bluuebunny/crossref_metadata_2025_split huggingface dataset:
Autumn in New York: The Case of Long-Term Care Facilities in the “Safe Staffing” Lawsuit With Less Staffing But Similar COVID-19 Outcomes
Authors: Semprini Jason , Kaskie Brian 
Published: August 2023

Abstract

Background and Objectives
In 2022, 239 New York state long-term care facilities (LTCFs) challenged a “Safe Staffing” law in court. Our study compares LTCFs involved and not involved in the lawsuit, testing for differences in staffing measures and resident outcomes during the first year of the coronavirus disease 2019 (COVID-19) pandemic.

Research Design and Methods
New York LTCF-level data were obtained from the Centers for Medicare and Medicaid Services 2019 organization and 2020 COVID-19 data files. These data were then linked to data from the Long-Term Care Community Coalition, which identified the LTCFs involved in the “Safe Staffing” lawsuit. We first tested for differences in reported 2019 staffing levels by lawsuit involvement. Second, we specified “Doubly Robust” regression models to test if lawsuit involvement was associated with differences in resident COVID-19 infections, COVID-19 deaths, and overall mortality.

Results
LTCFs involved in the lawsuit reported lower staff ratings and fewer staffing hours compared to LTCFs not involved in the lawsuit. Despite finding higher rates of admissions with COVID-19 in LTCFs involved in the lawsuit, we did not find that COVID-19 infections, COVID-19 deaths, or overall mortality differed by lawsuit involvement.

Discussion and Implications
LTCFs involved in the lawsuit were deemed by policymakers as reducing staff, earning excess profits, and placing residents at risk. While these LTCFs reported lower staffing levels, we observed no differences in resident outcomes during the first year of the COVID-19 pandemic. Researchers and policymakers should develop more nuanced perspectives concerning the relationship among LTCF staffing, outcomes, and organizational profitability.
College students’ preferences for tobacco treatment: a discrete choice experiment
Authors: Choi S H , Templin T 
Published: August 2023

Abstract
The purpose of this study was to elicit preferences for the ‘format’ and ‘content’ of tobacco treatment among college student smokers, using an online discrete choice experiment (DCE) survey. A DCE survey, supplemented with a think-aloud method, was conducted among 54 college students who smoked combustible cigarettes and/or e-cigarettes. Conditional logistic regression models were constructed to determine optimal profiles of treatment. Cutting down nicotine rather than quitting ‘cold turkey’ (P &lt; 0.001) and two-way communication (P &lt; 0.001) were viewed as the most critical attributes for the intervention ‘format’; changing behaviors rather than social groups/peers (P &lt; 0.001) and autonomy (P &lt; 0.001) were viewed as the most critical attributes for the intervention ‘content’. Some preferences varied based on smoking subgroups. Combustible cigarette users preferred interventions with a longer time commitment (P &lt; 0.05) and without nicotine replacement therapies (NRTs) (P &lt; 0.001). Think-aloud data supported the DCE findings and further revealed a strong desire for cutting down nicotine and keeping social groups/peers and misconceptions regarding NRTs. Our study findings can guide tobacco treatment tailored to college students. These treatments should be tailored to specific smoker subgroups.
Physical Medicine Applications in Hand Burns: Treatment or Rehabilitation
Authors: Ergani Hasan Murat , Yalçın Topçuoğlu Elif , Yaşar Burak , Akgün Ali Emre , Acicbe Okan , Akın Merve , Erkin Ünlü Ramazan , Yastı Ahmet Çınar 
Published: August 2023

Abstract
The aim of this study is to investigate the contribution of concurrent physical therapy to the preservation of hand function in patients with hand burns. This retrospective cohort study included the records of adult patients who presented with hand burns between July 1, 2020, and December 1, 2021. A total of 67 of 1578 burn patients who attended the clinic were included in this study. The patients’ age, sex, total BSA with burns, causative agent, depth of burn on the hand, right or left hand, location of the burned area on the hand, treatment applied, healing time of the burn on the hand, limitation of movement, the joint restrictions, contractures, and compliance with physical therapy were assessed and recorded. Among the 67 patients included, 82.1% (n = 55) had no limitation in terms of their joint range of motion, whereas 17.9% (n = 12) had a limitation of movement in their finger joints. When the prevalence of movement limitation was examined by gender, such limitation was found to be more common in females (P = .041). Moreover, contractures were found to occur more frequently in patients with full-thickness burns (P = .032). It was also found that the limitation of movement was more severe in patients with skin grafts (P = .044). In addition, it was observed that the recovery time of the burn area was longer in those patients who had movement limitations (P = .004). In this study, we found that applying early physical therapy to patients after burn injuries facilitated the recovery of hand functions.
External Application of Human Umbilical Cord-Derived Mesenchymal Stem Cells in Hyaluronic Acid Gel Repairs Foot Wounds of Types I and II Diabetic Rats Through Paracrine Action Mode
Authors: Chen Jingan , Liu Yi , Zhang Jingwen , Yang Yuping , Liang Haowei , Li Ting , Yan Li , Zhou Li , Shan Letian , Wang Hui 
Published: August 2023

