bluuebunny/crossref_metadata_2025_split huggingface dataset:
Trends in mental health care and telehealth use across area deprivation: An analysis of electronic health records from 2016 to 2024
Authors: Ettman Catherine K , Ringlein Grace V , Dohlman Priya , Straub Jason , Brantner Carly Lupton , Chin Elizabeth T , Sthapit Sazal , Badillo Goicoechea Elena , Mojtabai Ramin , Albert Michael , Spivak Stanislav , Iwashyna Theodore J , Goes Fernando S , Stuart Elizabeth A , Zandi Peter P 
Published: February 2025

Abstract
While telehealth may improve access to healthcare for some, it may also widen gaps in access across different economic groups. Using electronic health records for outpatient mental health care of patients with depression in a large US academic health system, we assessed changes in mental health care utilization from 2016 to 2024 (primary care: n = 42,640 patients, 270,754 visits; psychiatry: n = 12,846 patients, 336,918 visits) and odds of using telehealth relative to in-person care from 2020 to 2024, across national area deprivation index (ADI) percentiles. We found that over 3 years prepandemic (July 2016–June 2019), the volume of mental health care delivered to patients from low-deprivation areas (1st–25th national ADI percentile) was increasing at a steeper rate than for high-deprivation areas (76th–100th national ADI percentile). Visit volume changed rapidly at the onset of the COVID-19 pandemic, and by July 2021 it was increased relative to prepandemic levels. From July 2021 to June 2024, volume of care declined for all deprivation groups, but at a more rapid rate for the high-deprivation group than the low-deprivation group. Further, on average from July 2020 to June 2024, the odds of receiving telehealth relative to in-person care were significantly higher for patients living in low deprivation rather than high-deprivation areas in both primary care and psychiatry. We did not find evidence of telehealth improving access to care for patients in high-deprivation areas. Differences in telehealth use may contribute to sustained disparities in access to mental health care across economic groups.
Periacetabular Osteotomy Multimodal Pain Control Using Erector Spinae Plane vs Epidural Catheter: A Retrospective Cohort Analysis
Authors: Fiedler Anna K , Siahaan Jacob J , Aboulafia Alexis H , Ham Angel A , Mansour Alfred A 
Published: February 2025

Background:
Periacetabular osteotomy (PAO) is an established treatment for symptomatic developmental hip dysplasia. Epidural analgesia is traditionally used for perioperative pain management but may have negative secondary effects, including distal motor and sensory deficits, and hypotension which delays rehabilitation and prolongs discharge. One alternative is Erector Spinae Plane Block (ESPB), an ultrasound-guided injection or catheter insertion remote to the spinal canal. Despite high success with minimal complications, ESPB use during PAO has not been studied. This study's purpose was to retrospectively evaluate the efficacy and side effect profile of ESPB compared to epidural analgesia for PAO pain control.

Methods:
Patients at a single site received preoperative epidural (n=73) or ESPB (n=73) for PAO pain management. Data including pain scores, morphine equivalents, complications, and discharge details was retrospectively reviewed. Welch’s t test, Glass’ Delta, and Fisher exact tests were utilized, with an alpha level of 0.05 to indicate statistical significance.

Results:
There were no significant differences in patient populations, catheter use duration, or length of stay between groups (p>0.05). Patients reported slightly more pain with ESPB on postoperative day 0 (4.5 [CI: 4.0,4.9]) compared to epidural (3.5 [CI: 2.9,4.0]), p=0.008. Patients who received ESPB required fewer morphine equivalents than epidural patients on postoperative day 0, postoperative day 1, and postoperative day 2 (p<0.001). The epidural cohort had more weakness (16.44%), numbness (39.73%), and symptomatic hypotension (10.96%) compared to the ESPB cohort (4.11%, 9.59%, 1.37% respectively, p=0.03, p<0.001, p=0.03). Epidural patients were more likely to report adverse events (17.81% vs 43.16%, p<0.001).

Conclusion:
ESPB provides an effective method of pain control for PAO patients. Compared to lumbar epidurals, patients required less systemic opioids and reported fewer side effects, particularly numbness, symptomatic hypotension, and weakness. ESPB is an attractive option in multimodal pain protocol for PAO.
Relationships Between Neighborhood Disadvantage, Race/Ethnicity, and Neurobehavioral Symptoms Among Veterans With Mild Traumatic Brain Injury
Authors: Kinney Adam R. , Bahraini Nazanin H. , Schneider Alexandra L. , Yan Xiang-Dong , Forster Jeri E. , Holliday Ryan , Brenner Lisa A. 
Published: February 2025

Objective:
To examine the relationship between neighborhood disadvantage and severity of vestibular, sensory, mood-behavioral, and cognitive neurobehavioral symptoms among Veterans with a mild traumatic brain injury (mTBI); and whether Veterans in underrepresented racial/ethnic groups with high neighborhood disadvantage experience the most severe symptoms.

