bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of Pediatric Patients With and Without Multisystem Inflammatory Syndrome Associated With COVID-19: Retrospective Cohort From Ecuador
Authors: Legarda Eliana M. , Martínez Jenny , Sisa Ivan
Published: February 2023

Background:

Multisystem inflammatory syndrome in children (MIS-C) has been associated with severe acute respiratory syndrome coronavirus 2 infection in the pediatric population cared for in the pediatric intensive care unit. We aimed to compare patients with pediatric acute respiratory distress syndrome (PARDS) with those who also present a MIS-C diagnosis (PARDS vs. PARDS + MIS-C).

Methods:

One hundred and sixty-seven children (0–15 years) admitted to the pediatric intensive care unit COVID-19 ward of a national reference children’s hospital in Quito, Ecuador, from June 2020 to June 2021 who developed PARDS with or without MIS-C. To diagnose PARDS, the criteria of the Pediatric Acute Lung Injury Consensus Conference Group were used, and to diagnose MIS-C, the criteria of the Centers for Disease Control and Prevention were used. Additionally, the PRISM score was used to calculate the mortality risk of study patients on admission.

Results:

Of the 167 patients with PARDS, ~59% also developed MIS-C. Patients with PARDS + MIS-C had higher risks than patients without MIS-C in the following: frequency of associated bacterial infections (81.6% vs. 55.1%), mortality risk (36.7% vs. 11.6%), use of respiratory support (invasive mechanical ventilation: 92% vs. 86%), use of vasopressors/inotropes (90.8% vs. 30.4%), renal complications (36.7% vs. 8.7%), septic shock (84.7% vs. 20.3%), multiorgan failure (39.8% vs. 1.4%) and mortality at discharge (39.8% vs. 4.3%). Logistic regression failed to find an association between MIS-C and age, race, sex, ≥3 signs/symptoms and ≥2 comorbidities.

Conclusions:

Patients with PARDS + MIS-C had a more severe clinical picture than patients without MIS-C. The findings provide useful information to improve the management of PARDS patients with and without MIS-C in Ecuador.
Ventricular Arrhythmia and COVID-19 Vaccine-associated Myocarditis
Authors: Sheth Saloni P. , Gandhi Rupali
Published: February 2023

17-year-old male presented with COVID-19 vaccine-associated myocarditis. Six months later, due to chest discomfort with exercise, the patient underwent an exercise stress test that revealed a 3-beat run of nonsustained ventricular tachycardia at 230 bpm at peak exercise. The long-term outcomes of COVID-19 vaccine-associated myocarditis are unclear. This patient had nonsustained ventricular tachycardia over 6 months after diagnosis.
Vision and patient-reported outcomes with nondiffractive EDOF or neutral aspheric monofocal intraocular lenses
Authors: Pantanelli Seth M. , O'Rourke Tara , Bolognia Olga , Scruggs Kathleen , Longenecker Amy , Lehman Erik
Published: February 2023

Purpose:

To compare outcomes in patients who underwent cataract extraction with implantation of nondiffractive extended depth-of-focus (ND-EDOF; Alcon AcrySof Vivity) or neutral aspheric monofocal (Bausch & Lomb enVista) intraocular lenses (IOLs).

Setting:

Academic medical center.

Design:

Prospective single-center double-arm patient- and assessor-masked randomized controlled trial.

Methods:

Patients were randomized to receive either a ND-EDOF or monofocal IOL in both eyes, targeted for emmetropia. Uncorrected and corrected (CDVA) distance visual acuities, distance-corrected intermediate visual acuity (DCIVA), distance-corrected near visual acuity (DCNVA), level of spectacle independence, and severity of photic phenomena were assessed at 3 months postoperatively.

Results:

56 patients were enrolled, of which 24 in the ND-EDOF group and 27 in the monofocal group completed follow-up. The binocular mean CDVA, DCIVA, and DCNVA were 20/20, 20/19, and 20/21 for the ND-EDOF IOL and 20/18 (P= .188), 20/31 (P< .001), and 20/30 (P= .004) for the monofocal IOL, respectively. At intermediate, 88% of the ND-EDOF vs 30% of the monofocal patients had a binocular DCIVA of 20/25 or better (P< .001). Moderate or severe glare occurred in 20.8% of ND-EDOF vs 7.4% of monofocal patients (P= .228), whereas moderate or severe halos occurred in 16.7% of ND-EDOF vs 11.1% of monofocal patients (P= .697).

Conclusions:

The ND-EDOF and monofocal IOLs provided similarly excellent distance vision. Patients implanted with the ND-EDOF IOL had 2 more lines of vision at both intermediate and near, and a greater proportion reported spectacle independence. Most patients in both groups reported low severity of photic phenomena.
Emergence of nociceptive functionality and opioid signaling in human induced pluripotent stem cell–derived sensory neurons
Authors: Röderer Pascal , Belu Andreea , Heidrich Luzia , Siobal Maike , Isensee Jörg , Prolingheuer Jonathan , Janocha Elke , Valdor Markus , Hagendorf Silke , Bahrenberg Gregor , Opitz Thoralf , Segschneider Michaela , Haupt Simone , Nitzsche Anja , Brüstle Oliver , Hucho Tim
Published: February 2023

