bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bone Marrow Mononuclear Cell Transplantation Promotes Bone Healing via Gap Junction-Mediated Cell-Cell Interaction
Authors: Suda Yoshihito , Taguchi Akihiko , Matsumoto Tomoyuki , Okinaka Yuka , Hayashi Shinya , Tsubosaka Masanori , Kamenaga Tomoyuki , Kuroda Yuichi , Nakano Naoki , Onoi Yuma , Tachibana Shotaro , Wada Kensuke , Saito Akira , Maeda Takuma , Araki Shotaro , Motono Kohei , Kuroda Ryosuke 
Published: January 2025

Abstract

Aims
Bone marrow mononuclear cells (BM-MNCs) are a rich source of hematopoietic stem cells that have been widely used in experimental therapies for patients with various diseases, including fractures.
Activation of angiogenesis is believed to be one of the major modes of action of BM-MNCs; however, the essential mechanism by which BM-MNCs activate angiogenesis remains elusive. This study aimed to demonstrate that BM-MNCs promote bone healing by enhancing angiogenesis through direct cell-to-cell interactions via gap junctions, in addition to a previously reported method.

Methods
Using a murine fracture model, we aimed to elucidate the relationship between gap junction-mediated cell-to-cell interactions and enhanced fracture healing after BM-MNC transplantation. We evaluated the transfer of substances from BM-MNCs to vascular endothelial cells and osteoblasts in the tissues surrounding the fracture site and assessed the effects of BM-MNC transplantation on bone healing, angiogenesis, and osteogenesis.

Results
BM-MNCs transferred substances to vascular endothelial cells and osteoblasts in the tissues surrounding the fracture site. Moreover, BM-MNC transplantation promoted bone healing via gap junction-mediated cell-to-cell interactions, accelerating both angiogenesis and osteogenesis.

Conclusions
Our findings provide a novel understanding of fracture healing mechanisms and suggest that BM-MNC transplantation enhances bone healing through gap junction-mediated cell-to-cell interactions, contributing to the development of regenerative medicine strategies targeting bone repair.
Getting high school students doing mathematical research
Authors: Baker Swart Breeanne , Chen Mei-Qin , Flórez Rigoberto , Mukherjee Antara 
Published: January 2025

Abstract
This paper explores strategies for involving high school students with an algebra background in mathematical research endeavors. Through the utilization of open problems sourced from respected academic journals, we guide students in problem-solving approaches and ultimately achieving solutions. The students are not only encouraged to submit their findings for publication but also to partake in public presentations.
Mistaken for migraine
Authors: Morgan Anna , Hoyt Stephen James , Park Jamie , Holmes Vic 
Published: January 2025

ABSTRACT
The incidence of coccidioidomycosis has been rising in the past decade. This case report focuses on a man with a history of persistent migraine who presented to the ED with altered mental status. After cerebrospinal fluid testing, the patient was diagnosed with coccidioidal meningitis and treated with lifelong antifungal therapy. Clinician awareness and early identification of this disease can lead to reduced patient morbidity and mortality.
Orthopedic management of a patient with synovial chondromatosis
Authors: Smith Shawn C. , Snyder Garrett M. 
Published: January 2025

ABSTRACT
This article reviews practice guidelines, diagnosis, and treatment for synovial chondromatosis, a rare, benign condition that involves the synovium of the joints, most commonly the knee. The condition also can affect the hip, ankle, shoulder, elbow, and temporomandibular joint.
Acute pelvic pain
Authors: Nielsen Tiffany , Bribiesca Rosa , Whealon Candice 
Published: January 2025

ABSTRACT
Acute pelvic pain in reproductive-aged persons who are assigned female at birth is associated with an extensive differential diagnosis, with possible causes ranging from the genitourinary or gastrointestinal to the musculoskeletal or neurovascular, in some cases even extending to psychological and dermatologic presentations. This article presents a case study that serves as an exemplar of the differential diagnosis of acute pelvic pain, culminating in diagnosis of the patient with a hemorrhagic ovarian cyst as well as a review of outpatient surveillance guidelines for adnexal masses. Management of this difficult-to-diagnose condition is reviewed, and special populations are considered.
Nurses' Perceptions of the Role of Nursing Organizations in Promoting Engagement with the Sustainable Development Goals: A Global Study
Authors: Hawkins Janice Evans , Chiu Patrick , Mumba Mercy Ngosa , Gray Sarah E. , Hawkins Robert Joseph 
Published: January 2025

