bluuebunny/crossref_metadata_2025_split huggingface dataset:
An Investigation of Latex Sensitivity and Respiratory Complaints in Workers in a Rubber-Based Material Manufacturing Industry
Authors: Elverişli Mehmet Fatih , Yildiz Gülhan Pinar , Mungan Dilşad , Erçelik Merve , Şahin İbrahim Ethem , Güleç Balbay Ege , Çoban Seyit , Karav Halil Mehmet , Arbak Peri Meram 
Published: March 2023

Objective
To present study aimed to investigate the prevalence of latex sensitivity in a workplace that produced rubber-based vehicle seals.

Method
The serum latex-specific IgE levels, respiratory complaints, PFT, serum interleukin (IL)-4, IL-5, IL-8, IL-10, IL-13 levels of all male workers (n = 108) exposed to latex in the workplace, which produced rubber seals, were compared with the control group (n = 52).

Results
The rates of latex-specific IgE >0.10 kU/L in the workers and control group were 12.3% and 4.1%, respectively (P = 0.147). There was no difference in IL-4, IL-5, IL-10, and IL-13 levels between latex-specific IgE-positive, and -negative participants.

Conclusion
Latex sensitivity was higher in workers who used rubber as a raw material than in the control group but it was not statistically significant.
Prophylactic acid suppression and enteral nutrition
Authors: Barletta Jeffrey F. 
Published: March 2023

Purpose of review
Stress ulcer prophylaxis (SUP) is routinely administered to critically ill patients who are at high-risk for clinically important gastrointestinal bleeding. Recent evidence however has highlighted adverse effects with acid suppressive therapy, particularly proton pump inhibitors where associations with higher mortality have been reported. Enteral nutrition may provide benefits in reducing the incidence of stress ulceration and may mitigate the need for acid suppressive therapy. This manuscript will describe the most recent evidence evaluating enteral nutrition for the provision of SUP.

Recent findings
There are limited data evaluating enteral nutrition for SUP. The available studies compare enteral nutrition with or without acid suppressive therapy rather than enteral nutrition vs. placebo. Although data exist demonstrating similar clinically important bleeding rates in patients on enteral nutrition who receive SUP vs. no SUP, these studies are underpowered for this endpoint. In the largest placebo-controlled trial conducted to date, lower bleeding rates were observed with SUP and most patients were receiving enteral nutrition. Pooled analyses had also described benefit with SUP vs. placebo and enteral nutrition did not change the impact of these therapies.

Summary
Although enteral nutrition may provide some benefit as SUP, existing data are not strong enough to validate their use in place of acid suppressive therapy. Clinicians should continue to prescribe acid suppressive therapy for SUP in critically ill patients who are at high risk for clinically important bleeding even when enteral nutrition is being provided.
Disparities in Telemedicine Use Among Louisiana Medicaid Beneficiaries During the COVID-19 Pandemic
Authors: Callison Kevin , Anderson Andrew , Shao Yixue , LaVeist Thomas A. , Walker Brigham 
Published: March 2023

Background:The COVID-19 pandemic led to an increased reliance on telemedicine. Whether this exacerbated existing disparities within vulnerable populations is not yet known.Objectives:Characterize changes in outpatient telemedicine evaluation and management (E&M) services for Louisiana Medicaid beneficiaries by race, ethnicity, and rurality during the COVID-19 pandemic.Research Design:Interrupted time series regression models estimated pre-COVID-19 trends and changes in E&M service use at the April and July 2020 peaks in COVID-19 infections in Louisiana and in December 2020 after those peaks had subsided.Subjects:Louisiana Medicaid beneficiaries continuously enrolled between January 2018 and December 2020 who were not also enrolled in Medicare.Measures:Monthly outpatient E&M claims per 1000 beneficiaries.Results:Prepandemic differences in service use between non-Hispanic White and non-Hispanic Black beneficiaries narrowed by 34% through December 2020 (95% CI: 17.6%–50.6%), while differences between non-Hispanic White and Hispanic beneficiaries increased by 10.5% (95% CI: 0.1%–20.7%). Non-Hispanic White beneficiaries used telemedicine at higher rates than non-Hispanic Black (difference=24.9 claims per 1000 beneficiaries, 95% CI: 22.3–27.4) and Hispanic beneficiaries (difference=42.3 claims per 1000 beneficiaries, 95% CI: 39.1–45.5) during the first wave of COVID-19 infections in Louisiana. Telemedicine use increased slightly for rural beneficiaries compared with urban beneficiaries (difference=5.3 claims per 1000 beneficiaries, 95% CI: 4.0–6.6).Conclusions:The COVID-19 pandemic narrowed gaps in outpatient E&M service use between non-Hispanic White and non-Hispanic Black Louisiana Medicaid beneficiaries, though gaps in telemedicine use emerged. Hispanic beneficiaries experienced large reductions in service use and relatively small increases in telemedicine use.
Virtual Care and Urinary Tract Infection Management
Authors: Gander Jennifer C. , Goodrich Glenn , McDonald Bennet , McCracken Courtney E. , Tavel Heather M. , Davis Teaniese L. , Weinfield Nancy S. , Ritzwoller Debra P. , Roblin Douglas W. 
Published: March 2023

