bluuebunny/crossref_metadata_2025_split huggingface dataset:
Public health informatics specialists in state and local public health workforce: insights from public health workforce interests and needs survey
Authors: Rajamani Sripriya , Leider Jonathon P , Gunashekar Divya Rupini , Dixon Brian E 
Published: February 2025

Abstract

Objective
Modernizing and strengthening the US public health data and information infrastructure requires a strong public health informatics (PHI) workforce. The study objectives were to characterize existing PHI specialists and assess informatics-related training needs.

Materials and Methods
To examine the PHI workforce, the 2021 Public Health Workforce Interests and Needs Survey (PH WINS), a nationally representative survey with 44 732 governmental public health (PH) respondents was analyzed. The survey included data from 47 state health agencies-central office, 29 large local health departments (Big Cities Health Coalition members), and 259 other local/regional health departments. Analysis focused on “public health informatics specialist” (PHI), “information system manager/information technology specialist” (IT/IS), “public health science” (PHS), and “clinical and laboratory” (CL) roles.

Results
PHI specialists account for less than 2% of the governmental PH workforce. A majority were female (68%), White (55%), and close to half in 31-50 age category (49%). Most (74%) were in non-supervisory roles and &lt;1% in managerial/executive roles, with less than one-third (29%) earning &gt;$75 000 salary. Skill gaps on informatics-related tasks included: identify appropriate data/information sources; collect valid data for decision making; participate in quality improvement processes; identify evidence-based approaches. The PHI specialists reported lower skill gaps in data/informatics areas when compared to other public health roles (PHS and CL), and this was consistent across state/local settings.

Discussion
Given the scale of work needed for modernization of information systems, PH agencies need more individuals in informatics roles. To attract PHI specialists, better salaries, clear PHI job classifications and permanent PHI workers are needed, which requires sustained investments from federal and state governments.

Conclusion
Efforts to train PHI specialists, recruit and retain them in the governmental public health workforce, and address hiring issues in public health agencies are essential next steps to transform the US public health enterprise.
Increased arterial stiffness and left ventricular remodelling as markers of masked hypertension: findings from the PAMELA population
Authors: Cuspidi Cesare , Facchetti Rita , Gherbesi Elisa , Quarti-Trevano Fosca , Vanoli Jennifer , Mancia Giuseppe , Grassi Guido 
Published: February 2025

Background:
The value of the association of arterial stiffness with left ventricular concentric remodelling/left ventricular hypertrophy (LVH) assessed by echocardiography, for prediction of masked hypertension defined by office and ambulatory blood pressure monitoring (ABPM) in the general population is largely undefined. We investigated this topic in the participants to the Pressioni Monitorate E Loro Associazioni (PAMELA) study.

Methods:
The study included 272 participants (153 normotensives and 119 with masked hypertension) who attended the second and third survey of the PAMELA study performed after 10 and 25 years from the initial evaluation. Data collection included medical history, physical examination, blood tests, office, ABPM, echocardiographic and Cardio-Ankle Vascular Index (CAVI) measurements.

Results:
Compared to normotensive individuals, participants with masked hypertension were younger, had significantly higher office, home, mean 24-h, day-time, night-time SBP/DBP and heart rate. The likelihood of having masked hypertension, was approximately more than two-fold higher [odds ratio (OR) = 2.29, confidence interval (CI): 1.01–5.31, P = 0.04] in participants with increased CAVI and left ventricular remodelling/LVH compared to their counterparts without organ damage. This association showed a unique value in identifying masked hypertension compared to both isolated markers of organ damage (OR = 1.69, P = 0.15 for increased CAVI and OR = 0.82, P = 0.80 for left ventricular remodelling/LVH), after adjusting for age, sex, office SBP/DBP, antihypertensive treatment and diabetes.

Conclusion:
The present study offers a new piece of evidence of the key value of looking for both vascular and cardiac organ damage to unmask MH and improve its clinical management in the general population.
Three decades of pediatric intoxication trends in Taiwan: A retrospective cohort analysis (1985–2020)
Authors: Lin Chih-Wei , Chen Wei-Yu , Lin Yu-Jia , Tsao Pei-Chen , Lee Yu-Sheng , Juan Chien-Chang , Yang Chen-Chang , Jeng Mei-Jy 
Published: February 2025

Background:
Pediatric drug intoxication is a significant public health issue worldwide. The present study aimed to delineate the epidemiology, exposure-related conditions, and outcome severity of pediatric drug intoxication cases in Taiwan for over a 36-year period.

