bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association of Hospital Readmission Rates With Discharge Disposition for Patients With Psychotic Disorders
Authors: Tucker Kariba , Zikos Dimitrios , Vick Dan J. 
Published: May 2023

Goal:
We explored how readmissions may result from patients' lack of access to aftercare services, failure to adhere to psychotropic medication plans, and inability to understand and follow hospital discharge recommendations. We also investigated whether insurance status, demographics, and socioeconomic status are associated with hospital readmissions. This study is important because readmissions contribute to increased personal and hospital expenses and decreased community tenure (the ability to maintain stability between hospital admissions). Addressing hospital readmissions will promote optimal discharge practices beginning on day one of hospital admission.

Methods:
The study examined the differences in hospital readmission rates for patients with a primary psychotic disorder diagnosis. Discharge data were drawn in 2017 from the Nationwide Readmissions Database. Inclusion criteria included patients aged 0–89 years who were readmitted to a hospital between less than 24 hr and up to 30 days from discharge. Exclusion criteria were principal medical diagnoses, unplanned 30-day readmissions, and discharges against medical advice. The sampling frame included 269,906 weighted number of patients diagnosed with a psychotic disorder treated at one of 2,355 U.S. community hospitals. The sample size was 148,529 unweighted numbers of patients discharged.

Principal Findings:
In a logistic regression model, weighted variables were calculated and used to determine an association between the discharge dispositions and readmissions. After controlling for hospital characteristics and patient demographics, we found that the odds for readmission for routine and short-term hospital discharge dispositions decreased for home health care discharges, which indicated that home health care can prevent readmissions. The finding was statistically significant when controlling for payer type and patient age and gender.

Practical Applications:
The findings support home health care as an effective option for patients with severe psychosis. Home health care reduces readmissions and is recommended, when appropriate, as an aftercare service following inpatient hospitalization and may enhance the quality of patient care. Improving healthcare quality involves optimizing, streamlining, and promoting standardized processes in discharge planning and direct transitions to aftercare services.
Understanding the Impact of Span of Control on Nurse Managers and Hospital Outcomes
Authors: Ruffin Asiah , Shirey Maria R. , Dick Tracey , Fazeli Pariya L. , Patrician Patricia A. 
Published: May 2023

Goal:
Span of control is a multidimensional concept requiring a comprehensive definition that captures the complexities of the nurse manager's role in acute care settings. This concept analysis aimed to identify factors associated with span of control and provide a comprehensive definition outlining the breadth of this concept.

Methods:
ProQuest, PubMed, and Scopus databases were used to search peer-reviewed literature addressing the span of control in acute care nurse management. The search produced 185 articles; 177 titles and abstracts were screened for eligibility. Data from 22 articles were included in this analysis.

Principal Findings:
This analysis includes antecedents, attributes, and consequences of expanded nurse manager spans of control. Work-related factors such as staff and manager experience levels, work complexity, and patient acuity are attributes of a nurse manager's span of control. Our findings suggest that expanded spans of control can have negative consequences on nurse managers such as role overload and burnout. Low satisfaction among staff and patients can result from excessive spans of control.

Practical Implications:
An awareness of span of control can promote sustainable nursing practices by improving workplace conditions, staff satisfaction, and patient care quality. Our findings may translate across other health disciplines and thus contribute to scientific knowledge that can support changes in job designs and encourage more manageable workloads.
Preclinical simulation integrated into a nurse practitioner disease management course: Student perceptions and learning outcomes
Authors: Fitz Sarah M. , Burt Leah 
Published: May 2023

ABSTRACT
Nurse practitioner (NP) educators have been tasked with incorporating simulation into preclinical curricula while pivoting to competency-based education. Despite evidence supporting simulation's role in preclinical health care education, limited scholarship has evaluated this educational method among NP students. We sought to evaluate student perceptions, learning satisfaction, and confidence after participation in an experientially designed, preclinical, simulation program and to compare levels of clinical communication self-efficacy and self-rated, clinical rotation preparedness before and after participation. The preclinical simulation program was designed, implemented, and evaluated within a disease management course. Students reported high levels of satisfaction and confidence with learning. Clinical communication self-efficacy (t[17] = 3.73, p < .01) and self-rated levels of clinical rotation preparedness (t[17] = −2.97, p < .01) were significantly higher after program participation. Simulation may be successfully implemented in preclinical disease management courses. Positive program evaluations create a foundation for further competency-based NP educational design using simulation. Faculty should consider implementing experientially designed preclinical simulation in NP programs to promote progression toward competency within the NP role and to encourage clinical readiness.
The Gender Landscape of Academic Pediatric Emergency Medicine
Authors: Levine Marla C. , Lin Timmy , Baird Janette , Constantine Erika 
Published: May 2023

