bluuebunny/crossref_metadata_2025_split huggingface dataset:
Causes of Death in the 12 Months After Hospital Discharge Among Patients With Opioid Use Disorder
Authors: King Caroline , Cook Ryan , Korthuis P. Todd , Morris Cynthia D. , Englander Honora 
Published: September 2021

Background
Patients with substance use disorders are seven times more likely hospitalized than the general population. However, causes of death for recently hospitalized patients with Opioid Use Disorder (OUD) are not well described. This study describes causes of death in the year post-discharge among hospitalized patients with OUD.

Methods
We analyzed data from participants who were at least 18 years old, with Medicaid insurance, and had a diagnosis of OUD during a general hospital admission in Oregon between April 2015 and December 2017.

Results
During the study window, 6,654 Oregon Medicaid patients with an OUD diagnosis were hospitalized. Patients were predominately female (56.7%) and White (72.2%), an average age of 44.2 years (SD = 15.4 years) and average hospital length of stay of 6.5 days (SD = 10.9 days). In the 12 months post-discharge, 522 patients died (7.8%); 301 patients from a drug or substance related cause (4.5%), including 71 from drug overdose (1.1%). Stated another way, of those who died within 12 months, 58% of deaths were attributed to drug-related causes, including 13.6% of deaths attributed to overdose; 42% died of non-drug related causes. Drug-related death was the most frequent cause of mortality.

Conclusions
Hospitalized patients with OUD are at high risk of death, from drug and non-drug related causes, in the year after discharge. Future research should consider not only overdose, but a more comprehensive definition of drug-related death in understanding post-discharge mortality among hospitalized patients with OUD, and care systems should work to mitigate the risk of death in this population.
An Interdisciplinary Approach to Reducing NEC While Optimizing Growth
Authors: Noonan Jane M. 
Published: September 2021

Background:
Necrotizing enterocolitis (NEC) and postnatal growth restriction are significant clinical dilemmas that contribute to short- and long-term morbidities for the most premature infants.

Purpose:
After a rise in NEC rates in a regional neonatal intensive care unit (NICU), improvement practices were implemented by an interdisciplinary quality improvement (QI) work group whose focus was initially on nutrition and growth. QI work was refocused to address both NEC and growth concurrently.

Methods:
Through various QI initiatives and with evolving understanding of NEC and nutrition, the work group identified and implemented multiple practices changes over 2-decade time span. A standardized tool was used to review each case of NEC and outcomes were continually tracked to guide QI initiatives.

Local Findings:
Focused QI work contributed to a significant reduction in NEC rates from 16.2% in 2007 to 0% in 2018 for inborn infants. Exclusive human milk diet was a critical part of the success. Postnatal growth outcomes initially declined after initial NEC improvement work. Improvement work that focused jointly on NEC and nutrition resulted in improved growth outcomes without impacting NEC.

Implications for Practice:
Use of historical perspective along with evolving scientific understanding can guide local improvement initiatives. Work must continue to optimize lactation during NICU hospitalization. More research is needed to determine impact of care practices on gastrointestinal inflammation including medication osmolality, probiotics, and noninvasive respiratory support.
Proximal Humerus Geriatric Fracture Care: Fix, Replace, or Nonoperative Treatment?
Authors: O'Donnell Jeffrey A. , Gage Mark J. 
Published: September 2021

Summary:
Decision-making in the treatment of proximal humerus fractures can be challenging. A careful assessment of the patient's anticipated activity and specific fracture features can help determine which treatment strategy best aligns with an individual's goals. Treatment of geriatric proximal humerus fractures is dependent on these factors and an awareness of one's own technical ability.
Advances in Geriatric Hip Fractures: Pre-Operative Considerations and Tips to Optimize Outcome
Authors: Marenghi Natalie Marie , Tyler-Paris Pilson Holly , Halvorson Jason J. 
Published: September 2021

Summary:
Geriatric hip fractures are complicated by increased morbidity and mortality, and their incidence continues to rise around the world. Frequent considerations in treating geriatric hip fractures include optimal time to surgery, need for preoperative cardiac clearance, risks of operating through anticoagulation, utilization of regional anesthesia, and collaborative care between treatment teams. This article aims to summarize these factors as well as to provide some tips and tricks that can be helpful in their surgical management.
Modified Lumbopelvic Technique Using S1 Pedicle Screws for Spinopelvic Dissociation U-Type and H-Type Sacral Fractures With Kyphotic Deformity
Authors: Saiz Augustine M. , Shieh Alvin K. , Hideshima Kelsey , Wong Felix , Klineberg Eric O. , Eastman Jonathan G. 
Published: September 2021

