Nursing Commons^™

Feasibility Of A Community-Based, Online, Peer-Supported Spinal Cord Injury Self-Management Intervention: Protocol For A Pilot Wait-Listed Randomized Trial, Susan Dunreath Newman Phd, Rn, Crrn, Faan, Sherwood Toatley, Marka Danielle Rodgers, Suparna Qanungo, Martina Mueller, Brian Denny, Angela Rodriguez

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BACKGROUND:

People with spinal cord injury (SCI) report feeling unprepared to manage their disability upon discharge to the community. This situation is exacerbated when they return to settings where self-management support and resources are sparse, thus increasing the risk of costly secondary conditions and rehospitalizations. These factors make a compelling case for implementing innovative community-based SCI self-management programs that empower and engage individuals with SCI. Using a community-engaged research (CEnR) approach, we developed a peer-supported SCI self-management intervention, known as PHOENIX (Peer-supported Health Outreach, Education, and Information Exchange), which integrates online educational content and support from peer navigators (PNs) through …

Social Isolation In Community-Dwelling Older Adults During Covid-19: Understanding The Role Of Resilience, A Garnett, K Prentice, R Booth, Lorie Donelle Phd, Rn, Fcan, J. B. Orange, F. Webster

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The COVID-19 pandemic increased social isolation for many older adults, causing concern for their health and well-being. To enhance understanding of how community-dwelling older adults were impacted by prolonged social isolation during COVID-19, a qualitative descriptive study was conducted to: (1) explore the self-reported factors supporting their resilience during COVID-19 related social isolation, and (2) to help understand the intentional and unintentional outcomes of the government mandated health measures. A total of 19 community dwelling older adults were sampled. Factors that supported older adults' resilience during COVID-19 included maintaining positivity, drawing on historical experiences of resilience and finding opportunities to …

Using Medical Expenditure Panel Survey Data To Explore The Relationship Between Patient-Centered Medical Homes And Racial Disparities In Severe Maternal Morbidity Outcomes, Curisa M. Tucker, Nathaniel Bell, Cynthia F. Corbett Phd, Rn, Faan, Audrey Lyndon, Tisha M. Felder

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BACKGROUND: There are persistent racial/ethnic disparities in the occurrence of severe maternal morbidity. Patient-centered medical home care has the potential to address disparities in maternal outcomes.

OBJECTIVES: To examine (1) the association between receiving patient-centered medical home care and severe maternal morbidity outcomes and (2) the interaction of race/ethnicity on patient-centered medical home status and severe maternal morbidity.

DESIGN/METHODS: Using 2007 to 2016 data from the Medical Expenditures Panel Survey, we conducted a cross-sectional study to estimate the association between receipt of care from a patient-centered medical home and the occurrence of severe maternal morbidity, and racial-specific (White, Black, Asian, …

Putting All My Eggs Into The App': Self, Relational And Systemic Surveillance Of Mothers' Use Of Digital Technologies During The Transition To Parenting, Jodi Hall, Bradley Hiebert, Danica Facca, Lorie Donelle Phd, Rn, Fcan

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This paper builds on thematic findings from a larger study that explored how digital technologies (e.g. smartphones, apps, search engines) shape expectant and new mothers' early parenting practices. An overarching theme that arose across these mothers' experiences which deserved deeper exploration was relational digital surveillance. In the context of this paper, relational digital surveillance describes how mothers evaluate their sense of preparedness, goodness or suitability for motherhood as they transition into parenting in relation to: their own use of digital technologies when caring for their pregnant bodies (self-surveillance), partners' and family members' commentary and/or judgement regarding their use of digital …

A Flexible Pressure Sensor With Highly Customizable Sensitivity And Linearity Via Positive Design Of Microhierarchical Structures With A Hyperelastic Model, Zhenjin Xu, Dezhi Wu, Zhiwen Chen, Zhongbao Wang, Cong Cao, Xiangyu Shao, Gang Zhou, Shaohua Zhang, Lingyun Wang, Daoheng Sun

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The tactile pressure sensor is of great significance in flexible electronics, but sensitivity customization over the required working range with high linearity still remains a critical challenge. Despite numerous efforts to achieve high sensitivity and a wide working range, most sensitive microstructures tend to be obtained only by inverting naturally existing templates without rational design based on fundamental contact principles or models for piezoresistive pressure sensors. Here, a positive design strategy with a hyperelastic model and a Hertzian contact model for comparison was proposed to develop a flexible pressure sensor with highly customizable linear sensitivity and linearity, in which the …