Setting:
Outpatient Veterans Health Administration (VHA).

Participants:
Veterans with the following data available in the electronic health record (2014-2020): (1) clinician-confirmed mTBI and complete neurobehavioral symptom inventory (NSI) as part of their comprehensive traumatic brain injury evaluation (CTBIE) and (2) area deprivation index (ADI) scores assessing neighborhood disadvantage from the same quarter as their CTBIE.

Design:
Retrospective cohort study. Latent variable regression was used to examine unique and interactive relationships between neighborhood disadvantage, race/ethnicity, and neurobehavioral symptoms.

Main Measures:
NSI and ADI national percentile rank.

Results:
The study included 58 698 eligible Veterans. Relative to Veterans in the first quintile of ADI national percentile rank, representing those with the least neighborhood disadvantage, Veterans in the ADI quintiles indicating greater neighborhood disadvantage reported more severe vestibular, sensory, mood-behavioral, and cognitive symptoms. The strongest associations between neighborhood disadvantage and neurobehavioral symptoms were observed within the sensory (β = 0.07-0.16) and mood-behavioral domains (β = 0.06-0.15). Statistical interactions indicated that the association between underrepresented racial/ethnic group status (vs. identifying as white, non-Hispanic) and the severity of neurobehavioral symptoms did not differ among those with severe neighborhood disadvantage versus those without.

Conclusion:
Veterans with mTBI living in more disadvantaged neighborhoods reported more severe neurobehavioral symptoms relative to those in the most advantaged neighborhoods, with the strongest relationships detected within the sensory and mood-behavioral domains. While neighborhood disadvantage and underrepresented race/ethnicity were both independently associated with symptoms, these factors did not interact to produce more severe symptoms. Findings suggest that addressing factors driving socioeconomic disadvantage may assist in mitigating symptoms in this population.
Predictive Value of Quantitative CRP Levels as a Marker of Nosocomial Neonatal Sepsis
Authors: Mir Nasir Ahmad , Ganie Jabish , Shah Idrees A. , Qazi Iqbal A. , Charoo Bashir A. 
Published: February 2025

Background:
Nosocomial infection (NI) is a serious health concern primarily for premature neonates and for term babies with illnesses requiring continued hospitalisation. Early diagnosis of NI using biomarkers is central to decreased neonatal mortality and morbidity. We aimed to evaluate the predictive value of C-reactive protein (CRP) as a marker of NI.

Methods:
Sixty-four neonates, suspected of sepsis, admitted to the Department of Paediatrics and Neonatology with a negative workup for sepsis on their first day of admission were investigated for various haematological parameters, blood culture positivity, and CRP levels. The patients were then stratified into culture-positive and culture-negative groups. All the parameters analysed were compared between these 2 groups, and ROC curve analysis was performed to determine the value of CRP in predicting positive blood culture in NI.

Results:
NI was seen in a total of 70.31% (n = 45) neonates based on blood culture-positive status. Compared to females, a greater number of male neonates were culture-positive (60% vs 40%). The mean birth-weight of the culture-positive group was significantly lower than the negative group (P = 0.03). The mean CRP levels were elevated in the positive group (98.5 ± 47.8) when compared to the negative group (32.2 ± 24.1; P < .001). Using the ROC curve,a cut-off value (45.05 mg/L) of CRP had sensitivity and specificity of 80.0% and 73.7% respectively in predicting blood culture-positive NI.

Conclusion:
Serum CRP is a sensitive marker to diagnose NI in admitted neonates.

Implication for practice and research:
CRP levels can aid in the diagnosis of clinical deterioration, and a treating physician can modify the regimen based on elevated CRP levels.
Peroral Endoscopic Myotomy for Achalasia Among the Elderly Population
Authors: Hayat Umar , Kamal Faisal , Memon Adil , Sadiq Syeda Madeeha , Rana Usman Iqbal , Gangwani Manesh K. , Ali Hassam , Gopalakrishnan Keerthy , Obuch Joshua C. , Adler Doulas G. 
Published: February 2025

Objective:
Achalasia is an esophageal motility disorder associated with halting symptoms. There is conflicting evidence about the feasibility of peroral endoscopic myotomy (POEM) for achalasia among the elderly. In this meta-analysis, we sought to evaluate POEM’s therapeutic safety and efficacy among elderly patients with achalasia.

