bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association between precipitation and mortality due to diarrheal diseases by climate zone: A multi-country modeling study
Authors: Chua Paul L. C. , Tobias Aurelio , Madaniyazi Lina , Ng Chris Fook Sheng , Phung Vera Ling Hui , Fu Sze Hang , Rodriguez Peter S. , Brown Patrick , Coelho Micheline de Sousa Zanotti Stagliorio , Saldiva Paulo Hilario Nascimento , Scovronick Noah , Deshpande Aniruddha , Salazar Miguel Antonio S. , Dorotan Miguel Manuel C. , Tantrakarnapa Kraichat , Kliengchuay Wissanupong , Abrutzky Rosana , Carrasco-Escobar Gabriel , Roye Dominic , Hales Simon , Hashizume Masahiro 
Published: July 2024

Background:
Precipitation could affect the transmission of diarrheal diseases. The diverse precipitation patterns across different climates might influence the degree of diarrheal risk from precipitation. This study determined the associations between precipitation and diarrheal mortality in tropical, temperate, and arid climate regions.

Methods:
Daily counts of diarrheal mortality and 28-day cumulative precipitation from 1997 to 2019 were analyzed across 29 locations in eight middle-income countries (Argentina, Brazil, Costa Rica, India, Peru, the Philippines, South Africa, and Thailand). A two-stage approach was employed: the first stage is conditional Poisson regression models for each location, and the second stage is meta-analysis for pooling location-specific coefficients by climate zone.

Results:
In tropical climates, higher precipitation increases the risk of diarrheal mortality. Under extremely wet conditions (95th percentile of 28-day cumulative precipitation), diarrheal mortality increased by 17.8% (95% confidence interval [CI] = 10.4%, 25.7%) compared with minimum-risk precipitation. For temperate and arid climates, diarrheal mortality increases in both dry and wet conditions. In extremely dry conditions (fifth percentile of 28-day cumulative precipitation), diarrheal mortality risk increases by 3.8% (95% CI = 1.2%, 6.5%) for temperate and 5.5% (95% CI = 1.0%, 10.2%) for arid climates. Similarly, under extremely wet conditions, diarrheal mortality risk increases by 2.5% (95% CI = −0.1%, 5.1%) for temperate and 4.1% (95% CI = 1.1%, 7.3%) for arid climates.

Conclusions:
Associations between precipitation and diarrheal mortality exhibit variations across different climate zones. It is crucial to consider climate-specific variations when generating global projections of future precipitation-related diarrheal mortality.
Chyle Leak Management in the Setting of Tissue Expander Breast Reconstruction with Acellular Dermal Matrix: Case Series and Literature Review
Authors: O’Neill Elizabeth S. , Graham Shelby , Seu Michelle Y. , Adepoju Jubril , Toms John A. , Alvarado Rosalinda , Perez Claudia , Shenaq Deana 
Published: July 2024

Background:
Chylous leakage is a rare surgical complication most frequently encountered following operations involving the neck and thorax. Even more rare are axillary chyle leaks secondary to breast cancer involving the axillary lymph nodes. Anatomic variability in the termination of the thoracic duct may play a role in the susceptibility some individuals may have to this type of leakage. There is no consensus on the definitive management of these complications, especially in the context of breast reconstruction.

Methods:
Here, we report our experience in the management of chylous leakage in three patients who underwent left axillary lymph node dissection and immediate breast reconstruction with the use of tissue expanders and acellular dermal matrix. Descriptions of each case are followed by a review of the relevant literature. We also present an original treatment algorithm.

Results:
Two of three patients with suspected chylous leakage secondary to intraoperative injury to the axillary region underwent definitive diagnosis by clinical examination and drain fluid triglyceride analysis, followed by conservative management with a low-fat diet. The third patient was diagnosed clinically with no fluid analysis. All leakages resolved through conservative means, with no need to return to the operating room for surgical exploration and repair.

