bluuebunny/crossref_metadata_2025_split huggingface dataset:
Black vs African American: Why are communication and clinical researchers not paying attention to what descendants of the African Diaspora want to be called, and why is that a problem?
Authors: Owusu Raiven , Ridley-Merriweather Katherine , Hoffmann-Longtin Krista 
Published: December 2020

Problem: Descendants of African Diaspora (DADs) in the U.S. experience greater health disparities than other racial or ethnic minority groups. Many factors play a role, including their lack of participation in clinical trials. By refusing to participate, DADs cannot benefit from medical research. The barriers to recruiting DADs is well discussed in literature, but we found no research suggesting that mislabeling participants could be creating another barrier. This essay delves into the history of labeling DADs to illuminate the existing tensions between the use of “Black” and “African American” and the impact they may have on recruitment.
Processes: Communication Theory of Identity and Critical Race Theory shaped our analysis of this mislabeling issue and its possible implications. Both theories offer insight into how an individual shapes and is simultaneously shaped by communication. We reviewed, summarized, and coded literature in the academic and popular press to answer the research question: How can mislabeling DADs possibly deter them from participating in clinical trials?
Findings: Within DADs, there are several subgroups with different cultural heritages that contribute to how people identify. Therefore, no “catch-all” label can be used to accurately describe DADs. Academic and popular press literature indicate that preferences exist amongst this group for how they wish to be identified. Researchers should realize that “Black” and “African American” are not perceived the same by many DADs and should refrain from using them interchangeably.
Conclusion: Given the current Black Lives Matter movement, it is imperative that health communication scholars and health researchers consider how language shapes participation and research outcomes for DADs. More research is needed to determine if the use of “Black” and “African American” interchangeably creates another barrier to the recruitment of DADs. However, if possible, researchers should take time to note the preferences of their target populations prior to recruitment.
Review of mechanisms of brain injury identified in severe malaria from 2010-2020
Authors: Patel Minal , Gopinadhan Adnan , Co Katrina , Belvin Amy , Opoka Robert , Bangirana Paul , Datta Dibyadyuti , John Chandy 
Published: December 2020

Background:
Severe malaria manifests as various conditions with severe malarial anemia being the most common and cerebral malaria being the most severe and affecting over 200,000 children annually. A 2010 review highlighted blood brain barrier degradation and decreased cerebral perfusion as contributors to the long-term behavioral, cognitive, and neurological sequalae of severe malaria. Since then, new research has identified various surface marker proteins and cytokines/chemokines playing a role in vascular changes and inflammation that progresses to acute kidney injury, retinopathy, and seizures. Our goal is to summarize the updated research and provide further insight into the mechanisms of brain injury and the outcomes that follow cerebral malaria.

Project Methods:
Hypotheses on future areas of study from the 2010 review were used to generate an outline for the updated review. Search strategies using the PubMed database were developed so that all relevant primary articles pertaining to human (pediatric and adult), murine, and in vitro studies done from 2010-2020 could be identified. The articles were then sorted and inputted into EndNote to generate a library. Review articles, case reports, and articles discussing the treatment of malaria were excluded from this index.

Results:
88 articles remarking on vasculopathy, 88 on leukocytes, 114 on cytokines/chemokines, 11 on seizures, 56 on acute kidney injury, and 35 on retinopathy have been identified as promising literature for this review. The results suggest that infected individuals have increased endothelial activation which promotes red blood cell adherence to vasculature and edema. This reduces blood flow to the brain, kidneys, and eyes and causes injury to the organs.

Conclusion and Potential Impact:
The EndNote library contains current literature on the mechanisms of brain injury secondary to severe malaria, which will be used to write a review article and identify new areas of research to further our understanding of severe malaria pathogenesis and how to target treatments.
Resumption of Driving after Total Hip Arthroplasty: A Systematic Review and Meta-Analysis
Authors: Patel Purva , Palma Samantha , Palan Jeya , Pandit Hemant , Van Duren Bernard 
Published: December 2020

Background/Objective:
The advice given to patients on resumption of driving after total hip arthroplasty (THA) is inconsistent. Due to a lack of clear guidelines, surgeons make recommendations in the range of waiting 4 to 8 weeks after surgery to resume driving. Driving is a crucial part of daily life thus, withholding driving longer than necessary can have a detrimental social and economic impact on the patient. However, it is equally important to ensure that patients only resume driving once safe. This study presents a systematic review of the literature and a meta-analysis of simulation studies to establish when it is safe for patients to return to driving after hip arthroplasty.

Methods:
The review was performed according to the PRISMA guidelines. Medline, EMBASE, and CENTRAL databases were searched to June 2020 for studies examining ‘return to driving’ or ‘brake reaction time’ after ‘total hip arthroplasty’. Titles and abstracts were screened for inclusion, data was extracted, and studies were assessed for risk of bias. Review Manager, Version 5.4 was used for statistical analysis.