ABSTRACT

Background:
RNs are integral to achieving the United Nations' 17 Sustainable Development Goals (SDGs). Professional nursing organizations can play a significant role in educating and preparing nurses to work more effectively toward achieving the SDGs. While there is much literature that speaks to the importance of nurses engaging in these goals, there is a lack of research that has explored nurses' perceptions of the role of professional nursing organizations in promoting SDG-related knowledge and engagement. Since 2012, Sigma Theta Tau International Honor Society of Nursing (Sigma) has been formally accredited as a nongovernmental organization with special consultative status to the United Nations Economic and Social Council. As such, Sigma is committed to educating RNs about the SDGs and engaging them in working to advance the goals.

Purpose:
This study examined RNs' learning preferences regarding the SDGs, and their perceptions of their professional nursing organization's engagement in advancing these goals, its recognition of nursing's contributions to these goals, and its impact on increasing nurses' knowledge of these goals.

Methods:
This descriptive cross-sectional study used convenience and snowball sampling methods to recruit participants from multiple countries. Data were collected via an anonymous online survey. Descriptive and nonparametric statistics were used for data analysis.

Results:
The majority (84%) of Sigma members enrolled in this study believed Sigma should be actively engaged in advancing the SDGs. Forty-eight percent were aware of Sigma's engagement and 44% reported that Sigma had increased their knowledge of the SDGs. When comparing participants who were Sigma members to those who were not, Sigma members had significantly higher levels of perceived knowledge of the SDGs and higher levels of belief that nurses are integral to SDG advancement. There were no significant between-group differences regarding nurses' desire to know more about the goals, what nurses are doing to advance them, and how to take action themselves. Participants' top 3 preferred means of learning about the SDGs were emailed and online newsletters (28.8%), webinars and online presentations (24.3%), and internet websites (14.9%).

Conclusions:
The results of this study underscore the importance of professional nursing organizations' efforts to increase nurses' engagement with the SDGs and can be used in developing multilevel strategies to further educate nurses about the SDGs.
Prescribing rate, healthcare utilization, and expenditure of older adults using potentially inappropriate medications in China: A nationwide cross-sectional study
Authors: Zhao Zinan , Fu Mengyuan , Li Can , Gong Zhiwen , Li Ting , Ling Kexin , Li Huangqianyu , Li Jianchun , Cao Weihang , Hong Dongzhe , Hu Xin , Shi Luwen , Guan Xiaodong , Jin Pengfei 
Published: January 2025

Abstract

Background:
The use of potentially inappropriate medications (PIMs) is a major concern for medication safety as it may entail more harm than potential benefits for older adults. This study aimed to explore the prescribing rate, healthcare utilization, and expenditure of older adults using PIMs in China.

Methods:
A cross-sectional analysis was conducted using a national representative database of all medical insurance beneficiaries across China, extracting ambulatory visit records of adults aged 65 years and above between 2015 and 2017. Descriptive analysis was conducted to measure the rate of patients exposed to PIM, prescribing rate of each PIM, average annual outpatient visits per patient, average total medication costs for each visit, average annual cost of PIMs for each patient, and average annual medication costs for each patient. Generalized linear model with logit link function and binomial distribution was used to examine the adjusted associations between PIMs and independent variables.

Results:
In total, 845,278 (33.2%) participants were identified to be exposed to at least one PIM. Patients aged 75–84 years (38.1%) and ≥85 years (37.9%) were more likely to be prescribed with PIMs. Beneficiaries of the Urban Employee Basic Medical Insurance (UEBMI) and living in eastern and southern regions were more frequently prescribed with PIMs. Compared with patients without PIM exposure (7.5 visits, drug cost of RMB 1545.0 Yuan), patients with PIM exposure showed higher adjusted average annual number of outpatient visits (10.7 visits, β = 3.228, 95% confidence interval [CI] = 3.196–3.261) and higher annual drug costs (RMB 2461.8 Yuan, Coef. = 916.864, 95% CI = RMB 906.292–927.436 Yuan).

