cometadata/datacite-titles-descriptions-related-identifiers huggingface dataset:
DOI: 10.6084/m9.figshare.20452166
title: Disparities in Prehospital Non-Traumatic Pain Management

description: <b>Introduction:</b> While prior research has identified racial disparities in prehospital analgesia for traumatic pain, little is known about non-traumatic pain. Using a national prehospital dataset, we sought to evaluate for racial and ethnic disparities in analgesia given by EMS for non-traumatic pain. <b>Methods:</b> We analyzed the 2018 and 2019 data from the ESO Data Collaborative, a collection of de-identified prehospital electronic health records from nearly 1,300 participating EMS agencies in the US. We included all transported, adult, non-traumatic encounters with a primary or secondary impression of a pain complaint, and we stratified encounters based on race and ethnicity as recorded by the EMS clinicians. We performed a mixed model analysis, modeling EMS agency as a random intercept and adjusting for age, sex, pain location, level of service, location of incident, and highest pain score. With non-Hispanic White patients as the reference group, we then evaluated the association between race/ethnicity and receiving any pain medication (acetaminophen, non-steroidal anti-inflammatories, or opioids), receiving opioid pain medication, and receiving pain medication within 20 minutes of EMS arrival. <b>Results:</b> We included 1,035,486 patients; 67.5% non-Hispanic White, 26.8% Black, 4.9% Hispanic, 0.5% Asian, 0.1% Native Hawaiian or Other Pacific Islander, and 0.2% American Indian or Alaska Native patients. 4.7% of patients received pain medications. Compared to White patients (5.1%), Black patients were less likely to receive pain medication (3.3%, aOR 0.7; 95% CI 0.7-0.7) and Hispanics were more likely to receive pain medication (7.6%, aOR 1.5; 95% CI 1.4-1.6). Black patients were also less likely to receive opioids (1.8% for Black v 3.0% for White, aOR 0.7; 95% CI 0.6-0.7), while Hispanic patients were more likely to receive opioids (4.9%, aOR 1.4; 95% CI 1.3-1.5). The odds of receiving pain medication within 20 minutes was lower for Black patients (aOR 0.9; 95% CI 0.8-0.95) but no different for Hispanic patients (aOR 1.0; 95% CI 0.9-1.1), when compared to White patients. <b>Conclusion:</b> Pain medication administration is uncommon for non-traumatic pain complaints. While Black patients were less likely than White patients to receive pain medications and receive pain medication within 20 minutes, Hispanics were more likely to receive pain medications.
DOI: 10.6084/m9.figshare.20452166.v2
title: Disparities in Prehospital Non-Traumatic Pain Management

description: <b>Introduction:</b> While prior research has identified racial disparities in prehospital analgesia for traumatic pain, little is known about non-traumatic pain. Using a national prehospital dataset, we sought to evaluate for racial and ethnic disparities in analgesia given by EMS for non-traumatic pain. <b>Methods:</b> We analyzed the 2018 and 2019 data from the ESO Data Collaborative, a collection of de-identified prehospital electronic health records from nearly 1,300 participating EMS agencies in the US. We included all transported, adult, non-traumatic encounters with a primary or secondary impression of a pain complaint, and we stratified encounters based on race and ethnicity as recorded by the EMS clinicians. We performed a mixed model analysis, modeling EMS agency as a random intercept and adjusting for age, sex, pain location, level of service, location of incident, and highest pain score. With non-Hispanic White patients as the reference group, we then evaluated the association between race/ethnicity and receiving any pain medication (acetaminophen, non-steroidal anti-inflammatories, or opioids), receiving opioid pain medication, and receiving pain medication within 20 minutes of EMS arrival. <b>Results:</b> We included 1,035,486 patients; 67.5% non-Hispanic White, 26.8% Black, 4.9% Hispanic, 0.5% Asian, 0.1% Native Hawaiian or Other Pacific Islander, and 0.2% American Indian or Alaska Native patients. 4.7% of patients received pain medications. Compared to White patients (5.1%), Black patients were less likely to receive pain medication (3.3%, aOR 0.7; 95% CI 0.7-0.7) and Hispanics were more likely to receive pain medication (7.6%, aOR 1.5; 95% CI 1.4-1.6). Black patients were also less likely to receive opioids (1.8% for Black v 3.0% for White, aOR 0.7; 95% CI 0.6-0.7), while Hispanic patients were more likely to receive opioids (4.9%, aOR 1.4; 95% CI 1.3-1.5). The odds of receiving pain medication within 20 minutes was lower for Black patients (aOR 0.9; 95% CI 0.8-0.95) but no different for Hispanic patients (aOR 1.0; 95% CI 0.9-1.1), when compared to White patients. <b>Conclusion:</b> Pain medication administration is uncommon for non-traumatic pain complaints. While Black patients were less likely than White patients to receive pain medications and receive pain medication within 20 minutes, Hispanics were more likely to receive pain medications.
DOI: 10.6084/m9.figshare.21070905.v1
title: Prehospital Ultrasound Diagnosis of Massive Pulmonary Embolism by Non-Physicians: A Case Series