Methods:
This retrospective cohort study analyzed pediatric drug intoxication cases registered in Taiwan’s National Poison Control Center (PCC) database between 1985 and 2020. Data on patient demographics, toxic substances, exposure-related conditions, and outcome severity were extracted and analyzed. Descriptive statistics were used to summarize the findings.

Results:
Altogether, 19,893 pediatric drug intoxication cases were reported. The majority of cases involved boys (54.7%) and the highest percentage of cases occurred in children aged0–2 years (56.4%), but there is a second, relatively lower peak in adolescents, where female cases outnumbered the male cases. Pharmaceuticals were the predominant toxic substances (70.3%), with most drug intoxication cases being acute (97.2%) and occurring at home (88.8%). Witnesses were present in 62.8% of the cases. The outcomes were mostly asymptomatic (51.0%) or involved mild discomfort (34.1%), with severe complications and mortality occurring in 0.76% and in 0.37% of the cases, respectively. Unintentional poisoning accounted for 85.4% of the cases, whereas intentional poisoning was noted in 12.1% of the cases, with the highest rate seen in adolescents aged 15–17 years. Intentional cases mainly involved suicide attempts (68.4%) and predominantly occurred in girls (70.7%).

Conclusion:
This analysis of data obtained from Taiwan’s National PCC database for over 36 years reveals bimodal trends in pediatric drug intoxication, showing high rates in young children due to unintentional exposures and peaks in intentional poisoning among adolescent girls. Pharmaceuticals were the predominant toxic agents. Future efforts should focus on age- and sex-targeted preventions, public education on medication safety, and age-specific interventions.
Work-related factors of low back pain among Indonesian manufacturing workers in Taiwan
Authors: Riyandani Edo , Deng Jou-Fan , Chen Ruey-Yu , Yang Chen-Chang 
Published: February 2025

Background:
The manufacturing industry, one of the largest employers of migrant workers in Taiwan, reports a high incidence of musculoskeletal disorders, particularly low back pain (LBP), among its workforce overall. Understanding the prevalence and risk factors of LBP among Indonesian migrant workers, who make up a substantial portion of this workforce, is essential for developing effective preventive programs.

Methods:
This cross-sectional study surveyed Indonesian migrant workers in the manufacturing sector. The Indonesian version of the Oswestry Disability Index was used to assess LBP prevalence and disability levels. The chi-square test was used to evaluate the association between work-related factors and LBP outcomes. Multivariable logistic regression was used to identify the independent factors associated with LBP, adjusted for other variables.

Results:
According to the LBP disability index, 63.14% of the participants had minimal disability, 29.80% had moderate disability, and 7.05% had severe disability. Mild trunk flexion was associated with a lower risk of LBP disability compared with neutral trunk flexion (OR [95% CI] 0.11 [0.03–0.31], p = 0.01). Among women, lifting less than 25 kg was associated with a lower risk of severe LBP compared with lifting more than 25 kg (OR [95% CI] 0.01 [0.01–0.61], p = 0.03). In men, whole-body vibration was associated with a lower risk of severe LBP compared with no vibration exposure (OR [95% CI] 0.41 [0.19–0.88], p = 0.02).

Conclusion:
Trunk flexion, lifting, and whole-body vibration consistently emerged as significant determinants of LBP disability. More detailed assessments of these factors are necessary to clarify their associations.
Laryngeal mucinous adenocarcinoma in a 45 year old woman: a case report
Authors: Mercado Gabrielle Angela Go , Fang Tuan-Jen , Lee Li-Yu , Santos Marissa Krizelda D. 
Published: February 2025

Introduction and importance:
This paper emphasizes on an infrequent case of primary laryngeal mucinous adenocarcinoma. Despite partial laryngectomies being a traditional surgical technique, it is not frequently used in the treatment of laryngeal lesions. We would like to highlight the efficacy of open partial laryngectomy as a viable treatment option in cases of nonsquamous cell carcinoma of the larynx. The use of traditional and modern surgical techniques can aid in the preservation of voice and swallowing functions. This case report has been reported in line with the SCARE Criteria [Sohrabi C, Mathew G, Maria N, Kerwan A, Franchi T, Agha RA. The SCARE 2023 guideline: updating consensus Surgical CAse REport (SCARE) guidelines. Int J Surg Lond Engl. 2023;109(5):1136]

