bluuebunny/crossref_metadata_2025_split huggingface dataset:
Building an entrepreneurial Caribbean university library: practice, possibilities, and lessons
Authors: Harris Sasekea ,   Head: Science & Engineering Branch Library (SEBL)
Published: May 2022

Purpose Entrepreneurship is being seen as a core driver of economic revival. Consequently, organizations and institutions, including universities, are being called upon to accelerate their role in an increasingly entrepreneurial environment. The sub-streams of entrepreneurship are manifold; yet, there is still the notion that entrepreneurship is solely about making profits. Within this context there are questions, within and without librarianship, regarding whether a library, which is a non-profit entity, can be an entrepreneur. As such, this paper purposed to examine the extent to which the terms library and entrepreneurship harmonise, through a case study of a large Caribbean university library, with the objective of highlighting practice, possibilities and lessons. Design/Methodology Employees of the understudy library were purposively sampled and surveyed. Findings The theo-practical lens through which one views entrepreneurship, determine perceptions regarding the status of the understudy library as an entrepreneur. Research Limitations/Implications This paper examined one of the largest indigenous university library in the English-speaking Caribbean; it is possible that the situation for other types/sizes of Caribbean university libraries may vary. Therefore, it would be useful to study other Caribbean university libraries. Originality/Value This paper contributes to the growing body of literature on “libraries and entrepreneurship” and evidence for “value of libraries” albeit from a Caribbean perspective. It also highlights the status of entrepreneurship in libraries in general, and a Caribbean university library in particular, and in this regard offers a case for strengthening entrepreneurship in other Caribbean university libraries. Additionally, it is the first scholarly paper on Caribbean university library entrepreneurship. Practical & Social Implications There is a gap in the literature on practical examples and scholarly papers on building a Caribbean entrepreneurial university library. Using the response of the understudy Caribbean university library, this paper seeks to fill this gap, albeit incrementally, through proposing a broad “Entrepreneurial University Library Framework for building an entrepreneurial university library within the context of the Caribbean. Although this study was conducted within a Caribbean context, hence the phrase entrepreneurial Caribbean university library, its model can be used by other comparable institutions worldwide, struggling with increasing demands to be entrepreneurial.
The Association Between Multitasking and Multi-Patient Care Skills in a Simulated Patient Care Video Game Among Second Year Medical Students Based on Specialty Choice
Authors: Korand Sridevi , Fung Cha Chi , Cohen Sammy , Talbot Thomas B. , Fischer Susan , Luu Cindy , Sargsyan Mariam , Ben-Isaac Eyal , Espinoza Juan , Chang Todd P. 
Published: May 2022

Background and Objective Healthcare providers require multitasking and multi-patient care skills, and training programs do not formally incorporate curricula specifically for multitasking skills to trainees. The medical education community is in equipoise on whether multitasking ability is a fixed trait. Furthermore, it is unclear whether multitasking ability affects those who gravitate toward careers that demand it, particularly among medical students deciding on a specialty. We sought to define the association between specialty choice, multitasking abilities and multi-patient care delivery among pre-clinical medical students. For this study, we examined both efficiency and accuracy metrics within multitasking and whether they were different between students choosing specialties. Methods This was a planned cross-sectional sub-study focused on 2nd year medical students (MS-IIs) within a parent study evaluating multi-patient care skills using a serious game (VitalSigns:EDTM) depicting a pediatric emergency department. Subjects completed a Multitasking Ability Test (MTAT) and five VitalSigns:ED gameplays. The predictor variable was specialty choice, categorized into multitasking and non-multitasking groups. Outcome variables measuring efficiency and diagnostic accuracy were obtained from the MTAT and the game. The primary analysis was a Mann–Whitney U test, and secondary analyses employed Spearman Rank correlations. Results Twelve students applied to multitasking specialties and 18 applied to others. Those in the multitasking specialties had faster MTAT completions than the other cohort (29.8 vs. 59.7 sec, 95%CI difference -0.9 to -39.8 sec). Differential diagnoses were higher in multitasking specialties in VitalSigns:ED (2.03 vs. 1.06, 95%CI difference +0.05 to +1.54) but efficiency metrics in the game did not differ. Conclusion Multitasking and multi-patient care performance show some association with preferred specialty choices for MS-IIs prior to clinical exposure.
Squamosal Suture Synostosis: An Under-Recognized Phenomenon
Authors: W. Beiriger Justin , Zhu Xiao , Bruce Madeleine K. , Irgebay Zhazira , Smetona John , Losee Joseph E. , Goldstein Jesse A. 
Published: May 2022