Abstract
Diabetic foot ulcer (DFU) is a main diabetic complication with unmet treatment needs. This study applied human umbilical cord-derived mesenchymal stem cells-hyaluronic acid (hucMSCs-HA) gel to treat DFU in a noninvasive external way and investigated its paracrine action and mechanism. In this study, after analyzing the physical and biological properties of HA gel, hucMSCs-HA gel was applied in 2 in vivo models (types I and II DFU), and a molecular mechanism was investigated. To evaluate the paracrine action of hucMSCs, hucMSCs-conditional medium (MSC-CM) was collected to treat 1 in vivo model (type I DFU) and 2 in vitro models (high glucose (HG)-injured human umbilical vein endothelial cells (HUVECs) and human skin fibroblasts (HSFs)). The results indicated that HA gel with a porous microstructure underwent over 90% degradation and swelled to the maximum value within 48 h. In vivo, hucMSCs-HA gel accelerated wound healing of DFU rats by improving re-epithelialization, collagen deposition, and angiogenesis, in which a paracrine action of hucMSCs was confirmed and the phosphorylation of p38, ERK1/2, JNK, and Akt was increased. In vitro, MSC-CM improved cell viability, wound healing, migration, tube formation, cell senescence, and abnormal expressions (TNF-α, IL-1β, IL-6, ET-1, p16 genes, and PCNA protein) of HUVECs, also improved cell viability, wound healing, antioxidant stress, and abnormal expressions (COL1, COL3, COL4, SOD1, SOD2 genes, and PCNA protein) of HSFs. Summarily, noninvasive external application of hucMSCs-HA gel shows great perspective against DFU and exerts wound healing effects through the MAPK and Akt pathways-mediated paracrine mechanism.
Yes‐associated protein regulates cortical actin architecture and dynamics through intracellular translocation of Rho GTPase‐activating protein 18
Authors: Zhang Yanshu , Kitagawa Takao , Furutani‐Seiki Makoto , Yoshimura Shige H. 
Published: August 2023

AbstractYes‐associated protein (YAP) is a transcriptional co‐activator that controls the transcription of target genes and modulates the structures of various cytoskeletal architecture as mechanical responses. Although it has been known that YAP regulates actin‐regulatory proteins, the detailed molecular mechanism of how they control and coordinate intracellular actin architecture remains elusive. Herein, we aimed to examine the structure and dynamics of intracellular actin architecture from molecular to cellular scales in normal and YAP‐knockout (YAP‐KO) cells utilizing high‐speed atomic force microscopy (HS‐AFM) for live‐cell imaging and other microscope‐based mechanical manipulation and measurement techniques. YAP‐KO Madin–Darby canine kidney cells had a higher density and turnover of actin filaments in the cell cortex and a higher elastic modulus. Laser aberration assay demonstrated that YAP‐KO cells were more resistant to damage than normal cells. We also found that Rho GTPase‐activating protein 18 (ARHGAP18), a downstream factor of YAP, translocated from the cortex to the edge of sparsely cultured YAP‐KO cells. It resulted in high RhoA activity and promotion of actin polymerization in the cell cortex and their reductions at the edge. HS‐AFM imaging of live cell edge and a cell‐migration assay demonstrated lower membrane dynamics and motility of YAP‐KO cells than those of normal cells, suggesting lower actin dynamics at the edge. Together, these results demonstrate that a YAP‐dependent pathway changes the intracellular distribution of RhoGAP and modulates actin dynamics in different parts of the cell, providing a mechanistic insight into how a mechano‐sensitive transcription cofactor regulates multiple intracellular actin architecture and coordinates mechano‐responses.
The Long-Term Use of Diagnostic Subdural Electroencephalogram Electrodes and Subdural Hematoma: A Prospective Cohort Study*
Authors: Won Sae-Yeon , Freiman Thomas M. , Lee-Müller Sara Sujin , Dubinski Daniel , Willems Laurent M. , Reif Philipp S. , Hattingen Elke , Ullmann Joana , Herrmann Eva , Melzer Nico , Seifert Volker , Gessler Florian , Rosenow Felix , Konczalla Juergen , Strzelczyk Adam 
Published: August 2023

