bluuebunny/crossref_metadata_2025_split huggingface dataset:
Visual clues for the histopathological diagnosis of psoriasis
Authors: Song Hao , Yang Xian-Hong , Jiang Yi-Qun 
Published: February 2023

Objective:
The histopathologic diagnosis of psoriasis remains challenging. This study aimed to uncover visual clues for the histopathologic diagnosis of psoriasis in patients whose lesions required differentiation from other inflammatory skin disorders.

Methods:
A retrospective analysis was conducted of 100 psoriasis biopsy sections. Sections of other inflammatory skin diseases were included as the control group. The psoriasis and control groups were compared regarding the pathological characteristics, including the ñ sign, hypogranulosis, and neutrophilic infiltration or pustules within the epidermis. We also summarized the clinical information and the classic and non-classic histological features of psoriasis.

Results:
Biopsy sections from 190 patients were analyzed. Of these patients, 100 had a confirmed clinicopathological diagnosis of psoriasis, while 90 were diagnosed with an inflammatory skin disorder other than psoriasis (control group). The ñ sign was present in 79.0% and 21.11%, respectively, of the lesional biopsy samples from the psoriasis and control groups. The combination of the ñ sign and neutrophil infiltration in the upper epidermis was present in 74.0% and 10.0%, respectively, of the lesional biopsy samples from the psoriasis and control groups. The combination of these two features had a sensitivity of 0.89 and specificity of 0.76 in distinguishing between the psoriasis and control groups.

Conclusion:
The ñ sign is a useful visual clue for the histopathological diagnosis of psoriasis. However, for some inflammatory skin disorders that are very similar to psoriasis, such as pityriasis rubra pilaris, the combination of the ñ sign and neutrophil infiltration in the upper epidermis is needed to distinguish the condition from psoriasis.
Neutrophilic panniculitis associated with myelodysplastic syndrome/myeloproliferative neoplasm: a case report and literature review
Authors: Cohen Alexa J. , Gleason Laura K. , Bhatti Safiyyah A. , Nikbakht Neda 
Published: February 2023

Introduction:
Neutrophilic panniculitis (NP) is a rare subtype of neutrophilic dermatosis, a group of neutrophil-rich inflammatory skin disorders that can present in association with myeloid neoplasms. NP is defined by the presence of a neutrophilic infiltrate in the fat lobules of the subcutis in the absence of either infection or vasculitis. We herein describe a 65-year-old woman with a recent diagnosis of myelodysplastic syndrome/myeloproliferative neoplasm overlap syndrome (MDS/MPN) who abruptly developed painful, pruritic nodules consistent with NP.

Case presentation:
A 65-year-old woman with MDS/MPN presented for evaluation of painful and pruritic nodules on her upper and lower extremities. A biopsy revealed a lobular neutrophilic infiltrate in the subcutis without evidence of microorganisms or vasculitis. The patient was diagnosed with NP and treated with oral prednisone. Within 1 month of treatment, she reported complete resolution of the nodules.

Discussion:
Similar to other neutrophilic dermatoses, NP may arise in association with hematologic malignancies of myeloid origin, such as MDS/MPN. A literature review revealed that most cases of NP associated with MDS occur after the onset of MDS and respond to systemic corticosteroids, not antibiotics. Infection should be ruled out before initiating treatment with systemic steroids.

Conclusion:
Although the mechanism is still unknown, it is important for clinicians to be aware that NP is associated with MDS; thus, hematological malignancies should be investigated upon diagnosis of NP. Once diagnosed, NP is easily treated and has an excellent response to systemic corticosteroids.
Assessing the Mental Health Impact of the COVID-19 Pandemic on US Fire-Based Emergency Medical Services Responders
Authors: Raposa Madison E. , Mullin Gabrielle , Murray Regan M. , Shepler Lauren J. , Castro Katherine C. , Fisher Alexandra B. , Gallogly Victoria H. , Davis Andrea L. , Resick Christian J. , Lee Jin , Allen Joseph A. , Taylor Jennifer A. 
Published: February 2023

Objective
This study aimed to examine the COVID-19 pandemic's impact on fire service safety culture, behavior and morale, levers of well-being, and well-being outcomes.

