bluuebunny/crossref_metadata_2025_split huggingface dataset:
Costs of Implementing Teen Dating Violence and Youth Violence Prevention Strategies: Evidence From 5 CDC-Funded Local Health Departments
Authors: Rice Ketra L. , Ottley Phyllis , Bing Melissa , McMonigle Megan , Miller Gabrielle F. 
Published: October 2023

Objectives: In 2016, the Centers for Disease Control and Prevention supported 5 local health departments (LHDs) to implement teen dating violence and youth violence primary prevention strategies across multiple levels of the social–ecological model and build capacity for the expansion of such prevention efforts at the local level. The objective of this study was to estimate the total cost of implementing primary prevention strategies for all LHDs across 3 years of program implementation. Methods: We used a microcosting analytic approach to identify resources and compute costs for all prevention strategies implemented by LHDs. We computed the total program cost, total and average cost per strategy by social–ecological model level, and average cost of implementation per participant served by the program. All costs were inflated via the monthly Consumer Price Index and reported in August 2020 dollars. Results: For 3 years of program implementation, the total estimated cost of implementing teen dating violence and youth violence primary prevention strategies was >$7.1 million across all 5 LHDs. The largest shares of program-related costs were program staff (55.9%-57.0%) and contracts (22.4%-25.5%). Among prevention strategies, the largest share of total costs was for strategies implemented at the community level of the social–ecological model (42.8%). Conclusions: The findings from this analysis provide a first look at the total costs of implementing comprehensive teen dating violence and youth violence primary prevention strategies and serve as a foundation for investments in local violence prevention funding for young people.
Systematic analysis reveals distinct roles of USF family proteins in various cancer types
Authors: Liu Xia , Wang Zhuo-Zhi , Meng Shuai , Zang Fenglin , Zhang Huilai , Wang Ju , Chen Yong-Zi 
Published: October 2023

Background Upstream stimulatory factors ( USFs) are members of the basic helix-loop-helix leucine zipper transcription factor family, including USF1, USF2, and USF3. The first two members have been well studied compared to the third member, USF3, which has received scarce attention in cancer research to date. Despite a recently reported association of its alteration with thyroid carcinoma, its expression has not been previously analyzed. Methods We comprehensively analyzed differential levels of USFs expression, genomic alteration, DNA methylation, and their prognostic value across different cancer types and the possible correlation with tumor-infiltrating immune cells and drug response by using different bioinformatics tools. Results Our findings established that USFs play an important role in cancers related to the urinary system and justify the necessity for further investigation. We implemented and offer a useful ShinyApp to facilitate researchers’ efforts to inquire about any other gene of interest and to perform the analysis of drug response in a user-friendly fashion at http://zzdlab.com:3838/Drugdiscovery/ .
The Problem of Gender in Economics
Authors: Kim Marlene 
Published: October 2023

Why do women leave economics so that there is a “leaky pipeline”? I synthesize the research on the gender disparities in the profession and examine this topic further by interviewing women who work in or who have left the profession. I find that structural theories of inequality explain these patterns: women are perceived and treated differently in economics. They are less likely to be respected, valued, and supported and to receive recognition for their work. Consequently, they are less likely to publish, receive tenure and promotion, and stay in the profession. JEL Classification: J7, J10
Clinical disease activity index applicability in lupus arthropathy: Unraveling underdiagnosed joint activity
Authors: Moura Carlos Antonio , Fonseca Vanessa , Alves Eneida M , Silva de Oliveira Isabela , Santiago Mittermayer B 
Published: October 2023

Introduction Lupus arthropathy (LA) ranges from arthralgia and non-deforming arthritis to severe forms such as Jaccoud-type deformities and mutilating arthritis. Considering the evolving concept of LA, measuring arthritis activity in lupus patients may require a more practical and sensitive tool other than the classical composite scores. Methods In this cross-sectional study, we evaluated the articular pattern of a sample of SLE patients which were divided into those that scored in articular domain on Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) and those with activity arthritis using the Clinical Disease Activity Index (CDAI). After all, we analyzed the association between CDAI and arthritis by SLEDAI-2K as well as its association with the presence or not of Jaccoud-type arthropathy (JA). Results A total of 127 patients with SLE were evaluated. According to SLEDAI-2K, 17 (13.4%) patients have scored in its joint criteria and 32 patients (25.19%) were considered to have some articular activity by CDAI. A total of 16 patients (50%) who scored some activity on CDAI did not score in articular domain of SLEDAI-2K. Also, the presence of Jaccoud-type arthropathy was significantly associated with arthritis activity according to the CDAI score ( p = .014) but not with SLEDAI-2K joint criteria ( p = .524). Conclusion The CDAI was not directly associated with the presence of arthritis by the joint criteria of SLEDAI-2K and the presence of JA was significantly associated with the CDAI but not with arthritis at SLEDAI-2K.
In silico Rationalization for Leads from Oldenlandia umbellata L. to Inhibit Multiple Molecular Targets Regulating Osteoporosis
Authors: Paramasivam Sivasakthi , Perumal Senthamil Selvan 
Published: October 2023

