bluuebunny/crossref_metadata_2025_split huggingface dataset:
Job Stress and Sleep Disturbances Among Career Firefighters in Northern California
Authors: Chin Dal Lae , Odes Rachel , Hong OiSaeng 
Published: June 2023

ObjectThis study examined the association between job stress and sleep disturbance among career firefighters.MethodsA cross-sectional survey study was conducted with 154 career firefighters working in Northern California, US job stress was measured using the short form of the Effort-Reward Imbalance questionnaire and sleep was measured with the Patient-Reported Outcomes Measurement Information System Sleep Disturbance.ResultsApproximately 75% experienced sleep disturbance. For firefighters’ job stress, high effort (odds ratio [OR] = 3.68; 95% confidence interval [CI]: 1.25–10.80), high effort-reward ratio (OR = 3.55; 95% CI: 1.23–10.23), and high overcommitment (OR = 9.09; 95% CI: 2.30–35.85) were significantly associated with increased likelihood of sleep disturbance, after adjustment for other factors.ConclusionsJob stress significantly affected firefighters’ sleep health, suggesting the need to design effective health promotion interventions to reduce job stress and improve sleep quality for these public service workers.
The Impact of COVID-19 on Physical Therapy Clinical Education Experiences in Florida
Authors: Svoboda Stephanie M. , Kostrna Jason , Pabian Patrick 
Published: June 2023

Introduction.
Full-time clinical education experiences (CEEs) constitute a significant component of entry-level physical therapy education. COVID-19 challenged clinical education throughout the country by affecting the availability of CEEs.

Review of Literature.
Research suggested that the number of clinical education spots available would stay the same. By contrast, the number of students enrolling in physical therapist (PT) and physical therapist assistant (PTA) education programs continues to rise. In response to the COVID-19 pandemic, students and faculty expressed concerns about the lack of student readiness and the availability of CEEs. The purpose of this study was to examine prepandemic factors that influenced the number of CEE slots available in Florida and the impact that the COVID-19 pandemic had on slot availability. Furthermore, researchers sought to identify factors that prevented a return to prepandemic levels of CEE spot offerings and recognize solutions to overcome those barriers. Finally, the researchers aimed to pinpoint suggestions to enhance collaborations between the clinical sites and physical therapy education programs.

Subjects.
Forty-eight site coordinators of clinical education (SCCEs) from various settings and regions in Florida completed the survey.

Methods.
An online survey was distributed to Florida SCCEs to ascertain their perceptions on how COVID-19 influenced clinical education. The researchers used descriptive and inferential statistics to analyze the data.

Results.
Clinical instructor (CI) volunteerism was the primary determinant of CEE spots available before the COVID-19 pandemic. The number of CEE spots was reduced for both PT and PTA education programs during the COVID-19 pandemic. Although the PTA slots returned to their baseline from 2019, the PT placements remained significantly lower in 2021. Social distancing and CI availability had the most considerable impact on CEE offerings. Site coordinators of clinical education also suggested that the greatest supports needed from the academic institutions were educating students on COVID-19 prevention and providing personal protective equipment (PPE) to students for their CEEs. This article also offers suggested incentives that academic sites can provide their clinical partners, such as in-services earning continuing education units, to enhance their participation in clinical education.

Discussion and Conclusion.
All clinical education stakeholders must collaborate to provide students with the required clinical educational opportunities. Academic sites should continue to provide support, training, and incentives to CIs to enhance participation from clinical education sites. Educational programs must add content about COVID-19 to their curriculum and consider providing students with PPE during their rotations to restore the number of CEEs post-COVID-19 pandemic.
Magnetic Resonance Imaging in Patients with Cochlear Implants without Magnet Removal: A Radiology-Administered Protocol to Enhance Operational Efficiency and Improve Workflow
Authors: Johnson B. Jake , Macielak Robert J. , Watson Robert E. , Heimer Jean M. , Wiste Britany J. , Lane John I. , Edmonson Heidi A. , Carlson Matthew L. 
Published: June 2023

Objective
To describe the development, implementation, and validation of a radiology-administered protocol to obtain magnetic resonance imaging (MRI) in patients with cochlear implants and auditory brainstem implants without magnet removal.

