bluuebunny/crossref_metadata_2025_split huggingface dataset:
U.S. Medical School Participation in Nationally Funded Biomedical Research: A New Accounting of NIH Award Dollars
Authors: Geboy Alexander G. , Dandar Valerie M. , Dutterer Jordan , Brandenburg Katherine , Alexander Hershel 
Published: June 2024

Abstract
To better understand the amount of National Institutes of Health (NIH) funding received by U.S. medical schools with Liaison Committee on Medical Education–accredited medical education programs, the Association of American Medical Colleges (AAMC) developed a new methodology that crosswalks faculty NIH grants with medical schools and their affiliated organizations (e.g., teaching hospitals). This approach offers a more comprehensive and methodologically transparent accounting of NIH extramural funding to academic medicine than existing processes.
The AAMC Crosswalk utilized publicly available grants data from the NIH and resources unique to the AAMC, such as the Faculty Roster and Council of Teaching Hospitals and Health Systems records. Using a multistep algorithm, the AAMC Crosswalk linked individual faculty with NIH grants, their organizations, and partner medical schools, aggregated at the level of the medical school and its affiliated organizations for fiscal year (FY) 2017–2021.
The AAMC Crosswalk attributed, on average, $3.7 billion more per year in NIH funding to U.S. medical schools, representing a 24% increase compared to the NIH and Blue Ridge Institute for Medical Research (BRIMR) methodologies. In FY 2021, the AAMC Crosswalk attributed 60% of NIH funding to U.S. medical schools compared with 47% by NIH and 50% by BRIMR. An exploration of limitations showed that no medical school affiliations were missed by the AAMC Crosswalk among 90 randomly sampled organizations, and medical school affiliations for 30 randomly sampled principal investigator faculty members were attributed correctly.
These findings indicate that academic medicine’s contribution to biomedical research may be greater than historically reported. Systematically accounting for grants awarded to faculty across medical schools and their affiliated organizations provides a more comprehensive understanding of NIH funding to U.S. medical schools. The AAMC Crosswalk provides a new tool to better estimate the true investment and role of academic medicine in advancing biomedical research.
An Exploratory Analysis of Sociodemographic Factors Associated With Physical Functional Impairment in ICU Survivors
Authors: Watson Megan A. , Sandi Marie , Bixby Johanna , Perry Grace , Offner Patrick J. , Burnham Ellen L. , Jolley Sarah E. 
Published: June 2024

IMPORTANCE:
Physical functional impairment is one of three components of postintensive care syndrome (PICS) that affects up to 60% of ICU survivors.

OBJECTIVES:
To explore the prevalence of objective physical functional impairment among a diverse cohort of ICU survivors, both at discharge and longitudinally, and to highlight sociodemographic factors that might be associated with the presence of objective physical functional impairment.

DESIGN, SETTING, AND PARTICIPANTS:
This was a secondary analysis of 37 patients admitted to the ICU in New Orleans, Louisiana, and Denver, Colorado between 2016 and 2019 who survived with longitudinal follow-up data.

MAIN OUTCOMES AND MEASURES:
Our primary outcome of physical functional impairment was defined by handgrip strength and the short physical performance battery. We explored associations between functional impairment and sociodemographic factors that included race/ethnicity, sex, primary language, education status, and medical comorbidities.

RESULTS:
More than 75% of ICU survivors were affected by physical functional impairment at discharge and longitudinally at 3- to 6-month follow-up. We did not see a significant difference in the proportion of patients with physical functional impairment by race/ethnicity, primary language, or education status. Impairment was relatively higher in the follow-up period among women, compared with men, and those with comorbidities. Among 18 patients with scores at both time points, White patients demonstrated greater change in handgrip strength than non-White patients. Four non-White patients demonstrated diminished handgrip strength between discharge and follow-up.

CONCLUSIONS AND RELEVANCE:
In this exploratory analysis, we saw that the prevalence of objective physical functional impairment among ICU survivors was high and persisted after hospital discharge. Our findings suggest a possible relationship between race/ethnicity and physical functional impairment. These exploratory findings may inform future investigations to evaluate the impact of sociodemographic factors on functional recovery.
Global, regional, and national burden of ovarian cancer among young women during 1990–2019
Authors: Zhuang Qingyuan , Gu Gaocheng , Chen Jiyu , Tang Zhuojun , Wu Chenxi , Liu Jiahui , Qu Lili 
Published: June 2024

Background
Ovarian cancer, the most devastating tumor in women globally, significantly impacts young women, compromising their daily lives and overall well-being. Ovarian cancer represents a significant public health concern due to its extensive physical and psychological consequences.

