bluuebunny/crossref_metadata_2025_split huggingface dataset:
Changes in opioid prescription duration for musculoskeletal injury associated with the North Carolina Strengthen Opioid Misuse Prevention (STOP) Act
Authors: Wally Meghan K , Thompson Michael E , Odum Susan , Kazemi Donna M , Hsu Joseph R , Seymour Rachel B ,   PRIMUM Group:, Beuhler Michael , Bosse Michael , Castro Manuel , Gibbs Michael , Griggs Christopher , Jarrett Steven , Leas Daniel , Rachal James , Roomian Tamar , Runyon Michael , Saha Animita , Watling Brad , Yu Ziqing 
Published: March 2023

Abstract

Objectives
To assess whether implementation of the Strengthen Opioid Misuse Prevention (STOP) Act was associated with an increase in the percentage of opioid prescriptions written for 7 days or fewer among patients with acute or postsurgical musculoskeletal conditions.

Design
An interrupted time-series study was conducted to determine the change in duration of opioid prescriptions associated with the STOP Act.

Setting
Data were extracted from the electronic health record of a large health care system in North Carolina.

Subjects
Patients presenting from 2016 to 2020 with an acute musculoskeletal injury and the clinicians treating them were included in an interrupted time-series study (n = 12 839).

Methods
Trends were assessed over time, including the change in trend associated with implementation of the STOP Act, for the percentage of prescriptions written for ≤7 days.

Results
Among patients with acute musculoskeletal injury, less than 30% of prescriptions were written for ≤7 days in January of 2016; by December of 2020, almost 90% of prescriptions were written for ≤7 days. Prescriptions written for ≤7 days increased 17.7% after the STOP Act was implemented (P &lt; .001), after adjustment for the existing trend.

Conclusions
These results demonstrate significant potential for legislation to influence opioid prescribing behavior.
Erection hardness score or penile Doppler ultrasound: which is a better predictor of failure of nonsurgical treatment of erectile dysfunction?
Authors: Silva Alberto Costa , Silva Carlos Martins , Morgado Afonso 
Published: March 2023

AbstractBackgroundIn the evaluation of men presenting for erectile dysfunction (ED), specific diagnostic tests, such as an intracavernous injection test (IIT) with Erection Hardness Score (EHS) assessment or penile Doppler ultrasound (PDU), may be necessary.AimThe study sought to compare the prognostic value of PDU parameters with erection rigidity with EHS during IIT in predicting refractory ED after 5 years.MethodsPatients referred for ED were evaluated and had a PDU with at least 15 μg of intracavernous alprostadil and without any sexual stimulation. At 5 years of follow-up, current and past ED treatments were noted. Refractory ED was defined as having a penile prosthesis (PP) implanted, having failed nonsurgical treatments but having refused PP implantation, or having discontinuation of nonsurgical treatments due to loss of efficacy. Patients with hypogonadism and pelvic surgery were excluded. Receiver-operating characteristic curves were drawn and the area under the curve (AUC) was calculated.OutcomesThe outcome was the AUC for predicting refractory ED.ResultsAt 5 years, 69 men were still in follow-up with a mean age of 58.47 ± 10.39 years, and 13 (18.8%) were classified as having refractory ED. The AUC for the EHS, peak systolic velocity, end-diastolic flow, and resistive index to discriminate refractory ED were 0.820, 0.613, 0.730, and 0.714, respectively.Clinical ImplicationsEHS can be a good predictor of response to nonsurgical treatments in ED.Strengths and LimitationsThis was a prospective study to compare IIT with PDU, and validated disease-specific questionnaires were used to assess both clinical efficacy and satisfaction. PDU was performed by a blinded third party. However, resulting from a single-center study, our sample size can be considered small, and the number of events observed was also low.ConclusionOur data suggest that an abnormal EHS during an IIT is, at least, noninferior than an abnormal PDU in predicting those patients that will not respond to nonsurgical treatments and that will need a PP in long-term.
Evaluation of corn-fermented protein as a dietary ingredient in extruded dog and cat diets
Authors: Smith Spencer C , Aldrich Charles G 
Published: March 2023

