bluuebunny/crossref_metadata_2025_split huggingface dataset:
New graduates learning to make intervention decisions in acute paediatric hospital settings: Support and influences
Authors: Moir Elizabeth , Copley Jodie A , Turpin Merrill J 
Published: June 2022

Introduction New graduate occupational therapists’ experiences of learning to make paediatric intervention decisions within hospital settings are unexplored. New graduates commonly find clinical decision-making challenging. Previous research has predominantly evaluated support programs designed to assist their transition to practice. Exploring new graduates’ experiences working in hospital settings is important because they are common employers of new graduates and typically provide substantial support. Method A case study approach enabled exploration of the experiences of four new graduate and perspectives of four experienced occupational therapists working in an Australian paediatric hospital. Data were collected through semi-structured interviews, informal discussions, observations and review of documents. Inductive analysis was used to identify codes and themes within the data. Findings New graduates reported substantial access to workplace supports and resources to inform their intervention decisions. However, the immediacy with which occupational therapists needed to respond to referrals impacted new graduates’ ability to consistently access available supports. They were acutely aware of needing to manage clinical risk and actively sought informal support for making intervention decisions. Conclusion Providing opportunities to seek informal support on an ‘as-needs’ basis was most important for assisting new graduates to obtain reassurance that they were making safe, high-quality intervention decisions.
Effects of dibutyl phthalate and di (2-ethylhexyl) phthalate on hepatic structure and function of adult male mice
Authors: Batool Saira , Batool Sajida , Shameem Sitara , Batool Tahira , Batool Saima 
Published: June 2022

The objective of the present research was to determine if dibutyl phthalate (DBP) and di-(2-ethylhexyl) phthalate (DEHP) alone and combined exposure induced pathological alterations in laboratory reared albino mice. Adult male mice were equally divided (n = 10) into Control, corn oil (CO), DBP, DEHP, and DBP+DEHP treated groups. Dibutyl phthalate (250 mg/kg), DEHP (300 mg/kg), and DBP+DEHP (250+300 mg/kg), respectively, were administered by oral gavage mixed in corn oil (0.2 mL) for 28 days. All animals were sacrificed following 28 days of treatment and blood was collected for serum lipid profiles and liver function tests. Liver samples were also collected for observation of histological changes. Microphotographs of hematoxylin and eosin-stained sections were used for computer-based micrometry. CO, DBP, DEHP, and DBP+DEHP treatment resulted in a significant increase in the mean body and liver weights as compared with the Control group. Histological examination of the livers with DBP and/or DEHP treatment showed marked alterations leading to hepatic hypertrophy. In the treated groups, a significant increase in the mean number of mononucleated, binucleated cells, and oval cells per unit area was noticed with disorganized trabecular arrangement as compared with the Control group. Treatment with DBP and/or DEHP resulted in large regeneration zones in the liver and an increased relative nucleo-cytoplasmic index of mononuclear shepatocytes when compared with the Control group. All treatments caused a significant increases in the liver enzymes and proteins as well as altered serum cholesterol, triglycerides, LDL, and VLDL levels. The histopathological and serological findings confirmed the toxic potentials to hepatic tissue of DBP and DEHP either given alone or in combination.
Helicopter flight dynamics with simulated rainfall
Authors: Li Guozhi , Cao Yihua 
Published: June 2022

Sustaining flight operation that encounters with rainfall might be a challenge to a pilot due to lacking of understanding flight dynamics in the rain conditions. This paper, combined with a computational fluid dynamics (CFD) technique, develops a nonlinear flight dynamics model in the rain conditions that can be capable of exploring UH-60A single-rotor helicopter flight dynamics in the rain conditions, including trim, stability, and controllability. Firstly, in order to obtain a data-driven basis relating to multiple working conditions of the blades, a CFD-based method of simulation of the blade airfoil in the conditions of the angles of attack ranging from −26° to 26° and under a thunderstorm heavy rain scenario when the rate of rainfall is 1500 mm/h is developed. Then, these data are incorporated into a nonlinear flight dynamics model in the form of coefficient increments. Numerical simulations are conducted in the range of the flight velocities from 0 knots to 160 knots. The quantitative results indicate that rainfall degrades the blade airfoil aerodynamic performance and increases the rotor torque and required power, affecting the helicopter trim, stability, and controllability. More importantly, helicopter that flies in a small or moderate flight velocity and that encounters rainfall might be a relative serious case, which should be paid attention to.
Pre-bedtime activities and light-emitting screen use in university students and their relationships with self-reported sleep duration and quality
Authors: Huiberts LM , Opperhuizen AL , Schlangen LJM 
Published: June 2022