Induced pluripotent stem cells (iPSCs) have enabled the generation of various difficult-to-access cell types such as human nociceptors. A key challenge associated with human iPSC-derived nociceptors (hiPSCdNs) is their prolonged functional maturation. While numerous studies have addressed the expression of classic neuronal markers and ion channels in hiPSCdNs, the temporal development of key signaling cascades regulating nociceptor activity has remained largely unexplored. In this study, we used an immunocytochemical high-content imaging approach alongside electrophysiological staging to assess metabotropic and ionotropic signaling of large scale–generated hiPSCdNs across 70 days of in vitro differentiation. During this period, the resting membrane potential became more hyperpolarized, while rheobase, action potential peak amplitude, and membrane capacitance increased. After 70 days, hiPSCdNs exhibited robust physiological responses induced by GABA, pH shift, ATP, and capsaicin. Direct activation of protein kinase A type II (PKA-II) through adenylyl cyclase stimulation with forskolin resulted in PKA-II activation at all time points. Depolarization-induced activation of PKA-II emerged after 35 days of differentiation. However, effective inhibition of forskolin-induced PKA-II activation by opioid receptor agonists required 70 days of in vitro differentiation. Our results identify a pronounced time difference between early expression of functionally important ion channels and emergence of regulatory metabotropic sensitizing and desensitizing signaling only at advanced stages of in vitro cultivation, suggesting an independent regulation of ionotropic and metabotropic signaling. These data are relevant for devising future studies into the development and regulation of human nociceptor function and for defining time windows suitable for hiPSCdN-based drug discovery.
Feasibility and reliability of a quantitative sensory testing protocol in youth with acute musculoskeletal pain postsurgery or postinjury
Authors: Li Rui , Holley Amy L. , Palermo Tonya M. , Ohls Olivia , Edwards Robert R. , Rabbitts Jennifer A.
Published: February 2023

Quantitative sensory testing (QST) is increasingly used in pediatric chronic pain; however, assessment in youth with acute musculoskeletal (MSK) pain is limited. This study evaluated the feasibility, reliability, and sources of variability of a brief QST protocol in 2 clinical samples of youth with acute MSK pain. Participants were 277 youth (Mage = 14.5 years, SD = 2.0, range = 11-18 years, 59% female, 81% non-Hispanic) across 3 geographic study sites who completed a QST protocol assessing pressure and thermal pain sensitivity, temporal summation of pain, and conditioned pain modulation 8 weeks after MSK surgery (n = 100) or within 4 weeks after an acute MSK injury (n = 177). High feasibility was demonstrated by protocol completion rates ranging from 97.5% to 100% for each task, with 95.3% of youth completing all tasks. Reliability was high, with reliability coefficients of >0.97 for 7 out of 8 QST parameters and minimal influence of examiner or participating site effects. Younger youth had lower pressure and heat pain thresholds (11-12 vs 13-18 years, d = −0.80 to −0.56) and cold pain tolerance (d = −0.33). Hispanic youth had higher pressure and heat pain thresholds (d = 0.37-0.45) and pain ratings for cold pain tolerance (d = 0.54) compared with non-Hispanic youth. No significant differences were observed in QST values by sex or personal contextual factors at the time of assessment (momentary pain, menstrual period, use of pain medications). Overall findings demonstrate feasibility of a brief QST protocol with youth with diverse acute MSK pain and data provide initial support for the reliability of this QST protocol for multisite research studies.
Process Improvement and Information Technology
Authors: Chaiken Barry , Restuccia Joseph
Published: February 2023

Human beings are inherently resistant to change. In our technologically driven world, change happens fast, thereby regularly challenging us inherently change-averse humans to adjust. Only through rapid, effective, outcomes-driven change can we address the numerous challenges facing health care today. And as health care leaders, it is our responsibility to learn how to become the most effective change leader so that we can deliver the changes in systems, processes, and thinking required to deliver ever-improving quality, safety, and access to care while managing its cost.
Efficacy and Safety of Oral Hydration 1 Hour After Extubation of Patients Undergoing Cardiac Surgery
Authors: Liang Ting , Li Sai-Lan , Peng Yan-Chun , Chen Qi , Chen Liang-Wan , Lin Yan-Juan
Published: February 2023

Background

Thirst is one of the most common and uncomfortable symptoms in patients after cardiac surgery. The postextubation time for early oral hydration (EOH) remains unclear, and there is a lack of studies on its safety and effectiveness.

Objective

The aim of this study was to investigate the effects of oral hydration 1 hour after extubation on thirst, salivary pH, salivary flow, oral mucosa, halitosis, gastrointestinal adverse reactions, aspiration pneumonia, and satisfaction in patients undergoing cardiac surgery.

Methods

Eighty-four patients who underwent cardiac surgery were randomly assigned into 2 groups, for either conventional oral hydration (COH) or EOH. The EOH group drank 30 mL of warm water 1 hour post extubation and thereafter 50 mL hourly for 4 hours. The COH group had nil per os for 4 hours after extubation. If no dysphagia was evident after 4 hours, the patients were instructed to slowly drink water. Thirst intensity was evaluated every hour before the intervention. Nausea and vomiting were recorded after drinking water. The salivary pH, unstimulated salivary flow rate, oral odor, and oral mucosal moisture were evaluated at 1 hour post extubation, immediately before the intervention, and at 4 hour post intervention. Aspiration pneumonia data were collected within 72 hours post intervention. Satisfaction was assessed before leaving the intensive care unit.