Abstract
Most pet foods utilize traditional ingredients like corn, wheat, and soy. These ingredients and other grains, such as distillers dried grains (DDG), have been used by the pet food industry. Corn-fermented protein (CFP) is a nutrient-dense enhancement on DDG but has not been evaluated in pet food. Therefore, it was the objective of this study to determine the effect of CFP in the production of extruded pet diets, and to determine the effect on nutrient utilization (digestibility) and stool consistency in dogs, and palatability in dogs and cats. Experimental diets with treatment protein sources (corn gluten meal [CGM], soybean meal [SBM], and CFP) were produced in triplicate using a single-screw extruder. Processing parameters and kibble samples were collected at timed intervals during diet production. Kibbles were evaluated for physical dimension and texture. No differences (P &gt; 0.05) were observed in any physical dimension or texture parameters evaluated, with exception of radial expansion, which was lower (P &lt; 0.05) for CFP kibble compared to others. The CFP kibble required a smaller (P &lt; 0.05) mass restriction valve opening, to keep similar bulk density among dietary treatments. However, there was no difference (P &gt; 0.05) in specific mechanical energy among treatments during diet production. Twelve beagles were fed the experimental diets in a 3 × 3 replicated Latin Square design in which four dogs were randomly assigned to each of three treatments for each period. Diets were formulated to be isonitrogenous and were supplemented with titanium dioxide to serve as an external marker in order to estimate apparent total tract digestibility. Dogs were housed individually and fed twice daily, and water was available ad libitum. Feces were collected after feedings. The diet produced with CGM was more digestible (P &lt; 0.05) than CFP and SBM for dry matter, organic matter, crude protein, crude fat, and gross energy. Further, the CFP diet was also less (P &lt; 0.05) digestible than the SBM diet for dry matter and organic matter. Dogs fed the diet containing CFP had higher (P &lt; 0.05) fecal mass than those fed SBM and CGM. The CFP diet also resulted in a higher fecal score (P &lt; 0.05) than those fed diets with the CGM diet, but similar (P &gt; 0.05) to the SBM diet. For palatability assessment, dogs had a preference (P &lt; 0.05) for CGM over SBM or CFP, but cats showed a preference (P &lt; 0.05) for SBM and CFP over CGM. Results indicate that CFP is acceptable for use in dog and cat diets. Further research should be conducted to evaluate the use of these ingredients at lower inclusion levels.
Rectal carriage of extended-spectrum β-lactamase-producing Enterobacteriales among neonates admitted into a special care baby unit, southwest Nigeria
Authors: Obadare Temitope O , Adeyemo Adeyemi T , Odetoyin Babatunde W , Ugowe Osagie J , Anyabolu Chineme H , Adejuyigbe Ebunoluwa A , Onipede Antony O 
Published: March 2023

ABSTRACT

Background
The intestinal microbiota of neonates can be colonised by extended-spectrum β-lactamase-producing Enterobacteriales (ESBL-PE) with the risks of subsequent infections. The antimicrobial resistance profile of the gut flora of neonates is not well defined in Nigeria. This study determined the burden of rectal carriage of ESBL-PE among neonates.

Methods
We conducted a prospective longitudinal study among neonates admitted into a tertiary hospital from September 2019 to November 2019. Stools were sampled at admission and weekly until exit and processed by standard laboratory methods including polymerase chain reaction to identify ESBL genes. The ESBL-PE colonisation period prevalence at admission and acquisition rate were determined.

Results
The period prevalence of the ESBL-PE colonisation and acquisition rate were 46.5% (59/127) and 34.6% (36/104), respectively. Prolonged rupture of the amniotic membrane (PROM; &gt;24 h; p=0.004, odds ratio [OR] 0.297), number of neonates on admission in the same room (p&lt;0.001, OR 0.053) and presence of an ESBL-PE colonisers (p=0.004, OR 0.272) were independent risk factors for ESBL-PE rectal colonisation. ESBL-PE colonisation did not correlate with mortality (Fisher's exact test 1.342, p=0.196).

Conclusions
The rate of ESBL-PE neonatal rectal colonisation is high in our settings and this underscores the need for a review of neonatal admission protocols, embracing of antibiotic stewardship in the management of PROM, resistance surveillance and implementation of infection prevention and control in the neonatal unit.
Abnormally Increased Effective Connectivity of the Periaqueductal Gray in Migraine Without Aura Patients
Authors: Liu Kun , Cheng Jinming , Cao Yungang , Chen Keyang , Li Yan , Zhang Xi , Dong LiPeng , Wang Zhihong , Liu Xiaozheng 
Published: March 2023

Objectives:
The periaqueductal gray (PAG) is a key region in the descending pain modulatory system. We applied a Granger causality analysis-based approach to examine resting-state effective connectivity of the bilateral PAG regions in migraine patients without aura (MwoA).