Methods:
Major databases were searched to find articles that compared the feasibility and safety of POEM for Achalasia between 4 age groups in 2 separate comparisons: ≥75 and <75 years, and ≥65 and <65 years. Our primary outcomes of interest were to compare POEM’s technical and clinical success rates. The secondary outcome was the adverse events of the procedure. A random effect model calculated pooled odds ratios with 95% CIs.

Results:
Six studies were included with 290 patients ≥75 years of age and 2290 <75, 177 ≥65, and 354 younger than 65. The pooled technical success rate was 98.66% and 97.81% for patients ≥75 years of age and younger than 75, respectively. Similarly, the pooled clinical success rate was 99.01% and 97.97% for ≥75 and younger than 75, respectively. The pooled technical success rate was 99.69% and 99.84% for ≥65 and younger than 65, respectively. Similarly, the pooled clinical success rate was 95.74% and 95.31% for ≥65 and younger than 65, respectively. There was no difference in the technical and clinical success rates in both comparison groups. Also, the 2 groups had no difference in the adverse events profile of the 2 comparison groups.

Conclusions:
Our study demonstrates the feasibility and safety of POEM for achalasia among older people despite their comorbidities.
MASLD-F Algorithm to the Rescue
Authors: Lin Joanne , Green Victoria , McGrath Morgan , Lloyd Aaron , Ma Pearl , Higa Kelvin , Roytman Marina 
Published: February 2025

Objective:
The gold standard to stage hepatic fibrosis is with a liver biopsy. It is not without its drawbacks and is more challenging for patients with severe obesity. Noninvasive testing, including the fibrosis-4 (FIB-4) score and vibration-controlled transient elastography (VCTE), have begun to be increasingly used as initial screening methods.
The applicability and accuracy of these noninvasive methods remain uncertain in patients with severe obesity and metabolic dysfunction-associated steatotic liver disease. Our study explored combining VCTE with lower FIB-4 cutoffs to improve concordance with biopsy in staging hepatic fibrosis in patients with metabolic dysfunction-associated steatotic liver disease and severe obesity undergoing bariatric surgery.

Methods:
A total of 632 patients with severe obesity underwent preoperative VCTE and intraoperative liver biopsy during bariatric surgery from January 2020 to August 2021. Variables collected included patient demographics, laboratory values, abdominal ultrasound, VCTE, and liver biopsy results. Analysis of variance 1-way test, χ2 tests, and Fisher exact tests were used for quantitative and qualitative variables, respectively. The 95% CIs for the mean FIB-4 scores were used to generate surrogate cutoff values. The VCTE and FIB-4 scores were integrated using an algorithm that utilized a dynamic decision-making process at each stage to find the values that would yield the highest concordance with liver biopsy.

Results:
VCTE alone was in concordance with liver biopsy results in 59.7% of cases. Combining the proposed FIB-4 cutoff scores with VCTE led to an improved concordance with a liver biopsy of 88%.

Conclusion:
Our study demonstrated that accessible noninvasive testing has limitations alone but when combined, can improve staging of hepatic fibrosis.
Gastrointestinal pathologist consensus of revised high-grade dysplasia in inflammatory bowel disease impacts the advanced neoplasia rate: a multicenter study
Authors: te Groen Maarten , Derks Monica E.W. , Nagtegaal Iris D. , Peters Charlotte P. , de Vries Annemarie C. , Dijkstra Gerard , Romkens Tessa E.H. , Horjus Carmen S. , de Boer Nanne K. , de Jong Michiel E. , van Ruijven Britt , Hoentjen Frank , Vos Shoko , Derikx Lauranne A.A.P. ,   on behalf of the Dutch Initiative on Crohn’s and Colitis (ICC) and the Dutch Nationwide Pathology Databank (PALGA) group
Published: February 2025

Objective
The diagnosis of inflammatory bowel disease (IBD) associated with high-grade dysplasia (HGD) has a significant impact on clinical management, including colectomy. However, the prognosis of HGD remains unclear due to diagnostic uncertainty and low-quality data on subsequent synchronous and metachronous neoplasia. We aimed to evaluate a diagnostic strategy with dedicated gastrointestinal (GI) pathologist consensus of revised HGD and the impact on synchronous and metachronous neoplasia rates.

Methods
In this retrospective multicenter cohort study, we used the Dutch Nationwide Pathology Databank to identify IBD patients with HGD in seven hospitals. Histopathological specimens of the initial HGD were independently revised by two dedicated GI pathologists. Definitive diagnosis was established in a consensus meeting. Synchronous and metachronous neoplasia incidences were assessed with a competing risk analysis.