An Investigation Of Mhealth And Digital Health Literacy Among New Parents During Covid-19, Lorie Donelle Phd, Rn, Fcan, Brad Hiebert, Jodi Hall

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INTRODUCTION: Especially during the COVID-19 pandemic, parents were expected to understand increasingly sophisticated information about health issues and healthcare systems and access online resources as a part of their caregiving role. Yet little is known about parents' online digital technology use and digital health literacy skill. This study aimed to investigate parents' digital technology use, their self-reported digital health literacy skill, and demographic information as potential factors influencing their use of digital technologies. METHODS: An online survey utilizing convenience sampling was administered to new parents during the COVID-19 pandemic that inquired about their demographic information, digital technology use, and digital …

Community Organization Perspectives On Covid-19 Vaccine Hesitancy And How They Increased Covid-19 Vaccine Confidence: A Canadian Immunization Research Network, Social Sciences And Humanities Network Study, Sarah Ashfield, Lorie Donelle Phd, Rn, Fcan, Gina Uppal, Michael A. Bauer

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BACKGROUND: COVID-19 vaccines play a critical role in reducing the morbidity and mortality associated with SARS-CoV-2 infection and despite vaccine availability, disparities in COVID-19 vaccine uptake among Canadian subgroups exist. Community organizations are uniquely situated to relay important vaccine messaging around all vaccines, understand components of vaccine hesitancy, and facilitate vaccine uptake within the communities they serve. The objective of this research was to solicit community organizations perspectives specific to COVID-19 vaccines and explore strategies of increasing vaccine uptake within their communities. METHODS: A qualitative focus group study was held in the spring of 2021 with 40 community organizations from …

An Investigation Of Media Reports Of Digital Surveillance Within The First Year Of The Covid-19 Pandemic, Leigha Comer, Lorie Donelle Phd, Rn, Fcan, Marionette Ngole, Jacob J. Shelley, Anita Kothari, Maxwell Smith, James M. Shelley, Saverio Stranges, Brad Hiebert, Jason Gilliland, Tommy Cooke, Jodi Hall, Jed Long

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INTRODUCTION: The COVID-19 pandemic prompted a surge in digital public health surveillance worldwide, with limited opportunities to consider the effectiveness or impact of digital surveillance. The news media shape public understanding of topics of importance, contributing to our perception of priority issues. This study investigated news media reports published during the first year of the pandemic to understand how the use and consequences of digital surveillance technologies were reported on. METHODS: A media content analysis of 34 high- to low-income countries was completed. The terms "COVID-19," "surveillance," "technologies," and "public health" were used to retrieve and inductively code media reports. …

Leveraging Digital Technology For Social Connectedness Among Adults With Chronic Conditions: A Systematic Review, Pamela J. Wright Phd, Ms, Med, Rn, Cen, Phyllis A. Raynor, Dana Bowers, Elizabeth M. Combs, Cynthia F. Corbett Phd, Rn, Faan, Hannah Hardy, Khushi S. Patel

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PURPOSE: To review the evidence about the impact of digital technology on social connectedness among adults with one or more chronic health conditions.

METHODS: PubMed, Embase, Social Sciences, CINAHL, and Compendex were systematically searched for full-text, peer-reviewed empirical evidence published between 2012 and 2023 and reported using the PRISMA flow diagram. Articles were critically appraised applying the Joanna Briggs Institute checklists. Specific data were extracted based on the framework for social identity and technology approaches for health outcomes and then analyzed and synthesized.

RESULTS: Thirty-four studies met study criteria. Evidence showed heterogeneity among research methodology, chronic health conditions, digital technology, …

Use Of Digital Technologies For Public Health Surveillance During The Covid-19 Pandemic: A Scoping Review, Lorie Donelle Phd, Rn, Fcan, Leigha Comer, Brad Hiebert, Jodi Hall, Jacob J. Shelley, Maxwell J. Smith, Anita Kothari, Jacquelyn Burkell, Saverio Stranges, Tommy Cooke, James M. Shelley, Jason Gilliland, Marionette Ngole, Danica Facca