Conclusions:
Based on our experience, we believe that patients with suspected chylous leakage secondary to axillary lymph node dissection in the context of breast reconstruction can be safely and effectively managed by conservative management in the acute postoperative period. If these measures are insufficient, surgical management may be necessary.
Randomized Feasibility Study Evaluating Multiple FDA-approved Microbubbles for CEUS Lymphography
Authors: Jang Samuel , Rames Jess D. , Hesley Gina K. , Brinkman Nathan J. , Tran Nho V. , Fahradyan Vahe , Lee Christine U. 
Published: July 2024

Summary:
Prior studies on contrast-enhanced ultrasound (CEUS) lymphography for preoperative mapping before lymphaticovenous anastomosis surgery in patients with extremity lymphedema have been limited to using only Lumason and Sonazoid as microbubble contrast agents. The purpose of this study was to determine the feasibility of using two other Food & Drug Administration–approved microbubble agents, Optison and Definity, for imaging lymphatic vessels in the upper extremities. Nine female adults with unilateral upper extremity lymphedema anticipating lymphaticovenous anastomosis surgery underwent CEUS lymphography of the unaffected upper extremity randomized to either Lumason, Definity, or Optison. Lymphatic vessels were visualized in all but one case when undilated Definity was used. In the eight upper extremities where lymphatic vessels were visualized, an average of eight intradermal injections of microbubbles were performed in the extremity. Lymphatic vessels could be identified in 57% (36 of 63) of the injections. The effective dilution for each of the microbubble agents is provided. This was the first successful demonstration of lymphatic vessel visualization using either Definity or Optison. Broadening the range of available microbubble agents for CEUS lymphography could improve accessibility to the procedure and provide potentially safer alternatives.
Risk factors for acute kidney injury or mortality and long-term follow-up in coronavirus disease 2019 infected patients in the era before vaccination
Authors: Chen Shu-Ming , Hsiao Yu-Cheng , Cheng Chung-Yi , Lin Che-Yu , Lai Wei-Shian , Zeng Guo-Qiang , Kao Chih-Chin , Wu Mei-Yi , Wu Mai-Szu , Lin Yen-Chung , Hsu Raymond K. 
Published: July 2024

Background:
Acute kidney injury (AKI) is a severe complication of coronavirus disease 2019 (COVID-19) and is associated with a higher risk of mortality. Understanding the risk factors contributing to COVID-19-related AKI and mortality before vaccination is important for the initiation of preventative measures and early treatment strategies.

Methods:
This study included patients aged ≥18 years diagnosed with COVID-19 through polymerase chain reaction from May 2020 to July 2021, admitted in three local hospitals in Taiwan, with an extended follow-up until June 30, 2022. A median follow-up period of 250 days was used to assess AKI development and mortality. AKI was defined according to the Kidney Disease Improving Global Outcomes criteria. Multivarible Cox regression analysis of AKI and mortality-related risk factors were performed.

Results:
Of the 720 hospitalized patients with COVID-19, 90 (22%) developed AKI. Moreover, 80%, 10.1%, and 8.9% of the patients had stage 1, 2, and 3 AKI, respectively. Patients with stage 1 to 3 AKI had significantly lower survival rates than those without AKI (p = 0.001). The mean duration of post-admission AKI occurrence was 9.50 ± 11.32 days. Older age, hypoalbuminemia, and higher D-dimer and ferritin levels were associated with COVID-19 mortality. In COVID-19 AKI, in addition to older age and high D-dimer and ferritin levels, chronic kidney disease emerged as an independent risk factor.

Conclusion:
COVID-19-related AKI develops early, exhibits a temporal association with respiratory failure, and is linked to an unfavorable prognosis. The mortality rate increased according to the AKI stage (p = 0.001). Age, albumin, D-dimer, and ferritin levels, and the underlying chronic kidney disease status upon admission are crucial factors for predicting AKI development, which increases the mortality risk. Monitoring the renal function not only within 10 days of COVID-19 onset, but also within 1 month after the disease onset.
Impact of a Participatory Wellness Continuing Medical Education Program on Physician Burnout and Well-Being
Authors: Hensrud Donald D. , Thompson Warren G. , Rieck Thomas M. , West Colin P. , Jenkins Sarah M. , Ferguson Jennifer A. , Clark Matthew M. 
Published: July 2024

Objective
Examine the impact of a participatory wellness continuing medical education (CME) program on physician burnout, wellness, and well-being.

Methods
Physicians attending a 3-day wellness CME program. Self-reported questionnaires at baseline with paired analyses at 26-week follow-up.

Results
Compared to baseline, at 26 weeks there were decreases in burnout (P < 0.001, ES −0.68), red meat consumption (P = 0.02, ES −0.29), and current stress levels (P < 0.001, ES −0.50). There were increases in fruit/vegetable consumption (P < 0.001, ES 0.55), energy levels at work (P < 0.001, ES 0.60) and at home (P < 0.001, ES 0.66), quality of life (P < 0.001, ES 0.53), and confidence (P < 0.001, ES 0.89) and frequency (P = 0.01, ES 0.32) of counseling patients on wellness.