Methods
Two samples (Stress and Violence against fire-based EMS Responders [SAVER], consisting of 3 metropolitan departments, and Fire service Organizational Culture of Safety [FOCUS], a geographically stratified random sample of 17 departments) were assessed monthly from May to October 2020. Fire department–specific and pooled scores were calculated. Linear regression was used to model trends.

Results
We observed concerningly low and decreasing scores on management commitment to safety, leadership communication, supervisor sensegiving, and decision-making. We observed increasing and concerning scores for burnout, intent to leave the profession, and percentage at high risk for anxiety and depression.

Conclusions
Our findings suggest that organizational attributes remained generally stable but low during the pandemic and impacted well-being outcomes, job satisfaction, and engagement. Improving safety culture can address the mental health burden of this work.
Relationship Between Work-Family Conflict and Depressive Symptoms Among Male Firefighters in China
Authors: Yu Yebo , Yang Fan , Fu Mingqi , Ahmed Farooq , Shahid Muhammad , Guo Jing 
Published: February 2023

Objectives
This study aims to examine the relationship between work-family conflict and depressive symptoms while considering job types and family structure as moderators.

Methods
In July and August 2021, 1328 male Chinese firefighters completed an online cross-sectional survey.

Results
The results indicated that work-family conflicts among Chinese firefighters presented a significant association with worse depressive symptoms. More specifically, strain conflict and behavioral conflict had positive relationships with worse depressive symptoms, while time conflict had a negative relationship. In addition, job types moderated the association between work-family conflict, strain conflict, and behavior conflict with depressive symptoms.

Conclusions
This study shows that work-family conflict is significantly associated with depressive symptoms among Chinese firefighters. Our findings advocate working system reform for Chinese firefighters, and more attention is needed on their mental health protection in the future.
Burnout Among Public Health Workers During the COVID-19 Pandemic in South Korea
Authors: Lee Jakyung , Jang Soong-Nang , Kim Nam-Soon 
Published: February 2023

Objective
This study aimed to investigate the prevalence of burnout experiences and factors associated with burnout among Korean health care workers during the coronavirus disease 2019 (COVID-19) pandemic.

Methods
A nationwide survey was conducted in 2021, and the sample comprised 1000 public health center employees. Multivariate linear regression was used to examine the factors associated with burnout among the participants during the COVID-19 pandemic. Perceived factors contributing to burnout were also analyzed using an open-ended question.

Results
Personal (e.g., age, gender, and self-rated health) and work-related factors (e.g., type of job tasks and COVID-19–related discrimination experience) affected burnout among health care workers. However, organizational support, including emotional support and sufficient financial compensation, was associated with lower burnout.

Conclusions
Ensuring sufficient support and rewards for health care workers is essential to guaranteeing their well-being during the current public health crisis.
Comorbidities and Causes of Death of Patients With Asbestosis
Authors: Keskitalo Eerika , Salonen Johanna , Nurmi Hanna , Vähänikkilä Hannu , Kaarteenaho Riitta 
Published: February 2023

Objective
Comorbidities are common and affect the prognosis of patients with interstitial lung diseases, but few previous studies have investigated patients with asbestosis.

Methods
We collected comorbidities and death causes of 116 patients with asbestosis treated in Oulu University Hospital. Causes of death were confirmed by autopsy in 68% of the cases.

Results
The most common comorbidities of asbestosis patients were pleural plaques (96%) and coronary artery disease (CAD; 67%). The prevalence of rheumatoid arthritis was 8.6%. The most common underlying causes of death were asbestosis (36%), CAD (24%), and lung cancer (LC) (10%). CAD and LC were associated with shorter survival in adjusted analyses.

Conclusions
Patients with asbestosis have multiple comorbidities. Prevention and treatment of CAD and LC may influence the prognosis of asbestosis patients.
Genetics and Genomics Education for Physician Assistant Students: A Review of the Literature
Authors: Patterson Wesley G. , Ward Linda D. 
Published: February 2023

Introduction
The purpose of this article was to critically review the literature and determine what is known about genetics-genomics education for physician assistants (PAs).