Study Design
Retrospective review and description of novel care pathway.

Methods
A radiology-administered protocol was designed based on careful input from the radiology safety committee and neurotology. Radiology technologist training modules, consent instructions, patient educational material, clinical audits, and other safeguards were implemented, with samples provided in this report. The primary outcomes measured included instances of magnet displacement during MRI and premature termination of MRI studies secondary to pain.

Results
Between June 19, 2018, and October 12, 2021, 301 implanted ears underwent MRI without magnet removal, including 153 devices housing diametric MRI-conditional magnets, and 148 implants with conventional axial (i.e., nondiametric) magnets. Among cases with diametric MRI-conditional magnets, all studies were completed without magnet dislodgement or need to terminate imaging early due to pain. Among cases with conventional axial (nondiametric) magnets, 29 (19.6%) MRI studies were stopped prematurely secondary to pain or discomfort; the overall rate of this event was 9.6% (29 of 301) among the entire study cohort. In addition, 6.1% (9 of 148) experienced confirmed magnet displacement despite headwrap placement; the overall rate among all cases was 3.0% (9 of 301). Eight of these patients received successful external magnet reseating through manual pressure on the external scalp without surgery, and one required surgical replacement of the magnet in the operating room. There were no documented instances of hematoma, infection, device or magnet extrusion, internal device movement (i.e., gross receiver-stimulator migration), or device malfunction in this cohort related to MRI.

Conclusions
We present the successful implementation of a radiology-administered protocol designed to streamline care for cochlear implant and auditory brainstem implant recipients who require MRI and ease clinical demands for otolaryngology providers. Examples of resources developed, including a process map, radiology training modules, consent instructions, patient educational materials, clinical audit, and other procedural safety measures are provided so interested groups may consider adapting and implementing related measures according to need.
Practice of IDH1, ATRX, and P53 Immunohistochemistry in Integrated Diagnosis of Adult Diffuse Gliomas: Single Center Study
Authors: Shabanzadeh nejabad Zohreh , Mabroukzadeh kavari Hoda , Saffar Hana , Tavangar Seyed Mohammad , Sefidbakht Salma , Khoshnevisan Alireza , Zare-Mirzaie Ali , Vasei Mohammad , Jafari Ensieh , Yaghmaii Marjan , Saffar Hiva 
Published: June 2023

Diffuse gliomas exhibit different molecular and genetic profiles with a wide range of heterogeneity and prognosis. Recently, molecular parameters including ATRX, P53, and IDH mutation status or absence or presence of 1p/19q co-deletion have become a crucial part of the diagnosis of diffuse glioma.
In the present study, we tried to analyze the routine practice of the above-mentioned molecular markers focusing on the IHC method in cases of adult diffuse gliomas to evaluate their utility in the integrated diagnosis of adult diffuse gliomas.
Totally, 134 cases of adult diffuse glioma were evaluated. Using the IHC method, 33,12, and 12 cases of IDH mutant Astrocytoma grade 2, 3, 4, and 45 cases of gliobalstoma, IDH wild type, were molecularly diagnosed. By adding the FISH study for 1p/19q co-deletion, 9 and 8 cases of oligodendroglioma grade 2 and 3 also were included. Two IDH mutant cases were negative for IDH1 in IHC but revealed a positive mutation in further molecular testing. Finally, we were not able to incorporate a complete integrated diagnosis in 16/134(11.94%) of cases. The main molecularly unclassified group was histologically high-grade diffuse glial tumors in patients less than 55 years old and negative IDH1 immunostaining. P53 was positive in 23/33 grade 2, 4/12 grade 3, and 7/12 grade 4 astrocytomas, respectively. Four out of 45 glioblastomas showed positive immunostain, and all oligodendrogliomas were negative.
In conclusion, a panel of IHC markers for IDH1 R132H, P53, and ATRX significantly improves the molecular classification of adult diffuse gliomas in daily practice and can be used as a tool to select limited cases for co-deletion testing in the low resources area.
Outcomes of Calvarial and Soft Tissue Reconstruction with Latissimus Dorsi Rib Osteomyocutaneous Free Flap
Authors: Bassiri Gharb Bahar , Meyers Abigail , Rezaei Majid , Figueroa Brian , Maasarani Samantha , Annunziata Michael , Nagel Sean , Bain Mark , Murthy Sudish , Rampazzo Antonio 
Published: June 2023

Purpose:
The latissimus dorsi-rib osteomyocutaneous free flap (LDRF) has been used for autologous reconstruction of large composite calvarial and scalp defects. In this study, we aim to present clinical and patient-reported outcomes after LDRF reconstruction.