Results

The scores for thirst (3.38 ± 1.04; F = 306.21, P < .001), oral mucosa (2.03 ± 0.74; P < .001), and halitosis (2.77 ± 0.63; P < .001) in the EOH group were significantly lower than those in the COH group. The EOH group had significantly higher salivary pH (6.44 ± 1.06; P < .001), unstimulated salivary flow rates (0.18 ± 0.08; P < .001), and patient satisfaction (4.28 ± 0.45; P < .001) than the COH group. Nausea and vomiting did not differ significantly between groups (P = .60). Aspiration pneumonia was not observed in either group.

Conclusions

Oral hydration 1 hour after extubation significantly alleviated thirst and stabilized the oral environment without gastrointestinal adverse reactions or aspiration pneumonia, and with increased patient satisfaction.
Correlation of whole blood zinc levels, CD4 cell count, HIV disease stage, and dermatologic manifestations among diagnosed HIV patients in a tertiary hospital
Authors: Sarne Riza I. , Gabriel Ma. Teresita G. , Vista Emmerson Gale S. , Aguado Maria Jenina P. , Karim Cynthia Angela
Published: February 2023

Objectives:

Zinc deficiency is the most common micronutrient abnormality seen in human immunodeficiency virus (HIV) infection. Depletion of CD4 cells is a hallmark of HIV infection. The study aims to determine the association between whole blood zinc levels and CD4 cell count and stage of HIV infection among patients in a tertiary hospital in the Philippines.

Methods:

Sixty-five newly diagnosed HIV positive patients of the institution were recruited. Demographic profile, whole blood zinc levels, CD4 cell count level, HIV Disease Stage, and presence of any dermatologic manifestations were noted. Prevalence of zinc deficiency and orrelation between whole blood zinc levels and CD4 cell count were determined.

Results:

Among the 65 patients, overall zinc deficiency was noted at 33.8%. Low CD4 count and HIV Disease Stage IV participants had the highest percentage of zinc deficiency at 54.6% and 50%, respectively. A correlation coefficient at r=0.3364 was noted between whole blood zinc levels and CD4 cell count (P<0.050). Twenty-nine patients presented with dermatologic manifestations, with 10 patients being zinc deficient.

Conclusion:

A weak positive correlation was seen between zinc levels and CD4 count. There is an increasing frequency of zinc level deficiency with a higher HIV disease stage. Dermatologic manifestations of HIV may be present in both patients with normal and deficient zinc levels.
Self-reported hair-loss following COVID-19 infection
Authors: Alajlan Abdulmajeed , Aldihan Rema , Almana Lyan , Althnayan Rahaf , Awartani Hadeel , Alsuwaidan Sami
Published: February 2023

Objectives:

This study was performed to estimate the prevalence of hair loss among patients with COVID-19 and to determine the correlation of the severity of COVID-19 with the severity of hair loss.

Methods:

Data were collected through a self-administered electronic questionnaire that was distributed among social media platforms. Participants were invited to complete the survey using a convenience sampling technique.

Results:

Among 420 participants who reported a positive polymerase chain reaction for SARS‐CoV‐2 infection, 77.6% reported hair loss after the development of COVID-19. Notably, the onset of hair loss was within 3 weeks of the development of COVID-19 in 29% of participants. Most of the participants reported that the duration of hair loss was up to 6 months, and hair regrowth was noticed within 1 year after the development of COVID-19. Patients who were admitted to the hospital, who experienced respiratory difficulties, who had lost weight due to COVID-19, and who experienced symptoms for longer than 10 days were significantly more prone to experience severe hair loss following COVID-19 (P < 0.001).

Conclusion:

This study demonstrated a high frequency of self-reported hair loss after the development of COVID-19. Interestingly, even patients with mild COVID-19 symptoms were significantly more prone to experience moderate hair loss. Unique to COVID-19 infection, the onset of hair loss following the development of COVID-19 was within 3 weeks in one-third of the participants.
Multiple Cutaneous Nodules as Clinical Harbinger of Gallbladder Adenocarcinoma: A Case Report
Authors: Tariq Hira , Fayyaz Afshan , Batool Saelah , Aman Shahbaz
Published: February 2023

Introduction:

Cutaneous metastasis is defined as invasion of the skin by malignant cells originating elsewhere in the body. Cutaneous metastasis of adenocarcinoma gall bladder is extremely rare. The skin can be involved simultaneously or metachronously with the primary tumor.

 Here, we reported a case of cutaneous metastases as a clinical harbinger to an otherwise difficult to diagnose primary adenocarcinoma gallbladder.

Case presentation:

A 46-year-old male presented with multiple nodules on scalp, trunk, and limbs along with fever, weight loss, and lymphadenopathy. Histopathologic examination of the nodule revealed a malignant infiltrating glandular neoplasm in dermis, consistent with metastatic adenocarcinoma with intestinal metaplasia on immunohistochemistry. Radiological investigations further confirmed the primary tumor in gall bladder with metastases in liver and lymph nodes. Unfortunately, the patient succumbed to his disease.

Discussion:

Gallbladder adenocarcinoma is the most commonly seen tumor of the biliary tract. Skin involvement in malignancy helps determine the treatment course and has inevitable prognostic significance.

Conclusion:

We reported multiple cutaneous nodules as a remote manifestation of gallbladder adenocarcinoma. Biopsy of the skin lesion was easy to perform and quite reliably guided us toward the diagnosis of the primary tumor which would have been very difficult to diagnose otherwise.
Large cell acanthoma in a 10-year-old child: A case report
Authors: Wu Hao , Chang Jian-Min
Published: February 2023

Introduction:

Large cell acanthoma (LCA) is a rare benign tumor of epidermal origin. It is mainly seen on sun-exposed areas such as the head and extremities of older patients. Histopathologically, LCA is characterized by acanthosis and keratinocytes that are twice as large as normal cells.