Methods
A rapid review method was used to search CINAHL, MEDLINE, PubMed, and Web of Science databases. The review is presented historically to describe the development of genetics-genomics education in PA programs.

Results
Of 594 publications retrieved, 11 articles met inclusion criteria. Retained articles include an assessment of PA programs, genetics-genomics competencies, educational efforts developed by PA programs regarding genetics-genomics, and continuing education programs for PAs.

Discussion
A paucity of published literature regarding genetics-genomics education for PAs was found. The few studies retrieved describe content being taught in PA programs, the number of genetics-genomics contact hours that PA students receive, and recommendations for continuing education programs. Most of the available literature is outdated, leaving a need for more current information to inform the education of genetic- and genomic-competent PAs. Recommendations for future research include assessment of PA programs regarding genetics-genomics education; development and validation of an assessment tool to measure genetics-genomics knowledge; and utilization of the RISE2 Genomics standards to plan, implement, evaluate, and report educational interventions. These recommendations are necessary to build an evidence base regarding genomics education for PA students and practicing PAs.
The Effect of Prosthetic Ankle Dorsiflexion Stiffness on Standing Balance and Gait Biomechanics in Individuals with Unilateral Transtibial Amputation
Authors: Vaca Miguel , Stine Rebecca , Hammond Paul , Cavanaugh Michael , Major Matthew J. , Gard Steven A. 
Published: February 2023

ABSTRACT

Introduction
Modular prosthetic ankle components have been shown to improve walking in transtibial prosthesis users, but they may reduce stability during standing. Therefore, the stiffness of the prosthetic foot-ankle components may need to be appropriately tuned to provide a balance between walking mobility and standing balance. The present research investigates both concepts to improve our knowledge about how prosthetic ankle stiffness influences standing and walking performance.

Methods
Ten individuals with unilateral transtibial amputation and categorized as minimum K3-level ambulators participated. Standing balance and gait analyses at three self-selected speeds were performed at three different levels of ankle dorsiflexion stiffness (Soft, Medium, and Firm) using the College Park Venture foot (College Park Industries, Warren, MI, USA). Repeated-measures analyses of variance (ANOVAs) were performed on relevant standing balance, gait spatiotemporal, and roll-over shape (ROS) outcomes. Gait kinetic and kinematic data were analyzed using a one-dimension statistical parametric analysis.

Results
Ankle dorsiflexion stiffness influenced balance and gait. Overall, the Firm dorsiflexion stiffness provided a smaller body sway on standing balance, a ROS radius close to the one of able-bodied individuals, and reduced step length asymmetry while walking. Furthermore, walking speed had an influence on ROS radii, resulting in a larger radius for slow walking speeds and a smaller one for fast walking speeds.

Discussion
The Firm stiffness appeared to offer the most advantages for balance and gait. The radius of ROS under the Firm condition, close to the radius of able-bodied individuals, could have caused the improvement in step length symmetry by a greater progression of the center of pressure, resulting in further progression of the prosthetic side. This information, in addition to the observed walking speed effect on ROS radii, encourages us to develop studies to examine the effect of walking speed on foot performance and improve prosthetic foot design to maintain the same gait characteristics under different walking speeds.

Clinical Relevance
These results improve our understanding of how a specific prosthetic ankle dorsiflexion stiffness affects standing balance and gait, which supports the prosthetist's evaluation process to determine specific individual stiffness for each prosthesis user.
Predicting Severity of Head Collision Events in Elite Soccer Using Preinjury Data: A Machine Learning Approach
Authors: Tarzi Gabriel , Tarzi Christopher , Saha Ashirbani , Cusimano Michael D. 
Published: February 2023

Objective:
To develop machine learning (ML) models that predict severity of head collision events (HCEs) based on preinjury variables and to investigate which variables are important to predicting severity.