Conclusion
Attendance at this participatory wellness CME program was associated with improved physician burnout, health behaviors in diet, stress, energy, quality of life, and wellness counseling.
Recovering Work Productivity in a Population With Chronic Musculoskeletal Pain
Authors: Janela Dora , Areias Anabela C. , Moulder Robert G. , Molinos Maria , Bento Virgílio , Yanamadala Vijay , Correia Fernando Dias , Costa Fabíola 
Published: July 2024

Objective
To investigate potential savings obtained from restoring productivity in employees with chronic MSK pain through a digital care program (DCP).

Methods
Secondary analysis of a prospective longitudinal study assessing cumulative savings overall or across several industry sectors by analyzing changes in Work Productivity and Activities Impairment (WPAI questionnaire).

Results
Employees from 50 U.S. states started the program (n = 5032). Significant improvements in productivity impairment were observed across all industries, yielding median cumulative savings from $151 (95% confidence interval [CI], 128–174) to $294 (95% CI, 286–303) per participant at treatment end. Twelve-month projections estimated median savings of $2916 (95% CI, 2861–2972). Additionally, significant improvements in non–work-related daily activities were observed.

Conclusions
This study underlines the burden of MSK-related productivity loss on employers' financial balance, illustrating the importance of a DCP to assist patients to recover quality of life and succeed professionally.
The Pelvic Health Curricular Exposure Scale (PHCES): A Survey of Physical Therapy Students’ Comfort Discussing Sexual Health
Authors: Levay Elizabeth , Hall-Bibb Dawn 
Published: July 2024

Background:
As holistic, autonomous health care providers, physical therapists must be confident in discussing all aspects of health with patients, including sexual health. Lack of attention to patients’ sexual issues may result in aspects of health going unaddressed, leading to poor patient care.

Objectives:
The purpose of this study was to investigate the relationship between exposure to pelvic health content in physical therapy school curricula and Doctor of Physical Therapy (DPT) students’ comfort levels discussing sexual health issues with future patients.

Study Design:
Survey research report.

Methods:
A cluster sample of DPT students in the United States (n = 167) completed a novel tool, titled the Pelvic Health Curricular Exposure Scale (PHCES), as well as an adapted version of the Students’ Attitudes Towards Addressing Sexual Health (SA-SH) questionnaire.

Results:
Exposure to and comfort with pelvic floor dysfunction (p< .001; p< .001), obstetrical issues (p= .051; p< .001), colorectal health (p= .007; p< .001), and incontinence (p= .009; p< .001), as well as participating in a pelvic health elective (r
pb = 0.05) or clinical experience (r
pb < 0.003), positively correlated with comfort discussing sexual health with future patients.

Conclusion:
DPT programs should make a dedicated effort to implement pelvic health into the curriculum with an emphasis on topics such as pelvic floor dysfunction, obstetrical issues, colorectal health, and incontinence, as well as to provide students with pelvic health electives and clinical experiences.
The Supplemental Digital Content video abstract for this article is available at: http://links.lww.com/JWHPT/A131
Characterizing Chronic Pelvic Pain: The Relationship Between Extrapelvic Muscle Stiffness, Pain Level, Health History, and Pelvic Floor Symptoms in Women With Chronic Pelvic Pain
Authors: Proulx Laurel , Brizzolara Kelli , Thompson Mary , Wang-Price Sharon , Rodriguez Patricia , Koppenhaver Shane 
Published: July 2024

Purpose:
The purpose of this cross-sectional study was to assess the association of extrapelvic muscular stiffness measures with pelvic floor symptoms and clinical impairments in women with chronic pelvic pain (CPP). In addition to bivariate correlations, exploratory factor analysis (EFA) was used to identify multivariate clinical presentation patterns of CPP.

Methods:
Muscle stiffness measurements of 11 extrapelvic muscles were taken in 149 women with CPP. Associations between muscle stiffness and clinical measures such as pelvic floor function, pain, psychosocial status, and urogynecology history were calculated. In addition, variables were assessed using EFA to identify patterns of CPP.