We herein report a case involving a child diagnosed with LCA on an unexposed area of skin.

Case presentation:

A 10-year-old boy presented with a rough, painless light brown papule on his right chest that had been present for 11 months. He underwent surgical resection and pathological examination, and the histopathological findings were consistent with LCA.

Discussion:

LCA is common in adults but rare in children. It is difficult to differentiate from solar lentigo, actinic keratosis, or seborrheic keratosis because of its atypical clinical presentation. Dermoscopy, reflectance confocal microscopy, and cellular-resolution full-field optical coherence tomography can be used as auxiliary examinations, but pathological biopsy is still required to confirm the diagnosis.

Conclusion:

LCA is not limited to adults and exposed areas. This case reminds us that LCA may occur in children and that close attention is required for its identification.
Successful Treatment of Generalized Pustular Psoriasis with Adalimumab in a Pediatric Patient: A Case Report
Authors: Iraqi Mohamed F. , Alhomida Faris A. , Masoud Hasan , AlRasheed Girnasah , Almahlasi Reema
Published: February 2023

Introduction:

Generalized pustular psoriasis (GPP) is a rare life-threatening subtype of psoriasis and continues to be a therapeutic challenge. The first line therapies include acitretin, cyclosporin A, and methotrexate which have long-term side effects for children. Adalimumab has a favorable safety profile with low rates of adverse events, and has been described for successful treatment of adults with GPP in a few reports.

 We herein describe a 3-year-old girl with a body weight of 14.2 kg in whom adalimumab was used to successfully treat GPP.

Case presentation:

A 3-year-old girl with a 10-day history of systemic symptoms of fever, malaise, and the onset of studded painful pustules overlying an erythematous base on the scalp, face, neck, trunk, and bilateral extremities, affecting a body surface area of 90%. Laboratory examination results were notable for leukocytosis and elevated inflammatory markers. Biopsy confirmed the diagnosis of GPP. After failure of conventional therapies including cyclosporine and methotrexate, the patient began off-label treatment with adalimumab and achieved complete lesion clearance. During 14-month follow-up, she remains in remission on maintenance adalimumab therapy.

Discussion:

No consensus on the standard treatment regimen for GPP has been reached. Unfortunately, all drugs that have been reported to be effective for GPP are off-label. These treatments include systemic immunomodulators such as cyclosporine and methotrexate, systemic retinoids such as acitretin and isotretinoin, and various biologics. Our findings lend weight to the scant evidence describing the effective use of adalimumab in the treatment of pediatric GPP.

Conclusion:

Off-label use of adalimumab may be an effective and safe therapeutic option for GPP.
Nurse Engagement in Antibiotic Stewardship Programs: A Scoping Review of the Literature
Authors: Thurman Johnson Cara , Ridge Laura J. , Hessels Amanda J.
Published: February 2023

Introduction:

Hospital-based antibiotic stewardship programs (ASPs) are an important strategy in combating antibiotic resistance. Four antibiotic stewardship interventions are recommended by the CDC as particularly well-designed to engage nurses. However, there is limited information on whether and how existing hospital-based ASPs reflect these practices.

Purpose:

To describe how nurses are being engaged in hospital ASPs and to what extent this overlaps with the CDC framework.

Methods:

This scoping review included studies published in the last 10 years on engaging nurses in hospital-based ASPs. Three databases, PubMed, CINAHL, and Embase, were searched.

Results:

The search yielded 195 unique articles. Ten articles were retained for review detailing how nurses are engaged. One CDC recommended intervention, initiating discussion of antibiotic treatment, appeared in nine studies.

Conclusions:

Although hospitals are engaging nurses in antibiotic stewardship programs, their selected approaches do not reflect the full breadth of the opportunities identified by the CDC. More detail as to how exactly nurses engage would also be a useful addition to the literature.

Implications:

More research is needed on nurse engagement on culturing or testing and penicillin allergy evaluation. Standardized measures should be collected and reported to measure the impact of engaging nurses in ASPs.
HIV Continuum of Care Among People Who Inject Drugs in Iran: A Cross-sectional Study
Authors: Ghalekhani Nima , Mirzazadeh Ali , Tavakoli Fatemeh , Mousavian Ghazal , Khezri Mehrdad , Zamani Omid , Mehmandoost Soheil , Haghdoost Ali Akbar , Sharifi Hamid
Published: February 2023

People living with HIV who inject drugs may have lower access to treatment services. We aimed to assess the HIV continuum of care among people who inject drugs (PWID) in Iran. Data were collected from 2,663 PWID who were recruited via respondent-driven sampling from 11 cities of Iran between June 2019 and March 2020. Participants who tested positive for HIV infection were asked questions to calculate the status of HIV cascade of care. Of 95 PWID living with HIV, 67% were aware of their HIV status, 57% were linked to care service and initiated ART, 49% retained on ART, and only 15% had viral load less than 1,000 copies/ml. About half of the PWID diagnosed with HIV ever started ART and less than one in six were virally suppressed. Strategies to improve linkage to ART programs and ART retention may improve HIV care outcomes among PWID in Iran.
Mining Tenure and Job Duties Differ Among Contemporary and Historic Underground Coal Miners With Progressive Massive Fibrosis
Authors: Zell-Baran Lauren M. , Go Leonard H.T. , Sarver Emily , Almberg Kirsten S. , Iwaniuk Cayla , Green Francis H.Y. , Abraham Jerrold L. , Cool Carlyne , Franko Angela , Hubbs Ann F. , Murray Jill , Orandle Marlene S. , Sanyal Soma , Vorajee Naseema , Cohen Robert A. , Rose Cecile S.
Published: February 2023

Objective

To characterize differences in mining jobs and tenure between contemporary (born 1930+, working primarily with modern mining technologies) and historic coal miners with progressive massive fibrosis (PMF).