In a three-day field study among 61 university students, we collected data on self-reported light-emitting screen activities (watching TV/series and using social media) and other behaviours (physical activity and food intake) during the 2 hours before bedtime and examined interrelations with self-reported sleep duration and quality. Students spent on average 19 minutes on screens using social media and 29 minutes watching TV/series before going to bed. Linear mixed model analyses revealed that a 10-minute increase in pre-bedtime social media use was associated with a significant decrease in sleep duration of 7 minutes, while 10 extra minutes of watching TV/series tended to increase sleep duration by 3 minutes. Physical activity and food intake before bedtime, and total screen time in bed were not significantly related to sleep duration. Subjective sleep quality was not significantly correlated with any of the investigated pre-sleep activities. In line with previous research, these findings suggest that the influence of pre-bedtime light-emitting screen use on sleep duration might be (partly) attributable to differences in screen activities. Discriminating between various types of screen activities is important when researching and developing recommendations for pre-bedtime behavioural strategies that are supportive for sleep, (school) performance and health.
The prevalence and assessment of pain and dyspnoea in acute exacerbations of COPD: A systematic review
Authors: Clarke Stephanie Y , Williams Marie T , Johnston Kylie N , Lee Annemarie L 
Published: June 2022

Background Dyspnoea and pain are symptoms of chronic obstructive pulmonary disease (COPD). This review focused upon pain and dyspnoea during hospital admissions for acute exacerbations of COPD (AECOPD), with the aim of examining prevalence, assessment, clinical associations, and researcher-reported implications of these symptoms. Methods Four electronic databases were searched from inception to 31 May 2021. Full text versions of studies were assessed for methodological quality and data were extracted independently by two reviewers. Where data permitted, pooled prevalence of pain and dyspnoea were calculated by meta-analysis. Results Four studies were included. The pooled prevalence of pain and dyspnoea was 44% (95% confidence interval (CI) 35%–52%) and 91% (95% CI 87%–94%) respectively. An array of instruments with varying focal periods were reported (pain: six tools, dyspnoea: four tools). Associations and clinical implications between the two symptoms at the time of hospital admission were rarely reported. Conclusions Few studies reported prevalence of pain and dyspnoea during an AECOPD. A greater understanding into the prevalence, intensity and associations of these symptoms during AECOPD could be furthered by use of standardised assessment tools with clearly defined focal periods.
Gout increases length of stay in patients hospitalized for heart failure exacerbation
Authors: DeMizio Daniel , Wu Guojing , Wei Ying , Bathon Joan , Wang Runsheng 
Published: June 2022