Objectives
Although many areas of medicine are male dominated, pediatric emergency medicine (PEM) is a female-dominated subspecialty. Despite this, executive leadership within PEM remains male dominated. The aim of this study was to describe the gender landscape of the key positions within academic PEM fellowship programs within the United States, as described by PEM fellowships' online presence.

Methods
Using the 2021–2022 Electronic Residency Application Service American Association of Medical Colleges Pediatric Fellowships (services.aamc.org/eras/erasstats/par/) application service, we were able to identify published information from 84 academic PEM fellowship programs in the United States. Each program's Web site was evaluated to determine which individuals held the position of chief or chair, medical director, and fellowship director. These individuals' genders were then cross-referenced with the National Provider Inventory database.

Results
There were 154 executive leadership roles (division chief or medical director) in total. The executive leadership role was significantly different by gender (z score: 2.54, P < 0.01), with greater male representation (n = 61; 62.9%) among identified executive leadership roles (n = 97). There were significantly more men for the medical director role (z score: 2.06, P < 0.05). Female representation was greater than male in the fellowship program director role (n = 53; 67.9%) among listed roles (z score: −3.17, P < 0.001). This gender landscape among key leadership positions was not influenced by the geographic location of the PEM fellowship program.

Conclusions
Although PEM is a female-dominated specialty, executive leadership positions continue to be male dominated. To promote improved gender representation within leadership positions in PEM, PEM fellowship programs must provide consistent and easily accessible executive leadership descriptions within their online storefront.
Pediatric Blunt Cerebrovascular Injuries
Authors: El Tawil Chady , Nemeth Joe , Al Sawafi Muzna 
Published: May 2023

Abstract
The low incidence of blunt cerebrovascular injury (BCVI) reported in pediatric studies (<1%) might be related to an underreporting due to both the absence of current screening guidelines and the use of inadequate imaging techniques. This research is a review of the literature limited to the last 5 years (2017–2022) about the approach and management of BCVI in pediatrics. The strongest predictors for BCVI were the presence of basal skull fracture, cervical spine fracture, intracranial hemorrhage, Glasgow Coma Scale score less than 8, mandible fracture, and injury severity score more than 15. Vertebral artery injuries had the highest associated stroke rate of any injury type at 27.6% (vs 20.1% in carotid injury). The sensitivity of the well-established screening guidelines of BCVI varies when applied to the pediatric population (Utah score – 36%, 17%, Eastern Association for the Surgery of Trauma (EAST) guideline – 17%, and Denver criteria – 2%). A recent metaanalysis of 8 studies comparing early computed tomographic angiogram (CTA) to digital subtraction angiography for BCVI detection in adult trauma patients demonstrated high variability in the sensitivity and specificity of CTA across centers. Overall, CTA was found to have a high specificity but low sensitivity for BCVI. The role of antithrombotic as well as the type and duration of therapy remain controversial. Studies suggest that systemic heparinization and antiplatelet therapy are equally effective.
Complications of Percutaneous and Surgical Gastrostomy Placements in Children: a Single-Centre Series
Authors: Tazi Kaoutar , Kotilea Kallirroi , Dassonville Martine , Bontems Patrick 
Published: May 2023

Objectives:
Gastrostomy placement is a standard procedure for children requiring enteral feeding for more than 3–6 weeks. Various techniques have been described (percutaneous endoscopic, laparoscopy, and laparotomy), and many complications have been reported. In our center, gastrostomy placement is performed either percutaneously by pediatric gastroenterologists, by laparoscopy/laparotomy by the visceral surgery team, or jointly, that is laparoscopic-assisted percutaneous endoscopic gastrostomy. This study aims to report all complications and identify risk factors and ways to prevent them.