Methods:
An anatomical study was conducted to evaluate the distribution of the connecting perforators between the thoraco-dorsal and intercostal system. An IRB-approved retrospective review of ten patients who underwent LDRF and one or two ribs for treatment of cranial defects was conducted. Patient-reported outcomes regarding quality of life, neurological and functional status were evaluated using validated surveys. One-way analysis of variance (ANOVA) and post hoc Tukey’s tests were used for anatomical outcomes. Preoperative and postoperative scores were compared using paired t-tests.

Results:
The 10th rib (4.65± 2.01) followed by 9th rib (3.7±1.63) had the highest number of perforators. A combination of the 9 th and 11 th ribs exhibited maximal perforator number and pedicle length.
All patients had stable LDRF reconstructions. Eight patients completed both pre and postoperative questionnaires; Median clinical follow-up was 48 [34-70] months. Scores trended toward improvement but did not reach statistical significance on the Karnofsky Performance Scale (p=0.22), Functional Independence Measure (FIM; Motor p=0.52, Cognitive p=0.55), Headache Disability Index (p=0.38). The minimum clinically important difference (MCID) was surpassed, demonstrating improvement of function for 71% of patients on the Barthel Index and 63% on the Selective Functional Movement Assessment test.

Conclusion:
The LDRF can improve cognitive and physical functional status in complex patients with prior failed reconstructions for composite scalp and skull defects.
The Positive and Negative Predictive Value of Targeted Diagnostic Botox Injection in Nerve Decompression Migraine Surgery
Authors: ElHawary Hassan , Kavanagh Kaitlin , Janis Jeffrey E. 
Published: June 2023

Introduction:
Nerve decompression surgery is an effective treatment modality for patients who suffer from migraines. Botulinum toxin type A (BOTOX) injections have been traditionally used as a method to identify trigger sites, however there is a paucity in data regarding its diagnostic efficacy. The goal of this study was to assess the diagnostic capacity of BOTOX in successfully identifying migraine trigger sites and predicting surgical success.

Methods:
A sensitivity analysis was performed on all patients receiving BOTOX for migraine trigger site localization followed by a surgical decompression of affected peripheral nerves. Positive and negative predictive values were calculated.

Results:
A total of 40 patients met our inclusion criteria and underwent targeted diagnostic BOTOX injection followed by a peripheral nerve deactivation surgery with at least three months follow-up. Patients with successful BOTOX injections (defined as at least 50% improvement in Migraine Headache Index (MHI) scores post injection) had significantly higher average reduction in migraine intensity (56.7% vs 25.8%; p=0.020, respectively), frequency (78.1% vs 46.8%; p=0.018, respectively), and MHI (89.7% vs 49.2%; p=0.016, respectively) post-surgical deactivation. Sensitivity analysis shows that the use of BOTOX injection as a diagnostic modality for migraine headaches has a sensitivity of 56.7% and a specificity of 80.0%. The positive predictive value is 89.5% and the negative predictive value is 38.1%.

Conclusion:
Diagnostic targeted BOTOX injections have a very high positive predictive value. It is therefore a useful diagnostic modality that can help identify migraine trigger sites and improve pre-operative patient selection.
“Bipedicled Scrotal Flap for Penile Resurfacing”
Authors: McLaughlin Mariel M , Abbassi Bahar , Pribaz Julian J 
Published: June 2023

Background
Acquired penile defects can be secondary to various pathologies including infection, scar, or complications following urologic procedures. Penis defects with skin deficit carry a distinct challenge for reconstructive surgeons. Scrotal flaps can provide reliable coverage and can restore distinct qualities of native penile skin.