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Throughout the COVID-19 pandemic, a variety of digital technologies have been leveraged for public health surveillance worldwide. However, concerns remain around the rapid development and deployment of digital technologies, how these technologies have been used, and their efficacy in supporting public health goals. Following the five-stage scoping review framework, we conducted a scoping review of the peer-reviewed and grey literature to identify the types and nature of digital technologies used for surveillance during the COVID-19 pandemic and the success of these measures. We conducted a search of the peer-reviewed and grey literature published between 1 December 2019 and 31 December …

Key Informant Perceptions Of Challenges And Facilitators To Implementing Passive Remote Monitoring Technology For Home Care Clients, Grace Warner, Lori E. Weeks, Yu Ting Chen, Bradley Hiebert, Kathleen Ledoux, Lorie Donelle Phd, Rn, Fcan

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Background: Passive remote monitoring technologies (RMT) are an option that could keep frail older adults home longer while reducing care burdens on family/friend caregivers. In contrast to active RMT which requires an individual to engage with the technology (i.e., push a button), passive RMT does not require any action to function (i.e., sensors or cameras). Objective: This qualitative study explored the challenges and facilitators of implementing passive RMT in home care settings by applying an implementation science lens. Method: Twenty semi-structured interviews were conducted with key informant stakeholders. Data were coded using a Framework Analysis approach that inductively and deductively …

Hepatitis B Immunity Among Undergraduate Nursing Students: A Brief Report, Robin M. Dawson Phd, Rn, Cpnp-Pc, Courtney Catledge, Ann Scott Dnp, Rn, Ccrn-K, Cne, Leigh Blackmon Pate Dnp, Msn, Aprn, Fnp-Bc, Gail Vereen

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Background: Health sciences students who report low/equivocal hepatitis B titers may be required to repeat the immunization series, even though the result may not indicate non-immunity. Method: To describe hepatitis B immunity patterns, this retrospective, descriptive study utilized de-identified vaccination records and anti-HBs titers of three cohorts of sophomore nursing students entering clinical rotations in 2018–2019. Results: Only 33% of students had initial anti-HBs quantitative serum titer ≥10 mIU/ml, demonstrating immunity. After students with low/equivocal titers (n = 191, 64%) were re-immunized per institution protocol, only 2% (n = 7) were identified as non-responders. Cumulative costs incurred by students for …

Successes And Barriers Of Health Information Exchange Participation Across Hospitals In South Carolina From 2014 To 2020: Longitudinal Observational Study, Kausik Lakkaraju, Aniket Gupta, Biplav Srivastava, Marco Valtorta, Dezhi Wu

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Sentiment Analysis Systems (SASs) are data-driven Artificial Intelligence (AI) systems that output polarity and emotional intensity when given a piece of text as input. Like other AIs, SASs are also known to have unstable behavior when subjected to changes in data which can make them problematic to trust out of concerns like bias when AI works with humans and data has protected attributes like gender, race, and age. Recently, an approach was introduced to assess SASs in a blackbox setting without training data or code, and rating them for bias using synthetic English data. We augment it by introducing two …

Mutational Analysis Of Egfr Mutations In Non-Small Cell Lung Carcinoma-An Indian Perspective Of 212 Patients, Amrit Kaur Kaler, Khushi Patel, Harshali Patil, Yash Tiwarekar, Bijal Kulkarni, Meenal Hastak, Nivetha Athikari, Samrudhi Rane, Ankita Nikam, Smita Umarji, Imran Shaikh, Sandeep Goyle, Rajesh Mistry

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Lung cancer is the world's leading cause of cancer-related deaths. Epidermal growth factor receptor (EGFR) is one of the critical oncogenes and plays a significant role in tumor proliferation and metastasis. Patients with sensitizing mutations in the EGFR gene have better clinical outcomes when treated with tyrosine kinase inhibitors (TKI). This study expands our knowledge of the spectrum of EGFR mutations among lung cancer patients in the Indian scenario. This is a retrospective descriptive study of all newly diagnosed patients with lung cancer in tertiary care hospital in India. All the samples were subjected to real-time PCR (q-PCR) analysis and …

Spaci: Deciphering Spatial Cellular Communications Through Adaptive Graph Model, Ziyang Tang, Tonglin Zhang, Baijian Yang Ph.D., Jing Su, Qianqian Song