OBJECTIVES:
Seizures and status epilepticus (SE) are frequent complications of acute subdural hematoma (aSDH) associated with increased morbidity and mortality. Therefore, we aimed to evaluate whether invasive subdural electroencephalogram recording leads to earlier seizure detection and treatment initiation in patients with aSDH.

DESIGN:
Prospective, single-center, cohort trial.

SETTING:
Neurologic and neurosurgical ICUs of one academic hospital in Germany.

PATIENTS:
Patients with aSDH undergoing surgical treatment. In total, 76 patients were enrolled in this study, 31 patients (40.8%) were assigned to the invasive electroencephalogram (iEEG) monitoring group and 45 patients (59.2%) to control group.

INTERVENTIONS:
The electrode group was implanted with a subdural strip electrode providing up to 7 days of real-time electroencephalogram recording in the neurointensive care unit, whereas the control group received regular normal surface electroencephalograms during the 7-day period. The primary outcomes were the prevalence and time to seizures and SE occurrence. Secondary outcomes included neurologic outcomes assessed using the Glasgow Outcome Scale (GOS) at discharge and 6-month follow-up and the prevalence of focal structural epilepsy within 2 years after discharge.

MEASUREMENTS AND MAIN RESULTS:
The trial was stopped after a study committee meeting when the prespecified criteria were met. The iEEG and control groups were well-matched for clinical characteristics at admission. Frequencies of seizures and SE detection were significantly higher in the iEEG group than in the control group (61% vs 15.6%; p < 0.001 and 38.7% vs 11.1%; p = 0.005). Time to seizure and SE detection was significantly earlier (median 29.2 vs 83.8 hr; p = 0.018 and 17.2 vs 83.8 hr; p = 0.033) in the iEEG group than in the control group. Favorable outcomes (GOS 4–5) were more frequently achieved in the iEEG group than in the control group (58% vs 31%; p = 0.065). No significant differences were detected in long-term mortality or post-traumatic epilepsy.

CONCLUSIONS:
Invasive subdural electroencephalogram monitoring is valuable and safe for early seizure/SE detection and treatment and might improve outcomes in the neurocritical care of patients with aSDH.
Return to Work Experience of Young and Middle-Aged Patients With Acute Myocardial Infarction
Authors: Zhang Qian , Ning Li , Yang Xiangying , Yu Mengying , Zheng Beibei , Wang Yongmei , Lu Jun 
Published: August 2023

Background
Return to work (RTW) is a critical component of rehabilitation for most young and middle-aged patients after an acute myocardial infarction (AMI). Its success is related to the quality of life and social psychological function of patients, and their social economic growth. However, healthcare professionals often do not deeply understand the patients' experience and their difficulties and coping methods during this process, which limits their ability to institute effective management and support.

Objective
In this study, we aimed to explore the lived experiences and change processes of young and middle-aged patients with AMI at the different stages of RTW.

Methods
A descriptive qualitative approach was used. Patients aged 20 to 59 years with AMI were recruited from the Department of Cardiology of 3 general hospitals. Data were collected via semistructured interviews. Data analysis was performed by conventional content analysis methods.

Results
In total, 18 participants were included. Five main themes emerged: (1) “chaos,” (2) “rebuilding,” (3) “conflict,” (4) “coping,” and (5) “benefits.” Patients may be more concerned about physical recovery during the initial clinical event. They then begin to plan and adjust for an RTW. Patients in the maintenance phase need strategies to prevent, identify, and respond to conflicts and challenges to maintain long-term stable work.

Conclusion
We identified several post-AMI stages spanning from the initial illness event to the maintenance of stable work. We described their perceived barriers, coping strategies, and support needs at these various stages. These data are crucial for healthcare professionals to develop improved vocational rehabilitation strategies for patients with AMI.
A Case of Cerebral Large-Vessel Vasculitis Concomitant Fahr Syndrome in Systemic Lupus Erythematosus
Authors: Jiang Wen , Mei Song , Deng Qionghua , Lei Chunyan , Pang Ailan 
Published: August 2023

Introduction:
Systemic lupus erythematosus (SLE) is a heterogenous, devastating autoimmune inflammatory disease with multiorgan involvement. A variety of neurological and psychiatric symptoms may be caused by nervous system involvement, termed neuropsychiatric systemic lupus erythematosus.