Conclusions:
The results showed that the use of PIM among older adults was common in China. This study suggests that it represents a clear target, pending multidimensional efforts, to promote rational prescribing for older adults.
The Cutaneous Pathology of Erythromelalgia and Its Role in Establishing Critical Clues Regarding Pathogenesis
Authors: Magro Cynthia , Kalomeris Taylor , Guo Lily 
Published: January 2025

Abstract:
Erythromelalgia, a rare cutaneous pain syndrome, is characterized by acral burning pain and flushing, often alleviated by cold and rest. Primary erythromelalgia is caused by gain-of-function mutations of genes encoding for sodium channels, resulting in hyperexcitability of pain signaling neurons. Autoimmunity and hematologic dyscrasias such as thrombocythemia have been implicated in secondary erythromelalgia. The pathology of this rare disease remains poorly defined. The Weill Cornell dermatopathology database was analyzed for acral biopsies procured from patients here there was a clinical concern for erythromelalgia. We identified 9 patients with clinical diagnoses of erythromelalgia who had a skin biopsy from an affected area. The female-to-male ratio was 2:1. Three of 9 individuals had concurrent diagnoses of autoimmune disease including vitiligo, lupus erythematosus, and psoriatic arthritis. Biopsies showed superficial vascular ectasia in association with microvascular C5b-9 and variable upregulation of type I interferon expression in endothelial cells. CD56 stain revealed diminished autonomic innervation of the eccrine coil and arteries, mirroring similar autonomic denervation seen in small fiber neuropathy. This study suggests that erythromelalgia is a dysautonomia syndrome with reproducible findings on biopsy, hallmarked by vascular ectasia and denervation of the eccrine coil and arteries. In addition, there is a potential link to immune and nonimmune-based microvascular compromise.
Reverse Fragility Index in Plastic Surgery Randomized Controlled Trials
Authors: Ahdoot Rodney , Benítez Trista M. , Wang Chien-Wei , Chung Kevin C. 
Published: January 2025

Background:
The reverse fragility index (RFI) is a measure used to evaluate the neutrality of statistically nonsignificant findings in randomized controlled trials (RCTs). The RFI represents the minimum number of events needed to reverse a statistically nonsignificant result into a significant one. This study applied the RFI to examine the robustness of statistically nonsignificant RCTs in plastic surgery.

Methods:
A systematic literature search of the 10 highest impact journals covering plastic and reconstructive surgery topics was conducted to identify RCTs published between January 2000 and March 2023. The Fisher exact test was used to calculate the RFI for each primary outcome. Bivariate analysis was performed to investigate the association of trial characteristics with the RFI.

Results:
Forty RCTs that yielded 65 primary outcomes were included in the analysis with a median sample size of 76 participants (interquartile range [IQR], 49–129) and a median of 10 events (IQR, 3–22). The median RFI was 4 (IQR, 3–5), indicating that statistical significance would have been achieved if 4 participants had a change in event status. The median RFQ was 0.053 (IQR, 0.038–0.08). Most studies (21 of 40) did not perform statistical power analysis. Twelve of 40 RCTs did not report or clearly indicate loss to follow-up.

Conclusions:
The findings of RCTs in the plastic surgery literature demonstrate fragility as the preservation of nonsignificant results rested on a small number of events. The RFI is a useful measure to complement the P value and examine the neutrality of null clinical trials.
Distribution of opioid analgesics by community racial/ethnic and socioeconomic profiles, 2011-2021
Authors: Hu Ju-Chen , Chakraborty Promi , Zhang Hao , Portenoy Russell , Rosa William E. , Zhang Yiye , Reid M. Carrington , Tamimi Rulla M. , Zhang Fang , Bruera Eduardo , Paice Judith A. , Bao Yuhua 
Published: January 2025