Design:
Data on HCEs were collected with respect to severity and 23 preinjury variables to create 2 datasets, a male dataset using men's tournaments and mixed dataset using men's and women's tournaments, to perform ML analysis. Machine learning analysis used a random forest classifier based on preinjury variables to predict HCE severity.

Setting:
Four elite international soccer tournaments.

Participants:
Elite athletes participating in analyzed tournaments.

Independent Variables:
The 23 preinjury variables collected for each HCE.

Main Outcome Measures:
Predictive ability of the ML models and association of important variables.

Results:
The ML models had an average area under the receiver operating characteristic curve for predicting HCE severity of 0.73 and 0.70 for the male and mixed datasets, respectively. The most important variables for prediction were the mechanism of injury and the event before injury. In the male dataset, the mechanisms “head-to-head” and “knee-to-head” were together significantly associated (P = 0.0244) with severity; they were not significant in the mixed dataset (P = 0.1113). In both datasets, the events “corner kicks” and “throw-ins” were together significantly associated with severity (male, P = 0.0001; mixed, P = 0.0004).

Conclusions:
ML models accurately predicted the severity of HCE. The mechanism and event preceding injury were most important for predicting severity of HCEs. These findings support the use of ML to inform preventative measures that will mitigate the impact of these preinjury factors on player health.
Individual Symptom Report Prevalence in Children and Adolescents With One, Two, and Three or More Persistent Symptoms After Concussion: A Brief Report
Authors: Chandler Madison C. , Bloom Josh , Fonseca Janna , Ramsey Kristen , DeMaio Valerie J. , Callahan Christine E. , Register-Mihalik Johna K. 
Published: February 2023

Objective:
To examine differences in individual symptom report prevalence between children and adolescents experiencing 1 to 2 versus ≥3 persistent postconcussion symptoms.

Design:
A prospective cohort study.

Setting:
Three community practice concussion clinics within a family practice network.

Patients:
Children and adolescents aged 8 to 18 years presenting to clinics within 72 hours of a sport-related or recreation-related concussion. Those with complete symptom data from a 1-month follow-up time point (n = 236) were included in analyses.

Independent Variables:
One hundred thirty-six patients (n = 136) reported 0 symptoms as worse than preinjury at the 1-month time point. Participants reporting 1+ symptoms as worse than preinjury at 1 month were assigned to groups based on the number of symptoms endorsed: those with 1 to 2 (n = 38) compared with those experiencing ≥3 (n = 62).

Main Outcome Measures:
Fisher exact tests were used to compare symptom report prevalence for each item of the Rivermead Postconcussion Symptoms Questionnaire. This research question was formulated and examined after completion of data collection.

Results:
Across both groups, headache and fatigue were the most commonly reported persistent postconcussion symptoms. Several emotional symptoms (eg, irritability, depression) were primarily or only present in those reporting ≥3 persistent symptoms.

Conclusions:
Findings provide detail regarding the clinical manifestation of experiencing fewer versus more persistent postconcussion symptoms, underscoring the importance of developing individualized, multifaceted rehabilitation programs.
The Association of Sport Specialization and Concussion History on Self-Reported Depressive Symptoms and Quality of Life Among High School Athletes
Authors: Chou Tsung-Yeh , Biese Kevin , Leung Willie , Bell David , Kaminski Thomas , McGuine Timothy 
Published: February 2023

Objective:
To assess the association of sport specialization combined with sport-related concussion (SRC) history on depression and health-related quality of life (HRQoL) in a population of high school athletes.

Design:
Cross-sectional study.

Setting:
High schools.

Participants:
Two thousand four hundred fifty-three athletes through the State of Wisconsin.

Independent Variables:
Sport specialization and SRC history.

Main Outcome Measures:
Athletes completed questionnaires reporting their SRC history, sports participation (single-sport or multisport), Patient Health Questionnaire-9 (PHQ-9), and Pediatric Quality of Life 4.0 (PedsQL). We used multivariate binary logistic regression to assess the odds ratio (OR) for depressive symptoms based on SRC and sport participation history. Separate multilinear regression evaluated the association between the PedsQL, SRC, and sport participation history. The interaction of sport specialization and SRC history was explored in both regression models.