Methods

We classified jobs as designated occupations (DOs) and non-DOs based on regulatory sampling requirements. Demographic, occupational characteristics, and histopathological PMF type were compared between groups.

Results

Contemporary miners (n = 33) had significantly shorter mean total (30.4 years vs 37.1 years, P = 0.0006) and underground (28.8 years vs 35.8 years, P = 0.001) mining tenure compared with historic miners (n = 289). Silica-type PMF was significantly more common among miners in non-DOs (30.1% vs 15.8%, P = 0.03) and contemporary miners (58.1% vs 15.2%, P < 0.0001).

Conclusions

Primary jobs changed over time with the introduction of modern mining technologies and likely changed exposures for workers. Elevated crystalline silica exposures are likely in non-DOs and require attention.
Measuring Presenteeism From Work Stress
Authors: Mathieu Cynthia , Gilbreath Brad
Published: February 2023

Objective

Presenteeism can result from a variety of causes, one of which is job stress. This study examined the factor structure and validity of the Job Stress-Related Presenteeism Scale (JSRPS).

Methods

Using three organizational samples, the study aimed to determine the factor structure of the JSRPS, its relationship to a sickness presenteeism scale, and the association between the JSRPS and associated concepts.

Results

Exploratory and confirmatory factor analyses supported a reliable 6-item, 2-factor model for the JSRPS. JSRPS scores were associated with higher levels of psychological distress, workplace harassment, and turnover intentions and lower levels of job satisfaction, and work engagement. The JSRPS had stronger associations with psychological distress and workplace harassment than did the Stanford Presenteeism Scale.

Conclusions

Results suggest that the JSRPS provides a valid measure of presenteeism resulting from job stress.
Association of Sleep, Work Environment, and Work–Life Balance With Work Performance
Authors: Nishioka Ryuichiro , Tatsuse Takashi , Sekine Michikazu , Yamada Masaaki
Published: February 2023

Objectives

To explore differences in work performance based on the influence of sleep, work environment, and work-life balance.

Methods

The datasets for this study were obtained from the Japan Civil Servant Study, which included 3478 participants (2199 men and 1279 women).

Results

Belonging to the younger generation, high levels of support at work, fewer social contacts with friends, and a negative personality were independently associated with low work performance in both men and women. Poor sleep quality and job dissatisfaction were associated with low work performance in men but not in women. Work-to-family conflict was associated with work performance in women.

Conclusion

Interventions that target not only the overall measure but also account for sex-specific characteristics are important for improving work performance.
Psychological Distress, Japanese Teleworkers, and Supervisor Support During COVID-19
Authors: Kikunaga Kazuki , Nakata Akinori , Kuwamura Mami , Odagami Kiminori , Mafune Kosuke , Ando Hajime , Muramatsu Keiji , Tateishi Seiichiro , Fujino Yoshihisa ,   for the CORoNa Work Project
Published: February 2023

Objective

During the COVID-19 pandemic, teleworking became the new workplace norm, creating a new challenge for workplace communication. This study investigated the association between source-specific workplace social support and psychological distress among Japanese teleworkers and nonteleworkers.

Methods

A total of 15,045 workers were extracted from a cross-sectional web-based survey that assessed psychological distress, workplace social support from supervisors and coworkers. After grouping participants into four groups based on their positions (managers, staff members) and teleworking arrangements (teleworking, nonteleworking), multiple logistic regression analyses were performed separately.

Results

Teleworkers with less supervisor support demonstrated the highest risk of psychological distress (adjusted odds ratio = 2.55, P = 0.024).

Conclusions

Insufficient supervisor support for teleworking staff members may be a key occupational risk factor for psychological distress in the postpandemic future.
A Longitudinal Cohort Study of Factors Impacting Healthcare Worker Burnout in New York City During the COVID-19 Pandemic
Authors: Peccoralo Lauren A. , Pietrzak Robert H. , Tong Michelle , Kaplan Sabrina , Feingold Jordyn H. , Feder Adriana , Chan Chi , Verity Jaclyn , Charney Dennis , Ripp Jonathan
Published: February 2023

Objective

This study aimed to longitudinally examine the prevalence and correlates of burnout in frontline healthcare workers (FHCWs) during COVID-19 in New York City.

Methods

A prospective cohort study of 786 FHCWs at Mount Sinai Hospital was conducted during the initial COVID surge in April to May 2020 (T1) and November 2020 to January 2021 (T2) to assess factors impacting burnout.

Results

Burnout increased from 38.9% to 44.8% (P= 0.002); 222 FHCWs (28.3%) had persistent burnout, 82 (10.5%) had early burnout, and 129 (16.5%) had delayed burnout. Relative to FHCWs with no burnout (n= 350; 44.7%), those with persistent burnout reported more prepandemic burnout (relative risk [RR], 6.67), less value by supervisors (RR, 1.79), and lower optimism (RR, 0.82), whereas FHCWs with delayed burnout reported more prepandemic burnout (RR, 1.75) and caring for patients who died (RR, 3.12).