Background:
During the COVID-19 pandemic, more health care issues were being managed remotely. Urinary tract infections (UTIs) are being managed more often using telehealth although few reports compare the rate of UTI ancillary service orders placed and fulfilled during these visits.

Objectives:
We aimed to evaluate and compare the rate of ancillary service orders and order fulfillments in incident UTI diagnoses between virtual and in-person encounters.

Research Design:
The retrospective cohort study involved 3 integrated health care systems: Kaiser Permanente (KP) Colorado, KP Georgia, and KP Mid-Atlantic States.

Subjects:
We included incident UTI encounters from adult primary care data from January 2019 to June 2021.

Measures:
Data were categorized as: prepandemic (January 2019–March 2020), COVID-19 Era 1 (April 2020–June 2020), and COVID-19 Era 2 (July 2020–June 2021). UTI-specific ancillary services included medication, laboratory, and imaging. Orders and order fulfillments were dichotomized for analyses. Weighted percentages for orders and fulfillments were calculated using inverse probability treatment weighting from logistic regression and compared between virtual and in-person encounters using χ2 tests.

Results:
We identified 123,907 incident encounters. Virtual encounters increased from 13.4% prepandemic to 39.1% in COVID-19 Era 2. Ancillary service orders from virtual encounters were not placed as often as in-person encounters. However, the weighted percentage for ancillary service order fulfillment across all services remained above 65.3% across sites and eras, with many fulfillment percentages above 90%.

Conclusions:
Our study reported a high rate of order fulfillment for both virtual and in-person encounters. Health care systems should encourage providers to place ancillary service orders for uncomplicated diagnoses, such as UTI, to provide enhanced access to patient-centered care.
Racial and Ethnic Segregation in Primary Care and Association of Practice Composition With Quality of Care
Authors: Ding Dong , Zhu Benjamin , Glied Sherry 
Published: March 2023

Objective:
To assess the extent of segregation between racial and ethnic minority and White patients across primary care physicians and the association of practice panel racial/ethnic composition with the quality of care delivered.

Research Design:
We examined the degree of racial/ethnic dissimilarity (a measure of segregation) in visits and the allocation of patient visits by different groups across primary care physicians (PCPs). We assessed the regression-adjusted relationship between the racial/ethnic composition of PCP practices and measures of the quality of care delivered. We compared outcomes in the pre-Affordable Care Act (ACA) and post-ACA (2006–2010/2011–2016) periods.

Subjects:
We analyzed data on all primary care visits to office-based practitioners in the 2006–2016 National Ambulatory Medical Care Survey. PCPs were defined as general/family practice or internal medicine physicians. We excluded cases with imputed race or ethnicity information. For the quality of care analyses, we limited the sample to adults.

Results:
Racial and ethnic minority patients remain concentrated within a small group of PCPs: 35% of PCPs accounted for 80% of non-White patients’ visits; 63% of non-White (or White) patients would need to switch physicians to make the distribution of visits across PCPs proportional between the groups. We observed little correlation between the PCPs panel’s racial/ethnic composition and quality of care. These patterns did not change substantially over time.