Material and methods
Data from the Global Burden of Disease were used to assess the global, regional, and national burden of ovarian cancer in young women aged 20–39 from 1990 to 2019. This analysis focused on trends measured by the estimated annual percentage change and explored the socioeconomic impacts via the socio-demographic index (SDI).

Results
During 1990–2019, the incidence and prevalence of ovarian cancer among young women increased globally, with annual rates of 0.74% and 0.89%, respectively. The mortality rate and disability-adjusted life years also rose annually by 0.20% and 0.23%, respectively. A significant burden shift was observed toward regions with lower SDI, with high fasting plasma glucose, BMI, and asbestos exposure identified as prominent risk factors, particularly in lower SDI regions.

Conclusion
Our findings underscore ovarian cancer in young women as an escalating global health challenge, with the burden increasingly shifting toward lower socioeconomic areas. This underscores the necessity for targeted prevention and control strategies for ovarian cancer, focusing on reducing the identified risk factors and ensuring equitable health resource distribution.
Changing Dermatologic Procedural Patterns in the Medicare Population: A National Trend Analysis
Authors: Gronbeck Christian , Jain Neelesh P. , Zhou Albert E. , Sloan Brett , Feng Hao 
Published: June 2024

BACKGROUND
Dermatologists are trained in diagnostic and therapeutic procedures for cutaneous lesions, yet comparative trends for basic dermatologic procedures across dermatology providers are lacking at the national level.

OBJECTIVE
To trend common dermatologic procedures among general dermatologists, Mohs surgeons, primary care providers or primary care physicians (PCPs), and nonphysician clinicians (NPCs).

METHODS
Longitudinal analysis of 2016 to 2021 Medicare Public Use Files.

RESULTS
Aggregate dermatologic procedural volume decreased 3.0%. Procedural volume declined among general dermatologists (−11.7%), Mohs surgeons (−16.7%), and PCPs (−41.7%) but increased among NPCs (+57.5%). The proportion of procedures by general dermatologists decreased substantially for premalignant destructions (−6.2%), skin biopsies and shave removals (−4.7%), and malignant excisions (−4.1%) and more notably in counties that were nonmetro (−7.1%), low in income (−6.1%), and with <4.0 dermatologists per 100,000 population (−7.0%).

CONCLUSION
Aggregate procedural volume decreased across the study period with general dermatologists, Mohs surgeons, and PCPs performing a progressively smaller proportion. The increase in procedures by NPCs may help to address demand but underscores the value of formalized procedural training. The procedural decline by general dermatologists in rural and low-income counties and those with baseline dermatologist shortages may exacerbate existing unmet need. Primary limitation included lack of commercial data.
Violence in the healthcare workplace
Authors: Hargreaves Courtney , Wax Joseph R. 
Published: June 2024

Purpose of review
Healthcare workers experience a disproportionate frequency of workplace violence. Identifying commonalities among incidents of workplace violence provides an opportunity for change to prevent and mitigate future violence.

Recent findings
Despite a continued decline in overall workplace violence, the rate of violence in the healthcare sector is steadily rising. While healthcare workers make up 13% of the workforce, they experience 60% of all workplace assaults. Environmental, structural, and staffing issues may all contribute to the increased rates of workplace violence affecting healthcare workers.

Summary
Comprehensive proactive workplace violence prevention programs can significantly reduce the frequency of violence and the negative impact on employees and institutions. Analyzing the factors that contribute to violence in the healthcare workplace provides the potential to mitigate these risks and reduce episodes of violence.
Emerging data on diagnosis and management of uterine isthmoceles: a rapid review
Authors: Cook Elizabeth N. , Jesse Nicholas , Harvey Lara 
Published: June 2024

Purpose of review
With a rising number of cesarean sections, the prevalence of uterine isthmoceles is increasing. We performed a rapid review to assess the most recent data on the diagnosis and management of uterine isthmoceles over the past 18 months to identify current trends and directions for continued research.

