bluuebunny/crossref_metadata_2025_split huggingface dataset:
Racial Variations in Pain Management and Outcomes in Hospitalized Patients With Acute Pancreatitis
Authors: McHenry Nicole , Shah Ishani , Ahmed Awais , Freedman Steven D. , Kothari Darshan J. , Sheth Sunil G. 
Published: April 2023

Objectives
Acute pancreatitis (AP) is a common cause of hospitalization. Black AP patients have higher risk for alcoholic etiology and hospitalization than White patients. We evaluated outcomes and treatment disparities by race in hospitalized AP patients.

Methods
We retrospectively analyzed Black and White AP patients admitted 2008–2018. Primary outcomes were length of stay, intensive care unit admission, 30-day readmissions, and mortality. Secondary outcomes included pain scores, opioid dosing, and complications.

Results
We identified 630 White and 186 Black AP patients. Alcoholic AP (P < 0.001), tobacco use (P = 0.013), and alcohol withdrawal (P < 0.001) were more common among Blacks. There were no differences in length of stay (P = 0.113), intensive care unit stay (P = 0.316), 30-day readmissions (P = 0.797), inpatient (P = 0.718) or 1-year (P = 0.071) mortality, complications (P = 0.080), or initial (P = 0.851) and discharge pain scores (P = 0.116). Discharge opioids were prescribed more frequently for Whites (P = 0.001).

Conclusions
Hospitalized Black and White AP patients had similar treatment and outcomes. Standardized protocols used to manage care may eliminate racial biases. Disparities in discharge opioid prescriptions may be explained by higher alcohol and tobacco use by Black patients.
Management of Splanchnic Vein Thrombosis in Patients With Acute Pancreatitis
Authors: Ghazanfar Mudassar A. , Ke Lu , Ramsay George , Smith Martin , Giovinazzo Francesco , Mohamed Moustafa , Pandanaboyana Sanjay , Huang Wei , Ahmed Irfan , Siriwardena Ajith K. , Windsor John A. , Bekheit Mohamed 
Published: April 2023

Objectives
Splanchnic venous thrombosis (SpVT) is a complication of acute pancreatitis (AP). There is scarce literature on the prevalence and treatment of SpVT in AP. The aim of this international survey was to document current approaches to the management of SpVT in patients with AP.

Methods
An online survey was designed by a group of international experts in the management of AP. Twenty-eight questions covered the level of experience of the respondents, disease demographics, and management of SpVT.

Results
There were 224 respondents from 25 countries. Most respondents (92.4%, n = 207) were from tertiary hospitals and predominantly consultants (attendings, 86.6%, n = 194). More than half of the respondents (57.2%, n = 106) “routinely” prescribed prophylactic anticoagulation for AP. Less than half of the respondents (44.3%, n = 82) “routinely” prescribed therapeutic anticoagulation for SpVT. A clinical trial was considered justified by most respondents (85.4%, n = 157) and 73.2% (n = 134) would be willing to enroll their patients.

Conclusions
The approach to anticoagulation in the treatment of patients with SpVT complicating AP was highly variable. Respondents indicate that a position of equipoise exists to justify randomized evaluation.
Impact of Preoperative Muscle Mass Maintenance and Perioperative Muscle Mass Loss Prevention After Pancreatectomy
Authors: Maekawa Takeru , Maehira Hiromitsu , Iida Hiroya , Mori Haruki , Nitta Nobuhito , Tokuda Aya , Kaida Sachiko , Miyake Toru , Takebayashi Katsushi , Tani Masaji 
Published: April 2023

Objectives
We investigated how preoperative sarcopenia and perioperative muscle mass changes affect postoperative nutritional parameters in patients undergoing pancreatectomy.

Methods
This study included 164 patients undergoing pancreatectomy between January 2011 and October 2018. Skeletal muscle area was measured by computed tomography before and 6 months after surgery. Sarcopenia was defined as the lowest sex-specific quartile, and patients with muscle mass ratios less than −10% were classified into the high-reduction group. We examined the relationship between perioperative muscle mass and postoperative nutritional parameters 6 months after pancreatectomy.

Results
There were no significant differences in nutritional parameters between the sarcopenia and nonsarcopenia groups at 6 months after surgery. In contrast, albumin (P < 0.001), cholinesterase (P < 0.001), and prognostic nutritional index (P < 0.001) were lower in the high-reduction group. According to each surgical procedure, albumin (P < 0.001), cholinesterase (P = 0.007), and prognostic nutritional index (P < 0.001) were lower in the high-reduction group of pancreaticoduodenectomy. In distal pancreatectomy cases, only cholinesterase (P = 0.005) was lower.