Materials and Methods:
Resting-state functional magnetic resonance imaging data were obtained from 28 MwoA patients and 17 healthy controls. The effective connectivity of the bilateral PAG was characterized using a voxel-wised Granger causality analysis method. The resulting effective connectivity measurements were assessed for correlations with other clinical features.

Results:
Compared with the healthy controls, MwoA patients showed increased effective connectivity from the left PAG to the left anterior cingulate gyrus and right postcentral gyrus. Meanwhile, MwoA patients also showed increased effective connectivity from the right PAG to the left precentral gyrus and increased effective connectivity from the left caudate and right middle occipital gyrus to the right PAG.

Discussion:
Abnormally increased effective connectivity between PAG and limbic system, primary sensorimotor cortex, and visual cortex may play a key role in neuropathological features, perception, and affection of MwoA. The current study provides further insights into the complex scenario of MwoA mechanisms.
Anesthesiology Performance Improvement and Reporting Exchange (ASPIRE) Quality Metrics in Patients Undergoing Decompressive Craniectomy and Endoscopic Clot Evacuation after Spontaneous Supratentorial Intracerebral Hemorrhage: A Retrospective Observational Study
Authors: Lele Abhijit V. , Fong Christine T. , Newman Shu-Fang , O’Reilly-Shah Vikas , Walters Andrew M. , Athiraman Umeshkumar , Souter Michael J. , Levitt Michael R. , Vavilala Monica S. 
Published: March 2023

Background:
We report adherence to 6 Anesthesiology Performance Improvement and Reporting Exchange (ASPIRE) quality metrics (QMs) relevant to patients undergoing decompressive craniectomy or endoscopic clot evacuation after spontaneous supratentorial intracerebral hemorrhage (sICH).

Methods:
In this retrospective observational study, we describe adherence to the following ASPIRE QMs: acute kidney injury (AKI-01); mean arterial pressure < 65 mm Hg for less than 15 minutes (BP-03); myocardial injury (CARD-02); treatment of high glucose (> 200 mg/dL, GLU-03); reversal of neuromuscular blockade (NMB-02); and perioperative hypothermia (TEMP-03).

Result:
The study included 95 patients (70% male) with median (interquartile range) age 55 (47 to 66) years and ICH score 2 (1 to 3) undergoing craniectomy (n=55) or endoscopic clot evacuation (n=40) after sICH. In-hospital mortality attributable to sICH was 23% (n=22). Patients with American Society of Anesthesiologists physical status class 5 (n=16), preoperative reduced glomerular filtration rate (n=5), elevated cardiac troponin (n=21) and no intraoperative labs with high glucose (n=71), those who were not extubated at the end of the case (n=62) or did not receive a neuromuscular blocker given (n=3), and patients having emergent surgery (n=64) were excluded from the analysis for their respective ASPIRE QM based on predetermined ASPIRE exclusion criteria. For the remaining patients, the adherence to ASPIRE QMs were: AKI-01, craniectomy 34%, endoscopic clot evacuation 1%; BP-03, craniectomy 72%, clot evacuation 73%; CARD-02, 100% for both groups; GLU-03, craniectomy 67%, clot evacuation 100%; NMB-02, clot evacuation 79%, and; TEMP-03, clot evacuation 0% with hypothermia.

Conclusion:
This study found variable adherence to ASPIRE QMs in sICH patients undergoing decompressive craniectomy or endoscopic clot evacuation. The relatively high number of patients excluded from individual ASPIRE metrics is a major limitation.
Inflammatory eye disease for rheumatologists
Authors: Corbitt Kelly , Nowatzky Johannes 
Published: March 2023

Purpose of reviewThis review provides a framework for understanding inflammatory eye disease diagnosis, differential diagnosis, and management for rheumatologists. Uveitis, scleritis, episcleritis, peripheral ulcerative keratitis, and orbital inflammation are all discussed. The goal is to facilitate the development of approaches to inflammatory eye diseases that will help rheumatologists co-manage these patients with eye care providers specializing in ocular inflammation.Recent findingsIn recent years, studies have aimed to advance biologic treatments and define standard-of-care therapy. Inflammatory eye diseases are highly heterogeneous and often rare, which poses significant challenges to their research and the interpretation of existing data. To date, glucocorticoids, mycophenolate, methotrexate, and TNF inhibitors remain the mainstay of treatment options for many of these diseases.SummaryPatients with inflammatory eye diseases require multidisciplinary care for best outcomes, frequently including rheumatologists. Understanding the differentials, diagnostics, and treatment are essential to preserving vision in these patients. The diverse nature of the disease processes within this field requires focusing on specific disease phenotypes and endotypes in research and clinical practice.
Study Quality and Patient Inclusion in Geriatric Orthopaedic Trauma Research: A Scoping Review
Authors: Schuijt Henk Jan , McCormick Brian. P. , Webb Alexander. R. , Fortier Luc M. , von Keudell Arvind , Weaver Michael J. 
Published: March 2023

Objectives:
To evaluate the quality of evidence published in geriatric traumatology, to investigate how many studies include patients with cognitive impairment, and to investigate which methods are used to determine cognitive impairment.