Case Report:
We describe a young man newly diagnosed with SLE who had a stroke as an initial symptom and was found to have cerebral large-vessel vasculitis and Fahr syndrome.

Conclusions:
The novelties of this report are the extensive cerebral calcification demonstrated on head computerized tomography in a patient with SLE, and the depiction of an underlying vasculitis on high-resolution magnetic resonance vessel wall imaging. It is our aim to describe this atypical form of neuropsychiatric systemic lupus erythematosus onset and to make known the usefulness of the new magnetic resonance imaging techniques for the diagnosis of cerebral large-vessel vasculitis.
Case Report: Unilateral Cranial Nerve VI Palsy Secondary to Intracranial Hypotension
Authors: Han Alice , Jun Weon , Winges Kimberly 
Published: August 2023

ABSTRACT

Significance
Intracranial hypotension is a condition that occurs from a cerebrospinal fluid leak. Various visual symptoms have been associated with this condition. Cranial nerve VI (CN VI) palsies are the most common ocular manifestation, as the abducens nerve is prone to injury due to its intracranial anatomical course.

Purpose
This case report presents a CN VI palsy secondary to intracranial hypotension from ventriculoperitoneal shunt over-filtration. Diagnosis, treatment, and management considerations are discussed. No identifiable health information was included in this case report.

Case Report
A 70-year-old Caucasian male was referred to the eye clinic for evaluation of binocular horizontal diplopia. The patient had a recent history of a left ventriculoperitoneal shunt for a persistent cerebrospinal fluid leak after complex mastoid surgery. The patient was also symptomatic for positional headaches which improved in a recumbent position. He was diagnosed with a left CN VI palsy secondary to intracranial hypotension from a ventriculoperitoneal shunt over-filtration. The patient was followed by neurosurgery for shunt adjustments to resolve the over-filtration. Binocular horizontal diplopia was managed conservatively with Fresnel prism.

Conclusions
Intracranial hypotension should be considered in patients presenting with cranial nerve palsies and positional headaches. Obtaining neuroimaging and co-managing with neurology or neurosurgery is advised to make prompt diagnosis and treatment. Careful clinical monitoring and conservative diplopia therapy is recommended as visual symptoms improve upon resolution of the cerebrospinal fluid leak.
Translation and validation of the Malay version of modified orthotics and prosthetics users’ survey
Authors: Hashim Natiara Mohamad , Che Daud Ahmad Zamir , Ibrahim Al Hafiz , Ab Majid Mohammad Hafidzi , Mohd Ghazali Mohd Nasrul , Abdul Razak Muhammad Mahdi , Mohd Rusli Muhamad Rahimi 
Published: August 2023

Background:
An excellent validated and reliable instrument is paramount in holistically evaluating the prosthetic and orthotic (P&O) service, encompassing functional outcomes, health-related quality of life (HRQoL), and patient satisfaction with devices and service.

Objective:
To perform a translation and cross-cultural adaptation of 3 modules of the Orthotics and Prosthetics Users' Survey (OPUS): (1) lower-extremity functional status (LEFS), (2) client satisfaction with device and services (CSDS), and (3) HRQoL in Malay language, and analyze its psychometric properties.

Study Design:
Translation and validation study.

Methods:
This translation process consisted of 4 phases: (1) a forward–backward translation, (2) content and face validity by utilizing content and face validity indices, (3) pilot testing and psychometric analysis using exploratory factor analysis, and (4) test–retest reliability.

Results:
One item from OPUS Health Quality of Life Index-Malay pilot version, 5 items from OPUS LEFS-Malay pilot version, and 4 items of OPUS Satisfaction with Device and Services-Malay pilot version were deleted because of poor factor loading of <0.6. The final version of Modified OPUS HRQoL-M, Modified OPUS LEFS-M, and Modified OPUS CSDS-M consisted of 22 items, 15 items, and 17 items, respectively. The final versions of all 3 Modified OPUS Malay version possess good internal consistency of 0.854, 0.927, and 0.98, and intraclass correlation of 0.773, 0.871, and 0.821, respectively.

