bluuebunny/crossref_metadata_2025_split huggingface dataset:
High prevalence and mortality of Pneumocystis jirovecii pneumonia in anti-MDA5 antibody-positive dermatomyositis
Authors: Chen Xixia , Shu Xiaoming , He Linrong , Yang Hanbo , Lu Xin , Wang Guochun , Ge Yongpeng 
Published: February 2023

Abstract

Objectives
To identify potential risk factors and prognostic factors of Pneumocystis jirovecii pneumonia (PJP) infection in anti-melanoma differentiation-associated gene 5 antibody-positive DM (anti-MDA5+ DM) patients, and to evaluate the diagnostic performance of metagenomic next-generation sequencing (mNGS).

Methods
Anti-MDA5+ DM patients who underwent mNGS or real-time PCR for PJP detection were recruited. The potential risk factors for PJP occurrence and death were analysed via Logistic regression and Cox proportional hazards regression, respectively. The diagnostic efficacy of mNGS was compared with the conventional methods.

Results
91 patients were enrolled and 44 were assigned to PJP+ group. The PJP detection rate was 48.4%. PJP often occurred in the first 3 months (68.2%) of the disease; this period also showed the highest mortality rate (20.5%). Fever and increased lactate dehydrogenase (LDH) were independent risk factors for PJP occurrence, while trimethoprim-sulfamethoxazole (TMP/SMZ) prophylaxis was an independent protective factor (all P &lt; 0.05). Older age and increased LDH were predictors for mortality in patients with anti-MDA5+ DM and PJP (all P &lt; 0.05). In addition, we found that mNGS had a sensitivity of 100.0% and specificity of 90.0% in diagnosing PJP, with the highest area under the curve of 0.95 (P &lt; 0.001).

Conclusion
PJP has high prevalence and mortality in anti-MDA5+ DM. It is crucial for clinicians to identify high-risk patients and promptly institute TMP/SMZ to prevent PJP. mNGS is the preferred approach for pathogen detection in anti-MDA5+ DM when PJP is suspected.
Tax principles, policy feedback and self-interest: cross-national experimental evidence on wealth tax preferences
Authors: Schechtl Manuel , Tisch Daria 
Published: February 2023

Abstract
Rising wealth inequality and squeezed public budgets has brought wealth tax back into policy discussions. A net wealth tax might help to boost state revenue and reduce wealth inequality. Yet little is known about citizens’ attitudes towards the design of a net wealth tax (i.e. the tax unit, exemption and rate). Using a novel multifactorial survey experiment, we examine citizens’ endorsement of fundamental principles of taxation. Building on policy feedback theory, we examine if preferences differ in three policy arenas (USA, Germany and UK) and whether individuals’ reasoning is dependent on self-interest. While a clear majority in all three countries generally endorses a wealth tax, our findings show that citizens care more about the amount exempted than the tax unit or rate. We do not identify a preference for any specific tax unit. Furthermore, tax preferences seem to be strikingly similar among citizens of all three countries. Yet we show that individuals are mostly concerned about not being personally affected by such a tax, which is reflected in their preference for substantial exemptions. We discuss our findings with regard to our understanding of wealth inequality, tax equity and the potential implications for policymakers.
A Telemedicine Standardized Patient Experience: Enhancing the Virtual Classroom and Preparing for Alternative Modalities of Care
Authors: Maynard Kristi , Knickerbocker Joshua 
Published: February 2023

Abstract
This pilot study explored the use of standardized patients in the virtual classroom in efforts to increase family nurse practitioner preparedness to engage in telemedicine care delivery. Using a mixed-methods approach, we determined this innovation significantly increased students’ confidence in their ability to perform a telemedicine visit while also improving their satisfaction with the virtual classroom.
Updates in diagnosis and management of paediatric mastocytosis
Authors: Tiano Rasa , Krase Ifat Z. , Sacco Keith 
Published: February 2023