Summary:
Spinopelvic dissociation injuries are complex injuries defined as discontinuity between the appendicular and axial skeleton. Fracture patterns are variable, but U-type and H-type fractures are common and often present with kyphotic deformity along with translational displacement and impaction. The ideal method of fixation has not been established for these injuries. The goals of treatment include restoration of alignment, stability, and neural decompression as needed. Traditional methods of lumbopelvic fixation have spanned the upper sacral fracture site. Our novel modified method of lumbopelvic fixation directly instruments the S1 body. This allows for direct manipulation of the fracture which we theorize improves reduction and increases stability across the fracture. This article characterizes the injury patterns, outlines the modified technique, and reports the clinical and radiographic outcomes of our modified lumbopelvic fixation technique and construct.
Effectiveness of azithromycin mass drug administration on trachoma: a systematic review
Authors: Xiong Tao , Yue Yan , Li Wen-Xing , Choonara Imti , Qazi Shamim , Chen Hong-Ju , Tang Jun , Shi Jing , Wang Hua , Zeng Li-Nan , Xia Bin , Qiao Li-Na , Qu Yi , Mu De-Zhi 
Published: September 2021

Backgrounds:
Azithromycin mass drug administration (MDA) is a key part of the strategy for controlling trachoma. This systematic review aimed to comprehensively summarize the present studies of azithromycin MDA on trachoma; provide an overview of the impact of azithromycin MDA on trachoma in different districts; and explore the possible methods to enhance the effectiveness of azithromycin MDA in hyperendemic districts.

Methods:
PubMed, Embase, the Cochrane Central Register of Controlled Trials, Web of Science, and ClinicalTrials.gov were searched up to February 2021 with no language restriction. Studies reporting the effect of azithromycin MDA on trachoma were included. Mathematical modeling studies, animal studies, case reports, and reviews were excluded. The trachomatous inflammation-follicular (TF) <5.0% was used to judge the effect of azithromycin MDA on eliminating trachoma as a public health problem. Two researchers independently conducted the selection process and risk of bias assessment.

Results:
A total of 1543 studies were screened, of which 67 studies including 13 cluster-randomized controlled trials and 54 non-randomized studies were included. The effect of azithromycin MDA on trachoma was closely related to the baseline prevalence in districts. For the districts with baseline prevalence between 5.0% and 9.9%, a single round of MDA achieved a TF <5.0%. For the districts with baseline between 10.0% and 29.9%, annual MDA for 3 to 5 years reduced TF <5.0%. However, for the districts with high level of baseline prevalence (TF >30.0%), especially with baseline TF >50.0%, annual MDA was unable to achieve the TF <5.0% even after 5 to 7 years of treatment. Quarterly MDA is more effective in controlling trachoma in these hyperendemic districts.

Conclusions:
Azithromycin MDA for controlling trachoma depends on the baseline prevalence. The recommendation by the World Health Organization that annual MDA for 3 to 5 years in the districts with TF baseline >10.0% is not appropriate for all eligible districts.
Racial, Ethnic, and Sociodemographic Disparities in Diagnosis of Children with Autism Spectrum Disorder
Authors: Aylward Brandon S. , Gal-Szabo Diana E. , Taraman Sharief 
Published: September 2021

ABSTRACT:
This special article uses a biosocial-ecological framework to discuss findings in the literature on racial, ethnic, and sociodemographic diagnostic disparities in autism spectrum disorder. We draw explanations from this framework on the complex and cumulative influences of social injustices across interpersonal and systemic levels.
Evaluation of Radiation Shielding Requirements and Self-shielding Characteristics for a Novel Radiosurgery System
Authors: Cao Qinjian , Tan Jun , Ren Yue , Xiong Wanchun , Wei Xiaofeng , Cheng Wei 
Published: September 2021