Data Sources:
A search was conducted in PubMed for all publications in English in 154 selected journals between 01/01/2017 and 01/01/2020.

Study Selection:
Clinical studies investigating patients 65 years of age and older with fractures in the appendicular skeleton or pelvis were included.

Data Extraction:
Two independent reviewers performed full-text screening and data extraction for all articles.

Data Synthesis:
A comparative analysis was performed for prospective cohort studies and RCTs. The results are discussed in a narrative review.

Conclusions:
A total of 2711 publications were screened for eligibility, and after exclusion, a total of 723 articles were included. There is a focus on retrospective studies investigating mortality and complications. Studies are often small in sample size, and there are relatively few prospective studies, RCT studies, patient-reported outcomes, and quality of life. Patients with cognitive impairment are selectively excluded from clinical studies, and no consensus exists on how cognitive impairment is diagnosed. This review identified pitfalls and provides recommendations to navigate these issues for future studies. Many studies exclude cognitively impaired patients, which may result in selection bias and inability to extrapolate results. The lack of use of objective measures to define cognitive impairment and lack appropriate outcome measures for the cognitively impaired is an important issue that needs to be addressed in future research.
Extracorporeal Carbon Dioxide Removal With the Hemolung in Patients With Acute Respiratory Failure: A Multicenter Retrospective Cohort Study*
Authors: Tiruvoipati Ravindranath , Akkanti Bindu , Dinh Kha , Barrett Nicholas , May Alexandra , Kimmel Jeremy , Conrad Steven A. 
Published: March 2023

Objectives:
Extracorporeal carbon dioxide removal (ECCO2R) devices are effective in reducing hypercapnia and mechanical ventilation support but have not been shown to reduce mortality. This may be due to case selection, device performance, familiarity, or the management. The objective of this study is to investigate the effectiveness and safety of a single ECCO2R device (Hemolung) in patients with acute respiratory failure and identify variables associated with survival that could help case selection in clinical practice as well as future research.

Design:
Multicenter, multinational, retrospective review.

Setting:
Data from the Hemolung Registry between April 2013 and June 2021, where 57 ICUs contributed deidentified data.

Patients:
Patients with acute respiratory failure treated with the Hemolung. The characteristics of patients who survived to ICU discharge were compared with those who died. Multivariable logistical regression analysis was used to identify variables associated with ICU survival.

Interventions:
None.

Measurements and Main Results:
Of the 159 patients included, 65 (41%) survived to ICU discharge. The survival was highest in status asthmaticus (86%), followed by acute respiratory distress syndrome (ARDS) (52%) and COVID-19 ARDS (31%). All patients had a significant reduction in Paco
2 and improvement in pH with reduction in mechanical ventilation support. Patients who died were older, had a lower Pao
2:Fio
2 (P/F) and higher use of adjunctive therapies. There was no difference in the complications between patients who survived to those who died. Multivariable regression analysis showed non-COVID-19 ARDS, age less than 65 years, and P/F at initiation of ECCO2R to be independently associated with survival to ICU discharge (P/F 100–200 vs <100: odds ratio, 6.57; 95% CI, 2.03–21.33).

Conclusions:
Significant improvement in hypercapnic acidosis along with reduction in ventilation supports was noted within 4 hours of initiating ECCO2R. Non-COVID-19 ARDS, age, and P/F at commencement of ECCO2R were independently associated with survival.
Barriers and facilitators related to COVID-19 vaccine acceptance and uptake among people living with HIV
Authors: Krause Kristen D. , Pérez-Figueroa Rafael E. , Halkitis Perry N. 
Published: March 2023

Purpose of review
This review reports on the myriad barriers and facilitators related to COVID-19 vaccine hesitancy and factors contribution to uptake among people living with HIV (PLWH) globally published over the past year (2021–2022).