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Cell-cell communications are vital for biological signalling and play important roles in complex diseases. Recent advances in single-cell spatial transcriptomics (SCST) technologies allow examining the spatial cell communication landscapes and hold the promise for disentangling the complex ligand-receptor (L-R) interactions across cells. However, due to frequent dropout events and noisy signals in SCST data, it is challenging and lack of effective and tailored methods to accurately infer cellular communications. Herein, to decipher the cell-to-cell communications from SCST profiles, we propose a novel adaptive graph model with attention mechanisms named spaCI. spaCI incorporates both spatial locations and gene expression profiles of …

Patient Trust In Physicians Matters-Understanding The Role Of A Mobile Patient Education System And Patient-Physician Communication In Improving Patient Adherence Behavior: Field Study, Dezhi Wu, Paul Benjamin Lowry, Dongsong Zhang, Youyou Tao

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BACKGROUND: The ultimate goal of any prescribed medical therapy is to achieve desired outcomes of patient care. However, patient nonadherence has long been a major problem detrimental to patient health and, thus, is a concern for all health care providers. Moreover, nonadherence is extremely costly for global medical systems because of unnecessary complications and expenses. Traditional patient education programs often serve as an intervention tool to increase patients' self-care awareness, disease knowledge, and motivation to change patient behaviors for better adherence. Patient trust in physicians, patient-physician relationships, and quality of communication have also been identified as critical factors influencing patient …

Association Of Chronic Kidney Disease With Prior Tinnitus: A Case-Control Study, Shih-Han Hung, Sudha Xirasagar Mbbs., Ph.D., Yen-Fu Cheng, Nai-Wen Kuo, Herng-Ching Lin

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This population-based, case−control study aims to explore the relationship between prior tinnitus and the occurrence of chronic kidney disease (CKD) using a nationwide, population-based cohort study. We used data from the Taiwan National Health Insurance Research Database to explore the association of CKD with tinnitus. We identified 15,314 patients aged ≥40 years old with a first-time diagnosis of CKD as the cases. We used propensity-scored matching to select 45,942 controls (1:3 ratio). We performed multivariate logistic regression to estimate the odds ratio (OR) of a prior tinnitus diagnosis among the CKD group vs. the control group. Analysis showed that 770 …

Topics And Sentiment Surrounding Vaping On Twitter And Reddit During The 2019 E-Cigarette And Vaping Use-Associated Lung Injury Outbreak: Comparative Study, Dezhi Wu, Erin Kasson, Avineet Kumar Singh, Yang Ren, Nina Kaiser, Ming Huang, Patricia A. Cavazos-Rehg

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BACKGROUND: Vaping or e-cigarette use has become dramatically more popular in the United States in recent years. e-Cigarette and vaping use-associated lung injury (EVALI) cases caused an increase in hospitalizations and deaths in 2019, and many instances were later linked to unregulated products. Previous literature has leveraged social media data for surveillance of health topics. Individuals are willing to share mental health experiences and other personal stories on social media platforms where they feel a sense of community, reduced stigma, and empowerment. OBJECTIVE: This study aimed to compare vaping-related content on 2 popular social media platforms (ie, Twitter and Reddit) …

Association Of Fabry Disease With Hearing Loss, Tinnitus, And Sudden Hearing Loss: A Nationwide Population-Based Study, Yen-Fu Cheng, Sudha Xirasagar Mbbs., Ph.D., Chin-Shyan Chen, Dau-Ming Niu, Herng-Ching Lin

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Hearing loss and the related otologic manifestations are receiving increased scrutiny as significant causes of morbidity in Fabry disease. However, the relative risks of auditory deficits among patients with Fabry disease relative to the general population without a diagnosis of Fabry disease have not been studied. This study aims to explore the associations between Fabry disease and hearing-related manifestations using a nationwide population-based dataset. We identified study patients for this cross-sectional study from the 2015−2017 claims databases of the Taiwan Longitudinal Health Insurance Database 2005. We first identified 2312 patients aged over 20 years with a diagnosis of Fabry disease. …

Understanding Alcohol Use Discourse And Stigma Patterns In Perinatal Care On Twitter, Fritz Culp, Yuqi Wu, Dezhi Wu, Yang Ren, Phyllis Raynor Phd, Aprn, Pmhnp-Bc, Peiyin Hung Ph.D, Shan Qiao Ph.D., Xiaoming Li Ph.D., Kacey Eichelberger

