carcaillon-Bentata Laure 
Published: July 2022

Abstract
Background
There are few studies reporting on self-medication, perceptions or difficulties older adults have with their medications. This study aimed to describe the uses and the perceptions of medications among older adults in France and to identify patient groups based on that information.

Methods
We used data from the 2020 ‘French Health Barometer’ – a nationally-representative cross-sectional survey. We assessed polypharmacy (five or more medications), self-medication, and patient perceptions of medications. Robust Poisson regression was used to investigate socio-demographic and health-related factors associated with the outcomes. Latent class analysis was used to identify patient groups classified by the use and the perceptions of medications. Factors associated with group assignment were investigated by multinomial logistic regression. All analyses were weighted.

Results
The study sample comprised 1,623 respondents aged 70–85 years. Polypharmacy and self-medication were reported in 23.5 and 48.7% of the older population, respectively. Polypharmacy was associated with increasing age, low education, and impaired health status. Self-medication was associated with female sex and high education. Among individuals taking at least 1 medication, 8.2% reported not to understand all their medications, and 9.7% having difficulty taking medications as prescribed. Among individuals taking at least 2 medications, 23.2% thought that they took too many medications. Three patient groups were identified: ‘Non-polypharmacy, positive perceptions’ (62.5%), ‘Polypharmacy, positive perceptions’ (28.0%), and ‘Negative perceptions’ (9.5%).

Conclusions
Polypharmacy and self-medication are common in French older adults. One segment of people reported negative perceptions of their medications regardless of their polypharmacy status. This underlines the difference between the objective and perceived measures of polypharmacy.