Conclusions:
PCPs remain segregated, but the racial/ethnic composition of a practice panel is not associated with the quality of health care that individual patients receive in either the pre or post-ACA passage periods.
Using Explainable Artificial Intelligence to Predict Potentially Preventable Hospitalizations
Authors: Riis Anders Hammerich , Kristensen Pia Kjær , Lauritsen Simon Meyer , Thiesson Bo , Jørgensen Marianne Johansson 
Published: March 2023

Background:
The increasing aging population and limited health care resources have placed new demands on the healthcare sector. Reducing the number of hospitalizations has become a political priority in many countries, and special focus has been directed at potentially preventable hospitalizations.

Objectives:
We aimed to develop an artificial intelligence (AI) prediction model for potentially preventable hospitalizations in the coming year, and to apply explainable AI to identify predictors of hospitalization and their interaction.

Methods:
We used the Danish CROSS-TRACKS cohort and included citizens in 2016-2017. We predicted potentially preventable hospitalizations within the following year using the citizens’ sociodemographic characteristics, clinical characteristics, and health care utilization as predictors. Extreme gradient boosting was used to predict potentially preventable hospitalizations with Shapley additive explanations values serving to explain the impact of each predictor. We reported the area under the receiver operating characteristic curve, the area under the precision-recall curve, and 95% confidence intervals (CI) based on five-fold cross-validation.

Results:
The best performing prediction model showed an area under the receiver operating characteristic curve of 0.789 (CI: 0.782–0.795) and an area under the precision-recall curve of 0.232 (CI: 0.219–0.246). The predictors with the highest impact on the prediction model were age, prescription drugs for obstructive airway diseases, antibiotics, and use of municipality services. We found an interaction between age and use of municipality services, suggesting that citizens aged 75+ years receiving municipality services had a lower risk of potentially preventable hospitalization.

Conclusion:
AI is suitable for predicting potentially preventable hospitalizations. The municipality-based health services seem to have a preventive effect on potentially preventable hospitalizations.
Development of a Common Data Model for a Multisite and Multiyear Study of Virtual Visit Implementation
Authors: Roblin Douglas W. , Rubenstein Kevin B. , Tavel Heather M. , Goodrich Glenn K. , Ritzwoller Debra P. , Certa Julia M. , Basra Sundeep S. , Weinfield Nancy S. , Cromwell Lee A. , McDonald Bennett , Davis Teaniese L. , Gander Jennifer C. , McCracken Courtney E. 
Published: March 2023

Background/Objective:
In multisite studies, a common data model (CDM) standardizes dataset organization, variable definitions, and variable code structures and can support distributed data processing. We describe the development of a CDM for a study of virtual visit implementation in 3 Kaiser Permanente (KP) regions.

Methods:
We conducted several scoping reviews to inform our study’s CDM design: (1) virtual visit mode, implementation timing, and scope (targeted clinical conditions and departments); and (2) extant sources of electronic health record data to specify study measures. Our study covered the period from 2017 through June 2021. Integrity of the CDM was assessed by a chart review of random samples of virtual and in-person visits, overall and by specific conditions of interest (neck or back pain, urinary tract infection, major depression).

Results:
The scoping reviews identified a need to address differences in virtual visit programs across the 3 KP regionsto harmonize measurement specifications for our research analyses. The final CDM contained patient-level, provider-level, and system-level measures on 7,476,604 person-years for KP members aged 19 years and above. Utilization included 2,966,112 virtual visits (synchronous chats, telephone visits, video visits) and 10,004,195 in-person visits. Chart review indicated the CDM correctly identified visit mode on>96% (n=444) of visits, and presenting diagnosis on >91% (n=482) of visits.

Conclusions:
Upfront design and implementation of CDMs may be resource intensive. Once implemented, CDMs, like the one we developed for our study, provide downstream programming and analytic efficiencies by harmonizing, in a consistent framework, otherwise idiosyncratic temporal and study site differences in source data.
What are the best indicators of myoelectric manifestation of fatigue?
Authors: Fegni Ndam Elvige Ornella , Goubault Étienne , Moyen-Sylvestre Béatrice , Côté Julie N. , Bouffard Jason , Maso Fabien Dal 
Published: March 2023