Introduction The squamosal suture (SQS) joins the temporal to the parietal bones bilaterally and is a poorly described site of craniosynostosis. SQS fusion is thought to occur as late as the fourth decade of life and beyond; however, we have incidentally noted its presence among our pediatric patients and hypothesize that it may occur earlier in life and more frequently than previously believed. Methods A retrospective review of imaging performed on pediatric patients was completed to identify patients with SQS synostosis. This included a review of clinical notes as well as computed tomography (CT) images obtained by our craniofacial clinic. Relevant patient data and imaging were reviewed. Results Forty-seven patients were identified with SQS synostosis, 21 were female (45%). Age at the time of radiographic diagnosis was 10.1 ± 8.4 years (range 17 days to 27 years). A majority of patients had bilateral SQS synostosis (57%), with a relatively even distribution of unilateral right (23%) versus left (19%). SQS was an isolated finding (no other suture involvement) in 15 patients (32%), all of whom were normocephalic and did not require surgical intervention. Thirty-two patients (68%) had concomitant craniosynostosis of other sutures, most commonly sagittal and coronal. Nine patients (19%) underwent surgery to correct cranial malformations—all these patients had multi-suture synostosis ( P = 0.012). Twenty-seven patients (57%) had SQS synostosis diagnosed incidentally compared to 20 (43%) who were imaged with suspicion for synostosis. In those who were symptomatic, common findings included developmental delay, elevated intracranial pressure, hydrocephalus, seizures, and visual/hearing impairments. Ten patients (21%) were syndromic, the most frequent of which was Crouzon syndrome. No single pattern of calvarial malformation could be definitively described for SQS synostosis. Conclusion Given that most isolated SQS synostosis cases were normocephalic, asymptomatic, and discovered incidentally, it is likely that there are many cases of unidentified SQS synostosis. The significance of SQS synostosis is currently unclear, and warrants further investigation into this phenomenon, its natural course, and its potential presence in the spectrum of normal development.
The Use of High-Dose Corticosteroids Versus Low-Dose Corticosteroids With and Without Tocilizumab in COVID-19 Acute Respiratory Distress Syndrome
Authors: Katz Alyson , Altshuler Diana , Papadopoulos John , Amoroso Nancy , Goldenberg Ronald , Tarras Elizabeth , Krolikowski Kelsey , Hagedorn Jacklyn , Fridman David , Chen Xian Jie Cindy , Iturrate Eduardo , Brosnahan Shari B. 
Published: May 2022

Background: Corticosteroids and tocilizumab have been shown to improve survival in patients who require supplemental oxygen from coronavirus disease 2019 (COVID-19) pneumonia. The optimal dose of immunosuppression for the treatment of COVID-19 acute respiratory distress syndrome (ARDS) is still unknown. Objective: The objective of this study was to evaluate the effectiveness and safety of high- versus low-dose corticosteroids with or without tocilizumab for the treatment of COVID-19 ARDS. Methods: This was a retrospective study of patients admitted to the intensive care unit (ICU) requiring mechanical ventilation who received high- versus low-dose corticosteroids with or without tocilizumab. The primary outcome was survival to discharge. Safety outcomes included infections and incidence of hyperglycemia. Results: In this cohort, 110 (54%) and 95 (46%) patients received high-dose (≥10 mg dexamethasone equivalent) and low-dose (<10 mg dexamethasone equivalent) corticosteroids for more than 3 consecutive days, respectively. Thirty-five patients (32%) in the high-dose group and 33 patients (35%) in the low-dose group survived to hospital discharge ( P = 0.85). There was no difference in 28-day mortality in patients who received high-dose corticosteroids without tocilizumab compared with those who received low-dose corticosteroids with tocilizumab (n = 38/82, 46% vs n = 19/40, 48% P = 0.99); however, there was a higher mortality if patients received low-dose corticosteroids without tocilizumab (n = 39/55, 71%, P = 0.01). The highest rate of a bacterial pneumonia was in patients who received high-dose corticosteroids with tocilizumab. Conclusions: In critically ill patients with COVID-19 ARDS requiring mechanical ventilation, we found no difference in high- versus low-dose corticosteroids with regard to survival to hospital discharge. However, patients receiving only low-dose corticosteroids without tocilizumab did worse than the other groups. Larger prospective studies are needed to determine the optimal immunosuppression dosing strategy in this patient population.
Assessment of Flatfoot Deformity Using Digitally Reconstructed Radiographs: Reliability and Comparison to Conventional Radiographs
Authors: Fuller Robert M. , Kim Jaeyoung , An Tonya W. , Rajan Lavan , Cororaton Agnes D. , Kumar Prashanth , Deland Jonathan T. , Ellis Scott J. 
Published: May 2022