Recent findings
A comprehensive search was conducted in PubMed (NLM), Embase (Ovid), CINAHL (EBSCOhost) to find English written articles discussing the diagnosis or management of uterine isthmoceles published in the previous 18 months. Data extraction was performed on one hundred articles that met inclusion criteria.

Summary
This rapid review highlights agreement regarding diagnostic methods, symptoms, and recommended treatment paths for patients with symptomatic uterine niches. However, the diversity in definitions hampers the capacity to formulate detailed conclusions regarding the features of uterine niches and their impact on women's health.
Ergonomic considerations for unique surgeon populations
Authors: Olig Emily , Ranieri Gina , Louie Michelle 
Published: June 2024

Purpose of review
Surgeons are rapidly diversifying as a population, introducing new ergonomic challenges. This review describes the challenges that are experienced by special populations of surgeons including small-handed surgeons, pregnant surgeons, and trainees, and evidence-based solutions to overcome them.

Recent findings
Small-handed and female surgeons report more musculoskeletal complaints compared with their male counterparts. Pregnant surgeons frequently report development or worsening of musculoskeletal disorders such as carpal tunnel syndrome and low back pain. Trainees also report high rates of musculoskeletal complaints with minimal autonomy to alter their environment. Limited objective data exists regarding the ideal instruments currently available for special populations. Several small, randomized studies have proposed exercise regimens targeting the upper extremities and pregnancy-related pain syndromes with improvements in symptoms. Various methods of ergonomic education have been studied in trainees with improvements in operating room posture and performance.

Summary
Limited objective data is available to recommend specific surgical instruments for high-risk surgeon populations. Beneficial exercise regimens have been described for musculoskeletal disorders commonly plaguing surgeons but have yet to be studied explicitly in small-handed or pregnant surgeons and trainees.
Alternative treatments of adenomyosis – an update in procedural management and clinical outcomes
Authors: Zeccola Alison M. , Allen Sarah E. 
Published: June 2024

Purpose of review
Adenomyosis is a common cause of abnormal uterine bleeding (AUB), dysmenorrhea, and pelvic pain. Definitive diagnosis and treatment have historically been by uterine histopathology at time of hysterectomy; however, advances in imaging have supported earlier diagnosis and subsequent conservative treatment. This review aims to update the evidence supporting the uterine-sparing, procedural management options with a focus on clinical outcomes.

Recent findings
Uterine artery embolization (UAE), radiofrequency ablation (RFA), high-intensity focused ultrasound (HIFU), percutaneous microwave ablation (PMWA), and adenomyomectomy are minimally invasive interventions proven to be effective in reducing AUB and dysmenorrhea due to adenomyosis. Symptom improvement is associated with a decrease in uterine volume. Studies support the use of alternative treatment options given the overall low rates of symptom recurrence and reintervention. Combination therapy may be more effective than monotherapy.

Summary
This review provides the current evidence for use of alternative treatment options for adenomyosis. Access to ablative therapies in the USA is limited and primarily off label, given lack of FDA approval. High-quality prospective and randomized controlled trials are needed in order to further delineate treatment comparisons, efficacy, safety, and ideal patient selection for these treatments. More data are needed to assess safety and utility in those desiring future fertility.
Circulating bacterial peptides and linked metabolomic signatures are indicative of early mortality in pediatric cirrhosis
Authors: Mathew Babu , Tripathi Gaurav , Gautam Vipul , Bindal Vasundhra , Sharma Nupur , Yadav Manisha , Pandey Sushmita , Sharma Neha , Gupta Abhishak C. , Bhat Sadam H. , Saini Akhilesh K. , Sood Vikrant , Lal Bikrant Bihari , Alam Seema , Khanna Rajeev , Maras Jaswinder Singh 
Published: June 2024

Background:
Patients with pediatric cirrhosis-sepsis (PC-S) attain early mortality. Plasma bacterial composition, the cognate metabolites, and their contribution to the deterioration of patients with PC-S to early mortality are unknown. We aimed to delineate the plasma metaproteome-metabolome landscape and identify molecular indicators capable of segregating patients with PC-S predisposed to early mortality in plasma, and we further validated the selected metabolite panel in paired 1-drop blood samples using untargeted metaproteomics-metabolomics by UHPLC-HRMS followed by validation using machine-learning algorithms.