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(1) Background: perinatal alcohol use generates a variety of health risks. Social media platforms discuss fetal alcohol spectrum disorder (FASD) and other widespread outcomes, providing personalized user-generated content about the perceptions and behaviors related to alcohol use during pregnancy. Data collected from Twitter underscores various narrative structures and sentiments in tweets that reflect large-scale discourses and foster societal stigmas; (2) Methods: We extracted alcohol-related tweets from May 2019 to October 2021 using an official Twitter search API based on a set of keywords provided by our clinical team. Our exploratory study utilized thematic content analysis and inductive qualitative coding methods …

Prompt Intervention In Large Bowel Obstruction Management: A Nationwide Inpatient Sample Analysis, Mary R. Kwaan, Yuqi Wu, Yang Ren, Sudha Xirasagar Mbbs., Ph.D.

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BACKGROUND: Large bowel obstruction is an urgent condition which can progress to ischemia and perforation. The importance of prompt intervention has not been rigorously demonstrated. METHODS: Patients with bowel obstruction who underwent stoma, stent, and/or colectomy in the Nationwide Inpatient Sample were used to study prompt intervention (defined as occurring within 2 days of admission). Outcomes were inpatient mortality, discharge to home, and length of stay in an adjusted analysis. RESULTS: Among the 31,277 patients, prompt intervention occurred in 42.6%. In an adjusted analysis, prompt intervention was more likely in higher income patients and less likely in patients with comorbidities; …

Use Of Equity-Informed Social Media Covid-19 Risk Communication Tools: A Scoping Review Protocol, Anita Kothari, Nedra Peter, Lorie Donelle Phd, Rn, Fcan

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INTRODUCTION: Health agencies and community organisations play a crucial role in disseminating information to the public about COVID-19 risks and events, providing instructions on how to change behaviour to mitigate those risks, motivating compliance with health directives and addressing false information. Social media platforms are a critical tool in risk communication, providing a medium for rapid transmission of messages as well as providing the opportunity for engagement and immediate feedback. Access to health information, services and support are especially important for marginalised and underserved ('equity-deserving') populations who are disproportionately affected by COVID-19. This scoping review aims to review the breadth …

The Genome And Gene Editing System Of Sea Barleygrass Provide A Novel Platform For Cereal Domestication And Stress Tolerance Studies, Liuhui Kuang, Qiufang Shen, Liyang Chen, Lingzhen Ye, Tao Yan, Zhong-Hua Chen, Robbie Waugh, Qi Li, Lu Huang, Shengguan Cai, Liangbo Fu, Pengwei Xing, Kai Wang, Jiari Shao, Feibo Wu, Lixi Jiang, Dezhi Wu, Guoping Zhang

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The tribe Triticeae provides important staple cereal crops and contains elite wild species with wide genetic diversity and high tolerance to abiotic stresses. Sea barleygrass (Hordeum marinum Huds.), a wild Triticeae species, thrives in saline marshlands and is well known for its high tolerance to salinity and waterlogging. Here, a 3.82-Gb high-quality reference genome of sea barleygrass is assembled de novo, with 3.69 Gb (96.8%) of its sequences anchored onto seven chromosomes. In total, 41 045 high-confidence (HC) genes are annotated by homology, de novo prediction, and transcriptome analysis. Phylogenetics, non-synonymous/synonymous mutation ratios (Ka/Ks), and transcriptomic and functional analyses provide …

Benefits Of Staying Active During Cancer Treatment Flyer, Hailey Powell, Tracy Lowe, Janice S. Withycombe

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No abstract provided.

First Steps Towards Validating Educational Material Related To In-Patient Mobility In Children With Cancer, Hailey Powell, Tracy Lowe, Janice Withycombe

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Children undergoing cancer treatment have markedly reduced mobility, especially during inpatient admissions for chemotherapy.1 Reduced mobility can increase the risk factors for chronic diseases such as obesity, cardiovascular disease, and type 2 diabetes. Mobility during in-patient stays is encouraged at many institutions but may not receive priority due to competing demands on staff time. Promoting mobility while in-patient, has known health benefits but also serves to role model expected outpatient behaviors. Prior research reflects that parents and caregivers need additional education related to mobility during childhood cancer therapy2, yet there is a lack of validated materials on this topic.