Conclusions
Postoperative nutritional parameters were correlated with muscle mass ratios but not with preoperative sarcopenia in patients undergoing pancreatectomy. Improvement and maintenance of perioperative muscle mass are important to maintain good nutritional parameters.
Lower Interobserver Reliability for Nondimensional Intracystic Features Among Abdominal Radiologists for Characterizing Intraductal Papillary Mucinous Neoplasms Using Magnetic Resonance Imaging
Authors: Scherer John A. , Gebhard Robyn , Firkins Stephen A. , Shah Zarine K. , Urbina Andersson Irma K. , Barker Samantha J. , Fiorillo Lauren E. , Hollander Ephraim , Shaheen Nicholas , Koay Eugene J. , Conwell Darwin L. , Krishna Somashekar G. 
Published: April 2023

Objectives
Current guidelines recommend magnetic resonance imaging (MRI)/magnetic resonance cholangiopancreatography (MRCP) for risk stratification of intraductal papillary mucinous neoplasms (IPMNs). We assessed the interobserver agreement among radiologists in evaluating and risk stratifying IPMNs.

Methods
This single-center study evaluated 30 patients with IPMNs who had undergone MRI/MRCP, endoscopic ultrasound, and/or surgical resection. Six abdominal radiologists evaluated the MRI/MRCPs to document multiple parameters. The analysis applied Landis and Koch κ interpretation for categorical variables and intraclass correlation coefficient (r) for continuous variables.

Results
Radiologists demonstrated almost perfect agreement for location (κ = 0.81, 95% confidence interval [CI], 0.74–0.87), size (r = 0.95; 95% CI, 0.89–0.98), and main pancreatic duct diameter (r = 0.98; 95% CI, 0.96–0.99). Substantial agreement was observed for communication with the main pancreatic duct (κ = 0.66; 95% CI, 0.57–0.75) and classification of IPMN subtype (κ = 0.77; 95% CI, 0.67–0.86). Presence of intracystic nodules (κ = 0.31; 95% CI, 0.21–0.42) and wall thickening (κ = 0.09; 95% CI, −0.01 to 0.18) reached only fair and slight agreement, respectively.

Conclusions
Although MRI/MRCP is excellent in the evaluation of spatial aspects, there is lower reliability for nondimensional characteristics of IPMNs. These data support guideline-recommended complementary evaluation of IPMNs with MRI/MRCP and endoscopic ultrasound.
The Pediatric Crohn Disease Morbidity Index (PCD-MI): Development of a Tool to Assess Long-Term Disease Burden Using a Data-Driven Approach
Authors: Ashton James J. , Gurung Abhilasha , Davis Cai , Seaby Eleanor G. , Coelho Tracy , Batra Akshay , Afzal Nadeem A. , Ennis Sarah , Beattie R. Mark 
Published: April 2023

Background/Objective:
Heterogeneity and chronicity of Crohn disease (CD) make prediction of outcomes difficult. To date, no longitudinal measure can quantify burden over a patient’s disease course, preventing assessment and integration into predictive modeling. Here, we aimed to demonstrate the feasibility of constructing a data driven, longitudinal disease burden score.

Methods:
Literature was reviewed for tools used in assessment of CD activity. Themes were identified to construct a pediatric CD morbidity index (PCD-MI). Scores were assigned to variables. Data were extracted automatically from the electronic patient records at Southampton Children’s Hospital, diagnosed from 2012 to 2019 (inclusive). PCD-MI scores were calculated, adjusted for duration of follow up and assessed for variation (ANOVA) and distribution (Kolmogorov-Smirnov).

Results:
Nineteen clinical/biological features across five themes were included in the PCD-MI including blood/fecal/radiological/endoscopic results, medication usage, surgery, growth parameters, and extraintestinal manifestations. Maximal score was 100 after accounting for follow-up duration. PCD-MI was assessed in 66 patients, mean age 12.5 years. Following quality filtering, 9528 blood/fecal test results and 1309 growth measures were included. Mean PCD-MI score was 14.95 (range 2.2–32.5); data were normally distributed (P = 0.2) with 25% of patients having a PCD-MI < 10. There was no difference in the mean PCD-MI when split by year of diagnosis, F-statistic 1.625, P = 0.147.