Methods:
We enrolled 160 patients with liver diseases (cirrhosis-sepsis/nonsepsis [n=110] and noncirrhosis [n=50]) and performed untargeted metaproteomics-metabolomics on a training cohort of 110 patients (Cirrhosis-Sepsis/Nonsepsis, n=70 and noncirrhosis, n=40). The candidate predictors were validated on 2 test cohorts—T1 (plasma test cohort) and T2 (1-drop blood test cohort). Both T1 and T2 had 120 patients each, of which 70 were from the training cohort.

Results:
Increased levels of tryptophan metabolites and Salmonella enterica and Escherichia coli–associated peptides segregated patients with cirrhosis. Increased levels of deoxyribose-1-phosphate, N5-citryl-d-ornithine, and Herbinix hemicellulolytic and Leifsonia xyli segregated patients with PC-S. MMCN-based integration analysis of WMCNA-WMpCNA identified key microbial-metabolic modules linked to PC-S nonsurvivors. Increased Indican, Staphylobillin, glucose-6-phosphate, 2-octenoylcarnitine, palmitic acid, and guanidoacetic acid along with L. xyli, Mycoplasma genitalium, and Hungateiclostridium thermocellum segregated PC-S nonsurvivors and superseded the liver disease severity indices with high accuracy, sensitivity, and specificity for mortality prediction using random forest machine-learning algorithm.

Conclusions:
Our study reveals a novel metabolite signature panel capable of segregating patients with PC-S predisposed to early mortality using as low as 1-drop blood.
Shifting Patterns of Sputum Culture Testing and Antibiotic Usage Among Patients With Pneumonia Before and After the COVID-19 Pandemic
Authors: Ito Hiroshi , Kitagawa Yuki , Nakashima Toshiya , Kobanawa Satoshi , Uki Kento , Oshida Jura , Kodama Taisuke , Kobayashi Daiki 
Published: June 2024

Abstract
The coronavirus disease 2019 (COVID-19) pandemic has greatly shifted the attitude of the public and health care workers toward health care practices. Furthermore, this pandemic led to reduced diagnostic testing of various diseases worldwide. This study investigated the impact of the COVID-19 pandemic on health care practices, mainly focusing on sputum culture testing for pneumonia and how these changes affected antibiotic selection and health outcomes. We conducted a retrospective observational study at the Tokyo Medical University Ibaraki Medical Center between January 2018 and December 2021. We compared clinical outcomes during the pre–COVID-19 and post–COVID-19 periods. These outcomes included microbiological test implementation (eg, sputum culture test), length of hospital stay, and in-hospital mortality. Of the 698 patients, 384 (55.0%) were from the pre–COVID-19 period, and 314 (45.0%) were from the post–COVID-19 period. The post–COVID-19 period was associated with a lower ordering rate of sputum cultures (odds ratio [OR], 0.68; 95% confidence interval [CI], 0.50–0.93). Furthermore, the post–COVID-19 period was associated with increased use of narrow-spectrum antibiotics (OR, 1.57; 95% CI, 1.12–2.21) and a higher rate of in-hospital death (OR, 1.78; 95% CI, 1.16–2.73). The COVID-19 pandemic has prompted changes in health care–seeking behaviors, affecting health care providers' diagnostic practices and potentially influencing patient outcomes. Our study outlines the importance of adapting health care strategies during pandemics. Further studies are required to understand the complex interplay among pandemic situations, diagnostic procedures, and patient prognosis.
Transcatheter Aortic Valve Replacement–Associated Prosthetic Valve Endocarditis Due to Pseudomonas aeruginosa
Authors: Boylan Kate E. , Myers Joseph P. 
Published: June 2024

Abstract

Introduction
In patients unsuitable for surgical aortic valve replacement (SAVR), transcatheter aortic valve replacement (TAVR) is an alternative treatment modality for severe aortic stenosis. Prosthetic valve endocarditis (PVE) is uncommon after TAVR, and TAVR-PVE due to Pseudomonas aeruginosa is rare. We report a patient with P. aeruginosa TAVR-PVE and review the literature on the topic.