Background: Digitally reconstructed radiographs (DRRs) generated from weightbearing computed tomography (WBCT) may potentially substitute for weightbearing plain radiographs (XRs) but have not been clinically validated. This study aims to test the reliability of 6 radiographic parameters of progressive collapsing foot deformity (PCFD) as measured on DRR, to investigate whether DRR represents comparably to XR through the same measurements, and to compare agreement of DRR and XR measurements of a standardized arch height parameter with reference measurements made on WBCT. Methods: DRR generated from preoperative WBCT of 71 patients (72 feet) treated surgically for PCFD were retrospectively compared with preoperative weight-bearing XR after exclusion criteria were applied. Six radiographic measurements were performed, including Meary angle, calcaneal pitch (CPA), medial cuneiform height (MCH), AP talar–first metatarsal angle (T-1MT), talonavicular coverage (TNCA), and talar incongruency (TIA). Arch height was measured on XR, DRR, and WBCT using a validated, standardized, navicular-based index. Intraclass correlation coefficients assessed DRR intraobserver and interobserver reliability. Paired samples t tests tested differences between XR and DRR. Bland-Altman limits of agreement analysis compared DRR and XR agreement with WBCT measurements. Results: Measurements were within standard PCFD ranges on XR and DRR. All measurements demonstrated excellent intrarater reliability and good to excellent interrater agreement, consistent with previous literature on XR. No differences were found for Meary, CPA, or TNCA. Minor differences were observed for MCH, T-1MT, and TIA. DRR measurements demonstrated greater agreement with WBCT than XR measurements. Conclusion: DRR from WBCT may be a promising substitute for XR in the clinical evaluation of PCFD. Radiographic measurements made on DRR demonstrated good to excellent reliability. Although small differences were found between XR and DRR for certain measurements, DRR more accurately represented medial arch anatomy compared to gold standard WBCT data than XR. If validated as a clinical substitute, DRR could eventually obviate XR where WBCT is available. Level of Evidence: Level III, retrospective cohort study.
Intra-articular Calcaneal Fracture Treatment With Staged Medial External Fixation
Authors: Kim Gi Beom , Park Jeong Jin , Park Chul Hyun 
Published: May 2022