Results:
There were small but significant correlations between muscle stiffness measurements and clinical measures. Three categorizations of CPP symptoms and impairments emerged from the 25 continuous variables chosen for EFA. These could be classified as follows: (1) pelvic floor dysfunction and psychosocial involvement; (2) muscle stiffness of the hips and thighs; and (3) muscle stiffness of the low back and abdomen, collectively making up 49.1% of the variance.

Discussion:
Stiffness of commonly treated extrapelvic muscles was not strongly correlated to pain level or health history of women with CPP. The first EFA component is consistent with patients routinely seen by pelvic health physical therapists, and the latter components are consistent with those who may benefit initially from orthopedic physical therapy. Further research looking at the relationship of muscle stiffness, pelvic floor function, and movement impairments is needed. EFA may be a starting point to better understand who may be appropriate for orthopedic physical therapy treatment versus specialized pelvic health physical therapy care.
Improved outcomes of ABO-incompatible living donor liver transplant with biologically related donors
Authors: Ranjan Priya , Pathak Nishant , Gupta Subhash , Agarwal Shaleen 
Published: July 2024

Liver transplantation is considered to be the only curative treatment for decompensated liver disease. Shortage of liver allografts is a major impediment to the widespread application of this procedure. ABO-incompatible (ABO-I) grafts have been used successfully, thereby increasing the living donor liver transplantation (LDLT) donor pool. However, ABO-I liver transplantation is associated with complications like acute liver rejection, hepatic artery thrombosis, and higher biliary stricture rates, leading to transplant failure, retransplantations, or sepsis-related complications. Various desensitization strategies have been adopted to improve outcomes. Biologically related donor-recipient pairs have the theoretical advantage of favorable HLA (human leukocyte antigen) match. We have analyzed the outcomes of ABO-I LDLT and compared the results of HLA-matched (biologically related) and HLA-unmatched (biologically unrelated) donor-recipient pairs. Retrospective data of 90 cases of ABO-I liver transplant recipients: HLA-matched (n = 35) and HLA-unmatched (n = 55) for comparison of preoperative and postoperative data. Peak bilirubin levels in HLA-unmatched recipients were higher. Platelet count was lower than HLA-matched recipients (7.3 vs. 8.9 mg/dL). No significant difference in days-to-normal bilirubin, peak International Normalised Ratio, hospital stay, and discharge-day from transplant between both groups. Postoperatively, HLA-unmatched recipients required more pulse-steroids therapy than HLA-matched: 21/55 (38.2%) versus 11/35 (31.4%). Biliary complications and interventions were more prevalent in the HLA-unmatched group (12/55, 21.8%) than in the HLA-matched group (4/35, 11.4%). Renal complications requiring postoperative hemodialysis were more prevalent in the HLA-unmatched group than the HLA-matched group (9/55 [16.4%] vs. 3/35 [8.6%]). The incidence of vascular complications was similar. ABO-I LDLT is an effective and safe method for increasing the donor pool in the absence of an ABO-compatible liver donor. Long-term outcomes of recipients with biologically related donors are marginally better than biologically unrelated ABO-I LDLT recipients. However, the incidence of antibody-mediated graft rejection and biliary complications is higher in biologically unrelated ABO-I liver recipients.
Legislating Nurse Staffing
Authors: Swant Lauren , Warner Karin E. , Zedreck-Gonzalez Judith 
Published: July 2024

OBJECTIVE
The aim of this study was to project the impact of legislated nurse staffing ratios on patient-, staff-, and system-level outcomes for Prospective Payment System (PPS) hospitals in Montana.

BACKGROUND
In 2023, House Bill 568 was introduced in Montana focused on legislating hospital safe nursing standards.

METHODS
A quantitative design was used for a convenience sample of Montana PPS hospitals. Data were gathered through a newly developed survey and from other publicly available sources for the years 2018 to 2022. Independent t tests were conducted when appropriate with the significance threshold set at 0.05.

RESULTS
Projections indicate no significant change in patient outcome metrics accompanied by increases in labor requirements, slower emergency department throughput times, and decreases in hospital operating margins.

CONCLUSIONS
In Montana, legislating nurse staffing ratios would have downstream implications inconsistent with the intended impact on patient safety, emphasizing the complexity of variables within and external to the healthcare system that drive patient-, staff-, and system-level outcomes.
How to Design Effective Audit and Feedback Interventions With Nurses
Authors: Dufour Emilie , Duhoux Arnaud 
Published: July 2024

OBJECTIVE
To propose practical hypotheses on audit and feedback that support the effectiveness with nurses.