Abstract
In order to provide safe operating conditions for radiation workers and the public at large, the radiation shielding for radiotherapy treatment rooms will have to be determined by an expert physicist according to the applicable radiation control regulations. A new radiosurgery system with integrated self-shielding, called the Zap-X, obviates the need for costly and complex radiation bunkers. Radiation levels in the vicinity of the ZAP-X radiosurgery system were acquired for a number of different operating conditions, and a 3D radiation dose distribution was measured for better visualization of hot spots and the general dose distribution. The radiation shielding requirements were evaluated according to the International and Chinese standards, respectively. While the integral self-shielding of the Zap-X was designed in accordance with international standards, it was found to be insufficient for Chinese standards. In order to meet the needs of the growing new generation of radiotherapy equipment, several suggestions for improvement of Chinese standards are proposed.
A Comparison of Current Methods for the Determination of Ra-226 and Ra-228 in Water by a Modified Georgia Tech Gamma Method Vs. US Environmental Protection Agency Drinking Water Methodologies
Authors: Nguyen Dao M. , Moody W. Allen , Williamson John A. 
Published: September 2021

Abstract
Radium is a significant source of human radiation exposure both from natural sources (NORM, or Naturally Occurring Radioactive Material) and from technologically enhanced natural radioactive material (TENORM). Gamma analysis for 226Ra and 228Ra in water using high purity germanium (HPGe) detectors was compared with current methods from the US Environmental Protection Agency (EPA) using alpha scintillation and gas proportional counters. Extensive evaluations of a modified version of the original Georgia Tech HPGe method were performed. Known value 226Ra samples from the US Department of Energy (DOE) Mixed-Analyte Performance Evaluation Program (MAPEP) program, mixed 226Ra and 228Ra samples from the Environmental Resource Associates Quality Assurance Program (ERA), and mixed 226Ra and 228Ra samples from the Laboratory Proficiency Testing Program of the International Atomic Energy Agency (IAEA) were used for cross-check comparisons of the modified Georgia Tech method with other methodologies (EPA 903.1 and Ra-05 for 226Ra and 228Ra, respectively). Minimum counting times for our gamma instrumentation to reach a minimum detectable activity (MDA) of 0.04 Bq L−1 were also determined.
HYPERREFLECTIVE FOCI AS IMPORTANT PROGNOSTIC INDICATORS OF PROGRESSION OF RETINITIS PIGMENTOSA
Authors: Huang Chu-Hsuan , Yang Chang-Hao , Lai Ying-Ju , Hsiao Chuhsing Kate , Hou Yu-Chih , Yang Chung-May , Chen Ta-Ching 
Published: September 2021

Purpose:To investigate the presence and clinical relevance of hyperreflective foci (HRFs) in retinitis pigmentosa.Methods:Seventy seven retinitis pigmentosa cases were retrospectively reviewed. The 10-mm wide cross-line macular scans in optical coherence tomography were acquired. Hyperreflective foci were classified according to the location in optical coherence tomography: outer layers within the macula (HRF-outer-central), macular border beyond the central 3 mm (HRF-outer-perifoveal), and choroid (HRF-choroidal). The visual acuity at baseline, at 12 months, and other fundus characteristics were collected.Results:The mean logMAR best-corrected visual acuity decreased from 0.59 ± 0.66 (20/78 in Snellen) to 0.74 ± 0.81 (20/106 in Snellen) in 1 year. Sixty-six (42.9%), 105 (68.2%), and 98 (63.6%) eyes were classified to HRF-outer-central, HRF-outer-perifoveal, and HRF-choroidal group, respectively. Hyperreflective foci were positively correlated with poorer vision, central macular thinning, and ellipsoid zone disruption (allP< 0.001). Worse vision was associated with older age, macular involvement, and the coexistence of two or three HRF groups (P= 0.014, 0.047, 0.019, <0.001, respectively). Hyperreflective foci developed more frequently in patients with thick choroid than in those with thin choroid. The coexistence of three HRF groups was correlated with quicker visual deterioration (P= 0.034).Conclusion:Hyperreflective foci are common in retinitis pigmentosa and can be a negative prognostic indicator of macular thickness and visual preservation. Thick choroid was associated with all groups of HRFs, especially HRF-choroidal.
STRAWBERRY RETINA: SILICONE OIL–RETINA INTERFACE ON MULTIMODAL IMAGING
Authors: Pilli Suman , Murjaneh Salem 
Published: September 2021

Purpose:
To report a new photographic macular feature identified on multimodal imaging in eyes with silicone oil in situ.