Absence Of Association Of Tinnitus With Pre-Existing Hypertension: A Population-Based Study, Po-Hsiu Huang, Sudha Xirasagar Mbbs., Ph.D., Jin-Hua Chen, Yen-Fu Cheng, Nai-Wen Kuo, Herng-Ching Lin

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OBJECTIVES: Whether tinnitus is associated with pre-existing hypertension remains uncertain. This study explored the association between tinnitus and pre-existing hypertension. METHODS: We obtained data on a retrospective cohort of 542 884 cases ≥18 years old with a first-time tinnitus diagnosis from Taiwan's National Health Insurance Research Database. We used propensity-score matching to select 542 884 matched controls and performed multiple logistic regression analyses to estimate the adjusted odds of prior hypertension among patients with tinnitus versus controls. RESULTS: Bivariate analysis showed no significant difference in the prevalence of prior hypertension between the tinnitus and no-tinnitus groups (35.58% vs 35.5%, P …

Passive Remote Monitoring And Aging In Place: A Scoping Review, Emily Read, Cora Woolsey, Lorie Donelle, Lori Weeks, Norma Chinho

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Passive remote monitoring is a relatively new technology that may support older adults to age in place. However, current knowledge about the effectiveness of this technology in extending older adults' independence is lacking. Therefore, we conducted a scoping review of studies examining passive remote monitoring to systematically synthesize evidence about the technology's effectiveness as an intervention. Our initial search of Embase, CINAHL, PubMed, and Scopus databases identified 486 unique articles. Of these, 14 articles met our inclusion criteria. Results show that passive remote monitoring technologies are being used in innovative and diverse ways to support older adults aging in place …

Covid Information And Masking Behaviors In U.S. Adolescents: Findings From The Adolescent Brain Cognitive Development (Abcd) Study, Jason M. Nagata, Kyle T. Ganson, Jingyi Liu, Khushi P. Patel, Josephine C. Tai, Stuart B. Murray, Kirsten Bibbins-Domingo

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Adolescents are particularly vulnerable to health misinformation and are at risk for suboptimal adherence to protective health behaviors in the COVID-19 pandemic. Guided by factors consistent with the theories of planned behavior and rumor transmission, this study sought to analyze the impact of multiple information sources, including social media, television media, internet and parental counseling, on masking behaviors in adolescents. Responses from the December 2020 COVID-19 survey, representing 4,106 U.S. adolescents ages 12-14 from the Adolescent Brain Cognitive Development Study (ABCD) were analyzed. The majority of parents (61.1%) reported counseling their children on the importance of wearing masks all the …

The Association Between Lung Cancer Stigma And Race: A Descriptive Correlational Study, Karen Kane Mcdonnell, Lisa A. Webb, Swann A. Adams Ph.D., Ms, Face, Tisha M. Felder Phd, Msw, Rachel E. Davis Ph.D.

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BACKGROUND:

Stigma is a formidable burden for survivors of lung cancer that can reduce the quality of life (QOL), resulting in physical, social and psychological challenges. This study investigates associations between stigma and depression, QOL and demographic and health-related characteristics, including race.

DESIGN:

An adapted conceptual model derived from the Cataldo Lung Cancer Stigma Scale guided this descriptive correlation study assessing stigma in African American and Caucasian survivors of lung cancer. Self-reported, written surveys measuring depression, QOL, lung cancer stigma and demographics were administered. Statistical analysis was conducted to assess associations between stigma and depression, stigma and QOL and stigma …

Assessment Of Vitamin D Among Male Adolescents And Young Adults Hospitalized With Eating Disorders, Jason M. Nagata, Anna Grandis, Paola Bojorquez-Ramirez, Anthony Nguyen, Amanda E. Downey, Kyle T. Ganson, Khushi P. Patel, Vanessa I. Machen, Sara M. Buckelew, Andrea K. Garber

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PURPOSE: Medical complications of eating disorders in males are understudied compared to females, as is the case of vitamin D deficiency. The aim of this study was to assess vitamin D levels among male and female adolescents and young adults hospitalized for medical complications of eating disorders. METHODS: We retrospectively reviewed electronic medical records of patients aged 9-25 years (N = 565) admitted to the University of California, San Francisco Eating Disorders Program for medical instability, between May 2012 and August 2020. Serum vitamin D (25-hydroxy) level was assessed at admission as was history of prior calcium, vitamin D, or …