Conclusion

FHCW burnout may be mitigated through increasing their sense of value, support, and optimism; treating mental health symptoms; and counseling regarding workplace distress.
Prevention of Laboratory Animal Allergy and Impact of COVID-19 on Prevention Programs in the United States
Authors: Martin William E. , Darcey Dennis J. , Stave Gregg M.
Published: February 2023

Objective

Laboratory animal allergy (LAA) is common and preventable. This study provides a 10-year update on LAA prevention programs in the United States and the effect of COVID-19 on prevention practices.

Methods

An electronic survey was e-mailed to designated institutional officials at laboratory animal facilities identified by the National Institutes of Health Office of Laboratory Animal Welfare. Results were compared with the prior survey.

Results

A total of 141 institutions employing 58,224 laboratory animal workers responded. Results were similar to the prior survey with wide variation in practices. Medical surveillance increased (58%–71%), but N95 respirator use decreased (17%–13%). As before, only 25% of institutions knew their LAA incidence and prevalence rates. COVID-19 had a small time-limited effect on personal protective equipment use.

Conclusions

Universal use of evidence-based practices and improved medical surveillance would provide greater worker protection from LAA.
Resilience-Related Resources Predict Physicians’ Fatigue, Job Search Behavior, and Productivity Outcomes
Authors: Sinclair Robert R. , Sawhney Gargi , Jones Karyn O. , Pittman Mark A. , Watson Gwendolyn Paige , Bitner Matthew
Published: February 2023

Objective

The objective of this research was to assess the relative contribution of three resilience-related dispositional resources (trait mindfulness, core self-evaluations, and optimism) to emergency medicine physicians’ fatigue, retention, and productivity.

Methods

We surveyed emergency physicians employed by a national (US) medical staffing organization. The survey included measures of work stressors, resilience resources, job search behavior, and fatigue. We linked the survey responses to objective demographic and productivity measures from the organization’s records.

Results

A total of 371 respondents completed the survey. Multiple regression analyses demonstrated support for each of the three resilience-related resources as predictors. Relative weights analyses showed that resilience accounted for 14% and 62% of the outcome variance, whereas work demands accounted for between 32% and 56%.

Conclusions

Multiple facets of dispositional resilience are important predictors of emergency medicine physicians’ occupational health, retention, and productivity.
Survival and Disease Burden Analysis of Occupational Pneumoconiosis From 1956 to 2021 in Jiangsu Province
Authors: Duan Zhizhen , Zhou Lang , Wang Tong , Han Lei , Zhang Juan
Published: February 2023

Objectives

The aims of the study are to investigate the survival status and its influencing factors of pneumoconiosis patients and to analyze the disease burden and its trend in Jiangsu Province.

Methods

We used the life table and Cox model to analyze the survival status. The disease burden and its temporal trend were examined using the disability-adjusted life years (DALY).

Results

The average survival time was 16.22 ± 10.11 years. First diagnosis age, first diagnosis stage, and upgrade of stages were crucial risk factors for the survival. The cumulative DALY was 154,500.83 person-years. The DALY attributed to silicosis, coal worker pneumoconiosis, and welder’s pneumoconiosis were 99,806.72 (64.60%), 35,483.21 (22.97%), and 37,85.83 (2.45%) person-years, respectively.

Conclusions

Although the disease burden of pneumoconiosis is decreasing because of the implementation of relevant health policies and improved medical standards, the prevention and control of pneumoconiosis still need greater attention.
The Well-being of Brazilian Industry Workers on Returning to the Physical Workplace During the COVID-19 Pandemic
Authors: Santana Geilson Lima , Baptista Marcos Campello , Gomes de Matos Geórgia Antony , Ogata Alberto José Niituma , Malik Ana Maria , Andrade Laura Helena
Published: February 2023

Objective

Our aim was to assess the prevalence and predictors of well-being among Brazilian industry workers on returning to the physical workplace during the COVID-19 pandemic.

Methods

Two thousand two hundred forty-one participants completed an online survey between October and November 2021. Well-being was assessed with the World Health Organization Well-being Index, and the questionnaire also addressed sociodemographic and occupational characteristics and the health of workers and their contacts. Associations were estimated with logistic regression models.

Results

The prevalence of adequate well-being was 63.15%. The predictors of poor well-being included being female, younger, working exclusively from home or on a hybrid model, having comorbid disorders, and living with someone with any comorbidity.

Conclusions

The identification of vulnerable groups with poor well-being may help organizations to direct efforts to the unmet psychological needs of these employees and develop well-being programs during this transition.
Suicides in Massachusetts by Industry and Occupation, 2016–2019
Authors: Reid Michelle , Laing James , Tumpney Matthew , Cunningham Kelley , Chaneco Aynsley , Batista Mariel , Sparer-Fine Emily
Published: February 2023

Objective

To examine suicide deaths among working-age residents in Massachusetts and to determine industries and occupations with high numbers and rates of suicides.

Methods

The Massachusetts Violent Death Reporting System and Massachusetts death certificates were used to analyze suicide deaths from 2016 to 2019. Counts and rates were generated by demographics and industry and occupation groupings.

Results

There were 2199 working-age Massachusetts residents who died by suicide. Higher suicide rates were associated with being male, 65 years or older, White, and non-Hispanic or having military background. Suicide rates were higher among the construction industry sector and the construction and extraction occupational group compared with the average rate for all Massachusetts workers.