Methods:
Retrospective, observational case series of three eyes of three patients.

Results:
Two eyes had undergone initial vitrectomy for vitreous hemorrhage with fibrovascular membranes causing tractional retinal detachments secondary to retinovascular occlusion. One eye had further vitrectomy for rhegmatogenous retinal detachment complicated with proliferative vitreoretinopathy. All three eyes had multiple, discrete, coarse, hyperreflective deposits at the silicone oil–retina interface on optical coherence tomography macular scans, with increased reflectivity from the inner retinal layers. On multicolor and infrared images, these preretinal deposits produced hyporeflective darker spots giving a quasi-pitting appearance of the retinal surface against glossy bright reflection from silicone oil, thus simulating an appearance of ‟a strawberry.” These deposits are causing inverse pitting of the oil bubble. On blue autoflourescence imaging, the preretinal deposits caused hypoautoflourescence. Partial silicone oil emulsification was seen superiorly in two of these patients with a different clinical and optical coherence tomography appearance from these hyperreflective macular deposits.

Conclusion:
We describe a new distinctive ‟Strawberry Retina” appearance identified on multicolor and infrared macular images associated with hyperreflective, coarse deposits at the silicone oil–retina interface.
To tolerate weather and to tolerate pain: two sides of the same coin? The Tromsø Study 7
Authors: Farbu Erlend Hoftun , Rypdal Martin , Skandfer Morten , Steingrímsdóttir Ólöf Anna , Brenn Tormod , Stubhaug Audun , Nielsen Christopher Sivert , Höper Anje Christina 
Published: September 2021

Abstract
It is a common belief that weather affects pain. Therefore, we hypothesized that weather can affect pain tolerance. This study used data from over 18,000 subjects aged 40 years or older from the general population, who participated in the Tromsø Study 7. They underwent a one-time assessment of cuff algometry pressure pain tolerance (PPT) and cold pain tolerance (CPT), tested with a cold pressor test. The results showed a clear seasonal variation in CPT. The rate of withdrawal in the cold pressor test was up to 75% higher in months in the warmer parts of the year compared with January 2016. There was no seasonal variation in PPT. The study not only found a nonrandom short-term variation in PPT but also indications of such a variation in CPT. The intrinsic timescale of this short-term variation in PPT was 5.1 days (95% % confidence interval 4.0-7.2), which is similar to the observed timescales of meteorological variables. Pressure pain tolerance and CPT correlated with meteorological variables, and these correlations changed over time. Finally, temperature and barometric pressure predicted future values of PPT. These findings suggest that weather has a causal and dynamic effect on pain tolerance, which supports the common belief that weather affects pain.
Declines and regional variation in opioid distribution by U.S. hospitals
Authors: Eidbo Sarah A. , Kropp Lopez Amalie K. , Hagedorn Joseph D. , Mathew Varkey , Kaufman Daniel E. , Nichols Stephanie D. , McCall Kenneth L. , Piper Brian J. 
Published: September 2021

Abstract
The United States is enduring a preventable opioid crisis, particularly involving a population being treated in a hospital setting, a subset of whom may escalate to illicit opioids. This project analyzed trends in distribution of opioids by hospitals in the United States. Opioids monitored included buprenorphine, codeine, fentanyl, hydrocodone, hydromorphone, meperidine, methadone, morphine, oxycodone, oxymorphone, powdered opium, remifentanil, and tapentadol. The Automation of Reports and Consolidated Orders System (ARCOS) reports on substances controlled by the Drug Enforcement Administration. National data from ARCOS reports 5 and 7 from 2000 to 2019 were used for an observational study on hospital opioid distribution. Morphine milligram equivalents (MMEs) were calculated using oral conversion factors. The MME per person per state was calculated to compare data from the peak year, 2012, with data from 2019. Opioid use peaked in 2012, with a −46.6% decline from 2012 to 2019. Half (25) of the states have seen a decrease of −50% or greater. Of the opioid compounds observed, buprenorphine has seen increased (+122.5%) hospital use from 2012 to 2019. All other opioids have been experiencing a decline (≥50%), particularly hydromorphone (−49.9%), oxymorphone (−57.7%), methadone (−58.7%), morphine (−66.9%), codeine (−67.5%), and meperidine (−77.6%). There was a 6-fold difference in population-corrected use of opioids in 2019 between the lowest (6.8 MME/person in New Jersey) and highest (Alaska = 39.6) states. This study demonstrates the considerable progress made thus far by hospitals in curbing the U.S. opioid crisis.
Measurement properties of grimace scales for pain assessment in nonhuman mammals: a systematic review
Authors: Evangelista Marina C. , Monteiro Beatriz P. , Steagall Paulo V. 
Published: September 2021