Results:
A total of 14 articles met the inclusion criteria. Of these, 7 measured brake reaction time and were included in the meta-analysis. The pooled means of both right and left THA show a brake reaction time (BRT) around or just above baseline at 1 week, 2 weeks and 3 weeks, and below baseline at 6 weeks, 12 weeks, 32 weeks and 52 weeks. Of these, the pooled means at 6, 32, and 52 weeks were significant (p < 0.05).

Conclusion:
The mean recommended return to driving time was 4.5 weeks. Based upon the meta-analysis of BRT, it appears that it is safe to return to driving at 6 weeks post operatively. Orthopedic surgeons should use these results as a guideline when advising patients on when to resume driving.
Pancreatic Islet Composition Affects Hormone Secretion in Isolated Alpha and Beta cells
Authors: Phillips William , Brissova Marcella , Kilburn Julie , Niland Joyce , Evans-Molina Carmella 
Published: December 2020

Background/Objective:
The Integrated Islet Distribution Program (IIDP) distributes islets from five isolation Centers and serves as the main source of human islets for research in the U.S. In 2016, the IIDP initiated the Human Islet Phenotyping Program (HIPP), which provides standardized post-shipment assessment of islet hormone secretion and endocrine cell composition for each IIDP-supported islet isolation. To date, islets from 276 non-diabetic donors have been analyzed. We hypothesized that analysis of this unique resource will provide novel insights into how demographic and clinical features impact islet health.

Methods:
Relationships between insulin and glucagon secretion assessed by perifusion and islet composition (% of β- and α-cells) were analyzed using SAS Version 9.4. For each analysis, the isolation center was used as a covariate.

Results:
Of the 276 donors, 60% were male; 59% of donors were Caucasian, 28% were Hispanic, 9% were African-American; 4% were Asian; and 0.36% were American Indian. The % of β-cells was moderately correlated with insulin responses to 16.7 mM glucose (r=0.2785; p<0.0001) and 20 mM KCL (r=0.3109, p<0.0001). Similarly, the α-cell% was moderately correlated with total glucagon content (r=0.3362, p<0.0001) and glucagon responses to 1.7 mM glucose + 1mM epinephrine (r=0.2015, p=0.0001). The % of β -cells was negatively correlated with glucagon total content (r=-.243,p=.0001), while the α-cell% was negatively correlated with insulin stimulation index to KCL (r=-0.2573, p<0.0001). Notably, Asian donors exhibited a significantly higher β-cell% compared to other groups (p<0.05). Consistent with this, glucose-stimulated insulin secretion was higher in Asian donors compared to responses observed in islets from African American donors (p<0.01).

Conclusion:
These data indicate that islet cell composition influences insulin and glucagon secretory responses and suggests that race may impact islet composition and hormone secretion. Continued analysis of the HIPP dataset may aid in our understanding of risk factors for the development islet dysfunction in diabetes.
Retrospective Review of Interventional Radiology Treatment and Outcomes in Pediatric Liver Disease
Authors: Purk Anna , Pfaff Sean , Marshalleck Francis , Molleston Jean 
Published: December 2020

Background: Interventional radiology (IR) procedures offer less invasive and low risk options for the treatment of pediatric liver abnormalities, as well as life sustaining measures to bridge patients to transplant. Literature regarding IR interventions for pediatric liver disease is limited. Common conditions that can be treated with IR procedures include vascular anomalies: congenital portosystemic shunts, arteriovenous malformations (AVM), and Budd-Chiari malformation. Transjugular intrahepatic portosystemic shunt (TIPS) can be used to prevent recalcitrant variceal bleeding in portal HTN. Liver biopsy (percutaneous and transjugular) is used to sample the liver and can be targeted to tumors and other lesions. Percutaneous approaches to image biliary abnormalities and treat strictures are useful in children after liver transplant and also without.,

Objective: describe liver IR procedures and their outcomes in a single-center cohort study

Methods: Patients will be identified through retrospective chart review at Riley Hospital for Children to identify and record the diagnoses, interventions, and relevant outcomes for eligible patients. Descriptive statistics can then be performed. This data set can be used to help inform clinicians on indications and expected outcomes for relevant hepatic IR procedures.