Methods:
This is a monocentric retrospective study including children younger than 18 years who underwent gastrostomy placement (percutaneous or surgical) between January 2012 and December 2020. Complications that occurred up to 1 year after placement were collected and classified according to their time of onset, degree of severity, and management. A univariate analysis was conducted to compare the groups and the occurrence of complications.

Results:
We established a cohort of 124 children. Sixty-three (50.8%) presented a concomitant neurological disease. Fifty-nine patients (47.6%) underwent endoscopic placement, 59 (47.6%) surgical placement, and 6 (4.8%) laparoscopic-assisted percutaneous endoscopic gastrostomy. Two hundred and two complications were described, including 29 (14.4%) major and 173 (85.6%) minor. Abdominal wall abscess and cellulitis were reported 13 times. Patients who underwent surgical placement presented more complications (major and minor combined) with a statistically significant difference compared with the endoscopic technique. Patients with a concomitant neurological disease had significantly more early complications in the percutaneous group. Patients with malnutrition had significantly more major complications requiring endoscopic or surgical management.

Conclusion:
This study highlights a significant number of major complications or complications requiring additional management under general anesthesia. Children with a concomitant neurological disease or malnutrition are at greater risk of severe and early complications. Infections remain a frequent complication, and prevention strategies should be reviewed.
Technical Precision with Autologous Fat Grafting for Facial Rejuvenation: A Review of the Evolving Science
Authors: Strong Amy L. , Rohrich Rod J. , Tonnard Patrick L. , Vargo James D. , Cederna Paul S. 
Published: May 2023

Summary:
The scientific study of facial aging has transformed modern facial rejuvenation. As we age, fat loss in specific fat compartments is a major contributor to the structural aging of the face. Autologous fat grafting is safe, abundant, readily available, and completely biocompatible, which makes it the preferred soft tissue filler in the correction of facial atrophy. The addition of volume through fat grafting gives an aged face a more youthful, healthy, and aesthetic appearance. Harvesting and preparation with different cannula size and filter cartridge techniques have allowed for fat grafts to be divided based on parcel size and cell type into three major subtypes - macrofat, microfat, and nanofat. Macrofat and microfat has the benefit of providing volume to restore areas of facial deflation and atrophy in addition to improving skin quality, while nanofat has been shown to improve skin texture and pigmentation. In this article, the current opinions regarding fat grafting and how the evolving science of fat grafting has led to the clinical utility of each type of fat to optimize facial rejuvenation will be discussed. We now have the opportunity to individualize the use of autologous fat grafting with the various subtypes of fat for the targeted correction of aging in different anatomic areas of the face. Fat grafting has become a very powerful tool that has revolutionized facial rejuvenation, and developing precise, individualized plans for autologous fat grafting for each patient is a vertical advancement in the evolution in facial rejuvenation.
Outcomes of Endocarditis in Pregnancy: A Single Center Experience
Authors: Shapero Kayle , Berlacher Kathryn , Megli Christina 
Published: May 2023

AbstractBackgroundThe incidence of infective endocarditis (IE) in pregnancy is rare (0.006%) with increasing prevalence during the opioid epidemic. IE in pregnancy is associated with high rates of maternal and fetal mortality and morbidity, and existing data on outcomes in pregnancy is limited to case reports and small studies. Our study compares the outcomes of pregnant patients with IE as compared to non-pregnant patients.MethodsPatients diagnosed with IE during pregnancy or 30 days post-partum between 2014-2021 were identified by ICD-9/10 codes. Pregnant cases were matched to a random sampling of non-pregnant reproductive-age female endocarditis patients in a 1:4 ratio. Demographic and clinical data was collected. Data was validated through chart review.Results180 patients with IE were identified for this cohort; 34 were pregnant or within 30 days post-partum at diagnosis. There were higher rates of hepatitis C and opioid maintenance therapy in the pregnant patients. Etiology of IE in pregnant patients was predominantlyS. aureus(MSSA/MRSA) whereas non-pregnant woman had greater microbiological variation. We observed comparable rates of valve replacement (32.4% vs 29% p=0.84), 2-yr mortality (20.6% vs 17.8%, p =.>0.99), and ICU admission (61.8% vs 69.8%, p=0.414) in pregnant patients. There was a trend towards higher rates of PE (17.6% vs 7.5%, p=0.098), arrhythmia (17.6% vs 9.6%, p=0.222) among pregnant patients. There were high rates of IVDU relapse in both groups (>40%).ConclusionWe observed similar rates of valve replacement, 2-year mortality, and ICU admission in both pregnant and non-pregnant patients with IE. We observed a microbial predilection forS.aureusin pregnancy suggesting that the physiology of pregnancy may select for this microbiologic etiology. These results represent the largest single center retrospective review of IE in pregnancy and suggests that pregnancy may have increased morbidity.
Long non-coding RNA small nucleolar RNA host genes as prognostic molecular biomarkers in hepatocellular carcinoma: a meta-analysis
Authors: Huang Meng , Zhao Zhiwen , Yang Lihua 
Published: May 2023