Abstract
Rapid declines in opioid analgesics dispensed in American communities since 2011 raise concerns about inadequate access to effective pain management among patients for whom opioid therapies are appropriate, especially for those living in racial/ethnic minority and socioeconomically deprived communities. Using 2011 to 2021 national data from the Automated Reports and Consolidated Ordering System and generalized linear models, this study examined quarterly per capita distribution of oxycodone, hydrocodone, and morphine (in oral morphine milligram equivalents [MMEs]) by communities' racial/ethnic and socioeconomic profiles. Communities (defined by 3-digit-zip codes areas) were classified as “majority White” (≥50% self-reported non-Hispanic White population) vs “majority non-White.” Community socioeconomic deprivation was measured by quartiles of population-weighted Social Deprivation Index. Overall, majority non-White communities had at least 40% lower mean adjusted per capita distribution than majority White communities across all levels of socioeconomic deprivation. Among the least deprived communities, the adjusted mean per capita distribution was 46.0 (95% confidence interval [CI], 40.0-52.0) for majority non-White vs 82.8 (95% CI, 78.5-87.1) MMEs for majority White communities. Among the most deprived communities, the distribution was 78.0 (95% CI, 70.8-85.1) for majority non-White vs 134.4 (95% CI, 125.4-143.4) MMEs for majority White communities. The lower distribution in majority non-White communities was statistically significant across all socioeconomic deprivation levels and over all study years. Availability of commonly prescribed opioid analgesics was substantially lower in majority non-White communities than in majority White communities across all levels of socioeconomic deprivation. Policies governing opioid analgesic availability warrant careful consideration and potential adjustments.
Hidden Trauma
Authors: Du Lydia R. , Waters David M. , Reynolds Meredith A. , Gitto Lorenzo 
Published: January 2025

Abstract
While abrasions and lacerations are typically easily identified, darker pigmentation of the skin may obscure contusions. Forensic pathology literature shows a disproportionate number of illustrations of contusions on lighter skin tones compared to darker ones. Skin and soft tissue dissection is the most reliable method to confirm contusions.
The authors seek to establish a correlation between skin tone and the visual identification of contusions, confirmed by soft tissue dissection. Additionally, they aim to determine the utility of specialized dissections for identifying contusions on different skin tones to identify cases that may benefit from such procedures.
A review of cases from the Cook County Medical Examiner's Office from 2014 to 2024 was conducted. The office database was searched for deaths in custody, causes including “assault,” and “child abuse.” Autopsy photos were compiled into predissection and postdissection sets, reviewed for skin tone, visual identification of contusions, and final confirmation of soft tissue hemorrhage.
Results found a negative association between skin color and accurate visual identification of contusions and determined that decedents with a skin tone of 7 or higher on the Massey-Martin scale may benefit from specialized dissections.
Intrauterine and Neonatal Deaths
Authors: Wilkinson Zachary A. , Weaver Kaitlin , Gilson Thomas , Krywanczyk Alison 
Published: January 2025

Abstract
Forensic investigation of intrauterine and perinatal deaths can be challenging, given their relative infrequency and the possible involvement of maternal substance use, trauma, and socioeconomic factors. Intrauterine and perinatal deaths investigated by the Cuyahoga County Medical Examiner's Officer between 2013–2023 were reviewed. One hundred twenty-eight cases were identified (83 stillborn and 45 live births). The predominant indications for referral were concern for maternal substance use (57.8%) or trauma (35.2%). Gestational ages ranged from 11.5 to 42.5 weeks; 36.7% were <22 weeks, and only 10.2% were full term (>37 weeks). The maternal age range was 16–41 years, with most (65.2%) between 20–34 years. Not all case files included obstetric history or home address; of those which did, 53.0% received no prenatal care and 81.7% came from zip codes in the bottom quartile of household incomes. Causes of death included acute and/or chronic maternal substance use (28.9%), chorioamnionitis (21.9%), and abruption (19.5%). Manners of death (when applicable) included natural (53.3%), accident (26.7%), homicide (8.9%), and undetermined/unassigned (11.1%). Potentially confounding socioeconomic factors were identified in most cases. This demonstrates the importance of considering these factors and exercising caution when assigning specific causes and manners to intrauterine and perinatal deaths.
A Death From Necrotizing Wound Infection After Cesarean Section
Authors: Ogburn Timothy , Knight Laura D. 
Published: January 2025