description: Massive pulmonary embolism (hemodynamically unstable, defined as systolic BP &lt;90 mmHg) has significant morbidity and mortality. Point of care ultrasound (POCUS) has allowed clinicians to detect evidence of massive pulmonary embolism much earlier in the patient’s clinical course, especially when patient instability precludes computerized tomography confirmation. POCUS detection of massive pulmonary embolism has traditionally been performed by physicians. This case series demonstrates four cases of massive pulmonary embolism diagnosed with POCUS performed by non-physician prehospital personnel.
DOI: 10.6084/m9.figshare.21070905
title: Prehospital Ultrasound Diagnosis of Massive Pulmonary Embolism by Non-Physicians: A Case Series

description: Massive pulmonary embolism (hemodynamically unstable, defined as systolic BP &lt;90 mmHg) has significant morbidity and mortality. Point of care ultrasound (POCUS) has allowed clinicians to detect evidence of massive pulmonary embolism much earlier in the patient’s clinical course, especially when patient instability precludes computerized tomography confirmation. POCUS detection of massive pulmonary embolism has traditionally been performed by physicians. This case series demonstrates four cases of massive pulmonary embolism diagnosed with POCUS performed by non-physician prehospital personnel.
DOI: 10.6084/m9.figshare.22896969
title: Prehospital Recognition and Management of Pediatric Sepsis: A Qualitative Assessment

description: Sepsis is a life-threatening disease in children and is a leading cause of morbidity and mortality. Early prehospital recognition and management of children with sepsis may have significant effects on the timely resuscitation of this high-risk clinical condition. However, the care of acutely ill and injured children in the prehospital setting can be challenging. This study aims to understand barriers, facilitators, and attitudes regarding recognition and management of pediatric sepsis in the prehospital setting. This was a qualitative study of EMS professionals participating in focus groups using a grounded theory-based design to gather information on recognition and management of septic children in the prehospital setting. Focus groups were held for EMS administrators and medical directors. Separate focus groups were held for field clinicians. Focus groups were conducted <i>via</i> video conference until saturation of ideas was reached. Using consensus methodology, transcripts were coded in an iterative process. Data were then organized into positive and negative factors based on the validated PRECEDE-PROCEED model for behavioral change. Thirty-eight participants in six focus groups identified nine environmental factors, 21 negative factors, and 14 positive factors pertaining to recognition and management of pediatric sepsis. These findings were organized into the PRECEDE-PROCEED planning model. Pediatric sepsis guidelines were identified as positive factors when they did exist and negative factors when they were complicated or did not exist. Six interventions were identified by participants. These include raising awareness of pediatric sepsis, increasing pediatric education, receiving feedback on prehospital encounters, increasing pediatric exposure and skills training, and improving dispatch information. This study fills a gap by examining barriers and facilitators to prehospital diagnosis and management of pediatric sepsis. Using the PRECEDE-PROCEED model, nine environmental factors, 21 negative factors, and 14 positive factors were identified. Participants identified six interventions that could create the foundation to improve prehospital pediatric sepsis care. Policy changes were suggested by the research team based on the results of this study. These interventions and policy changes provide a roadmap for improving care in this population and lay the groundwork for future research.
DOI: 10.6084/m9.figshare.22896969.v1
title: Prehospital Recognition and Management of Pediatric Sepsis: A Qualitative Assessment