Methods
A series of patients presented with a variety of acquired penile defects. Each of these patients underwent staged bi-pedicled scrotal flaps for coverage by senior author.

Results
Eight patients underwent bi-pedicled scrotal flap reconstruction for penile defects with a skin deficit. All eight patients had satisfactory outcomes post operatively. Only two of the eight patients had minor complications.

Conclusions
For select patients presenting with underlying deficit of penile skin, bipedicle scrotal flaps prove to be a safe, reproducible, and reliable reconstructive technique for penile resurfacing.
Opioid-Sparing Protocol for Endocrine Surgery (OSPREY): A Prospective Study
Authors: Kligerman Maxwell P , Austerlitz Joaquin , Orloff Lisa A , Noel Julia E 
Published: June 2023

Background:
Thyroid and parathyroid operations are amongst the most commonly performed surgeries in the world; however, there remains a paucity of prospective clinical trials evaluating the efficacy of opioid-sparing protocols following surgery.

Study Design:
This prospective non-randomized study was performed between March and October 2021. Participants self-selected their cohort of either an opioid-sparing protocol of acetaminophen/ibuprofen or a treatment-as-usual protocol with opioids. Primary endpoints were Overall Benefit of Analgesia Scores (OBAS) and opioid use as reported in daily medication logs. Data were recorded over seven days. Multivariable regression, pooled variance t-tests, Mann-Whitney test, and chi-square tests were used to evaluate the results.

Results:
A total of 87 participants were recruited; 48 participants opted for the opioid-sparing arm while 39 participants opted for the treatment as usual arm. Patients in the opioid-sparing arm used significantly less opioids (morphine equivalents 0.77 ± 1.71 vs. 3.34 ± 5.87, p=0.042) but had no significant difference in OBAS (p=0.37). Multivariable regression analysis demonstrated no significant difference in mean OBAS between treatment arms when controlling for age, sex, and type of surgery (p=0.88). There were no major adverse events in either group.

Conclusions:
An opioid-sparing treatment algorithm based on use of acetaminophen/ibuprofen may offer a safe and effective treatment algorithm compared to a primary opioid focused treatment pathway. Randomized adequately-powered studies are needed to confirm these findings.
Microbial Changes occurring during oronasal fistula wound healing
Authors: Goudy Steven L. , Bradley Heath , Gacasan Camillo Anthony , Toma Afra , Naudin Crystal R. , Wuest William M. , Tomov Martin , Serpooshan Vahid , Coskun Ahmet , Jones Rheinallt M. 
Published: June 2023

SummaryThe oral microbiome is a complex community that matures with dental development while oral health is also a recognized risk factor for systemic disease. Despite the oral cavity having a substantial microbial burden, healing of superficial oral wounds occurs quickly and with little scarring. By contrast, creation of an oro-nasal fistula (ONF), often occurring after surgery to correct a cleft palate, is a significant wound healing challenge that is further complicated by a connection of the oral and nasal microbiome. In this study, we characterized the changes in the oral microbiome of mice following a freshly inflicted wound in the oral palate that results in an open and unhealed ONF. Creation of an ONF in mice significantly lowered oral microbiome alpha diversity, with concurrent blooms ofEnterococcus faecalis, Staphylococcus lentus, and Staphylococcus xylosusin the oral cavity. Treatment of mice with oral antibiotics one week prior to ONF infliction resulted in a reduction in the alpha diversity, preventedE. faecalisandS. lentus, and S. xylosusblooms, but did not impact ONF healing. Strikingly, delivery of the beneficial microbeLactococcus lactissubsp. cremoris (LLC) to the wound bed of the freshly inflicted ONF via a PEG-MAL hydrogel vehicle resulted in rapid healing of the ONF. Healing of the ONF was associated with the maintenance of relatively high microbiome alpha diversity, and limited the abundance ofE. faecalisandS. lentus, and S. xylosusin the oral cavity. These data demonstrate that a freshly inflicted ONF in the murine palate is associated with a dysbiotic oral microbiome state that may prevent ONF healing, and a bloom of opportunistic pathogens. The data also demonstrate that delivery of a specific beneficial microbe, LLC, to the ONF can boost wound healing, can restore and/or preserve oral microbiome diversity, and inhibit blooms of opportunistic pathogens.
Species and habitat specific changes in bird activity in an urban environment during Covid 19 lockdown
Authors: Sun Congnan , Hassin Yoel , Boonman Arjan , Shwartz Assaf , Yovel Yossi 
Published: June 2023