Abstract
Necrotizing wound infections are potentially lethal complications of surgeries, including cesarean deliveries. A 32-year-old female with obesity and hidradenitis suppurativa (HS) underwent uncomplicated cesarean section. Four days later, she developed abdominal pain and imaging showed ascites; she was treated with antibiotics. She progressed to septic shock and expired the following day from cardiopulmonary arrest. Hospital blood cultures grew no microorganisms. Autopsy revealed soft tissue purulence around the incision and copious purulent ascites without evidence of tubo-ovarian abscess, retained products of conception, or emboli. Microscopic examination of the tissues demonstrated inflammatory debris with neutrophils and gram-positive cocciform bacteria. Postmortem bacterial cultures had no growth. Paraffin blocks submitted to the Centers for Disease Control Infectious Disease Pathology Branch revealed Streptococcus pyogenes. Historically, group A streptococcus (GAS) was a major cause of peripartum mortality, and the prevalence of puerperal sepsis-associated deaths declined with antibiotic usage. Although the rates of mortality have remained stable in the United States, GAS has made a resurgence over recent decades. Additionally, there is some evidence in the literature of cutaneous bacterial biofilms associated with HS. Theoretically, this could have increased the risk of perioperative infection due to colonization or secondary infection of HS lesions.
Improving Evidenced-based Outpatient Order Set Utilization in the Gastrointestinal Division of a Large Pediatric Health System
Authors: Watson Kevin L. , Love April M. , Lemerman Hanna , Gustaevel Cathy , Rajbhandari Prabi 
Published: January 2025

Introduction:
Standardization is crucial in improving healthcare outcomes, equity and quality. Clinical decision support tools are key to achieving this goal. At our organization, Epic serves as our electronic health record, and SmartSets are Epic’s version of outpatient standardized order sets with embedded clinical decision support tools. In 2022, the utilization of SmartSets in our hospital’s gastrointestinal division was only 1.9%, far below our organizational target of 50%.

Methods:
Our group formed a quality improvement (QI) team and chose the model for improvement methodology. The interventions focused on education, buy-in, feedback performance monitoring, and the enhancement and development of new SmartSets. Our primary aim was to increase the utilization rate of SmartSets by gastrointestinal providers from 1.9% to 20%, and our secondary aim was to reduce the time spent by providers on orders by 10% from 3.3 to 2.8 minutes per encounter. Our balancing measure was monitoring safety reports during the study period.

Results:
SmartSet utilization improved to greater than 20% within 7 months of the project initiation. Three months after implementing SmartSet updates and introducing new SmartSets into production, time spent on orders during clinical encounters decreased from a median of 3.3 to 2.4 minutes per encounter. We appreciated that there was no change in safety reporting during the project timeline.

Conclusions:
We achieved our goal of improving utilization rates of standardized SmartSets and reducing time spent on orders using a QI methodology. Our achievements underscore the effectiveness of QI methods in enhancing SmartSet utilization and streamlining order processes.
Schizophrenia and retention in HIV care among adults insured through Medicaid in the United States: a population-based retrospective cohort study.
Authors: Bazazi Alexander R. , Thomas Marilyn , Vittinghoff Eric , Walkup James , Hermida Richard , Arnold Emily A. , Cournos Francine , Crystal Stephen , Dawson Lindsey , Dahiya Priya , Alonso-Fraire Paola , Dilley James , Olfson Mark , Mangurian Christina 
Published: January 2025

Background:
People with schizophrenia spectrum disorders are at elevated risk of HIV, and people with both HIV and schizophrenia are at elevated risk of death compared to individuals with either diagnosis alone. Limited research has assessed the HIV care cascade, and in particular retention in care, among people with HIV (PWH) and schizophrenia in the U.S.

Methods:
This population-based retrospective cohort used Medicaid claims data to compare retention in HIV care between PWH with schizophrenia (n=38,217) and matched controls without schizophrenia (n=29,455) from 2001-2012. The primary outcome of annual retention in HIV care was at least 2 tests for CD4+ T-cell count or HIV viral load at least 90 days apart per year. Unadjusted and covariate-adjusted differences in period prevalence of retention among cases and controls were estimated.

Findings:
Annual retention in HIV care was 29·9% (95% CI: 29·4-30·4%) among people with schizophrenia and 38·5% (95% CI: 37·9-39·1%) among controls, representing 8·5% (95% CI 9·3-7·7) lower retention in unadjusted and 9·0% (95% CI 9·9-8·2) lower retention in adjusted estimates for people with HIV and schizophrenia. This disparity varied across states. Over time, retention increased and the disparity between people with and without schizophrenia diminished.

Interpretation:
PWH in the U.S. insured through Medicaid and diagnosed with schizophrenia experience lower retention in HIV care than controls. Suboptimal retention likely drives disparities in HIV-related morbidity and mortality for PWH with schizophrenia, and targeted individual and structural interventions are merited to improve the health of this population.