Conclusions:
PCD-MI is a calculatable measure for a cohort of patients diagnosed over an 8-year period, integrating a wide-range of data with potential to determine high or low disease burden. Future iterations of the PCD-MI require refinement of included features, optimized scores, and validation on external cohorts.
Threat of resurgence or hope for global eradication of poliovirus?
Authors: Kim Carla Y. , Piamonte Bernadeth , Allen Rebecca , Thakur Kiran T. 
Published: April 2023

Purpose of review
Recent outbreaks of poliomyelitis in countries that have been free of cases for decades highlight the challenges of eradicating polio in a globalized interconnected world beset with a novel viral pandemic. We provide an epidemiological update, advancements in vaccines, and amendments in public health strategy of poliomyelitis in this review.

Recent findings
Last year, new cases of wild poliovirus type 1 (WPV1) were documented in regions previously documented to have eradicated WPV1 and reports of circulating vaccine-derived poliovirus type 2 (cVDPV2) and 3 (cVDPV3) in New York and Jerusalem made international headlines. Sequencing of wastewater samples from environmental surveillance revealed that the WPV1 strains were related to WPV1 lineages from endemic countries and the cVDPV2 strains from New York and Jerusalem were not only related to each other but also to environmental isolates found in London. The evidence of importation of WPV1 cases from endemic countries, and global transmission of cVDPVs justifies renewed efforts in routine vaccination programs and outbreak control measures that were interrupted by the COVID-19 pandemic. After the novel oral poliovirus vaccine type 2 (nOPV2) received emergency authorization for containment of cVDPV2 outbreaks in 2021, subsequent reduced incidence, transmission rates, and vaccine adverse events, alongside increased genetic stability of viral isolates substantiates the safety and efficacy of nOPV2. The nOPV1 and nOPV3 vaccines, against type 1 and 3 cVDPVs, and measures to increase accessibility and efficacy of inactivated poliovirus vaccine (IPV) are in development.

Summary
A revised strategy utilizing more genetically stable vaccine formulations, with uninterrupted vaccination programs and continued active surveillance optimizes the prospect of global poliomyelitis eradication.
Addressing vaccine-preventable encephalitis in vulnerable populations
Authors: Piamonte Bernadeth Lyn C. , Easton Ava , Wood Greta K. , Davies Nicholas W.S. , Granerod Julia , Michael Benedict D. , Solomon Tom , Thakur Kiran T. 
Published: April 2023

Purpose of review
Vaccinations have been pivotal in lowering the global disease burden of vaccine-preventable encephalitides, including Japanese encephalitis, tick-borne encephalitis, measles encephalitis, and rabies encephalitis, among others.

Recent findings
Populations vulnerable to vaccine-preventable infections that may lead to encephalitis include those living in endemic and rural areas, military members, migrants, refugees, international travelers, younger and older persons, pregnant women, the immunocompromised, outdoor, healthcare and laboratory workers, and the homeless. There is scope for improving the availability and distribution of vaccinations, vaccine equity, surveillance of vaccine-preventable encephalitides, and public education and information.

Summary
Addressing these gaps in vaccination strategies will allow for improved vaccination coverage and lead to better health outcomes for those most at risk for vaccine-preventable encephalitis.
Choroid plexuses at the interface of peripheral immunity and tissue repair in multiple sclerosis
Authors: Ricigliano Vito A.G. , Stankoff Bruno 
Published: April 2023

Purpose of review
Choroid plexuses (ChPs) are key actors of the blood-to-cerebrospinal-fluid barrier and serve as brain immune checkpoint. The past years have seen a regain of interest about their potential involvement in the physiopathology of neuroinflammatory disorders like multiple sclerosis (MS). This article offers an overview of the recent findings on ChP alterations in MS, with a focus on the imaging tools able to detect these abnormalities and on their involvement in inflammation, tissue damage and repair.

Recent findings
On MRI, ChPs are enlarged in people with MS (PwMS) versus healthy individuals. This size increase is an early event, already detected in presymptomatic and pediatric MS. Enlargement of ChPs is linked to local inflammatory infiltrates, and their dysfunction selectively impacts periventricular damage, larger ChPs predicting the expansion of chronic active lesions, smoldering inflammation and remyelination failure in tissues surrounding the ventricles. ChP volumetry may add value for the prediction of disease activity and disability worsening.