Conclusion: It is anticipated that data collected for this project will show increased utilization of these procedures at the end of the study period compared to the beginning, and the complication rate for the IR procedure will be lower when compared to equivalent traditional procedures to treat the same condition.
Hepatic microRNAs in Type II Diabetes Pathogenesis
Authors: Qian Gene , Morral Nuria 
Published: December 2020

Background/Objective:
Diabetes mellitus is a disease with increasing incidence worldwide affecting more than 435 million patients, most of whom have Type II diabetes (T2D). Of the many organs affected by T2D, the liver is responsible for much of the dysregulated metabolic pathways in response to insulin signaling. These include, but are not limited to gluconeogenesis, glycogen storage, fatty acid and cholesterol biosynthesis and transport, and fatty acid oxidation. Recent studies show significant differences in miRNA expression profiles between healthy and disease states of T2D. This implicates an important role of miRNAs in T2D pathogenesis and makes miRNAs an attractive therapeutic target and diagnostic marker for T2D patients. The aim of this review is to provide an overview of the hepatic miRNAs relevant to T2D pathogenesis.

Methods:
We compiled and reviewed articles from the PubMed database that were relevant to miRNAs and T2D pathogenesis in the liver.

Results:
We found that hepatic miRNAs affect most if not all dysregulated metabolic pathways in T2D pathogenesis, which we categorized into carbohydrate metabolism, lipid metabolism, and insulin signaling. The miRNAs that are most represented in our literature include miR-122, miR-33a/b, miR-29, and miR-21. These miRNAs target a variety of molecules, including transcription factors that are master regulators of metabolic pathways (FOXO1, HNF4α), lipid transporters (ABCA1, ABCG1), or key insulin signaling molecules (IRS1/2, caveolin-1). In addition, circulating miR-122 is associated with the risk of developing metabolic syndrome and T2D in the general population.

Conclusion and Potential Impact:
Multiple miRNAs are dysregulated in the liver of animal models of T2D. Administration of miRNA mimics or antagomirs to correct aberrant miRNA expression improved the pathophysiology in vivo. miRNAs are also promising tools as markers for disease development. Ultimately, the identification of miRNAs can guide future research to facilitate the diagnosis and improve the treatment of T2D.
Effects of Irregular Shifts on Incidence of Type II Diabetes Among Healthcare Workers
Authors: Rameswara Varun , Blevins Amy , Eckert George , Jusufbegovic Denis , Bhatwadekar Ashay 
Published: December 2020

Background/Objective:
The prevalence of shift work ranges around 20% among American and European workers and is significantly higher in the healthcare field. Variable work schedules among shift workers are associated with adverse health effects, including the increased risk of metabolic disorders and obesity. This systematic review aims to evaluate the association between shift work and type 2 diabetes/insulin resistance.

Methods:
This research is part of a more extensive systematic review that has been registered on Prospero. Due to time constraints, we began with a scoping search with the goal of completing a rapid review. Searches were completed using the Ovid and PubMed databases with the following keywords and subject headings: Health Personnel; Shift Work Schedule; Circadian Rhythm; Work Schedule Tolerance; Metabolic Diseases; Overweight; Glucose Metabolism Disorders; Lipid Metabolism Disorders; Malabsorption Syndromes; Metabolic Syndrome; and Diabetes Mellitus. The resulting articles were uploaded onto Covidence for screening and data extraction. After screening the abstracts for diabetes and insulin resistance, eight articles were selected for the full-text screening of which data extraction was performed on three.

Results:
Overall, 163,555 participants performing evening, night, rotating shifts, or regular shifts were identified in the three studies. The average age of study participants was found to be 44.0 yrs, 163,422 were females (>99.9%), and of the total participants, 98,303 subjects were shift workers (60.10%). For healthcare shift workers, there was a significant association between shift work and diabetes across all three studies; however, the effect was modest (relative risk in the range of 1.19-1.26).

Conclusion:
There is a positive relationship between shift work and diabetes among healthcare workers. Therefore, strategies focusing on reducing shift work or treating these workers as a high-risk group for diabetes by taking measures to minimize other exposures will be beneficial in reducing the incidence of diabetes among this population.
Evaluation of Consultation Notes Within and Across Institutions: A Preliminary Study
Authors: Sangani Amee , Savoy April 
Published: December 2020

Background/Objective: Patients with multiple chronic conditions require specialty consultations both within and across institutions for effective co-management of comorbidities. Poor communication during the referral process increases physician workload, patient burden and risks. Successful co-management relies on bi-directional information flow that supports interpersonal communication and establishment of clear tasks and responsibilities among physicians. However, flow of health information is often limited to specific health network access, phone calls, or faxes. Interpersonal communication is dependent on limited encounter notes. In this preliminary study, our objective was to understand how consultants’ notes support physician collaboration within and across health care institutions.

Project Methods: To assess consultants’ notes, outpatient charts were randomly selected from the Indiana Network for Patient Care database representing consultations with five different specialties within the IU Health network, including referrals from within and outside of IU Health. The Quality of Consult Assessment tool was adapted to assess content of notes, emphasizing clinical recommendations, distribution of tasks and responsibilities, and communication plans.