Background: It is unclear whether patients with a history of gout have longer hospitalizations in general, or only when suffering a flare. This study examines the effect of gout diagnosis and gout flare on the length of stay (LoS) in patients admitted for heart failure (HF) exacerbation. Methods: We conducted a matched retrospective cohort study and searched electronic medical records for patients admitted for HF with a prior diagnosis of gout from 1 July 2012 to 30 June 2017 and matched them to patients admitted for HF without gout. Cases who had a gout flare during the admission were identified. The log of the length of stay (log LoS) was utilized for normalization of the data. We used a linear mixed-effect model to compare the adjusted LoS of gout patient with flare, gout patient without flare, and controls. Results: A total of 978 admissions for HF exacerbation in 738 patients, including 246 individual with gout and 492 matched controls, were identified and included in the analysis. The log LoS was significantly longer in cases (1.86 ± 0.95) compared with controls (1.72 ± 0.94; p = 0.0278). The log LoS was significantly longer in those with gout who flared (2.41 ± 0.96) compared to those without gout (1.72 ± 0.94, p < 0.0001). After adjusting for potential confounders, the log LoS of patients who flared ( p < 0.0001) remained significantly longer than controls, as well as those who did not flare ( p = 0.042), but to a lesser extent. Conclusion: HF patients with gout had significantly longer hospitalizations than those without gout, a finding driven primarily by gout flare during hospitalization.
Clozapine blood level assessment using a point-of-care device: feasibility and reliability
Authors: Kamhi-Nesher Shiri , Taub Sharon , Halimi Shikma , Frenkel Maria , Azam Mahmud , Bormant Gil , Isakov Helena , Radzinsky Dikla , Weizman Abraham , Krivoy Amir 
Published: June 2022

Background: Therapeutic drug monitoring (TDM) is useful to assess clozapine adherence and optimize treatment. However, analysis of venous blood levels by liquid chromatography tandem mass spectrometry (LC-MS/MS) is often logistically complicated and process time is prolonged. Objective: To assess the feasibility and reliability of a new point-of-care device, (MyCare™ Insite), using capillary blood for clozapine therapeutic monitoring. Methods: Matched venous and capillary blood samples were collected from patients treated with clozapine on a stable dose. Samples were analyzed by LC-MS/MS and MyCare Insite Clozapine Test. Clozapine plasma levels were compared between methods using linear regression model. Both patients and treatment team completed questionnaires about the feasibility of blood sampling. Results: Of the total sample (44 patients, 61% males, mean age 43 ± 12 years), mean daily clozapine dose was 293 ± 134 mg/day. Linear regression model demonstrated high correlation with R2 = 0.83 ( p < 0.0001) and mean difference of 26 ± 162 ng/ml. More than 60% of the patients found the clozapine TDM to be important. Most of the participants (58%) favored the capillary sampling and 11% claimed that testing method would affect their adherence to TDM. Moreover, a larger portion (72%) strongly preferred to be tested at the office rather than at the lab. Conclusions: The point-of-care device offers an accessible and satisfactory measurement of clozapine blood levels. Both patients and healthcare providers reported preference for capillary sampling as well as for the in-office TDM procedure. The immediate results provided by the device can facilitate rapid and informed clinical decisions and therefore improve clozapine treatment outcomes.
The Anatomy and Function of the Individual Bands of the Deltoid Ligament—and Implications for Stability Assessment of SER Ankle Fractures
Authors: Gregersen Martin G. , Fagerhaug Dalen Andreas , Nilsen Fredrik , Molund Marius 
Published: June 2022

Background: Deltoid ligament injury occurs often with supination-external rotation (SER) ankle trauma. SER fibula fractures with concomitant deltoid ligament injury are considered unstable—requiring operative fixation. Recent studies have questioned this general practice with emphasis on better defining the medial side ankle ligamentous injury. The function of the individual bands of the deltoid ligament, and the interplay between them, are not fully understood. We undertook this study to develop a better understanding of these complex ligamentous structures and ultimately aid assessment and treatment choice of SER ankle fractures with concomitant deltoid ligament injuries. Methods: Ten fresh-frozen cadaveric foot and ankle specimens were studied. We identified the various ligament bands and did a functional analysis by assessment of ligament length and tension at predefined angles of ankle dorsi-plantarflexion combined with valgus/varus and rotation. The results were determined by manual evaluation with calipers and goniometers, manual stress, and direct visualization. Results: We recorded primarily 5 different bands of the deltoid ligament: the tibionavicular (TNL; 10/10) tibiospring (TSL; 9/10), tibiocalcaneal (TCL; 10/10), deep anterior tibiotalar (dATTL; 9/10), and deep posterior tibiotalar (dPTTL; 10/10) ligaments. The tibiospring ligament was tense in plantarflexion, while the tibiocalcaneal and deep posterior tibiotalar ligaments were tense in dorsiflexion. The superficial layer ligaments and the deep anterior tibiotalar ligament length and tension were largely affected by changes in varus/valgus and rotation. The deep posterior tibiotalar ligament length and tension was altered predominantly by changes in dorsi-plantarflexion; varus/valgus positioning had a minor effect on this band. Conclusions: We confirmed the finding of previous studies that dorsi-plantarflexion affects the tensile engagement of the separate ligament bands differently. Likewise, combined movements with varus/valgus and rotation seem to affect the separate ligament bands differently. Our results suggest that the TNL, TSL, and dATTL are at risk of injury, whereas the TCL and particularly the dPTTL are protected in the event of an SER-type ankle fracture mechanism of injury. Level of Evidence Level V, cadaveric study.
Justice perceptions of occupational training subsidies: findings from a factorial survey
Authors: Wolff Richard V. , Struck Olaf , Osiander Christopher , Senghaas Monika , Stephan Gesine 
Published: June 2022