Recent findings
Across the literature, participants indicated concerns about the safety, efficacy and overall rapid development of the COVID-19 vaccine as a reason for delaying or not being vaccinated. Medical mistrust and perceptions about the risk of COVID-19 immune response and severity also played a role in COVID-19 vaccine hesitancy among PLWH. Almost every study examined different sociodemographic characteristics associated with COVID-19 vaccination acceptance and uptake, and although strong themes emerged around race/ethnicity, sex and educational attainment, the results were mixed across other characteristics, including age. Some studies also examined medical factors specifically related to PLWH including CD4+ cell count and adherence to antiretroviral therapy.

Summary
The findings highlight individual, structural and social differences in COVID-19 vaccine acceptance and uptake among PLWH, which are varied throughout the world. We call on researchers and interventionists to not just consider the role of medical mistrust and disinformation, but also how emotional, financial and political vulnerability plays into making decisions around COVID-19 vaccine uptake and overall healthcare.
Surgical Subcision for Acne Scars: A Review of Instrumentation
Authors: Lobo Yolanka , Lim Davin S. 
Published: March 2023

BACKGROUND
Subcision is a surgical technique for managing atrophic acne scars. Over time, new instruments have emerged to increase the efficiency, efficacy, and safety of the subcision procedure, including sharp, blunt, and energy-assisted devices.

OBJECTIVE
To review the instrumentation used for the subcision of acne scars and to provide clinicians with practical information regarding the selection of instrumentation, with a focus on advantages and disadvantages.

METHODS
A search of PubMed, MEDLINE, and Google Scholar was conducted for articles from January 2000 to June 2022 describing the use of subcision alone for the management of acne scarring. Demographic and clinical data were collected from the included articles.

RESULTS
A total of 417 patients from 17 articles were included; 155 patients underwent sharp subcision, 235 patients underwent blunt subcision, and 27 patients underwent energy-assisted subcision. The main indication for subcision was atrophic facial acne scars. Subcision using sharp, blunt, and energy-assisted instruments were all effective in treating atrophic acne scars. Adverse effects common to all subcision methods included erythema and edema.

CONCLUSION
Subcision is a safe and effective modality for the revision of selected acne scars and is a valuable skill set for dermatologists who perform scar revision to master.
Changes in Opioid and Benzodiazepine Poisoning Deaths After Cannabis Legalization in the US: A County-level Analysis, 2002–2020
Authors: Castillo-Carniglia Alvaro , Rivera-Aguirre Ariadne , Santaella-Tenorio Julian , Fink David S. , Crystal Stephen , Ponicki William , Gruenewald Paul , Martins Silvia S. , Keyes Katherine M. , Cerdá Magdalena 
Published: March 2023

Background:
Cannabis legalization for medical and recreational purposes has been suggested as an effective strategy to reduce opioid and benzodiazepine use and deaths. We examined the county-level association between medical and recreational cannabis laws and poisoning deaths involving opioids and benzodiazepines in the US from 2002 to 2020.

Methods:
Our ecologic county-level, spatiotemporal study comprised 49 states. Exposures were state-level implementation of medical and recreational cannabis laws and state-level initiation of cannabis dispensary sales. Our main outcomes were poisoning deaths involving any opioid, any benzodiazepine, and opioids with benzodiazepines. Secondary analyses included overdoses involving natural and semi-synthetic opioids, synthetic opioids, and heroin.

Results:
Implementation of medical cannabis laws was associated with increased deaths involving opioids (rate ratio [RR] = 1.14; 95% credible interval [CrI] = 1.11, 1.18), benzodiazepines (RR = 1.19; 95% CrI = 1.12, 1.26), and opioids+benzodiazepines (RR = 1.22; 95% CrI = 1.15, 1.30). Medical cannabis legalizations allowing dispensaries was associated with fewer deaths involving opioids (RR = 0.88; 95% CrI = 0.85, 0.91) but not benzodiazepine deaths; results for recreational cannabis implementation and opioid deaths were similar (RR = 0.81; 95% CrI = 0.75, 0.88). Recreational cannabis laws allowing dispensary sales was associated with consistent reductions in opioid- (RR = 0.83; 95% CrI = 0.76, 0.91), benzodiazepine- (RR = 0.79; 95% CrI = 0.68, 0.92), and opioid+benzodiazepine-related poisonings (RR = 0.83; 95% CrI = 0.70, 0.98).

Conclusions:
Implementation of medical cannabis laws was associated with higher rates of opioid- and benzodiazepine-related deaths, whereas laws permitting broader cannabis access, including implementation of recreational cannabis laws and medical and recreational dispensaries, were associated with lower rates. The estimated effects of the expanded availability of cannabis seem dependent on the type of law implemented and its provisions.