description: Sepsis is a life-threatening disease in children and is a leading cause of morbidity and mortality. Early prehospital recognition and management of children with sepsis may have significant effects on the timely resuscitation of this high-risk clinical condition. However, the care of acutely ill and injured children in the prehospital setting can be challenging. This study aims to understand barriers, facilitators, and attitudes regarding recognition and management of pediatric sepsis in the prehospital setting. This was a qualitative study of EMS professionals participating in focus groups using a grounded theory-based design to gather information on recognition and management of septic children in the prehospital setting. Focus groups were held for EMS administrators and medical directors. Separate focus groups were held for field clinicians. Focus groups were conducted <i>via</i> video conference until saturation of ideas was reached. Using consensus methodology, transcripts were coded in an iterative process. Data were then organized into positive and negative factors based on the validated PRECEDE-PROCEED model for behavioral change. Thirty-eight participants in six focus groups identified nine environmental factors, 21 negative factors, and 14 positive factors pertaining to recognition and management of pediatric sepsis. These findings were organized into the PRECEDE-PROCEED planning model. Pediatric sepsis guidelines were identified as positive factors when they did exist and negative factors when they were complicated or did not exist. Six interventions were identified by participants. These include raising awareness of pediatric sepsis, increasing pediatric education, receiving feedback on prehospital encounters, increasing pediatric exposure and skills training, and improving dispatch information. This study fills a gap by examining barriers and facilitators to prehospital diagnosis and management of pediatric sepsis. Using the PRECEDE-PROCEED model, nine environmental factors, 21 negative factors, and 14 positive factors were identified. Participants identified six interventions that could create the foundation to improve prehospital pediatric sepsis care. Policy changes were suggested by the research team based on the results of this study. These interventions and policy changes provide a roadmap for improving care in this population and lay the groundwork for future research.
DOI: 10.6084/m9.figshare.20359832
title: Pediatric Out-of-Hospital Cardiac Arrests: An Epidemiological Study

description: To identify the epidemiological patterns of pediatric out-of-hospital cardiac arrests (OHCA) in Queensland, Australia and to investigate associations between patient variables and prehospital outcome. Included were pediatric (&gt;4 days–18 years) OHCA patients attended by paramedics in the state of Queensland (Australia) between January 2009 and December 2019. Patient and arrest characteristics were described. Factors associated with return of spontaneous circulation (ROSC) on hospital arrival were investigated. A total of 1,612 pediatric patients were included; 611 were deceased prior to paramedic arrival and 1,001 received resuscitation attempts by paramedics. Approximately one quarter (26.8%) of resuscitation-attempted patients achieved ROSC on hospital arrival. Most arrests (49.7%) were due to medical causes. Arrests due to trauma had the lowest rate of ROSC on hospital arrival (9.6%), whereas those due to drug overdose had the highest rate (40%). Patients in rural areas had a lower rate of ROSC on hospital arrival than those in metropolitan areas (20.7% vs 32.5%, p &lt; 0.001). The median response interval to all OHCA patients was 8 minutes. Trauma was considerably more prevalent in rural areas than in metropolitan areas, while all other etiologies were comparable. Older pediatric age groups had higher rates of ROSC on hospital arrival than infants, particularly early adolescents (39.4% vs. 14.9%, p = 0.001). Etiology, age, bystander witness, shockable initial rhythm, and geographic locality factors were independently associated with ROSC on hospital arrival. Approximately a quarter of pediatric prehospital OHCA achieved ROSC on hospital arrival. Prehospital outcome differs according to patient cohort and is associated with diverse patient demographic variables.
DOI: 10.6084/m9.figshare.20359832.v1
title: Pediatric Out-of-Hospital Cardiac Arrests: An Epidemiological Study