Background Osteoporosis is a chronic metabolic bone disease caused due to the dysregulation in the functioning of osteoblast and osteoclast cells leading to increased bone resorption predominantly in postmenopausal women and the elderly, thereby affecting a significant global population. Purpose The present study aims to computationally screen the phytochemical constituents of Oldenlandia umbellata Linn against the unique molecular therapeutic targets of osteoporosis and validate the results using Molecular Dynamics (MD) Simulation. Materials and Methods The molecular docking analysis of the selected phytoconstituents against the molecular targets were performed using AutoDock 4.2.6 – AutoDock Tools 1.5.6. In addition, the drug likeliness, ADME, bioactivity, and toxicity were predicted using Molinspiration ADMELAB2.0, ProTox-II and Orisis DataWarrior online tools. Molecular Dynamic Simulation studies were performed using WebGRO macromolecular simulation server. Results Molecular docking results and data analysis revealed that deacetylasperuloside possesses good drug-likeness, ADME properties, and bioactive scores and did not indicate any toxicity compared to other phytochemicals exhibiting binding energies below –8.00 Kcal/mol against the targets. Together, the study emphasized that deacetylasperuloside could bind with the molecular targets of osteoporosis, and the lead is a potential therapeutic candidate for osteoporosis treatment. Further, molecular dynamic simulation analysis for 100 ns revealed that the ligand–protein complexes, including glycogen synthase kinase 3β (GSK3β)-deacetylasperuloside and cathepsin K (CTSK)-deacetylasperuloside complexes, were stable and highly compact assessed from their trajectories. Hence, it can be emphasized that deacetylasperuloside could be a potential therapeutic molecule that could inhibit the targets, including GSK3β and CTSK. Conclusion Oldenlandia umbellata L. is a potential candidate for identifying therapeutic leads for osteoporosis treatment. Further, in vitro and in vivo studies are needed as an output of this research to evaluate its therapeutic efficacy.
Advocating for Training in End-Of-Life Conversations With Seriously Ill Patients During Residency
Authors: Schukow Casey , Alawy Bilal 
Published: October 2023

According to section IV.B.1.e of common residency program requirements from the Accreditation Council for Graduate Medical Education (ACGME), “[r]esidents must learn to communicate with patients and families to partner with them to assess their care goals, including, when appropriate, end-of-care [EOL] goals”. EOL conversations are frequently appropriate for patients suffering from serious, life-threatening diseases (ie, terminal illness) or otherwise chronic health conditions with poor disease trajectories. These conversations are often followed with services and care from palliative medicine or hospice specialists depending on patients' projected prognoses (ie, 6 months or less). The focus of this patient-centered care, then, is on relieving patient and caregiver suffering, establishing clear treatment goals, and managing the physical, psychosocial, and spiritual burdens of disease. Although palliative medicine and hospice care have been shown to reduce health care costs and improve the overall care of patients who require these services, recent literature still suggests a gap in training programs being able to provide effective, educational strategies to their trainees regarding the appropriate and competent delivery of EOL conversations. Herein, this commentary will provide a discussion on what EOL is, palliative vs hospice care indications, and address current literature regarding EOL exposure within training programs while offering our personal insight and advocacy on the manner.
Evaluation of a decentralized investigational drug service pharmacist in a cancer clinical trial infusion unit
Authors: Baroody Christina , Sandler Melissa , Hong Christine , Madanat Yazan F , Conley Stefanie 
Published: October 2023

Introduction Investigational drug service (IDS) oversees and manages use of investigational products. There is limited data on utility of pharmacy services in clinical trial conduct and outcomes, specifically on the value of a decentralized IDS pharmacist. Methods This is a quasi-experimental study conducted in an oncology clinical trial infusion unit. A retrospective chart review was done to reflect current practice from January through June 2022. A decentralized IDS pharmacist was piloted in December 2022. Data collected included number and types of consults, personnel requesting the consult, and intervention performed. A satisfaction questionnaire was conducted after the pilot program. Results A total of 16.3% (173 of 1062 patient visits) of pharmacy consults were completed in the centralized IDS pharmacy model, while 44.5% (81 of 182 patient visits) of pharmacy consults were completed during the decentralized IDS pharmacist pilot, p < .001. Decentralized IDS pharmacist completed 77% (62/81) of the consults during the pilot period. Most common types of consults were toxicity management (20%), electronic medical record issues (17%), and tubing and drug administration issues (16%). More than 80% of respondents to the satisfaction questionnaire responded that implementation of a decentralized IDS pharmacist is acceptable, appropriate, and feasible. Conclusion This pilot study demonstrated that a decentralized IDS pharmacist in an oncology clinical trial infusion unit improved accessibility to an IDS pharmacist, increased pharmacy consults relevant to patient care and optimized centralized pharmacists medication distribution workflow. Further studies are needed to evaluate patient benefits from implementing decentralized IDS pharmacist in direct patient care activities.
Screening for Cystic Fibrosis Related Complications in the Context of a Pandemic and Altered Models of Care
Authors: Doumit Michael , Strachan Roxanne , Lazarus Raynuka , Middleton Peter , Dentice Ruth , Marouvo Jessica , Jeffrey Laura , Selvadurai Hiran , Sivam Sheila , Pacey Verity , Jaffe Adam , Gray Kelly 
Published: October 2023