Presentation of the Case:
This paper focuses on a 45 year old female who consulted at a tertiary private hospital. She had no known medical comorbidities or family history of cancer who complained on persistent globus sensation and frequent throat clearing. Her symptoms subjectively were similar to acid reflux but on flexible endoscopy a laryngeal lesion was seen. The initial impression with the additional information gathered from a neck CT scan was that of a cystic lesion. During surgery, no cystic component was seen; tissue samples were sent for biopsy. The biopsy results were signed out as a case of mucinous adenocarcinoma. Given the age and medical status of the patient, an organ preservation surgery was done. Post operatively the patient was able to maintain all swallowing and phonatory capabilities.

Clinical Discussion:
There are currently two reported cases of primary laryngeal mucinous adenocarcinoma. Both cases were located in the supraglottic region presenting with dysphonia and dysphagia. Due to the limited number of cases, there is currently no standardized surgical or medical treatment for the management primary laryngeal mucinous adenocarcinomas.

Conclusion:
Mucinous adenocarcinoma of the larynx is a rare disease usually found as distant metastatic lesions. Primary laryngeal mucinous adenocarcinoma is even more uncommon. To balance the oncological outcomes and life quality is important. We reported a primary laryngeal mucinous laryngeal adenocarcinoma after combined transoral transcervical partial laryngectomy that with good functional and oncological outcomes.
Brunner’s gland hamartoma masquerading as duodenal stricture: a case report
Authors: Adhikari Prabesh , Khanal Bishes , Maharjan Prabir 
Published: February 2025

Introduction and importance:
Brunner’s gland hamartoma is an infrequent benign lesion(0.008% incidence) that originates in the submucosa of the duodenum. The increased clinical attention to frequently addressed pathologies such as malignancies, peptic ulcer disease, and adhesions in stricture causation often overshadows such uncommon underlying lesions.

Case Presentation:
56 years-old male presented with a history of progressively worsening symptoms of gastric outlet obstruction, including upper abdominal pain and projectile vomiting for two weeks. The patient had a history of peptic ulcer. Imaging through Contrast Enhanced Computed Tomography scan and endoscopic observations unveiled duodenal stricture. Antrectomy followed by Billroth type-II gastrojejunostomy was performed. Finally, Brunner’s gland hamartoma without dysplasia or malignancy was identified through histopathological evaluation. The patient recovered gradually and was discharged on postoperative day 5 in stable condition.

Clinical Discussion:
Most asymptomatic patients are managed conservatively, whereas a small subset of symptomatic patients with obstruction or bleeding is indicated for surgical or endoscopic resection. Though useful, the utility of advanced imaging techniques and endoscopy often yields inconclusive or benign conclusions. Consistent with our case findings, a definitive diagnosis relies exclusively on tissue biopsy analysis.

Conclusion:
Rare presentation, non-specific clinical manifestations, and unclear etiology makes Brunner’s gland hamartoma an incidental diagnostic finding, often missed during routine investigations.
Regional heterogeneity in the use of extracorporeal membrane oxygenation for heart transplant after 2018 allocation policy change
Authors: Schumer Erin M. , Endo Toyokazu , Wada Takuya , Schilling Joel D. , Kotkar Kunal D. , Faraz Masood M. , Pawale Amit 
Published: February 2025