description: To identify the epidemiological patterns of pediatric out-of-hospital cardiac arrests (OHCA) in Queensland, Australia and to investigate associations between patient variables and prehospital outcome. Included were pediatric (&gt;4 days–18 years) OHCA patients attended by paramedics in the state of Queensland (Australia) between January 2009 and December 2019. Patient and arrest characteristics were described. Factors associated with return of spontaneous circulation (ROSC) on hospital arrival were investigated. A total of 1,612 pediatric patients were included; 611 were deceased prior to paramedic arrival and 1,001 received resuscitation attempts by paramedics. Approximately one quarter (26.8%) of resuscitation-attempted patients achieved ROSC on hospital arrival. Most arrests (49.7%) were due to medical causes. Arrests due to trauma had the lowest rate of ROSC on hospital arrival (9.6%), whereas those due to drug overdose had the highest rate (40%). Patients in rural areas had a lower rate of ROSC on hospital arrival than those in metropolitan areas (20.7% vs 32.5%, p &lt; 0.001). The median response interval to all OHCA patients was 8 minutes. Trauma was considerably more prevalent in rural areas than in metropolitan areas, while all other etiologies were comparable. Older pediatric age groups had higher rates of ROSC on hospital arrival than infants, particularly early adolescents (39.4% vs. 14.9%, p = 0.001). Etiology, age, bystander witness, shockable initial rhythm, and geographic locality factors were independently associated with ROSC on hospital arrival. Approximately a quarter of pediatric prehospital OHCA achieved ROSC on hospital arrival. Prehospital outcome differs according to patient cohort and is associated with diverse patient demographic variables.
DOI: 10.6084/m9.figshare.21210479
title: One and Done Epinephrine in Out-of-Hospital Cardiac Arrest? Outcomes in a Multiagency United States Study

description: Cardiac arrest guidelines recommend epinephrine every 3–5 minutes during cardiac arrest resuscitation. However, it is unclear if multiple epinephrine doses are associated with improved outcomes. The objective of this study was to determine if a single-dose epinephrine protocol was associated with improved survival compared to traditional multidose protocols. We conducted a pre-post study across five North Carolina EMS agencies from 11/1/2016 to 10/29/2019. Patients ≥18 years old with attempted resuscitation for non-traumatic prehospital cardiac arrest were included. Data were collected 1 year before and after implementation of the single-dose epinephrine protocol. Prior to implementation, all agencies used a multidose epinephrine protocol. The Cardiac Arrest Registry to Enhance Survival (CARES) was used to obtain patient outcomes. Study outcomes were survival to hospital discharge (primary) and return of spontaneous circulation (ROSC). Analysis was by intention to treat. Outcomes were compared pre- vs. post-implementation using generalized estimating equations to account for clustering within EMS agencies. Adjusted analyses included age, sex, race, shockable vs. non-shockable rhythm, witnessed arrest, automatic external defibrillator availability, EMS response interval, and bystander cardiopulmonary resuscitation. During the study period there were 1,690 encounters (899 pre- and 791 post-implementation). The population was 74.7% white, 61.1% male, and had a median age of 65 (IQR 53–76) years. Survival to hospital discharge was similar pre- vs. post-implementation [13.6% (122/899) vs. 15.4% (122/791); OR 1.19, 95%CI 0.89–1.59]. However, ROSC was more common post-implementation [42.3% (380/899) vs. 32.5% (257/791); OR 0.66, 95%CI 0.54–0.81]. After adjusting for covariates, the single-dose protocol was associated with similar survival to discharge rates (aOR 0.88, 95%CI 0.77–1.29), but with decreased ROSC rates (aOR 0.58, 95%CI 0.47–0.72). A prehospital single-dose epinephrine protocol was associated with similar survival to hospital discharge, but decreased ROSC rates compared to the traditional multidose epinephrine protocol.
DOI: 10.6084/m9.figshare.21210479.v1
title: One and Done Epinephrine in Out-of-Hospital Cardiac Arrest? Outcomes in a Multiagency United States Study