Background: Standard of care recommend that patients with cystic fibrosis (CF) require screening investigations to assess for complications. Changing models of care due to the COVID19 pandemic may have impacted completion of recommended screening. Objective: To compare the frequency of screening investigations completed in people with CF before and after the onset of the COVID19 pandemic. Methods: Medical records were reviewed at 4 CF-specialist centers to identify screening investigations completed in the 12-months before and after pandemic onset. Results: Records of 625 patients were reviewed. Prior to pandemic onset, there was between center variability in completion of screening investigations. There was greatest baseline variation between centers in performing oral glucose tolerance test (OGTT); range 38%-69%, exercise tests; 3%-51% and sputum screening for non-tuberculous mycobacteria; 53%-81%. Following pandemic onset, blood tests, and sputum cultures were maintained at the highest rates. Exercise testing, CXR and OGTT exhibited the greatest declines, with reductions at individual centers ranging between 10%-24%, 22%-43%, and 20%-26%, respectively. Return to in-person visits following pandemic onset was variable, ranging from 16% to 74% between centers. Conclusion: Completion of screening investigations varies between CF centers and changes in models of care, such as increased virtual care in response to COVID19 pandemic was associated with reduction in completion of investigations. Centers would benefit from auditing their adherence to standards of care, particularly considering recent changes in care delivery.
Barriers to healthcare and a ‘triple empathy problem’ may lead to adverse outcomes for autistic adults: A qualitative study
Authors: Shaw Sebastian CK , Carravallah Laura , Johnson Mona , O’Sullivan Jane , Chown Nicholas , Neilson Stuart , Doherty Mary 
Published: October 2023

Autistic people experience more co-occurring health conditions and, on average, die younger than non-autistic people. Despite growing awareness of health inequities, autistic people still report barriers to accessing healthcare. We aimed to explore the experiences of autistic people accessing healthcare, shining a light on the complex interplay of relevant factors and to explain, at least in part, the possible reasons underling health disparities and adverse health outcomes. This is a qualitative study from an autistic research team. Data were collected from 1248 autistic adults as part of a large, mixed-methods, international survey exploring barriers to primary healthcare. This article reports the qualitative findings, following a thematic analysis. Using our exploratory findings, we then constructed a model to explain the reported experiences. Respondents reported a variety of barriers. Here, our article gives voice to their stories, in their own words. Themes included: early barriers; communication mismatch; doubt – in oneself and from doctors; helplessness and fear; and healthcare avoidance and serious adverse health outcomes. Our constructed model outlines a chronological journey through which healthcare access barriers may lead to adverse health outcomes. Our findings also build on the double empathy problem, situating this in a medical context, proposing a triple empathy problem. Lay abstract Autistic people live with more mental and physical health conditions and, on average, die younger than non-autistic people. Despite widespread commitments to tackling these issues, autistic people still report various barriers to accessing healthcare. This article aims to explore the area in depth, from the perspective of autistic people. This research benefits from being led by autistic people, for autistic people – all of the researchers are autistic, and most of us are also medical doctors. Data, in the form of written comments and stories, were collected as part of a large survey. Here, we explored these for common themes and possible deeper meaning within the experiences. People who took part reported a variety of barriers. Here, our article gives voice to their stories, in their own words. Themes included: early barriers; communication mismatch; doubt – in oneself and from doctors; helplessness and fear; and healthcare avoidance and adverse health outcomes. Our findings allowed us to create a model that aimed to understand and explain the reported barriers in the context of the previously known consequences. We also built on wider autism theories to explain our findings in more depth.
A Cancer Center Multidisciplinary Lifestyle Medicine Clinic: Description of Program and Patient Population
Authors: Millstein Rachel A. , Lee Hannah , Lapioli Alisa , Winters Loren , Sullivan Carol , Bateman Samantha , Frates Elizabeth , Comander Amy , Eisenstat Stephanie , Peppercorn Jeffrey , O’Donnell Elizabeth K. 
Published: October 2023