Results
We included 54 IBD patients with HGD, of whom 33 (61.1%) with ulcerative colitis and 42 (77.8%) with extensive disease. After consensus, 18 (33.3%) lesions were downgraded to indefinite/low-grade dysplasia, and 6 (11.1%) were revised to colorectal cancer (CRC). Seven patients (13.0%) had synchronous CRC. Patients with downgraded lesions showed a lower cumulative advanced neoplasia (HGD/CRC) incidence compared with confirmed HGD [(Gray’s test P < 0.01), 5-year cumulative incidence 0.0% vs. 26.6%].

Conclusions
We demonstrated frequent downgrading of HGD, associated with lower metachronous neoplasia rates. This underlines the potential impact of dedicated GI pathologist consensus meetings. The high and synchronous and metachronous neoplasia rates after HGD underline the need for close surveillance.
Role of noninvasive tests on the prediction of hepatocellular carcinoma in nonalcoholic fatty liver disease patients without cirrhosis: a systematic review and meta-analysis of aggregate and individual patient data
Authors: Siriwong Nanicha , Sriphoosanaphan Supachaya , Decharatanachart Pakanat , Yongpisarn Tanat , Kerr Stephen J. , Treeprasertsuk Sombat , Tiyarattanachai Thodsawit , Apiparakoon Terapap , Hagström Hannes , Akbari Camilla , Ekstedt Mattias , Yip Terry Cheuk-Fung , Wong Grace Lai-Hung , Ito Takanori , Ishigami Masatoshi , Toyoda Hidenori , Peleg Noam , Shlomai Amir , Seko Yuya , Sumida Yoshio , Kawanaka Miwa , Hino Keisuke , Chaiteerakij Roongruedee 
Published: February 2025

Background
Nonalcoholic fatty liver disease (NAFLD) has been identified as an emerging risk factor for hepatocellular carcinoma (HCC). Identifying non-cirrhotic NAFLD patients at risk for HCC is crucial. We aimed to investigate the utility of noninvasive tests (NITs) as predictors for HCC and to determine optimal and cost-effective NIT cutoffs for HCC surveillance in non-cirrhotic NAFLD patients.

Methods
Medline, EMBASE, and Scopus databases were searched for studies evaluating the relationship between NITs and HCC in this population. Random-effects models were used to estimate hazard ratios or risk ratios and 95% confidence interval (95% CI). Cutoffs of NITs for identifying high-risk patients for HCC were determined.

Results
This systematic review comprised 20 studies. A meta-analysis of 379 194 patients was conducted using six studies with individual patient data and five studies with aggregate data. Among NITs studied, fibrosis-4 index (FIB-4), aspartate aminotransferase to platelet ratio index (APRI), and NAFLD fibrosis score (NFS) were significantly associated with HCC, with pooled risk ratio (95% CI) of 9.21 (5.79–14.64), pooled hazard ratio of 12.53 (6.57–23.90), and 13.32 (6.48–27.37), respectively. FIB-4, APRI, and NFS of more than 2.06, 0.65, and 0.51 resulted in the highest area under the receiver operating characteristics of 0.83, 0.80, and 0.85, respectively. Surveillance in patients with FIB-4 ≥ 5.91 and NFS ≥ 2.85 would be cost-effective with an annual HCC incidence of ≥15 per 1000 patient-years.

Conclusion
FIB-4, APRI, and NFS are associated with HCC development in non-cirrhotic NAFLD patients. Different NIT cutoffs may be used to enroll high-risk NAFLD patients for HCC surveillance, according to resource availability in different settings.
Directionality of endoscopic and histologic healing in ulcerative colitis: a prospective pilot study
Authors: Hanžel Jurij , Novak Gregor , Jairath Vipul , Zou Guangyong , Dong Hannah , Gui Xianyong Sean , Hindryckx Pieter , Beaton Melanie , Bressler Brian , Löwenberg Mark , Panaccione Remo , D’Haens Geert R. , Feagan Brian G. , Ma Christopher 
Published: February 2025

Objective
Endoscopic and histologic healing in ulcerative colitis (UC) is hypothesized to progress proximally to distally, with healing of the distal rectosigmoid occurring last. However, this has not been empirically verified.

Methods
We performed a prospective cohort study in patients with pancolonic UC commencing treatment with a tumor necrosis factor (TNF) antagonist or vedolizumab. Four biopsies were obtained from each of the five colonic segments at colonoscopy, both at baseline and 16–24 weeks after treatment initiation. Independent, blinded central reading of both endoscopic [modified Mayo Endoscopic Subscore (mMES) (score = 1 excludes any friability), UC Endoscopic Index of Severity (UCEIS)] and histologic disease activity [Robarts Histopathology Index (RHI), Nancy Histological Index (NHI), and Geboes Score] was performed for each colonic segment, and changes per segment were calculated.