Conclusions

Suicide rates differed between industries and occupations, suggesting that work-related factors may play a role and should be considered when planning outreach initiatives and interventions.
Differences in Resilience and Mental Health Symptoms Among US First Responders With Secure and Insecure Attachment
Authors: Schuman Donna L. , Whitworth James , Galusha Jeanine , Carbajal Jose , Ponder Warren N. , Shahan Kathryn , Jetelina Katelyn
Published: February 2023

Objective

This observational study aimed to determine whether attachment style predicted first responders' mental health and resilience.

Method

Data were from a treatment-seeking sample of first responders (N = 237). Each participant completed six assessments measuring attachment, resilience, generalized anxiety, depression, suicidality, and posttraumatic stress disorder.

Results

On the attachment assessment, 25.3% were categorized as secure, 19.0% as dismissive, 25.3% as preoccupied, and 30.4% as fearfully attached. As predicted, securely attached participants had the lowest scores for generalized anxiety, depression, suicidality, and posttraumatic stress disorder and the highest scores on the resiliency measure, followed by dismissive, preoccupied, and fearfully attached participants.

Limitations

These data are cross-sectional and causality cannot be inferred.

Conclusions

Results highlight the importance of the study of attachment to psychotherapy and mental health treatment with first responders.
Service-Learning in Physician Assistant Education: A Scoping Review
Authors: Oliveira Ana L. , Smith Catherine H. , Xavier Neena A.
Published: February 2023

Introduction

Service-learning (SL) is a pedagogy that can be used in healthcare education to develop students who are better prepared to address the various social determinants of health and to provide compassionate care to the diverse populations they will serve. Yet, an assessment of the quality and scope of the SL activities used in physician assistant (PA) education is not available. The purpose of this scoping review is to review the literature and identify and summarize articles about SL courses in PA education.

Methods

We performed a scoping literature search of 4 databases (CINAHL, PubMed, Embase, and Scopus) to identify peer-reviewed journal articles about SL in PA education. Studies that did not include PA students, were not a service-learning activity (but instead an interprofessional activity, simulation, or volunteerism), or were not a full article were all excluded.

Results

Nine articles were included in this scoping review after independent evaluation by 2 investigators based on specific inclusion and exclusion criteria. The most common reason for exclusion was lack of distinct learning objectives specific to the service learning and/or a lack of a structured, guided critical reflection that helped realize and demonstrate the desired learning outcomes.

Discussion

Although service-learning is considered to be a high-impact teaching practice, it is still an underutilized tool in PA education. Training faculty in the implementation of SL to align the hands-on activity with specific course learning objectives and in the effective use of structured critical reflection can create a more impactful and authentic SL educational experience.
Male Sexual Abuse
Authors: Houghton Aimée W. , Knight Lesley Nicole , Joseph Rachel
Published: February 2023

Male victims of sexual abuse are often overlooked and marginalized. We seek to understand current literature surrounding male sexual assault victims with the ultimate goal of exploring the role of nursing in providing physical, spiritual, mental, and emotional care to the patient. We reviewed current literature, using keywords, including sexual assault/abuse, male sexual assault/abuse, male victims, female-perpetrated sexual assault, mental health, male survivors of sexual assault/abuse, and mental health of sexual assault/abuse survivors. Studies show that approximately one in six men is sexually abused in their lifetime, and the abuse often occurs before the age of 18 years (1in6, 2020). Male victims are less likely to report sexual abuse. Behavioral-specific questions may help identify this patient population to provide trauma-informed care. Nurses must be trained to identify, treat, and care for male sexual abuse victims. Any adverse events experienced in childhood must be appropriately addressed to prevent late effects in adulthood.
Metabolomic Profiling of Recombinant Erythropoietin (rHuEpo) in Trained Caucasian Athletes
Authors: Lima Giscard , Shurlock Jonathan , Wang Guan , Karanikolou Antonia , Sutehall Shaun , Pitsiladis Yannis P. , D'Alessandro Angelo
Published: February 2023

Objective:

Recombinant human erythropoietin (rHuEpo) is prohibited by the World Anti-Doping Agency but remains the drug of choice for many cheating athletes wishing to evade detection using current methods. The aim of this study was to identify a robust metabolomics signature of rHuEpo using an untargeted approach in blood (plasma and serum) and urine.

Design:

Longitudinal study.

Setting:

University of Glasgow.

Participants:

Eighteen male participants regularly engaged in predominantly endurance-based activities, such as running, cycling, swimming, triathlon, and team sports, were recruited.

Interventions:

Each participant received 50 IU·kg−1 body mass of rHuEpo subcutaneously every 2 days for 4 weeks. Samples were collected at baseline, during rHuEpo administration (over 4 weeks) and after rHuEpo administration (week 7-10). The samples were analyzed using hydrophilic interaction liquid chromatography mass spectrometry.

Main Outcome Measures:

Significant metabolic signatures of rHuEpo administration were identified in all biofluids tested in this study.

Results:

Regarding metabolomics data, 488 plasma metabolites, 694 serum metabolites, and 1628 urinary metabolites were identified. Reproducible signatures of rHuEpo administration across all biofluids included alterations of pyrimidine metabolism (orotate and dihydroorotate) and acyl-carnitines (palmitoyl-carnitine and elaidic carnitine), metabolic pathways that are associated with erythropoiesis or erythrocyte membrane function, respectively.