Background: To compare the clinical and radiographic outcomes between the conventional delayed and staged approaches for intra-articular calcaneus fractures in which early definite fixation could not be performed because of severe soft tissue injury. Methods: From January 2015 to May 2019, a total of 32 cases with acute intra-articular calcaneal fractures met criteria and were enrolled in the study. We compared the outcomes of intra-articular calcaneal fractures that underwent delayed internal fixation between groups treated with a conventional delayed approach (non-EF group) vs a temporary medial external fixation (EF group). Clinical outcome measures included a 10-point visual analog scale score, the AOFAS score, and the Foot Function Index. Radiographic outcome measures included Böhler angle, talar declination angle, and calcaneal width. Reduction of the posterior facet was assessed on CT scans. Results: The first 15 (46.9%) were treated with a conventional delayed approach, and the latter 17 (53.1%) were treated with a staged approach with temporary medial external fixation. Clinical outcomes were not different between the groups at the last follow-up. The time from injury to definite internal fixation was shorter by an average of 3.8 days in the EF group ( P = .001). The Böhler angle, talar declination angle, and calcaneal width were not different between the groups before surgery and at the last follow-up. Reduction of the posterior facet on CT scans was significantly better in the EF group than in the non-EF group (good/excellent = 94% vs 60%, respectively, P = .033). Conclusion: The staged approach using medial external fixation for displaced intra-articular calcaneus fractures could be an effective method to decrease the time to definitive internal fixation and obtain optimal reduction of the posterior facet. Level of Evidence: Level III, retrospective case-control study.
Health Effects Associated With Kratom (Mitragyna speciosa) and Polysubstance Use: A Narrative Review
Authors: Striley Catherine W , Hoeflich Carolin C , Viegas Andrew T , Berkowitz Lindsey A , Matthews Emily G , Akin Leyla P , Iheanyi-Okeahialam Chidinma , Mansoor Urmeen , McCurdy Christopher R 
Published: May 2022

Background: Kratom ( Mitragyna speciosa) consumption and associated health effects have raised debates in the United States. Although most people using this herb do not experience adverse health effects associated with kratom use, medical providers should be knowledgeable of emerging substances and concurrent, sequential, or simultaneous use of other drugs which may impact healthcare recommendations and prescribing practices. Methods: The objective of this narrative review was to elucidate selected health effects associated with using kratom—either alone or with other substances. Since scientifically controlled human subjects research on kratom use is still limited, relevant case reports were also described. Results: Cardiovascular, gastrointestinal, neurological, and psychiatric effects associated with kratom use were especially notable, and in-utero exposure accompanied concern regarding a neonate’s risk for developing neonatal abstinence syndrome. Our ability to identify and understand the role of this herb in kratom-associated fatalities is complicated since kratom is not routinely screened for in standard forensic toxicology. If a screening is performed, it is usually for the major alkaloid, mitragynine, as a surrogate for kratom use. In addition to lacking a standard practice of screening decedents for kratom alkaloids, the association between mortality and kratom use may be confounded by polysubstance use, adulteration of kratom products, and drug-herb interactions. Conclusions: Increasing medical awareness of this herb is vital to ensuring prompt administration of best-practice medical advice or treatment for people seeking information related to kratom use or for patients experiencing an adverse health effect that may be associated with using or withdrawing from kratom. Knowledge gained from continued surveillance and study of kratom and its associated health effects may assist in guiding clinical decision-making and preventing development of adverse health effects among people using kratom.
The Pattern of Substance Use and Characteristics of the Individuals Enrolled in Residential Treatment at Selected Rehabilitation Centers in Sri Lanka: A Descriptive Cross-Sectional Study
Authors: Jayamaha Akila R , Dharmarathna Nishadi D , Herath Nimesha DM , Ranadeva Nadeeka DK , Fernando Medhavi M , Samarasinghe Kerstin L , Amarabandu Priyangi N , Senanayake Badhrani , Darshana Thamara , Renuka Nilani , Rajapakse Iyanthimala H , Gunasekara Chinthika P , Meegoda Lalitha , Fernando Neluka 
Published: May 2022