Conclusion:
Modified OPUS HRQoL-M, Modified OPUS LEFS-M, and Modified OPUS CSDS-M are valid and reliable instruments to be adopted into the local Malaysia population.
Do the Histological Differences of Soft Tissue Sarcomas Affect the Rate of Skin Defect Reconstruction?
Authors: Tokumoto Hideki , Akita Shinsuke , Kosaka Kentaro , Kubota Yoshitaka , Mitsukawa Nobuyuki 
Published: August 2023

Background
In soft tissue sarcoma (STS) resection, flap reconstruction and/or skin grafting is frequently required. However, it is not clear whether the histological difference affects the rate of reconstruction. The present study aimed to investigate it.

Methods
This study compared in 5 classifications (105 adipocytic tumors, 102 fibroblastic tumors, 39 muscle tumors, 31 peripheral nerve sheath tumors, and 178 tumors of uncertain differentiation). In addition, the reconstruction rates of detailed tumor sites were compared. The median and case number (percentage) were calculated.

Results
Tumor size (adipocytic 112 mm vs fibroblastic 79 mm, muscle 72 mm, nerve 90 mm, uncertain 74 mm, P < 0.0001 in all comparisons), histological low-grade rates (adipocytic 43.8% vs uncertain 3.9%, P < 0.0001; fibroblastic 46.1% vs muscle 15.4%, P = 0.003; fibroblastic vs uncertain, P < 0.0001; nerve 19.4% vs uncertain, P = 0.003) and reconstruction rates (adipocytic 5.7% vs fibroblastic 42.2%, muscle 33.3%, nerve 32.3%, uncertain 25.8%, P < 0.0001 in all comparisons) were significantly different. In the region of lower extremity, the regions of thigh [adipocytic 1/62 (1.6%) vs fibroblastic 7/32 (21.9%), P = 0.002], and lower leg [adipocytic 1/16 (6.3%) vs fibroblastic 11/19 (57.9%), P = 0.002] were significantly different.

Conclusions
In adipocytic tumors, the tumor size was significantly large; however, the skin defect reconstruction rate was significantly lower than that of the other STS. Histologically, the reconstruction rate of STS derived from superficial tissue increases, whereas the reconstruction rate derived from deep tissue such as adipocytic tumor decreases.
Mixed Methods Assessment of Incivility During Surgical Mortality and Morbidity Conference
Authors: Abahuje Egide , Yang Sohae , Hu Yue-Yung , Alam Hasan B. , Rosenblatt Audrey , Ballard Heather , Slocum John Dwight , Stey Anne M , Johnson Julie K. 
Published: August 2023

Objective:
This study assessed incivility during Mortality and Morbidity (M&M) Conference.

Background:
A psychologically safe environment at M&M Conference enables generative discussions to improve care. Incivility and exclusion demonstrated by “shame and blame” undermine generative discussion.

Methods:
We used a convergent mixed-methods design to collect qualitative data through non-participant observations of M&M conference and quantitative data through standardized survey instruments of M&M participants. The M&M conference was attended by attending surgeons (all academic ranks), fellows, residents, medical students on surgery rotation, advanced practice providers, and administrators from the department of surgery. A standardized observation guide was developed, piloted and adapted based on expert non-participant feedback. The Positive and Negative Affect Schedule Short-Form (PANAS) and the Uncivil Behavior in Clinical Nursing Education (UBCNE) survey instruments were distributed to the Department of Surgery clinical faculty and categorical general surgery residents in an academic medical center.

Results:
We observed 11 M&M discussions of 30 cases, over six months with four different moderators. Case presentations (virtual format) included clinical scenario, decision-making, operative management, complications, and management of the complications. Discussion was free form, without a standard structure. The central theme that limited discussion participation from attending surgeon of record, as well as absence of a systems-approach discussion led to blame and blame then set the stage for incivility. Among 147 eligible to participate in the survey, 54 (36.7%) responded. Assistant professors had a 2.60 higher Negative Affect score (p-value=0.02), a 4.13 higher Exclusion Behavior score (p-value=0.03), and a 7.6 higher UBCNE score (p-value=0.04) compared to associate and full professors. Females had a 2.7 higher Negative Affect Score compared to males (p-value=0.04).

Conclusion:
Free-form M&M discussions led to incivility. Structuring discussion to focus upon improving care may create inclusion and more generative discussions to improve care.