Purpose of reviewPaediatric mastocytosis is a rare clonal disorder characterized by the overproduction and organ infiltration of mast cells. Symptoms are due to mast cell mediator release. Cutaneous mastocytosis is the most common presentation in children with systemic disease being rare. Our aim is to provide a practical guideline in differentiating subtypes of paediatric mastocytosis while providing actionable recommendations on diagnosis, clinical management, follow-up and prognosis.Recent findingsLongitudinal cohort studies of paediatric cutaneous mastocytosis have shown spontaneous remission with favourable prognosis. Hereditary alpha-tryptasemia may coexist with mastocytosis; thus, screening for this disorder is recommended. There is an emerging role for serum tryptase in asthma endotyping and potential for using therapeutic tryptase inhibitors.SummaryMorbidity in paediatric mastocytosis typically arises from symptoms secondary to mast cell mediator release. Prognosis for nonaggressive disease is typically favourable; however, risks for anaphylaxis and psychosocial morbidity may be underestimated. Symptomatic management and anticipatory guidance may help support patients and families throughout the disease course.
Lung ultrasound monitoring: impact on economics and outcomes
Authors: Cammarota Gianmaria , Vetrugno Luigi , Longhini Federico 
Published: February 2023

Purpose of review
This review aims to summarize the impact of lung ultrasonography (LUS) on economics and possible impact on patients’ outcomes, proven its diagnostic accuracy in patients with acute respiratory failure.

Recent findings
Despite some previous ethical concerns on LUS examination, today this technique has showed several advantages. First, it is now clear that the daily use of LUS can provide a relevant cost reduction in healthcare of patients with acute respiratory failure, while reducing the risk of transport of patients to radiological departments for chest CT scan. In addition, LUS reduces the exposition to x-rays since can replace the bedside chest X-ray examination in many cases. Indeed, LUS is characterized by a diagnostic accuracy that is even superior to portable chest X-ray when performed by well trained personnel. Finally, LUS examination is a useful tool to predict the course of patients with pneumonia, including the need for hospitalization and ICU admission, noninvasive ventilation failure and orotracheal intubation, weaning success, and mortality.

Summary
LUS should be implemented not only in Intensive Care Units, but also in other setting like emergency departments. Since most data comes from the recent coronavirus disease 2019 pandemic, further investigations are required in Acute Respiratory Failure of different etiologies.
Harm Reduction Approach to Increasing Self-reported Safe Medication Storage Among Pregnant and Parenting People Receiving Opioid Use Disorder Treatment
Authors: Grist Elizabeth , Thakkar Bhushan , Dacha Phoebe , Lutins Erika , Maxwell Madison , Martin Caitlin E. 
Published: February 2023

Objectives
The expansion of access to buprenorphine-naloxone (BUP-NAL) for the treatment of opioid use disorder (OUD) is critical to combat the overdose crisis. Evidence is lacking to guide providers on how to best promote BUP-NAL medication safety for their patients. This study assessed (1) the current medication storage practices among a sample of pregnant and parenting people receiving BUP-NAL for OUD; (2) the feasibility and acceptability of providing a lockbox for safe medication storage.

Methods
Pregnant and/or parenting patients receiving sublingual BUP-NAL in an outpatient OUD clinic were recruited between June and November 2021. Participants completed a baseline survey, received a lockbox, and a follow-up survey 3 to 8 weeks later. The primary outcome of current self-reported safe medication storage practice was defined by storing BUP-NAL in a locked/latched place “almost always” or “always” on the baseline survey. Outcomes were analyzed using simple proportions.

Results
Sixty-three participants completed the baseline survey, and 50 completed the follow-up survey. Baseline survey results indicated that only a quarter of patients (26.6%) were practicing safe BUP-NAL medication storage practices. At follow up, 93.6% of patients were using the lockbox provided by the study, 93.4% reported being satisfied with the lockbox, and most participants (89.3%) reported safe BUP-NAL medication storage practices.

Conclusions
Many pregnant and parenting patients with OUD receiving BUP-NAL do not store their medications safely. The provision of a lockbox as part of OUD treatment is a feasible, acceptable, and potentially effective harm reduction intervention.
A Mixed-methods Evaluation of an Addiction/Cardiology Pilot Clinic With Contingency Management for Patients With Stimulant-associated Cardiomyopathy
Authors: Leyde Sarah , Abbs Elizabeth , Suen Leslie W. , Martin Marlene , Mitchell Andreas , Davis Jonathan , Azari Soraya 
Published: February 2023

Objectives
Contingency management (CM) is one of the most effective treatments for stimulant use disorder but has not been leveraged for people with stimulant-associated cardiomyopathy (SA-CMP), a chronic health condition with significant morbidity and mortality. We aimed to determine the feasibility and acceptability of a multidisciplinary addiction/cardiology clinic with CM for patients with SA-CMP and to explore barriers and facilitators to engagement and recovery.