BACKGROUND
Audit and feedback interventions have been mainly studied with physicians; however, the processes have been practiced by nurses for years. Nurses' response may differ from that of physicians and other healthcare disciplines because of their roles, power, and the configuration of nursing activities.

METHODS
A comparative analysis of the Clinical Performance Feedback Intervention Theory was conducted using nursing-specific empirical data from: 1) a mixed-methods systematic review and 2) a pilot study of audit and feedback with a team of primary care nurses.

RESULTS
Researchers hypothesize that audit and feedback interventions are more effective when: 1) feedback emphasizes how it relates to the relational aspect of nursing; 2) indicators are measured and reported at team level; and 3) feedback is provided in a way that highlights benefits to nurses' practice, such as the potential to reduce workload.

CONCLUSION
These proposed hypotheses provide concrete guidance to researchers and managers for an effective use of audit and feedback as a quality improvement strategy with nurses.
Silicone hydrogel versus hydrogel soft contact lenses for differences in patient-reported eye comfort and safety: A Cochrane systematic review summary
Authors: Travis Darian , Haworth Kristina , Leslie Louis , Fuller Daniel , Pucker Andrew D. 
Published: July 2024

SIGNIFICANCE
This work is significant because it is the first Cochrane systemic review that compares the comfort and safety of hydrogel and silicone hydrogel soft contact lenses (SCL).

PURPOSE
This study aimed to conduct a systemic review of randomized trials comparing the comfort and safety of silicone hydrogel and hydrogel SCLs.

METHODS
CENTRAL, MEDLINE Ovid, EMBASE.com, PubMed, LILACS, ClinicalTrials.gov, and World Health Organization International Clinical Trials Registry Platform were searched on or before June 24, 2022, to identify randomized clinical trials that compared silicone hydrogel and hydrogel SCLs.

RESULTS
Seven trials were identified and evaluated. One trial reported Ocular Surface Disease Index results, with the evidence being very uncertain about the effects of SCL material on Ocular Surface Disease Index scores (mean difference, −1.20; 95% confidence interval, −10.49 to 8.09). Three trials reported visual analog scale comfort score results, with no clear difference in comfort between materials, although results were of low certainty; trial results could not be combined because the three trials reported results at different time points. None of the included trials reported Contact Lens Dry Eye Questionnaire 8 or Standard Patient Evaluation of Eye Dryness scores. There was no evidence of a clinically meaningful difference (>0.5 unit) between daily disposable silicone hydrogel and hydrogel SCLs in corneal staining, conjunctival staining, or conjunctival redness (very low certainty evidence).

CONCLUSIONS
The overall evidence for a difference between all included silicone hydrogel and hydrogel SCL trials was of very low certainty, with most trials judged as having a high overall risk of bias. There was insufficient evidence to support recommending one SCL material over the other. Future well-designed trials are needed to generate high certainty evidence to further clarify differences in SCL material comfort and safety.
MDMB-4en-PINACA–Related Deaths in Cook County Jail
Authors: Gitto Lorenzo , Wadsworth Tracy , Isenschmid Daniel , Krotulski Alex J. , Logan Barry K. , Tarozzi Ilaria , Arunkumar Ponni 
Published: July 2024

Abstract
Since January 2023, a series of fatalities has occurred in the Cook County Jail. Upon reviewing surveillance videos, in some cases, the inmates shared paper strips, and it was followed by the onset of labored breathing and loss of consciousness. Scene investigation revealed burnt paper strips near the body in 3 cases. No trauma was observed during autopsy. The expanded toxicology panels did not detect any illegal drugs in the postmortem blood samples. However, additional analysis specifically targeting synthetic cannabinoids revealed the presence of MDMB-4en-PINACA [methyl 3,3-dimethyl-2-{[1-(pent-4-en-1-yl)-1H-indazole-3-carbonyl]amino}butanoate], a synthetic cannabinoid associated with a wide range of adverse effects, including cardiovascular complications such as tachycardia and hypertension, respiratory depression, and acute kidney injury. There is limited research on the lethality of MDMB-4en-PINACA. This case series suggests that even isolated use can potentially lead to death. This study aims to raise public awareness regarding MDMB-4en-PINACA, highlighting its unpredictable effects and potential for severe adverse reactions, and to facilitate the development of effective prevention and harm reduction strategies. Implementing screening methods in correctional facilities is crucial to prevent the circulation of potentially fatal substances.