Results
A total of eight patients were recruited (five TNF antagonists, three vedolizumab). There was no significant difference in the mean change between colonic segments for any of the endoscopic disease activity indices (P value based on Kruskal–Wallis test for differences between ascending, transverse, descending, sigmoid colon, and rectum: 0.328 for mMES and 0.317 for UCEIS). Similarly, there was no difference in change in histologic activity between colonic segments (P = 0.357 for RHI, P = 0.410 for NHI, P = 0.734 for Geboes score).

Conclusion
We did not observe evidence of an anatomical healing gradient in UC across different colonic segments, nor evidence of delayed distal improvement. Larger studies are required to validate whether the rectum truly does heal last in UC.
Post-COVID general health symptoms in patients with immune-mediated inflammatory diseases
Authors: van de Pol Natasja , van der Woude C. Janneke , Vis Marijn , van Doorn Martijn B.A. , Schrauwen Saskia L. , Cetinözman-Teunissen Fatos , West Rachel L. , Pan Qiuwei , de Vries Annemarie C. 
Published: February 2025

Background
Post-COVID entails persistent symptoms following a presumed or confirmed SARS-CoV-2 infection. This study aims to evaluate post-COVID general health symptoms reported by patients with IMIDs.

Methods
An online questionnaire was distributed to IMID patients on systemic therapy at dermatology, rheumatology, and gastroenterology departments in the Netherlands. General health symptoms were compared between patients with and without prior SARS-CoV-2 infection. Multivariable logistic regression was used to adjust for disease-related factors and known post-COVID risk factors. Self-reported prevalence of post-COVID symptoms was assessed by asking patients if they linked their symptoms to the previous SARS-CoV-2 infection.

Results
A total of 1518 patients were included, and 58% (n = 877) reported ≥1 SARS-CoV-2 infections. When assessing self-reported prevalence of post-COVID symptoms, 13.9% (122/877) linked their symptoms to a previous infection. Patients with a previous infection showed higher prevalence of symptoms than those without (56.2%, 43.9%; P < 0.001), and higher prevalence of fatigue (42%, 32%; P < 0.001). After adjusting for potential risk factors, previous infection was associated with symptoms (OR: 1.53; 95% CI: 1.23–1.91; P < 0.001), and fatigue (OR: 1.31; 95% CI: 1.04–1.64; P = 0.021). Subanalysis showed an association between self-reported COVID-19 severity and symptoms, while presumed SARS-CoV-2 variant (based on date of reported infection) and number of infections were not associated.

Conclusion
The self-reported prevalence of general health symptoms, particularly fatigue, is significantly higher in IMID patients with a previous SARS-CoV-2 infection. The cause of this increase requires further investigation and might provide insights into the pathogenesis of post-COVID, both relevant for IMID patients as well as the general population.
Psychometric Analysis of Disrespect and Abuse Scale
Authors: Alzyoud Fatima 
Published: February 2025

Abstract

Background
Disrespect and abuse of laboring and child-birthing women in health care is a global problem that violates the universal human rights of childbearing women. There is a lack of reliable and valid tools for measuring these behaviors. One instrument, the Disrespect and Abuse scale, has preliminary data with no established psychometrics in diverse populations. Further analysis is required to ensure the reliability and validity of this tool in diverse populations and health care settings.

Objectives
We examined the psychometric properties of the Disrespect and Abuse scale in diverse international nursing and midwifery populations.

Methods
A cross-sectional descriptive design was used to measure disrespect and abuse toward women during childbirth. Data were collected from 231 nurses and midwives across international labor and delivery units. Exploratory factor analysis was conducted using principal component analysis with oblimin rotation as the factor extraction method.

Results
The psychometric assessment yielded a two-factor structure. Factor 1 consisted of 13 items characterizing physical and verbal abuse. Factor 2 contained nine items reflecting disrespectful behaviors. The Cronbach’s alpha coefficients reflected high internal consistency.

Discussion
The scale was shown to be reliable and valid in assessing self-reported disrespectful and abusive behaviors among nurses and midwives in a diverse international sample. Use could assist in the assessment of these behaviors in maternal health care facilities. Further research is warranted to confirm the scale’s robustness and applicability across various populations and settings and use the Disrespect and Abuse scale to identify the burden and predictors of mistreatment of women in different health care settings.