description: Cardiac arrest guidelines recommend epinephrine every 3–5 minutes during cardiac arrest resuscitation. However, it is unclear if multiple epinephrine doses are associated with improved outcomes. The objective of this study was to determine if a single-dose epinephrine protocol was associated with improved survival compared to traditional multidose protocols. We conducted a pre-post study across five North Carolina EMS agencies from 11/1/2016 to 10/29/2019. Patients ≥18 years old with attempted resuscitation for non-traumatic prehospital cardiac arrest were included. Data were collected 1 year before and after implementation of the single-dose epinephrine protocol. Prior to implementation, all agencies used a multidose epinephrine protocol. The Cardiac Arrest Registry to Enhance Survival (CARES) was used to obtain patient outcomes. Study outcomes were survival to hospital discharge (primary) and return of spontaneous circulation (ROSC). Analysis was by intention to treat. Outcomes were compared pre- vs. post-implementation using generalized estimating equations to account for clustering within EMS agencies. Adjusted analyses included age, sex, race, shockable vs. non-shockable rhythm, witnessed arrest, automatic external defibrillator availability, EMS response interval, and bystander cardiopulmonary resuscitation. During the study period there were 1,690 encounters (899 pre- and 791 post-implementation). The population was 74.7% white, 61.1% male, and had a median age of 65 (IQR 53–76) years. Survival to hospital discharge was similar pre- vs. post-implementation [13.6% (122/899) vs. 15.4% (122/791); OR 1.19, 95%CI 0.89–1.59]. However, ROSC was more common post-implementation [42.3% (380/899) vs. 32.5% (257/791); OR 0.66, 95%CI 0.54–0.81]. After adjusting for covariates, the single-dose protocol was associated with similar survival to discharge rates (aOR 0.88, 95%CI 0.77–1.29), but with decreased ROSC rates (aOR 0.58, 95%CI 0.47–0.72). A prehospital single-dose epinephrine protocol was associated with similar survival to hospital discharge, but decreased ROSC rates compared to the traditional multidose epinephrine protocol.
DOI: 10.6084/m9.figshare.24135171
title: Rhabdomyzed genome

description: To both facilitate comparisons of transcriptomic data between <i>R.</i> <i>pumilio</i> and <i>M.</i> <i>musculus</i>, and to leverage the high quality gene annotations available for the latter, we generated an alternative, reference-guided assembly for the <i>R</i>. <i>pumilio</i> genome against which sequencing data was analyzed
DOI: 10.6084/m9.figshare.24135171.v1
title: Rhabdomyzed genome

description: To both facilitate comparisons of transcriptomic data between <i>R.</i> <i>pumilio</i> and <i>M.</i> <i>musculus</i>, and to leverage the high quality gene annotations available for the latter, we generated an alternative, reference-guided assembly for the <i>R</i>. <i>pumilio</i> genome against which sequencing data was analyzed
DOI: 10.34808/cf6c-0b90
title: LDRAW based renders of LEGO bricks moving on a conveyor belt with extracted models
DOI: 10.5281/zenodo.8342336
title: Let the body talk: a Dance Movement Therapy group intervention for eating disorders

description: There is growing support for considering Dance Movement Therapy (DMT) an effective approach to improve physical and psychological symptoms in eating disorders (ED), but additional evidence is needed. The current study aims to investigate the effectiveness of a DMT intervention for inpatients with ED during an in-hospital rehabilitation program for ED in reducing emotion dysregulation, and alexithymia and improving interoceptive awareness. Forty-nine consecutive inpatient young women with ED (aged between 18 and 34 yrs) recruited from a clinical center for the rehabilitation of obesity and ED received four group sessions of DMT intervention. All participants completed the Difficulties in Emotion Regulation Scale (DERS), the Toronto Alexithymia Scale (TAS), and the Multidimensional Assessment of Interoceptive Awareness Scale (MAIA) before (Time 0) and after the intervention (Time 1). Paired-sample t-tests were run to assess differences between Time 0 to Time 1. Results: From pre-to-post interventions there was a significant reduction in means of all the subscales of DERS, suggesting an improvement in emotion regulation competencies, with the only exception for difficulties in awareness that increased (p=0.016). We also found a significant reduction in alexithymia, as proved by significant differences in all the subscales and the total score of TAS (p&lt;0.001), and significant improvements in interoceptive awareness as suggested by increased scores of noticing (p=0.043), emotional awareness (p&lt;0.001), body listening (p&lt;0.001), and trusting (p&lt;0.001) subscales of MAIA. Discussion/conclusion: Overall, our results point towards the efficacy of dance/movement in reducing symptoms of eating disorders. Our findings also suggest that dancing can be considered a useful intervention to increase emotional regulation, reduce alexithymia, and enhance interoceptive awareness.