AbstractObjectiveRecently, increasing data have suggested that the lncRNA small nucleolar RNA host genes (SNHGs) were aberrantly expressed in hepatocellular carcinoma(HCC), but the association between the prognosis of HCC and their expression remained unclear. The purpose of this meta-analysis was to determine the prognostic significance of lncRNA SNHGs in HCC.MethodsWe systematically searched Embase, Web of Science, PubMed, and Cochrane Library for eligible articles published up to October 2022. The prognostic significance of SNHGs in HCC was evaluated by hazard ratios (HRs) and 95% confidence intervals (CIs). Odds ratios (ORs) were used to assess the clinicopathological features of SNHGs.ResultsThis analysis comprised a total of 25 studies covering 2314 patients with HCC. The findings demonstrated that over-expressed SNHGs were associated with larger tumor size, multiple tumor numbers, poor histologic grade, earlier lymphatic metastasis, vein invasion, advanced tumor stage, portal vein tumor thrombosis (PVTT), and higher AFP level, but not with gender, age, HBV infection, and cirrhosis. In terms of prognosis, patients with higher SNHG expression were more likely to have shorter overall survival (OS), relapse-free survival (RFS), and disease-free survival (DFS).ConclusionsIn conclusion, upregulation of SNHG expression correlated with clinicopathological parameters and could predict a poor prognosis for HCC patients.
Multi-omic analysis of bat versus human fibroblasts reveals altered central metabolism
Authors: Jagannathan N. Suhas , Koh Javier Yu Peng , Lee Younghwan , Sobota Radoslaw M , Irving Aaron , Wang Lin-Fa , Itahana Yoko , Itahana Koji , Tucker-Kellogg Lisa 
Published: May 2023

AbstractBats have unique characteristics compared to other mammals, including increased longevity and higher resistance to cancer and infectious disease. While previous studies have analyzed the metabolic requirements for flight, it is still unclear how bat metabolism supports these unique features, and no study has integrated metabolomics, transcriptomics, and proteomics to characterize bat metabolism. In this work, we performed a multi-omics data analysis using a computational model of metabolic fluxes to identify fundamental differences in central metabolism between primary lung fibroblast cell lines from the black flying fox fruit bat (Pteropus alecto) and human. Bat cells showed higher expression levels of Complex I components of electron transport chain (ETC), but, remarkably, a lower rate of oxygen consumption (OCR). Computational modeling interpreted these results as indicating that Complex II activity may be low or reversed, similar to an ischemic state. An ischemic-like state of bats was also supported by decreased levels of central metabolites and increased ratios of succinate to fumarate in bat cells. Ischemic states tend to produce reactive oxygen species (ROS), which would be incompatible with the longevity of bats. However, bat cells had higher antioxidant reservoirs (higher total glutathione and higher ratio of NADPH to NADP) despite higher mitochondrial ROS levels. In addition, bat cells were more resistant to glucose deprivation and had increased resistance to ferroptosis, one of the characteristics of which is oxidative stress. Thus, our studies revealed distinct differences in the ETC regulation and metabolic stress responses between human and bat cells.
Evolution of High-Molecular-Mass Hyaluronic Acid is Associated with Subterranean Lifestyle
Authors: Zhao Yang , Zheng Zhizhong , Zhang Zhihui , Hillpot Eric , Lin Yifei S. , Zakusilo Frances T. , Lu J. Yuyang , Ablaeva Julia , Miller Richard A. , Nevo Eviatar , Seluanov Andrei , Gorbunova Vera 
Published: May 2023