AbstractThe myoelectric manifestation of fatigue (MMF) is predominantly assessed using median frequency and amplitude of electromyographic (EMG) signals. However, EMG has complex features so that fractals, correlation, entropy, and chaos MMF indicators were introduced to detect alteration of EMG features caused by muscle fatigue that may not be detected by linear indicators. The aim of this study was to determine the best MMF indicators. Twenty-four participants were equipped with EMG sensors on 9 shoulder muscles and performed a repetitive pointing task. They reported their rate of perceived exertion every 30 seconds and were stopped when they reached 8 or higher on the CR10 Borg scale. Partial least square regression was used to predict perceived exertion through 15 MMF indicators. In addition, the proportion of participants with a significant change between task initiation and termination was determined for each MMF indicator and muscle. The PLSR model explained 73% of the perceived exertion variance. Median frequency, mobility, spectral entropy, fuzzy entropy, and Higuchi fractal dimension had the greatest importance to predict perceived exertion and changed for 83.5% participants on average between task initiation and termination for the anterior and medial deltoids. The amplitude, activity, approximate, sample, and multiscale entropy, degree of multifractality, percent determinism and recurrent, correlation dimension, and largest Lyapunov exponent analysis MMF indicators were not efficient to assess MMF. Mobility, spectral entropy, fuzzy entropy, and Higuchi fractal dimension should be further considered to assess muscle fatigue and their combination with median frequency may further improve the assessment of muscle fatigue.
Computation of longitudinal phenotypes in 466 individuals with a developmental and epileptic encephalopathy enables clinical trial readiness
Authors: Brimble Elise , Kim Joseph , Martin Richard L. , McKnight Dianalee , Lacoste Alix M. B. 
Published: March 2023

AbstractElectronic health records (EHRs) represent a rich data source to support precision medicine, particularly in disorders with small and heterogeneous populations where longitudinal phenotypes are poorly characterized. However, the impact of EHR data is often limited by incomplete or imperfect source documentation and the inability to leverage unstructured data. Here, we address these shortcomings through a computational analysis of one of the largest cohorts of developmental and epileptic encephalopathies (DEEs), representing 466 individuals across six genetically defined conditions. The DEEs encompass debilitating pediatric-onset disorders with high unmet needs for which treatment development is ongoing. By applying a platform approach to data curation and annotation of 18 clinical data entities from comprehensive medical records, we characterize variation in longitudinal clinical journeys. Assessments of the relative enrichment of phenotypes and semantic similarity analysis highlight commonalities and differences between the six cohorts. Evaluation of medication use reflects unmet needs, particularly in the management of movement disorders. We also present a novel composite measure of seizure severity that is more robust than existing measures of seizure frequency alone. Finally, we show that the attainment of developmental outcomes, including the ability to sit independently and the ability to walk, is correlated with seizure severity scores. Overall, the combined analyses demonstrate that patient-centric real world data generation, including structuring of medical records, holds promise to improve clinical trial success in rare disorders. Applications of this approach support improved understanding of baseline disease progression, selection of relevant endpoints, and definition of inclusion and exclusion criteria.
Values and Preferences Related to Workplace Mental Health Programs and Interventions: An International Survey
Authors: Murphy J.K. , Noble J.M. , Chakraborty P.A. , Michlig G. , Michalak E.E , Greenshaw A.J. , Lam R.W. 
Published: March 2023

AbstractIntroductionThis study explores the perspectives of workers and managers on workplace programs and interventions that seek to promote mental wellbeing, and prevent and treat mental health conditions The results contributed supporting evidence for the development of the WHO’s first global guidelines for mental health and work, which provide evidence-based recommendations to support the implementation of workplace mental health programs and supports, to improve their acceptability, appropriateness, and uptake.MethodsA survey was used to examine the values and preferences among workers and employers related to workplace mental health prevention, protection, promotion, and support programs and services. The survey was made available in English, French, and Spanish. Descriptive statistics were used to analyse the survey data. Rapid thematic analysis was used to analyse the results of qualitative questions.ResultsThese results provide a unique international perspective on programs and supports for mental health at work, from the standpoint of employees, including managers. Results suggest that employees value interventions developed in consultation with workers (including indicated, selective and universal interventions), increased training and capacity building among managers, and targeted interventions to address the pervasive impact of stigma on perceptions about mental health at work and help-seeking. The findings of this study seek to reflect the perspectives of workers, including managers, and therein to promote improved access, availability and uptake of mental health programs and supports at work and – ultimately- to support the potential of workplaces as environments that promote and support mental health.
Immune Microenvironment Profiling of Normal Appearing Colorectal Mucosa Biopsied Over Repeat Patient Visits Reproduciably Separates Lynch Syndrome Patients Based on Their History of Colon Cancer
Authors: Brand Rhonda M. , Dudley Beth , Karloski Eve , Zyhowski Ashley , Raphael Rebecca , Pitlor Danielle , Metter E. Jeffrey , Pai Reet , Lee Kenneth , Brand Randall E. , Uttam Shikhar 
Published: March 2023