AbstractWorkers whose jobs are affected by structural change and digitization are required to continuously adapt their vocational skills to the requirements of the labor market. This adaptation is also essential for the competitiveness of their employer firms. The German legislature addressed this issue with investive measures for unemployment insurance, one of which is the Qualification Opportunities Act (Qualifizierungschancengesetz). Funds taken from unemployment insurance can now be used to provide financial help for employers in a more direct way and on a broader scale than before. It became possible that not only unemployed individuals but also workers in companies receive state assistance. This paper analyses the extent to which citizens accept such public support programs for further training and which principles of justice they apply when assessing a just amount of training subsidies. We conducted two factorial surveys. First, we investigated the justice assessments of training subsidies for different types of firms. The results showed that citizens are inclined to subsidize companies by receiving social security funds for further training of their employees. However, when doing so, the principle of needs-based justice should be complied with. Second, we analyze whether citizens think it is just or unjust to provide training subsidies to different workers, as we present them with changing characteristics of workers. The findings confirmed that in addition to the principle of need, views on performance justice, as well as economic considerations are relevant in assessments of whether training subsidies co-financed by unemployment insurance are just.
Validation and prognostic value of EZ-ALBI score in patients with intermediate-stage hepatocellular carcinoma treated with trans-arterial chemoembolization
Authors: Ananchuensook Prooksa , Sriphoosanaphan Supachaya , Suksawatamnauy Sirinporn , Siripon Nipaporn , Pinjaroen Nutcha , Geratikornsupuk Nopavut , Kerr Stephen J. , Thanapirom Kessarin , Komolmit Piyawat 
Published: June 2022

Abstract
Background
Heterogeneity of liver function and tumor burden in intermediate-stage hepatocellular carcinoma (HCC) results in different outcomes after transarterial chemoembolization (TACE). Easy albumin-bilirubin (EZ-ALBI), a simplified albumin-bilirubin (ALBI) score, has recently been proposed as a new prognostic score for HCC. This study aimed to validate the EZ-ALBI score and evaluate the impact of dynamic changes in patients with intermediate-stage HCC undergoing TACE.

Methods
All patients with HCC treated with TACE at King Chulalongkorn Memorial Hospital, Bangkok, Thailand, between January 2015 and December 2019 were prospectively enrolled. Intermediate-stage HCC was defined as Barcelona Clinic Liver Cancer (BCLC) stage B or unresectable single HCC with size > 5 cm in BCLC stage A. EZ-ALBI and ALBI scores were calculated and stratified into three different grades. Overall survival (OS) and prognostic factors were assessed using the Kaplan–Meier curve and Cox proportional hazard model. Decision analysis curves were used to evaluate the clinical utility of the predictive scores.