Methods
We recruited patients with a hospitalization in the past 6 months, heart failure with reduced ejection fraction (<40%) and stimulant use disorder to participate in Heart Plus, a 12-week addiction/cardiology clinic with CM in an urban, safety-net, hospital-based cardiology clinic, which took place March 2021 through June 2021. Contingency management entailed gift card rewards for attendance and negative point-of-care urine drug screens. Our mixed-methods study used the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework. We obtained data from the medical record, staff surveys, and qualitative interviews with participants.

Results
Thirty-eight patients were referred, 17 scheduled an appointment, and 12 attended the intake appointment and enrolled in the study. Mean treatment duration was 8 of 12 weeks. Of the 9 participants who attended more than one visit, the median attendance was 82% of available visits for in-person visits and 83% for telephone visits, and all patients reported decreased stimulant use.

Conclusions
Delivering CM through a multidisciplinary addiction/cardiology clinic for patients with SA-CMP was feasible and engaged patients in care. Further research is needed to assess whether this program is associated with improved heart failure outcomes.
Integrative Analysis of Proteome-wide Association Studies and Functional Enrichment Analysis to Identify Genes and Chemicals Associated with Alcohol Dependence
Authors: Zhang Jingxi , Meng Peilin , Yao Yao , Zhang Huijie , Pan Chuyu , Li Chun'e , Chen Yujing , Zhang Zhen , Cheng Shiqiang , Liu Li , Yang Xuena , Jia Yumeng , Zhang Feng 
Published: February 2023

Objectives
Alcohol dependence accounts for a large proportion of the global burden of disease and disability. This study aims to investigate the candidate genes and chemicals associated with alcohol dependence.

Methods
Using data from published alcohol dependence genome-wide association studies, we first conducted a proteome-wide association study of alcohol dependence by integrating alcohol dependence genome-wide association studies with 2 human brain reference proteomes of dorsolateral prefrontal cortex from the Religious Order Study and Rush Memory and Aging Project and the Banner Sun Health Research Institute. Then, based on the identified genes in proteome-wide association study, we conducted functional enrichment analysis and chemical-related functional enrichment analysis to detect the related Gene Ontology terms and chemicals.

Results
Proteome-wide association study identified several potential candidate genes for alcohol dependence, such as GOT2 (P = 7.59 × 10−6) and C3orf33 (P = 5.00 × 10−3). Furthermore, functional enrichment analysis identified multiple candidate Gene Ontology terms associated with alcohol dependence, such as glyoxylate metabolic process (adjusted P = 2.99 × 10−6) and oxoglutarate metabolic process (adjusted P = 9.95 × 10−6). Chemical-related functional enrichment analysis detected several alcohol dependence–related candidate chemicals, such as pitavastatin (P = 2.00 × 10−4), cannabinoids (P = 4.00 × 10−4), 11-nor-Δ(9)-tetrahydrocannabinol-9-carboxylic acid (P = 4.00 × 10−4), and gabapentin (P = 2.00 × 10−3).

Conclusions
Our study reports multiple candidate genes and chemicals associated with alcohol dependence, providing novel clues for understanding the biological mechanism of alcohol dependence.
Defining Prescription Drug Misuse: A Naturalistic Evaluation of National Survey on Drug Use and Health Data From 2012–2014 to 2015–2017
Authors: McHugh R. Kathryn , Votaw Victoria R. , McCarthy Megan D. , Bichon Juliette A. , Bailey Allen J. , Fitzmaurice Garrett M. 
Published: February 2023

Objectives
Prescription drug misuse (PDM) is a significant public health problem. As research has evolved, the definitions of misuse have varied over time, yet the implications of this variability have not been systematically studied. The objective of this study was to leverage a change in the measurement of PDM in a large population survey to identify its impact on the prevalence and correlates of this behavior.

Methods
Data from the National Survey on Drug Use and Health were compared before and after a change in the definition of PDM from one that restricted the source and motive for use to one that captured any misuse other than directed by a prescriber. Three-year cohorts were constructed, representing a restricted definition of PDM (2012–2014) and a broad definition of PDM (2015–2017).