Abstract
Facial expressions of pain have been identified in several animal species. The aim of this systematic review was to provide evidence on the measurement properties of grimace scales for pain assessment. The protocol was registered (SyRF#21-November-2019), and the study is reported according to the PRISMA guidelines. Studies reporting the development, validation, and the assessment of measurement properties of grimace scales were included. Data extraction and assessment were performed by 2 investigators, following the COnsensus-based Standards for the Selection of Health Measurement INstruments guidelines. Six categories of measurement properties were assessed: internal consistency, reliability, measurement error, criterion and construct validity, and responsiveness. Overall strength of evidence (high, moderate, and low) of each instrument was based on methodological quality, number of studies, and studies' findings. Twelve scales for 9 species were included (mice, rats, rabbits, horses, piglets, sheep or lamb, ferrets, cats, and donkeys). Considerable variability regarding their development and measurement properties was observed. The Mouse, Rat, Horse and Feline Grimace Scales exhibited high level of evidence. The Rabbit, Lamb, Piglet and Ferret Grimace Scales and Sheep Pain Facial Expression Scale exhibited moderate level of evidence. The Sheep Grimace Scale, EQUUS-FAP, and EQUUS-Donkey-FAP exhibited low level of evidence for measurement properties. Construct validity was the most reported measurement property. Reliability and other forms of validity have been understudied. This systematic review identified gaps in knowledge on the measurement properties of grimace scales. Further studies should focus on improving psychometric testing, instrument refinement, and the use of grimace scales for pain assessment in nonhuman mammals.
Benefit–risk assessment and reporting in clinical trials of chronic pain treatments: IMMPACT recommendations
Authors: Kleykamp Bethea A. , Dworkin Robert H. , Turk Dennis C. , Bhagwagar Zubin , Cowan Penney , Eccleston Christopher , Ellenberg Susan S. , Evans Scott R. , Farrar John T. , Freeman Roy L. , Garrison Louis P. , Gewandter Jennifer S. , Goli Veeraindar , Iyengar Smriti , Jadad Alejandro R. , Jensen Mark P. , Junor Roderick , Katz Nathaniel P. , Kesslak J. Patrick , Kopecky Ernest A. , Lissin Dmitri , Markman John D. , McDermott Michael P. , Mease Philip J. , O'Connor Alec B. , Patel Kushang V. , Raja Srinivasa N. , Rowbotham Michael C. , Sampaio Cristina , Singh Jasvinder A. , Steigerwald Ilona , Strand Vibeke , Tive Leslie A. , Tobias Jeffrey , Wasan Ajay D. , Wilson Hilary D. 
Published: September 2021

Abstract
Chronic pain clinical trials have historically assessed benefit and risk outcomes separately. However, a growing body of research suggests that a composite metric that accounts for benefit and risk in relation to each other can provide valuable insights into the effects of different treatments. Researchers and regulators have developed a variety of benefit–risk composite metrics, although the extent to which these methods apply to randomized clinical trials (RCTs) of chronic pain has not been evaluated in the published literature. This article was motivated by an Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials consensus meeting and is based on the expert opinion of those who attended. In addition, a review of the benefit–risk assessment tools used in published chronic pain RCTs or highlighted by key professional organizations (ie, Cochrane, European Medicines Agency, Outcome Measures in Rheumatology, and U.S. Food and Drug Administration) was completed. Overall, the review found that benefit–risk metrics are not commonly used in RCTs of chronic pain despite the availability of published methods. A primary recommendation is that composite metrics of benefit–risk should be combined at the level of the individual patient, when possible, in addition to the benefit–risk assessment at the treatment group level. Both levels of analysis (individual and group) can provide valuable insights into the relationship between benefits and risks associated with specific treatments across different patient subpopulations. The systematic assessment of benefit–risk in clinical trials has the potential to enhance the clinical meaningfulness of RCT results.