Introduction: Substance use becomes censorious when it leads to harmful effects on individuals, their families, and the community. The nature of substance use in Sri Lankan context is poorly understood and empirical evidences are sparse. The study aimed to describe patterns of substance use and characteristics of the individuals enrolled in residential treatment at selected rehabilitation centers in Sri Lanka. Material and methods: A descriptive cross-sectional study was conducted among 205 individuals enrolled in selected rehabilitation centers. Pretested interviewer-administered questionnaire was used to collect data. Data were analyzed using descriptive statistics. Results: Most of the individuals who enrolled in residential treatment at selected rehabilitation centers were unmarried (n = 124, 60.5%), Sinhala (n = 186, 90.7%), Buddhist (n = 166, 81.0%), males (n = 202, 98.5%) and belonged to the young adult age (18-35 years) category (n = 178, 86.8%). All the participants were poly-drug users and cannabis was the most commonly used (n = 183, 89.3%) illicit drug followed by heroin (n = 172, 83.9%), methamphetamine (n = 150, 73.2%) and cocaine (n = 78, 38%). The most (n = 152, 74.1%) problematic substance for life was heroin. Most of the participants (n = 149, 72.7%) had used drugs several times per day. The mean duration of substance use was 7 ± 5 years. Participants (n = 177, 86.3%) reported that the substances were available in their residential areas and their friends (n = 197, 96.1%) were also using the substances. Conclusions: Pattern of substance use and characteristics of the individuals were unique in Sri Lanka and need to be considered when implementing and strengthening the programs for drug prevention and rehabilitation.
A Nomogram to Accurately Identify Pancreatic Neuroendocrine Tumors Metastasizing to Distant Organs: A Study Based on Two National Population-Based Cohorts From the United States and China
Authors: Zhang Xianbin , Lu Lili , Liu Jun , Liu Weihan , Li Li , Wei Yushan , Fan Jinhu , Ma Li , Gong Peng 
Published: May 2022

Background: Distant organ metastasis is the leading cause of death in pancreatic neuroendocrine tumor (pNET) patients. In the present study, we aimed to develop and validate a nomogram that could accurately identify pNET metastasizing to distant organs. Methods: The cases extracted from the Surveillance, Epidemiology, and End Results (SEER) program were assigned to the training cohort and validation cohort. The cases from the Chinese Gastrointestinal Neuroendocrine Tumors program were assigned to the external validation cohort. The strategy was developed with the support of a nomogram, and the predictive value of this strategy was evaluated by the receiver operating characteristic (ROC) curve analysis. Results: In total, 2024 American cases were involved in the present study. Besides, 1450 and 574 patients were allocated into training and internal validation cohorts, respectively. In addition, 122 Chinese patients were assigned to the external validation cohort. The results of the univariate logistic regression analysis suggested that tumor grade, tumor size, and the number of metastatic lymph nodes were the risk of metastasis to distant organs, and these 3 clinicopathological characteristics were used to develop the nomogram. We observed that the accuracy of the nomogram for predicting metastasis to distant organs was 0.797, 0.819, and 0.837 in the training cohort, internal validation cohort, and external validation cohort, respectively. Conclusions: A predictive nomogram was developed and validated, and it showed an acceptable performance in predicting metastasis to distant organs. The results will enable clinicians to identify pNETs, metastasizing to distant organs, and develop an effective individualized therapeutic strategy for these patients.
Socioeconomic differences in the association between maternal age and maternal obesity: a register-based study of 707,728 women in Finland
Authors: Roustaei Zahra , Räisänen Sari , Gissler Mika , Heinonen Seppo 
Published: May 2022

Aims: To examine the association between maternal age and maternal obesity across socioeconomic groups and to determine whether socioeconomic status modifies the association between maternal age and maternal obesity with a view to informing public health policies. Methods: Data for this register-based study were sourced from the Finnish Medical Birth Register and Statistics Finland, using the information of 707,728 women who gave birth in Finland from 2004 to 2015. We used multivariable regression models to assess the association between maternal age and maternal obesity across socioeconomic groups. We further assessed interactions on both multiplicative and additive scales. Results: Across all socioeconomic groups, the adjusted odds ratio for the association between maternal age and maternal obesity increased, peaking for women 35 years or older. Using women below 20 years of age in the category of upper-level employees as a single reference group, in the category of upper-level employees, the adjusted odds ratio and 95% confidence intervals among women 35 years or older was 1.92 (1.39–2.64) for maternal obesity. Equally, the adjusted odds ratio and 95% confidence intervals in the category of long-term unemployed was 4.35 (3.16–5.98). Synergistic interactions on both multiplicative and additive scales were found across age and socioeconomic groups. Conclusions: The association between maternal age and maternal obesity was strongest among women 35 years or older with lower socioeconomic status. Population-level interventions that address maternal risk factors from teenage years are needed alongside individual-level interventions that target high-risk mothers in areas of low socioeconomic status and maternal obesity.