Conclusions:

Preliminary metabolic signatures of rHuEpo administration were identified. Future studies will be required to validate these encouraging results in independent cohorts and with orthogonal techniques, such as integration of our data with signatures derived from other “omics” analyses of rHuEpo administration (eg, transcriptomics).
Focused Extracorporeal Shock Wave Therapy for Ischial Apophysitis in Young High-Level Gymnasts
Authors: Omodani Toru , Takahashi Kenji
Published: February 2023

Objective:

We aimed to investigate the effect and safety of extracorporeal shock wave therapy (ESWT) on ischial apophysitis (IA) in young high-level gymnasts. We hypothesized that ESWT would be safe and effective in alleviating pain.

Design:

Retrospective case series.

Setting:

Funabashi Orthopedic Hospital.

Patients:

The subjects were 18 high-level gymnasts (mean age of 13 years) with a chief complain of chronic buttock pain diagnosed with IA.

Interventions:

Ten patients received only physiotherapy (PT), whereas 8 received both PT and ESWT to the ischial tuberosity. The basic protocol for ESWT was to use an energy dose of 0.20 mJ/mm2 or less with 3000 shots per session at 4-week intervals.

Main Outcome Measures:

We investigated whether PT and ESWT relieved the pain and allowed the patient to return fully to gymnastics. Based on radiographs at the last observation, we examined whether early closure of the apophyseal line of the ischium and around hip joint on the affected side occurred.

Results:

In the PT group, pain was relieved in 2 of 10 patients. In the ESWT group, pain was relieved and full return to gymnastics was possible in all 8 patients. None of the patients showed early closure of the apophyseal line.

Conclusions:

Extracorporeal shock wave therapy can be a safe and effective treatment option for IA in young high-level gymnasts.
Exploring the Factors Involved in Being “Ready” to Return to Sport Following a Concussion
Authors: Caron Jeffrey G. , Cadotte Gabrielle , Collict Cameron , Josee van Ierssel Jacqueline , Podlog Leslie
Published: February 2023

Objective:

To explore the factors involved in athletes being ready (or not) to return to sport (RTS) after sport-related concussion (SRC).

Design:

Qualitative, semistructured interviews.

Setting: Videoconference.

Participants: Twenty-two sport-injury stakeholders involved in contact and collision sports at various levels of competition (high school, university, professional), including: formerly concussed athletes (n = 4), coaches (n = 5), athletic therapists (n = 5), physiotherapists (n = 4), nurse practitioner (n = 1), and sports medicine physicians (n = 3).

Interventions:

N/A.

Main Outcome Measures:

We included questions in the interview guide regarding factors participants believed were involved in athletes being ready (or not ready) to RTS after a concussion.

Results:

Participants describedphysical(concussion symptoms, return to pre-injury fitness),behavioral(changes in behavior, avoidance, malingering),psychological(individual factors, cognitive appraisals, mental health), andsocial(isolation, social support, communication, pressure) factors that they believed were involved in athletes being ready to RTS after SRC.

Conclusions:

The graduated RTS strategy outlined in the most recent Concussion in Sport Group consensus statement focuses on physical aspects involved in being ready to RTS, which does not address behavioral, psychological, and social factors, which were identified by participants as being related to returning to sport post-SRC. More research is needed to determine whether the additional factors outlined in this study are relevant among larger samples of athletes, coaches, and healthcare professionals.
Mechanisms of Hamstring Injury in Professional Soccer Players: Video Analysis and Magnetic Resonance Imaging Findings
Authors: Jokela Aleksi , Valle Xavier , Kosola Jussi , Rodas Gil , Til Lluís , Burova Maria , Pleshkov Pavel , Andersson Håkan , Pasta Giulio , Manetti Paolo , Lupón Gabriel , Pruna Ricard , García-Romero-Pérez Alvaro , Lempainen Lasse
Published: February 2023

Objective:

To describe the injury mechanisms and magnetic resonance imaging (MRI) findings in acute hamstring injuries of male soccer players using a systematic video analysis.

Design:

Descriptive case series study of consecutive acute hamstring injuries from September 2017 to January 2022.

Setting:

Two specialized sports medicine hospitals.

Participants:

Professional male soccer players aged between 18 and 40 years, referred for injury assessment within 7 days after an acute hamstring injury, with an available video footage of the injury and positive finding on MRI.

Independent Variables:

Hamstring injury mechanisms (specific scoring based on standardized models) in relation to hamstring muscle injury MRI findings.

Main Outcome Measures:

Hamstring injury mechanism (playing situation, player/opponent behavior, movement, and biomechanical body positions) and MRI injury location.

Results:

Fourteen videos of acute hamstring injuries in 13 professional male soccer players were analyzed. Three different injury mechanisms were seen: mixed-type (both sprint-related and stretch-related, 43%), stretch-type (36%), and sprint-type (21%). Most common actions during injury moments were change of direction (29%), kicking (29%), and running (21%). Most injuries occurred at high or very high horizontal speed (71%) and affected isolated proximal biceps femoris (BF) (36%). Most frequent body positions at defined injury moments were neutral trunk (43%), hip flexion 45-90 degrees (57%), and knee flexion <45 degrees (93%). Magnetic resonance imaging findings showed that 79% were isolated single-tendon injuries.

Conclusions:

According to a video analysis, most hamstring injuries in soccer occur during high-speed movements. Physicians should suspect proximal and isolated single-tendon—most often BF—hamstring injury, if represented injury mechanisms are seen during game play. In addition to sprinting and stretching, also mixed-type injury mechanisms occur.