Summary
ChP imaging metrics are emerging as possible biomarkers of neuroinflammation and repair failure in MS. Future works combining multimodal imaging techniques should provide a more refined characterization of ChP functional changes, their link with tissue damage, blood to cerebrospinal-fluid barrier dysfunction and fluid trafficking in MS.
A Phase I trial to inform clinical protocols for the safe administration of psilocybin-assisted psychotherapy
Authors: Bennett Jennifer N. , Blough Michael D. , Mitchell Ian , Galloway Lyle , Bains Ravinder 
Published: April 2023

AbstractThis Phase I trial aims to inform the development of safety protocols for psilocybin-assisted therapy. Psychedelics, including psilocybin, are increasingly being recognized as a successful treatment option for many mental health concerns. In order to decrease the risks associated with its clinical use, more data is required regarding its physiological effects in healthy individuals. Safety assessments (heart rate, blood pressure, temperature, and ECG data), as well as adverse event evaluations were the primary outcome measures used to assess the physiological effects of 25 mg of psilocybin extract administered to 14 healthy individuals. We hypothesized that there would be a transient, clinically insignificant rise in both blood pressure and heart rate that would not result in any long-term adverse effects. No unexpected effects were observed, blood pressure and heart rate returned to normal as drug effects waned, and all participants had normal two-month follow-ups. Mean peak systolic and diastolic blood pressures during the psilocybin session were 145.93 (SD= 19.01) and 93.93 (SD= 9.75), respectively. While this represents a significant increase from baseline (p< 0.0001), a healthy cardiovascular system is capable of tolerating such levels for a longer time period than the brief duration of drug effects. Therefore, we suggest implementing focused and limited screening protocols to balance patient safety and accessibility. Secondary outcomes of this trial centered on the subjective effects of psilocybin, assessed via the QIDS-SR16 and the MEQ-30. There was a statistically significant decrease in QIDS-SR16 scores from baseline scores (M= 3.50,SD= 2.35) to eight-week follow-up scores (M= 1.86,SD= 0.86),p= 0.018. Mean MEQ-30 scores, assessed on day two and seven after the psilocybin session, indicate participants had full mystical experiences.
Inflammation induced epigenetic activation of bivalent genes in osteoarthritic cartilage
Authors: Du Hao , Zhang Yao , Yu Xi , You Xuanhe , Wu Diwei , Luo Zhenyu , Cai Yongrui , Lu Hanpeng , Liao Zhixin , Ding Bi-Sen , Zhao Ya , Wang Yan , Xiao Ke , Yang Fan , Gan Fangji , Ning Ning , Zeng Jiancheng , Zhou Zongke , Huang Shishu 
Published: April 2023

AbstractOsteoarthritis (OA) is the most prevalent joint disorder occurring with articular cartilage degradation, which includes a switch from an articular to a growth-plate chondrocyte phenotype. Epigenetics serves as a new therapeutic target but histone modification changes in OA remain elusive. Here, we investigated the profiles of four histone modifications in normal and OA chondrocytes. The repressive mark H3K27me3 was significantly lost in OA, associated with up-regulated gene expression. Surprisingly, many of these genes were occupied by both H3K27me3 and H3K4me3 in normal chondrocytes, showing a poised bivalent state. These bivalent genes are deemed to be activated during the hypertrophy of growth plate chondrocytes. Furthermore, inflammation induced the expression of demethylase KDM6B and decreased H3K27me3 level in OA chondrocytes, which was rescued by the KDM6B inhibitor GSK-J4. Altogether, our results suggest an inherited bivalent epigenetic signature on developmental genes that makes articular chondrocytes prone to hypertrophy and contribute to a promising epigenetic therapy for OA.The Paper ExplainedProblemOsteoarthritis (OA) affects as much as 40% of the elderly population, representing the largest cause of age-related disability. The high susceptibility to OA suggests an intrinsic and systemic characteristic in articular chondrocytes that makes cartilage prone to degeneration.ResultsEpigenetic bivalent genes, which are occupied with both H3K27me3 and H3K4me3, are considered to poise expression of developmental genes. Surprisingly, we reported bivalency for hypertrophy related genes in normal articular chondrocytes. These bivalent genes need to be activated in growth plate chondrocytes for extracellular matrix degradation and ossification, but are left as a “bomb” for degeneration in articular chondrocytes. We further found that inflammation induced KDM6B remove H3K27me3 to activate hypertrophy related genes that promote OA.ImpactOur results suggest an inherited epigenetic signature that makes articular chondrocytes prone to hypertrophy and ossification and contribute to a promising epigenetic therapy for OA.
Catheter Laboratory Facilities in Indonesia: Number, Growth, and Distribution in The Largest Archipelago Nation
Authors: Muharram Farizal Rizky , Andrianto Andrianto , Salsabilla Senitza Anisa , Multazam Chaq El Chaq Zamzam , Harmadha Wigaviola Socha , Dakota Iwan , Andriantoro Hananto , Firman Doni , Prakoso Radityo 
Published: April 2023