AbstractCovid-19 lockdowns provided ecologists with a rare opportunity to examine how animals behave when humans are absent. Indeed many,sometimes contradicting, studies reported various effects of lockdowns on animal activity, especially in urban areas and other human-dominated habitats. We explored how Covid-19 lockdowns in Israel have influenced bird activity in an urban environment by using continuous acoustic recordings to monitor three common bird species that differ in their level of adaptation to the urban ecosystem: (1) the hooded crow, an urban exploiter, which depends heavily on anthropogenic resources; (2) the rose-ringed parakeet, an invasive alien species that has adapted to exploit human resources; and (3) the graceful prinia, an urban adapter, which is relatively shy of humansandcan be found urban habitats with shrubs and prairies. Acoustic recordings provided continuous monitoring of bird activity without an effect of the observer on the animal. We performed dense sampling of a 1.3 square km area in northern Tel-Aviv by placing 17 recorders for more than a month in different micro-habitats within this region including roads, residential areas and urban parks. We monitored both lockdown and no-lockdown periods. We portray a complex dynamic system where the activity of specific bird speciesdepended on many environmental parameters anddecreases or increases in a habitat-dependent manner during lockdown. Specifically, urban exploiter species decreased their activity in most urban habitats during lockdown, while human adapter species increased their activity during lockdown especially in parks where humans were absent. Our results also demonstrate the value of different habitats within urban environments for animal activity, specifically highlighting the importance of urban parks. These species- and habitat-specific changes in activity might explain the contradicting results reported by others who have not performed a habitat specific analysis.
Comodulation reduces interindividual variability of circuit output
Authors: Schneider Anna C. , Itani Omar , Cronin Elizabeth , Daur Nelly , Bucher Dirk , Nadim Farzan 
Published: June 2023

2AbstractIonic current levels of identified neurons vary substantially across individual animals. Yet, under similar conditions, neural circuit output can be remarkably similar, as evidenced in many motor systems. All neural circuits are influenced by multiple neuromodulators which provide flexibility to their output. These neuromodulators often overlap in their actions by modulating the same channel type or synapse, yet have neuron-specific actions resulting from distinct receptor expression. Because of this different receptor expression pattern, in the presence of multiple convergent neuromodulators, a common downstream target would be activated more uniformly in circuit neurons across individuals. We therefore propose that a baseline tonic (non-saturating) level of comodulation by convergent neuromodulators can reduce interindividual variability of circuit output. We tested this hypothesis in the pyloric circuit of the crab,Cancer borealis. Multiple excitatory neuropeptides converge to activate the same voltage-gated current in this circuit, but different subsets of pyloric neurons have receptors for each peptide. We quantified the interindividual variability of the unmodulated pyloric circuit output by measuring the activity phases, cycle frequency and intraburst spike number and frequency. We then examined the variability in the presence of different combinations and concentrations of three neuropeptides. We found that at mid-level concentration (30 nM) but not at near-threshold (1 nM) or saturating (1 μM) concentrations, comodulation by multiple neuropeptides reduced the circuit output variability. Notably, the interindividual variability of response properties of an isolated neuron was not reduced by comodulation, suggesting that the reduction of output variability may emerge as a network effect.3Significance StatementNeuromodulation has been explored as a mechanism to provide flexibility to the output of neural circuits. All neural circuits are subject to neuromodulation by multiple substances. Here, we propose a different but complimentary role for neuromodulation. We use two general facts about neuromodulation to show that convergent comodulation at tonic mid-concentration levels reduces interindividual variability of neural circuit output. These facts are that 1) Multiple neuromodulators can have convergent actions on the same subcellular substrates and 2) Neurons express different neuromodulator receptors at different levels.