Results: Our sample included ten charts for patients who had comorbidities. All notes contained clinical recommendations that included an assessment and plan. 70% of notes contained explicit responsibilities of the consultants. Conversely, only one contained explicit responsibilities for referrers. Charts denoted reliance on support staff to send messages between referrers, consultants, and patients via phone and fax. Phone calls and faxes were more prominent in referrals across institutions.

Conclusion and Impact: Our preliminary findings indicate that current clinical documentation supports specialty referrals for transitions of care rather than co-management of care. Difficulties in accessing patient charts across institutions leads to a lack of clinical context and workflow inefficiencies when attempting to co-manage care. These findings demonstrate negative implications in health outcomes for patients with multiple comorbidities that require more care coordination within and across institutions.
Subsequent opioid overdose resulting in death in individuals in Allen County, Indiana who receive naloxone administration for past opioid overdose
Authors: Schwartz Cassandra , Dykstra Thomas , Sanders Jana 
Published: December 2020

Background and Hypothesis:
Over-prescription of opioids has contributed to increases in opioid overdose (OOD) and OOD deaths. Studies suggest recurring OODs in an individual could be contributing. After a non-fatal overdose, one study found 7% of patients continued to abuse opioids and had another OOD within 1 year. Additionally, the literature suggests a positive correlation between non-fatal overdose and increased risk of subsequent overdose death. Allen County has also experienced increases in overdoses and overdose deaths. We aim to isolate opioid-specific overdoses and deaths in Allen County from current overdose data. We hypothesize individuals in Allen County who received naloxone for OOD have an increased risk of death from a subsequent OOD. An additional objective is to utilize data from the county ambulance service and the two major Allen County health systems to gain more accurate and current accountings of the OOD data.

Methods:
This study is a retrospective case-control using electronic medical records and/or electronic patient care reports from the Three Rivers Ambulance Authority, Parkview Health, and Lutheran Health Network. Patients who received naloxone between 2018-2020 will be divided into a case group of individuals who died of OOD and a control group of living individuals. Demographics and naloxone administrations data per subject will be collected. Box-and-whisker plots, a Mann-Whitney U Test, and a Wilcoxon matched-pairs signed rank test will be done for comparisons.

Results and Conclusion:
This project has resulted in a study protocol ready for IRB submission with IRB approval and study start date anticipated for Summer 2021.

Potential Impact:
This study will add to existing knowledge on OOD and subsequent OOD death. Specifically, this study will provide more accurate and current accountings of the OOD data that may aid in the development of policy and interventions to reduce the local opioid crisis.
Application of Viscoelastic testing to the field of Otolaryngology Head and Neck Surgery: A Scoping Review
Authors: Shariff Faisal , Marsee Mathew , Walsh Mark 
Published: December 2020

Background:
In Otolaryngology Head and Neck Surgery (OHNS), hematologic management requires attention to the intricate nature of hemostatic competence. Elderly patients can experience drug induced coagulopathies. Strategies are needed in order to minimize hemorrhagic and thromboembolic risk and maximize positive outcomes. Viscoelastic tests (VETs) such as Thromboelastography (TEG) and Rotational Thromboelastometry (ROTEM) have been used to guide blood component therapy. The purpose of this scoping review is to understand the utilization of VETs in OHNS.

Methods:

This scoping review included studies that discussed the utilization of VETs in the field of OHNS. The inclusion criteria was studies that discussed the application of VETs in Flap/Plastic Reconstruction, Facial Trauma/Resuscitation, Tonsillectomy, Obstructive Sleep Apnea (OSA), Epistaxis, Sinus Surgery, and HNC Resection. Studies that focused on general medical VET use were not included.

Results:

Fourteen articles met the study inclusion criteria from an initial pool of 45 articles. Seven articles discussed the use of VETs in free flap/reconstructive surgery, five articles explored use in HNC, two articles discussed use in facial trauma and resuscitation, one article mentioned use in OSA, and one article examined use in epistaxis.

Conclusion and potential impact:

Of the fourteen articles included, two articles found no clinically significant association between TEG parameters and flap loss or complications. Five studies found that TEG or ROTEM helpful in predicting coagulation clotting, a prothrombotic state, or a hyperfibrinolytic state in free flap and HNC patients. For facial trauma and HNC cancer patients two different studies found ROTEM helpful in guiding blood component resuscitation. Using the TEG, one study demonstrated a hypercoagulable state in OSA patients. This review encourages wider use of VETs in OHNS in order to monitor hemostasis and improve surgical outcomes. Further research is necessary to better understand how VETs can tailor hematologic management of OHNS patients.