AbstractIntroductionLynch syndrome (LS) is the most common hereditary cause of colorectal cancer (CRC), increasing lifetime risk of CRC by up to 70%. Despite this higher lifetime risk, disease penetrance in LS patients is highly variable and most LS patients undergoing CRC surveillance will not develop CRC. Therefore, biomarkers that can correctly and consistently predict CRC risk in LS patients are needed to both optimize LS patient surveillance and help identify better prevention strategies that reduce risk of CRC development in the subset of high-risk LS patients.MethodsNormal-appearing colorectal tissue biopsies were obtained during repeat surveillance colonoscopies of LS patients with and without a history of CRC, healthy controls (HC), and patients with a history of sporadic CRC. Biopsies were cultured in anex-vivoexplant system and their supernatants were assayed via multiplexed ELISA to profile the local immune signaling microenvironment. High quality cytokine signatures were identified usingrxCOV fidelity metric. These signatures were used to perform biomarker selection by computing their selection probability based on penalized logistic regression.ResultsOur study demonstrated that cytokine based local immune microenvironment profiling was reproducible over repeat visits and sensitive to patient LS-status and CRC history. Furthermore, we identified sets of biomarkers whose differential expression was predictive of LS-status in patients when compared to sporadic CRC patients and in identifying those LS patients with or without a history of CRC. Enrichment analysis based on these biomarkers revealed an LS and CRC status dependent constitutive inflammatory state of the normal appearing colonic mucosa.DiscussionThis prospective pilot study demonstrated that immune profiling of normal appearing colonic mucosa discriminates LS patients with a prior history of CRC from those without it, as well as patients with a history of sporadic CRC from HC. Importantly, it suggests existence of immune signatures specific to LS-status and CRC history. We anticipate that our findings have the potential to assess CRC risk in individuals with LS and help in preemptively mitigating it by optimizing surveillance and identifying candidate prevention targets. Further studies are required to validate our findings in an independent cohort of LS patients over multiple visits.
Targeted therapies prime oncogene-driven lung cancers for macrophage-mediated destruction
Authors: Vaccaro Kyle , Allen Juliet , Whitfield Troy W. , Maoz Asaf , Reeves Sarah , Velarde José , Yang Dian , Phan Nicole , Bell George W. , Hata Aaron N. , Weiskopf Kipp 
Published: March 2023

AbstractMacrophage immune checkpoint inhibitors, such as anti-CD47 antibodies, show promise in clinical trials for solid and hematologic malignancies. However, the best strategies to use these therapies remain unknown and ongoing studies suggest they may be most effective when used in combination with other anticancer agents. Here, we developed a novel screening platform to identify drugs that render lung cancer cells more vulnerable to macrophage attack, and we identified therapeutic synergy exists between genotype-directed therapies and anti-CD47 antibodies. In validation studies, we found the combination of genotype-directed therapies and CD47 blockade elicited robust phagocytosis and eliminated persister cells in vitro and maximized anti-tumor responses in vivo. Importantly, these findings broadly applied to lung cancers with various RTK/MAPK pathway alterations—includingEGFRmutations,ALKfusions, orKRASG12Cmutations. We observed downregulation of β2-microglobulin and CD73 as molecular mechanisms contributing to enhanced sensitivity to macrophage attack. Our findings demonstrate that dual inhibition of the RTK/MAPK pathway and the CD47/SIRPa axis is a promising immunotherapeutic strategy. Our study provides strong rationale for testing this therapeutic combination in patients with lung cancers bearing driver mutations.Brief summaryUnbiased drug screens identify targeted therapies as drugs that make lung cancers with driver mutations more vulnerable to macrophage attack.