AbstractBackgroundIndonesia, the world’s largest archipelago and fourth most populous nation, has limited transportation due to geographical obstacles. This affects the provision of acute time-dependent therapy such as Percutaneous Coronary Intervention (PCI). Indonesia’s ageing population, which will increase Acute Coronary Syndrome prevalence in the next decade, will worsen this problem. Therefore, the analysis and enhancement of cardiovascular care are crucial. The catheterization laboratory (cath lab) performs PCI procedures. This study maps the number and distribution of Indonesia’s cath lab facilities.MethodsA direct survey was used to collect the cath lab location data. Population data came from the Ministry of Home Affairs. The growth of cath labs is shown and analyzed by region. The ratio and the Gini index are the primary comparison tools between regions and over time.FindingsThe number of cath labs in Indonesia significantly increased from 181 to 310 in the last five years, with 44 of the 119 new labs built in an area that did not have one. Java has the most cath labs (208, 67%). The cath lab ratio in the provinces of Indonesia ranges from 0·0 in West Papua and Maluku to 4·46 in Jakarta; the median is 1·09. (IQR 0·71–1·18). The distribution remains a problem, as shown by the high cath lab Gini index (0·48).InterpretationThe number of cath labs in Indonesia has increased significantly recently. However, maldistribution remains a concern. In order to improve Indonesia’s cardiovascular emergency services, Future cath lab development must be planned better by considering the facility accessibility and density.FundingThe study was conducted with the researcher’s fundsEvidence Before StudyIndonesia is the fourth-largest nation by population and the largest archipelagic country. Unfortunately, the number of cath lab facilities nationwide in Indonesia was never examined or mentioned in any previous scientific articles that we could find. According to earlier studies, cathlab accessibility is critical in reducing the time ACS patients take to receive care. It is become crucial to map cathlab locations and plan them in strategic locations.What this Study AddsThis study provides data on the number of cathlabs, their primary geographic distribution, their cath lab-to-population ratio, and their evolution over the previous five years in Indonesia.Our research demonstrates that to ensure equity access, Indonesia, as the largest archipelagic nation, needs government policies that initiate the distribution of cathlabs and the strategic placing of cathlabs as critical factors.
Brief Multimodal Intervention to Address Bedtime Procrastination and Sleep through Self-Compassion and Sleep Hygiene during Stressful Times
Authors: Bistricky Steven L. , Lopez Alicia K. , Pollard Tarryn B. , Egan Alana , Gimenez-Zapiola Malena , Pascuzzi Bailey , Velasquez Kenia M. , Graves Miana 
Published: April 2023

AbstractBedtime procrastination is increasingly recognized as a widespread impediment to health-promoting sleep. Based on its potential malleability, bedtime procrastination is starting to be targeted for intervention using traditional health behavior models, but other cognitive and emotional factors that potentially modulate bedtime procrastination warrant more targeted intervention. The present research recruited college students (n = 93) with self-reported tendencies toward bedtime procrastination and low self-compassion early in the COVID-19 pandemic, and it examined a hybrid intervention model involving a single group meeting and home practices that focused on comprehensive sleep hygiene or intentional self-compassion practices, simultaneously leveraging social motivation and commitment. It also examined bedtime procrastination, sleep, emotion regulation, and procrastinatory cognitions. The study showed evidence for feasibility, acceptability, reduced bedtime procrastination, improved sleep, and moderated mediation whereby the relationship between increased self-compassion and decreased bedtime procrastination was mediated by improved emotion regulation for those with elevated reductions in procrastinatory cognition. Predictors of bedtime procrastination reduction and other relevant sequelae differed between self-compassion and sleep hygiene virtual trainings. Thus, the present research expands and synthesizes a burgeoning literature, suggesting that integrating effective elements into acceptable interventions may help reverse a cycle of self-criticism, emotion dysregulation, bedtime procrastination, and sleep-related difficulties for many who might benefit.