Results:
High school athletes who participated in single-sport activities had a greater odds of reporting higher severity of depressive symptoms on PHQ-9 scores (OR, 1.50; 95% CI, 1.11-2.02) and reduced PedsQL (P < 0.001) compared with their multisport counterparts. There were no associations between SRC history and either PHQ-9 or PedsQL scores. Statistically significant interactions between sport specialization and SRC were not found among all models.

Conclusion:
Single-sport high school athletes reported a reduction in HRQoL measures along with higher depressive symptoms when compared with the multisport athletes. The SRC history did not have a lingering effect on depression or HRQoL in this study. These findings raise some interesting concerns regarding the quality of mental health in adolescent athletes solely focused on single-sport endeavors.
The Impacts of the COVID-19 Pandemic on Doctor of Physical Therapy Students: A National Survey
Authors: Ge Weiqing , Ball Meghan , Balog-Bickerstaff Nicole , Kerns Lucy 
Published: February 2023

Introduction.
Since the lockdown in March 2020, the COVID-19 pandemic has inevitably affected all individuals across the world. The purpose of this study was to determine the perceived impacts of the pandemic on doctor of physical therapy (DPT) students and if there were any statistically significant differences based on minority status, gender, or class standing.

Review of Literature.
Literature suggested that DPT students experienced negative impacts of the pandemic on academic success and mental health. However, there is a lack of comprehensive understanding of the perceived physical, mental, financial, and academic impacts of the COVID-19 pandemic by physical therapist students nationally.

Subjects.
Convenience sampling was used to recruit all students enrolled in physical therapist programs in the United States.

Methods.
The research design was a cross-sectional survey administered electronically using the Alchemer survey platform with 12 Likert scale items compiled in the physical, mental, financial, and academic domains. All items were designed to evaluate the perceived impacts of the pandemic on a 5-point scale from 1 (strongly disagree) to 5 (strongly agree).

Results.
A total of 1,230 completed responses were received. The mean responses were 3.45 (SD 1.12), 3.48 (SD 0.92), 2.74 (SD 1.03), and 3.33 (SD 0.93) for the physical, mental, financial, and academic domains, respectively. No significant difference was found based on minority status. A statistically significant difference was found in the mental domain, with female students perceiving a more negative impact by the pandemic. First-year students reported a significantly higher negative impact in the physical domain compared with second-year students. The perceived impact in the academic domain was significantly higher for both first- and second-year students than third-year students.

Conclusions.
Developing and promoting access to campus and community resources to address the challenges caused by the COVID-19 pandemic is critical to facilitating student success during and after the pandemic.
Central Vertigo Disorder as Evidence of Creutzfeldt-Jakob Disease: A Case Report
Authors: Costa Villela Ferreira Luiza , Braz Rodrigues da Silva Camila , de Pinho Lilia Gama , Lima Fernanda Vidigal Vilela , Dias Claudia Marques , Bahmad Fayez 
Published: February 2023

Objective
To report a case of Creutzfeldt-Jakob disease (CJD) that presented atypical initial manifestations and highlight the importance of complementary investigation to avoid diagnosis delay.

Patients
A 54-year-old female patient who presented with vertigo with positional nystagmus, nausea, and vomiting as initial CJD manifestations.

Intervention
Neuro-otological and brain magnetic resonance images, which showed abnormal hyperintense cortical signal in both hemispheres.

Main Outcome Measure
We reached a presumptive diagnosis of the prion disease after the first magnetic resonance imaging. Eventually, the patient presented with typical neurological findings and met the criteria for probable CJD.

Results
Our case report presents a patient with sporadic CJD who experienced dizziness as an initial manifestation and met the diagnostic criteria for probable CJD a few weeks after symptoms onset.

Conclusion
We believe that this case may serve to help otolaryngologists pay better attention to cases of dizziness associated with neurological signs and highlight the importance of complementary investigation using magnetic resonance imaging and neuro-otological tests to prevent delayed or incorrect diagnosis.