AbstractHyaluronic acid (HA) is a major component of extracellular matrix (ECM) which plays an important role in development, cellular response to injury and inflammation, cell migration, and cancer. The naked mole-rat (NMR,Heterocephalus glaber) contains abundant high-molecular-mass HA (HMM-HA) in its tissues, which contributes to this species’ cancer resistance and possibly longevity. Here we report that abundant HMM-HA is found in a wide range of subterranean mammalian species, but not in phylogenetically related aboveground species. These species accumulate abundant HMM-HA by regulating the expression of genes involved in HA degradation and synthesis and contain unique mutations in these genes. The abundant high molecular weight HA may benefit the adaptation to subterranean environment by increasing skin elasticity and protecting from oxidative stress due to hypoxic subterranean environment. HMM-HA may also be coopted to confer cancer resistance and longevity to subterranean mammals. Our work suggests that HMM-HA has evolved with subterranean lifestyle.
Trehalose Consumption Ameliorates Pathogenesis in an Inducible Mouse Model of the Fragile X-associated Tremor/Ataxia Syndrome
Authors: Kul Emre , Stork Oliver 
Published: May 2023

ABSTRACTTrehalose is a naturally occurring sugar found in various food and pharmaceutical preparations with the ability to enhance cellular proteostasis and reduce formation of toxic intracellular protein aggregates, making it a promising therapeutic candidate for various neurodegenerative disorders. Here, we explored the effectiveness of nutritional trehalose supplementation in ameliorating symptoms in a mouse model of Fragile X-associated tremor/ataxia syndrome (FXTAS), an incurable late onset manifestation of moderately expanded trinucleotide CGG repeat expansion mutations in the 5’ untranslated region of the fragile X messenger ribonucleoprotein 1 gene (fmr1). An inducible mouse model of FXTAS expressing 90 CGG repeats in the brain had been previously developed, which faithfully captures hallmarks of the disorder, the formation of intracellular inclusions and the disturbance of motor function. Taking advantage of the inducible nature of the model, we investigated the therapeutic potential of orally administered trehalose under two regimens, modelling disease prevention and disease treatment. Trehalose’s effectiveness in combating protein aggregation is frequently attributed to its ability to induce autophagy. Accordingly, trehalose supplementation under the prevention regimen ameliorated the formation of intranuclear inclusions and improved the motor deficiencies resulting from the induced expression of 90 CGG repeats, but it failed to reverse the existing nuclear pathology as a treatment strategy. Given the favorable safety profile of trehalose, it is promising to further explore the potential of this agent for early stage FXTAS.
Lack of apoptosis leads to cellular senescence and tumorigenesis inDrosophilaepithelial cells
Authors: Garcia-Arias Juan Manuel , Pinal Noelia , Vargas Sara Cristóbal , Estella Carlos , Morata Ginés 
Published: May 2023

SummaryProgrammed cell death (apoptosis) is a homeostasis program of animal tissues designed to remove cells that are unwanted or are damaged by physiological insults. To assess the functional role of apoptosis we have studied the consequences of subjectingDrosophilaepithelial cells defective in apoptosis to stress or genetic perturbations that normally cause massive cell death. We find that many of those cells acquire persistent activity of the JNK pathway, which drives them into senescent status, characterized by arrest of cell division, cell hypertrophy, Senescent Associated ß-gal activity (SA-ß-gal), ROS production, Senescent Associated Secretory Phenotype (SASP) and migratory behaviour. We have identified two classes of senescent cells in the wing disc: 1) those that localize to the appendage part of the disc, express theupd,wganddppsignalling genes and generate tumour overgrowths, and 2) those located in the thoracic region do not expresswganddppnor they induce tumour overgrowths. Whether to become tumorigenic or non-tumorigenic depends on the original identity of the cell prior to the transformation. We also find that thep53gene contributes to senescence by enhancing the activity of JNK.