Results
Segmented logistic regression models indicated a significant increase in PDM prevalence for all 3 drug types examined (opioids, tranquilizers, and sedatives). Although the magnitude of differences varied somewhat based on drug type, the broader definition was generally associated with older age, higher prevalence of health insurance, and higher odds of misusing one's own prescription. Some worsening of mental health indicators was observed, but results indicated few other clinical or substance use differences.

Conclusions
Definitions of prescription drug misuse have a substantial impact on the prevalence of misuse and some impact on the characteristics of the population. Further research is needed to understand the optimal strategy for measuring this behavior, based on the scientific or public health question or interest.
Rapid Low-dose Buprenorphine Initiation for Hospitalized Patients With Opioid Use Disorder
Authors: Sokolski Eleasa , Skogrand Emily , Goff Amelia , Englander Honora 
Published: February 2023

Introduction
Low-dose buprenorphine initiation allows patients to start buprenorphine for treatment of opioid use disorder (OUD) while continuing full-agonist opioids. This strategy is beneficial for hospitalized patients who may have acute pain and are not able to tolerate withdrawal. However, most protocols require 7–10 to complete, which may create barriers in patients with shorter or unpredictable lengths of stay.

Objective
This cohort study examined the efficacy and feasibility of a rapid low-dose buprenorphine initiation protocol in the hospital setting.

Methods
We performed a retrospective cohort study of hospitalized patients with OUD (diagnosed by DSM-5 criteria) seen by an addiction medicine consult service at a single academic medical center who started buprenorphine via a rapid low-dose initiation between November 2021 and May 2022. Patients were prospectively tracked using an electronic registry, and data were abstracted from the electronic health record.

Results
Twenty-four patients underwent rapid low-dose initiation during the study period. All patients received full-agonist opioids before starting buprenorphine. Thirteen (54%) patients reported using fentanyl, with 5 patients reported endorsing use within 48 hours preceding buprenorphine initiation. Nineteen (79%) patients completed initiation with an average time to completion of 72 hours. Among patients who reported fentanyl use in the 48 hours before starting buprenorphine, 60% completed initiation and 40% elected to transition to methadone. No patients experienced precipitated withdrawal.

Conclusions
Rapid low-dose buprenorphine initiation provides a feasible and well-tolerated alternative to traditional and slower low-dose initiations for hospitalized patients.
Letrozole Compared With Clomiphene Citrate for Polycystic Ovarian Syndrome
Authors: Liu Zhuo , Geng Yuli , Huang Yanjing , Hu Runan , Li Fan , Song Yufan , Zhang Mingmin 
Published: February 2023

OBJECTIVE:
To estimate the effect of letrozole and clomiphene citrate in women with infertility and polycystic ovarian syndrome (PCOS).

METHODS OF STUDY SELECTION:
MEDLINE through PubMed, Web of Science, EMBASE, Cochrane Library, and ClinicalTrials.gov were searched for relevant studies from inception to February 1, 2022. Two reviewers retrieved, filtered, and extracted data independently using the bibliographic software EndNote X9 and Excel workbook. We included randomized controlled trials (RCTs) reporting ovulation induction outcomes in women with infertility and PCOS treated with either letrozole or clomiphene citrate followed by timed intercourse or intrauterine insemination. The data were merged into a mean difference or risk ratio (RR) with 95% CI, depending on variable types.

TABULATION, INTEGRATION, AND RESULTS:
Data collection and organization were conducted in accordance with the 2020 PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analyses) statement. Twenty-nine RCTs were eligible, which included 3,952 women and 7,633 ovulation induction cycles. We acquired evidence from 22 RCTs for the ovulation rate, 28 RCTs for the clinical pregnancy rate, and eight RCTs for live-birth rate. Pooled analysis indicated that letrozole treatment prevailed against clomiphene citrate in ovulation rate (RR 1.14, 95% CI 1.06–1.21, P<.001), clinical pregnancy rate (RR 1.48, 95% CI 1.34–1.63, P<.001), and live-birth rate (RR 1.49, 95% CI 1.27–1.74, P<.001).

CONCLUSIONS:
Letrozole was associated with improved ovulation, pregnancy, and live-birth rates compared with clomiphene citrate. We recommend letrozole over clomiphene citrate as an ovulation induction drug in women with infertility and PCOS, although the quality of the evidence is mixed.