Results
Among 672 patients with HCC treated with TACE, 166 patients with intermediate-stage HCC who met the eligibility criteria were enrolled. The median OS of all patients in the cohort was 21 months. A good correlation between the EZ-ALBI and ALBI scores was observed (correlation coefficient 1.000, p < 0.001). The baseline EZ-ALBI grades 1, 2, and 3 were 24.5%, 70%, and 5.5%, respectively. EZ-ALBI grade can stratify patients with significantly different prognoses (p = 0.002). Baseline EZ-ALBI grade 2, 3, and serum alpha-fetoprotein > 20 ng/ml were significantly associated with OS [hazard ratio (HR) 2.20 (95% confidence interval [CI] 1.24–3.88, p = 0.007), 3.26 (95% CI 1.24–8.57, p = 0.016), and 1.77 (95% CI 1.10–2.84, p = 0.018), respectively]. Following TACE, 42 (29.6%) patients had a worsening EZ-ALBI grade. However, the EZ-ALBI grade migration was not significantly correlated with OS. EZ-ALBI and ALBI score provided improved discriminatory ability (Harrell’s concordance index 0.599 and 0.602, respectively) and better net benefit compared with Child-Turcotte-Pugh and Model for End-stage Liver Disease scores.

Conclusions
The baseline EZ-ALBI score demonstrated good predictive performance for survival and a strong correlation with conventional ALBI scores. Both the EZ-ALBI and ALBI scores outperformed other prognostic models in patients with intermediate-stage HCC receiving TACE. However, the dynamic change in the EZ-ALBI grade after TACE was not associated with postprocedural survival.
Comparative study of indocyanine green (ICG)-R15 and Albumin-Indocyanine Green Evaluation (ALICE) grading system in the prediction of posthepatectomy liver failure and postoperative mortality in patients with hepatic alveolar echinococcosis
Authors: Liang Yuxin , Zhang Zilong , Dai Zonglin , Cao Rui , Zhong Deyuan , Lai Chunyou , Yao Yutong , Feng Tianhang , Huang Xiaolun 
Published: June 2022

Abstract
Background
A precise evaluation of liver reserve function in patients with hepatic alveolar echinococcosis (HAE) prior to hepatectomy could substantially increase the success rate of the operation and reduce the incidence of postoperative complications. The present study aimed to investigate the significance of the indocyanine green retention test at 15 min (ICG-R15) and the Albumin-Indocyanine Green Evaluation (ALICE) grading system in predicting severe posthepatectomy liver failure (PHLF) and postoperative mortality in HAE patients undergoing liver resection.

Methods
A total of 105 HAE patients undergoing hepatectomy were enrolled in this study. The value of each variable in predicting severe PHLF was evaluated by univariate and multivariate logistic regression analyses. The area under the receiver operating characteristic (ROC) curves (AUC) were calculated to evaluate the predictive ability of the Child–Pugh grade, ICG-R15, and ALICE grading system. Also, patients were classified using the optimal cutoff value for ICG-R15 and different ALICE grades, and the incidence of severe PHLF and postoperative mortality were compared with the predicted values.

Results
Out of the 105 HAE patients enrolled in this study, 34 patients (32.4%) developed severe PHLF. The ALICE grade and operative time were identified as independent predictors of severe PHLF. According to ROC analysis, the AUCs of the Child–Pugh grade, ICG-R15, and ALICE grade for predicting severe PHLF were 0.733 (95% confidence interval (CI), 0.637–0.814), 0.823 (95% CI, 0.737–0.891), 0.834 (95% CI, 0.749–0.900). The incidence of severe PHLF and postoperative 90-day mortality in patients with ICG-R15 > 7.2% were significantly higher than those with ICG-R15 ≤ 7.2% (P < 0.001; P = 0.008). Likewise, the incidence of severe PHLF and postoperative 90-day mortality in patients with ALICE grade 2 were higher than those with ALICE grade 1 within the Child–Pugh grade A (P < 0.001; P = 0.083).

Conclusion
ICG-R15 and ALICE grading system are powerful predictors of severe PHLF and postoperative mortality among HAE patients undergoing hepatectomy. Furthermore, a combination of the preoperative Child–Pugh grade and ALICE grading system may provide an even more precise and objective guidance and facilitate surgical decision-making for HAE patients.