BackgroundThe 2018 heart transplant allocation policy has changed the profile of patients receiving heart transplant, with an increased use of acute mechanical support and decreased use of durable left ventricular assist devices. We investigated the use of extracorporeal membrane oxygenation (ECMO) use pre- and post-allocation change.MethodsUsing the UNOS database, we identified adult patients who underwent heart transplant from January, 2006 - June, 2022. The study time period was divided into pre- and post-allocation change. We divided ECMO patients by region and analyzed change in the rate of ECMO use by region between eras. Differences between groups and survival comparison were analyzed.ResultsA total of 41,636 recipients were found, of which 891 (2.1%) were on ECMO at the time of transplant. Overall ECMO use increased from 231 (0.8%) to 660 (5.5%) between eras (p<0.001). There was significant regional variation in the rate of ECMO usage (p<0.001) and significant differences in postoperative dialysis (p=0.014) and acute rejection episodes (p<0.001). There was no significant difference in pacemaker rate (p=0.172), stroke (p=0.212), treatment for rejection within 1 year (p=0.358), or post-transplant survival in the current era between regions for patients on ECMO at the time of transplant (p=0.444).ConclusionThere is increased utilization of ECMO following implementation of an allocation system which prioritizes ECMO recipients on the waitlist and thereis a differentialincrease in the use of ECMO in various regions. Further granular studies are needed to see which patients may benefit more from ECMO and what can be done to reduce post-transplant mortality from ECMO to transplant as it remains high before and after allocation change.
Exploiting Zeta potential of air borne pathogenic bacteria for effective air decontamination
Authors: Peketi Arun Sai Kumar , Sai Kushal Kumar SVL , Kennedy Kumar P , Pradeep Bulagonda Eswarappa 
Published: February 2025

AbstractBackgroundAirborne microorganisms contribute significantly to hospital-associated infections (HAIs), particularly causing respiratory tract infections (RTIs). Multi-drug resistant (MDR) airborne pathogens pose a global clinical threat, challenging existing air decontamination technologies. While current methods effectively trap microbes, they often lack microbicidal properties. Exploitation of Zeta potential of microbes which are naturally charged could be a potential strategy for air decontamination, independent of their antimicrobial resistance. In this study, we tested the efficacy of ZeBox technology which relies on zeta potential to trap and eliminate airborne pathogens such as clinically isolated, MDRKlebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, Escherichia coliof respiratory origin and a non RTI isolateStaphylococcus aureus.MethodsFive MDR bacterial pathogens which includeK. pneumoniae(2 nos),A. baumannii, P. aeruginosa, andE. colifrom patients with RTI and one pus isolate ofS. aureuswere included in the study. These isolates were aerosolized in a certified BSL-2 setting containing a ZeBox-powered Air Sterilization device. Viable bacteria were enumerated before and after exposure to the Zebox powered device. Clinical and laboratory isolated bacterial strains were assessed for zeta potential variations to understand its association with antibiotic resistance and pathogenicity.ResultsOur analyses revealed that Zeta potential is species specific, but independent of the pathogenicity and antibiotic susceptibility of the tested bacteria. Exposure to Zebox powered device for 5 mins resulted in a remarkable decline of microbial load with a minimum 5 log reduction (99.999%) of all the tested isolates, irrespective of their species. Zeta potential measurements further indicated a consistent killing mechanism of MDR pathogens by Zebox technology.ConclusionsThe current study underscores the reliability of zeta potential based air decontamination strategies for potential elimination of diverse, air borne MDR bacteria in healthcare settings.HighlightsZeta potential value of bacteria is not influenced by AST or pathogenicity of bacteria.Zeta potential driven device traps and kills airborne MDR bacteria with 99.999% efficiency.The efficacy of ZeBox technology is consistent across pathogens.
Genetic-epigenetic interactions (meQTLs) in orofacial clefts etiology
Authors: Machado-Paula LA , Romanowska J , Lie RT , Hovey L , Doolittle B , Awotoye W , Dunlay L , Xie XJ , Zeng E , Butali A , Marazita ML , Murray JC , Moreno-Uribe LM , Petrin AL 
Published: February 2025