Case
A 70-year-old woman with history of atrial fibrillation and severe aortic stenosis status post TAVR 4 months previously presented with a third episode of P. aeruginosa bacteremia. She initially developed P. aeruginosa bacteremia 18 days after TAVR. She failed two 6-week courses of intravenous cefepime treatment and then developed P. aeruginosa breakthrough bacteremia while on her third course of intravenous cefepime. Surgical intervention was declined by the patient. Two prior transesophageal echocardiograms (TEEs) were negative for vegetation, but after her breakthrough bacteremia, a repeat TEE showed a 1.5 × 0.8-cm vegetation on the aortic valve. Patient and family declined further therapy and transitioned to hospice and died 5 days later.

Discussion
This is the sixth reported case of P. aeruginosa TAVR-PVE. Enterococcus faecalis, coagulase-negative Staphylococcus and Staphylococcus aureus, and streptococci are the most common etiologic agents causing TAVR-PVE. Diagnosis is difficult, and TEE may be nondiagnostic. Of the 6 reported cases, the only 2 to survive underwent SAVR despite high Society of Thoracic Surgery risk calculator scores.

Conclusion
TAVR-PVE due to P. aeruginosa is rare and will likely not be cured by medical therapy alone. Surgical intervention with SAVR should be considered as the only available curative therapy despite high Society of Thoracic Surgery surgical risk scores.
Sick Leave and Absence Rate of Hospital Workers During the Sixth to Eighth Wave of COVID-19 in Japan
Authors: Seki Yoshitaka , Uchiyama Shota , Matsui Yuma , Baba Yuri , Kamii Yasuhiro , Shinohara Wakako , Yoshida Kazushi , Ichikawa Akihiro , Yoshikawa Koji , Araya Jun 
Published: June 2024

Abstract

Background
There are several reports of breakthrough infections of severe acute respiratory syndrome coronavirus 2 in vaccinated individuals and reinfections in previously infected individuals. Although the coronavirus disease (COVID-19) pandemic has increased the incidence of infections at healthcare facilities, the association between the increase in community spread and absence rate of hospital workers due to COVID-19 infection-related sick leave has not yet been fully elucidated.

Method
We reviewed the case files of patients with COVID-19 diagnosed at the Jikei University Katsushika Medical Center, Tokyo, Japan, between January 1, 2022, and February 28, 2023. The obtained data was used to determine the number of COVID-19 admissions and absence rate of hospital workers due to COVID-19 infection-related sick leave during the sixth to eighth wave of the COVID-19 pandemic.

Results
Of 1899 patients with confirmed COVID-19, 397 (20.9%) were hospital workers. Of the 397 patients, 71, 156, and 119 contracted the infection during the sixth (January–March 2022), seventh (July–September 2022), and eighth wave (November 2022–February 2023), respectively. The absence rate of hospital workers due to COVID-19 was 6.3%, excluding leaves of absence due to close contact in the seventh wave, which had the highest number of infections.

Conclusions
Given the difficulty of maintaining a usual work schedule during the COVID-19 outbreak, it may be necessary to re-evaluate the backgrounds of healthcare workers at high risk of contracting COVID-19 and to make aggressive adjustments to their work schedules by distributing assignments and restricting leave.
Soft tissue coverage for IIIB fractures: from timing to coverage options
Authors: Azad Ali , Hacquebord Jacques H. 
Published: June 2024

Abstract
Open tibia fractures are the most common open long bone injury. Most of these injuries involve a high-energy mechanism. Many standards for management have been created to provide guidance and a baseline for quality. There are several factors that must be considered when determining the timing of coverage for an open fracture with soft tissue compromise. Understanding the available options for soft tissue coverage, including local/rotational flaps and free tissue transfer, will allow for a tailored approach based on the personality of the injury. The aim of this review was to characterize the critical window of treatment based on the current literature and to provide a review of the available soft tissue coverage options.
Classification of open tibia fractures: the rationale for a new classification system
Authors: Resad Ferati Sehar , Ganta Abhishek 
Published: June 2024

Abstract
Open tibial shaft fractures are one of the most common long bone injuries encountered. Current existing classifications are designed to characterize the nature of the injury and guide clinical decision making. However, despite these advancements, there are areas in our current classification system that can be improved to not only make reliability more producible but also create prognostic factors that can help guide treatment.