Background Cancer survivorship guidelines emphasize Lifestyle Medicine (LM) pillars, including physical activity, healthy eating, restorative sleep, stress management, and avoiding risky substance use. We describe the development and patient population of a multidisciplinary LM clinic in oncology. Methods The clinic launched virtually in 2020. Patients had same-day consultations with an oncologist/nurse practitioner, nutritionist, and psychologist. Patients completed a one-time online survey assessing demographics, quality of life, LM pillars, and mental health. Descriptive statistics were used to characterize the population. Results Seventy-six patients took the survey (July 2020-January 2023). Most were female, non-Hispanic White, with early-stage cancers. The mean BMI was 30 kg/m2. A minority of patients met aerobic physical activity (27.6%) and dietary (28.6%) recommendations. Two-thirds (67%) reported sleep difficulties, and 30%–36% reported elevated anxiety/depression. Over half (53.3%) gained weight due to cancer treatment and 78.7% were trying to lose weight. Conclusion This paper details the baseline LM needs of cancer survivors seeking lifestyle consultation and describes the development of the clinic to address these concerns. Patients were open to evaluation and treatment in an oncology-focused LM clinic. This clinic model has potential to improve quality of life for survivors.
Artificial intelligence improves transfer times and ischemic stroke workflow metrics
Authors: Field Nicholas C , Entezami Pouya , Boulos Alan S , Dalfino John , Paul Alexandra R 
Published: October 2023

Introduction Rapid initiation of mechanical thrombectomy (MT) for the treatment of large-vessel occlusion (LVO) critically improves patient outcomes. Artificial intelligence algorithms aid in the identification of LVOs and improve door to puncture times as well as patient transfer times. Objectives We aimed to determine whether the implementation of an LVO detection algorithm that provides immediate active notification to the thrombectomy team provider's cell phone would improve ischemic stroke workflow at our institution and aid in patient transfer from outlying hospitals when compared to our prior system of passive computed tomography perfusion software analysis and radiologist interpretation and notification. Methods A retrospective review of our institutional thrombectomy registry was performed for all patients who underwent MT between January 2020 and March 2022. Demographic, radiographic, and stroke workflow metrics and notification times were collected. Transfer times and stroke metrics were compared pre- and post-implementation of the Viz.ai (Viz.ai, San Francisco, California, USA) smartphone application. Results Two hundred sixty-two patients underwent MT during the study period. Door-to-puncture time decreased 15 min ( p = 0.009) after the implementation of Viz.ai at our Comprehensive Stroke Center. Transfer time from outside hospitals that implemented Viz.ai was reduced by 37 min ( p = 0.04). There was no significant change in transfer time over the same time period in outlying hospitals that did not implement the Viz.ai software. Conclusion Active notification of the neurosurgical team significantly reduces patient transfer time and initiation of MT.
Changes in Radiographic Alignment Following Metatarsophalangeal Fusion, Distal Metatarsal Osteotomy, and Lapidus
Authors: Dusch Timothy , Guareschi Alexander , Moore Andrew , Hoch Caroline , Gross Christopher E. , Scott Daniel J. 
Published: October 2023

Background The purpose of this study is to evaluate the effect of the different surgical treatments for hallux valgus on various radiographic measures of bunion correction. Methods A retrospective cohort study was conducted at a single academic medical center involving 2 fellowship-trained foot and ankle surgeons. One hundred and nineteen feet (110 patients) were included. Procedures included first metatarsophalangeal (MTP) arthrodesis (n = 88), Chevron and/or Scarf osteotomy (n = 23), and Lapidus (n = 8). Overall, 78.2% of patients were female, mean age was 60.49 (range, 16-81) years, and mean follow-up was 1.20 (range, 0.25-3.92) years. Results Hallux valgus angle (HVA) significantly differed preoperatively (MTP = 33.33°, Chevron/Scarf = 27.03°, Lapidus = 32.56°; P = .026). There was no difference in distal metatarsal articular angle (DMAA) preoperatively (MTP = 18.87°, Chevron/Scarf = 17.80°, Lapidus = 14.39°; P = .629). At final follow-up, DMAA was significantly greatest among the Lapidus bunionectomy cohort (MTP = 9.63°, Chevron/Scarf = 13.51°, Lapidus = 17.45°; P = .005). There was no difference in infection (MTP = 6.8%, Chevron/Scarf = 4.4%, Lapidus = 0.0%; P = 1.00) or reoperation (MTP = 19.3%, Chevron/Scarf = 21.7%, Lapidus = 12.5%; P = .921) rates between cohorts, although both rates were highest in the first MTP arthrodesis group. Conclusion Among the 3 hallux valgus corrections studied, Lapidus bunionectomy fared the worst regarding DMAA correction at first follow-up and final follow-up, compared with MTP fusion and distal metatarsal osteotomies. Other radiographic measures showed no significant difference among the groups. Level of Evidence: Level III: Retrospective cohort study