ABSTRACTObjectivesNonsyndromic orofacial clefts (OFCs) etiology involves multiple genetic and environmental factors with over 60 identified risk loci; however, they account for only a minority of the estimated risk. Epigenetic factors such as differential DNA methylation (DNAm) are also associated with OFCs risk and can alter risk for different cleft types and modify OFCs penetrance. DNAm is a covalent addition of a methyl (CH3) group to the nucleotide cytosine that can lead to changes in expression of the targeted gene. DNAm can be affected by environmental influences and genetic variation via methylation quantitative loci (meQTLs). We hypothesize that aberrant DNAm and the resulting alterations in gene expression play a key role in the etiology of OFCs, and that certain common genetic variants that affect OFCs risk do so by influencing DNAm.MethodsWe used genotype from 10 cleft-associated SNPs and genome-wide DNA methylation data (Illumina 450K array) for 409 cases with OFCs and 456 controls and identified 23 cleft-associated meQTLs. We then used an independent cohort of 362 cleft-discordant sib pairs for replication. We used methylation-specific qPCR to measure methylation levels of each CpG site and combined genotypic and methylation data for an interaction analysis of each SNP-CpG pair using the R package MatrixeQTL in a linear model. We also performed a Paired T-test to analyze differences in DNA methylation between each member of the sibling pairs.ResultsWe replicated 9 meQTLs, showing interactions between rs13041247 (MAFB) - cg18347630 (PLCG1) (P=0.04); rs227731 (NOG) - cg08592707(PPM1E)(P=0.01); rs227731 (NOG) - cg10303698 (CUEDC1) (P=0.001); rs3758249 (FOXE1) - cg20308679 (FRZB) (P=0.04); rs8001641 (SPRY2) - cg19191560 (LGR4) (P=0.04); rs987525(8q24) - cg16561172(MYC) (P=0.00000963); rs7590268(THADA) - cg06873343 (TTYH3) (P=0.04); rs7078160 (VAX1) - cg09487139 (P=0.05); rs560426 (ABCA4/ARHGAP29) - cg25196715 (ABCA4/ARHGAP29) (P=0,03). Paired T-test showed significant differences for cg06873343 (TTYH3) (P=0.04); cg17103269 (LPIN3) (P=0.002), and cg19191560 (LGR4) (P=0.05).ConclusionsOur results confirm previous evidence that some of the common non-coding variants detected through GWAS studies can influence the risk of OFCs via epigenetic mechanisms, such as DNAm, which can ultimately affect and regulate gene expression. Given the large prevalence of non-coding SNPs in most OFCs genome wide association studies, our findings can potentially address major knowledge gaps, like missing heritability, reduced penetrance, and variable expressivity associated with OFCs phenotypes.
Multimodal predictors of functional and cognitive decline in relapsing-remitting multiple sclerosis
Authors: Korbmacher Max , Lie Ingrid Anne , Wesnes Kristin , Westman Eric , Espeseth Thomas , Specht Karsten , Andreassen Ole A. , Westlye Lars T. , Wergeland Stig , Myhr Kjell-Morten , Torkildsen Øivind , Høgestøl Einar A. 
Published: February 2025

AbstractThe underlying mechanisms for neurodegeneration in multiple sclerosis are complex and incompletely understood. Multivariate and multimodal investigations integrating demographic, clinical, multi-omics, and neuroimaging data provide opportunities for nuanced analyses, aimed to define disease progression markers. We used data from a 12-year longitudinal cohort of 88 people with multiple sclerosis, to test the predictive value of multi-omics, MRI, clinical examinations, self-reports on quality of life, demographics, and general health-related variables for future functional and cognitive disability. Progressive functional loss beyond an Expanded Disability Status Scale score≥4 was used to define a functional loss group. A cognitive decline group was defined by a ≥25% decrease from the maximum (cognitive) Paced Auditory Serial Addition Test score. We used a multiverse approach to identify which baseline variables were most predictive for functional and cognitive loss group memberships, independent of analysis bias.We identified several factors predicting an increased risk of future functional loss (FLG) and cognitive decline groups (CDG) within the next 12 years from baseline: functional score (0-10, median Odds Ratio per baseline unit increase [mORFLG=2.15±0.51; mORCDG=2.46±1.60]), cognitive scores (1-60 [mORFLG=0.98±0.03; mORCDG=0.91±0.06]), the number of previous relapses [mORFLG=1.56±0.26; mORCDG=1.44±0.60], serum vitamin A levels (umol/l [mORFLG=0.92±0.06; mORCDG=0.33±0.36]), self-reported mental health (1-100 [mORFLG=0.96±0.02; mORCDG=0.91±0.09]) and physical functioning (1-100 [mORFLG=0.99±0.01; mORCDG=0.97±0.03]). Our results suggest that clinical assessment of physical function and cognition, self-reported mental health, and potentially vitamin A levels are the best predictors for risk-group stratifications of people with MS at baseline. While these findings are promising, we also want to underscore the observed analysis-choice induced variability which necessitates both an increase in transparency when reporting study findings as well as strategies which are robust to the many researcher degrees of freedom.