SYSTEMATIC REVIEW REGISTRATION:
PROSPERO, CRD42022308777.
Texas Senate Bill 8 and Abortion Experiences in Patients With Fetal Diagnoses
Authors: Baker Courtney C. , Smith Emma , Creinin Mitchell D. , Moayedi Ghazaleh , Chen Melissa J. 
Published: February 2023

OBJECTIVE:
To describe experiences with abortion counseling and access in patients with lethal or life-limiting fetal diagnoses in Texas after enactment of Senate Bill 8 (SB8).

METHODS:
In this qualitative study, we interviewed patients who obtained abortions after enactment of SB8, using semi-structured interviews to explore how restrictions affected abortion care. Two researchers coded all transcripts using an inductive technique and analyzed themes in an iterative approach.

RESULTS:
We interviewed 16 participants who reported gestational durations from 13 to 29 weeks at the time of abortion. Participants described loss of the therapeutic patient–physician relationship and feelings of isolation while pursuing abortion due to the limitations imposed by SB8. For example, participants felt there was a physician “gag rule” regarding abortion (“the unspoken word of termination”), resulting in the need to find information about pregnancy options outside of the medical community and further highlighting the privilege of financial resources necessary to obtain an abortion on their own. Participants also expressed fears regarding confidentiality with their support systems and clinicians (“I would joke around and say, well don't sue me, but halfway mean it”) and personal safety when self-referring for abortion (“…am I making the right choice on where I need to go? Is it safe?”).

CONCLUSION:
Abortion restrictions and bans such as SB8 erode the patient–physician relationship, evoking fear and safety concerns during a vulnerable time for those undergoing abortion for lethal or life-limiting fetal diagnoses. They force patients to shoulder the significant burden of understanding pregnancy options and navigating the process of abortion alone, which is likely to have greater effects on those with fewer resources.
Perinatal Outcomes After Bariatric Surgery Compared With a Matched Control Group
Authors: Boller Marie J. , Xu Fei , Lee Catherine , Sridhar Sneha , Greenberg Mara B. , Hedderson Monique M. 
Published: February 2023

OBJECTIVE:
To evaluate perinatal outcomes associated with pregnancy after bariatric surgery within a large integrated health care system using propensity score matching.

METHODS:
We conducted a retrospective cohort study that evaluated perinatal outcomes in pregnant patients after bariatric surgery from January 2012 through December 2018. History of bariatric surgery was identified by using International Classification of Diseases codes and a clinical database. Primary outcomes were preterm birth (PTB), gestational hypertension, preeclampsia, impaired glucose tolerance or gestational diabetes, a large-for-gestational-age (LGA) or small-for-gestational-age (SGA) neonates, and cesarean birth. Propensity scores were estimated by using logistic regression that accounted for age at delivery, prepregnancy body mass index, year of delivery, parity, neighborhood deprivation index, race and ethnicity, insurance status, initiation of prenatal visit in the first trimester, smoking during pregnancy, chronic hypertension, and preexisting diabetes. Five patients in the control group were matched to each patient in the case group on linear propensity score, and modified Poisson regression was used to adjust for covariates. Sensitivity analyses by timing and type of surgery were performed.

RESULTS:
We identified a case cohort of 1,591 pregnancies in patients after bariatric surgery and a matched cohort of 7,955 pregnancies in patients who had not undergone bariatric surgery. Demographic characteristics were similar in both groups. In multivariate models, pregnancy after bariatric surgery was associated with a decreased risk of preeclampsia (7.5% vs 10.2%, adjusted relative risk [aRR] 0.72, 95% CI 0.60–0.86), gestational diabetes or impaired fasting glucose (23.5% vs 35.0%, aRR 0.73, 95% CI 0.66–0.80), and LGA (10.6% vs 19.9%, aRR 0.56, 95% CI 0.48–0.65) and an increased risk of SGA (10.9% vs 6.6%, aRR 1.51, 95% CI 1.28–1.78). No significant differences were observed in PTB, gestational hypertension and cesarean delivery.

CONCLUSION:
Pregnancy after bariatric surgery in a racially and ethnically diverse cohort of patients is associated with decreased risk of preeclampsia, gestational diabetes or impaired fasting glucose, and LGA neonates; it is also associated with an increased risk of SGA neonates compared with pregnant patients in a matched control group.