bluuebunny/crossref_metadata_2025_split huggingface dataset:
Telemedicine Impact on the Patient–Provider Relationship in Primary Care During the COVID-19 Pandemic
Authors: Andreadis Katerina , Muellers Kimberly , Ancker Jessica S. , Horowitz Carol , Kaushal Rainu , Lin Jenny J. 
Published: March 2023

Background:
The COVID-19 pandemic has necessitated a rapid uptake of telemedicine in primary care requiring both patients and providers to learn how to navigate care remotely. This change can impact the patient–provider relationship that often defines care, especially in primary care.

Objective:
This study aims to provide insight into the experiences of patients and providers with telemedicine during the pandemic, and the impact it had on their relationship.

Research Design:
A qualitative study using thematic analysis of semistructured interviews.

Subjects:
Primary care providers (n=21) and adult patients (n=65) with chronic disease across primary care practices in 3 National Patient-centered Clinical Research Network sites in New York City, North Carolina, and Florida.

Measures:
Experiences with telemedicine during the COVID-19 pandemic in primary care. Codes related to the patient–provider relationship were analyzed for this study.

Results:
A recurrent theme was the challenge telemedicine posed on rapport building and alliance. Patients felt that telemedicine affected provider’s attentiveness in varying ways, whereas providers appreciated that telemedicine provided unique insight into patients’ lives and living situations. Finally, both patients and providers described communication challenges.

Conclusions:
Telemedicine has altered structure and process aspects of primary health care such as the physical spaces of encounters, creating a new setting to which both patients and providers must adjust. It is important to recognize the opportunities and limits that this new technology has to help providers maintain the type of one-on-one attention that patients expect and that contributes to relationship building.
Telehealth Use, Care Continuity, and Quality
Authors: Tierney Aaron A. , Payán Denise D. , Brown Timothy T. , Aguilera Adrian , Shortell Stephen M. , Rodriguez Hector P. 
Published: March 2023

Background:
Community health centers (CHCs) pivoted to using telehealth to deliver chronic care during the coronavirus COVID-19 pandemic. While care continuity can improve care quality and patients’ experiences, it is unclear whether telehealth supported this relationship.

Objective:
We examine the association of care continuity with diabetes and hypertension care quality in CHCs before and during COVID-19 and the mediating effect of telehealth.

Research Design:
This was a cohort study.

Participants:
Electronic health record data from 166 CHCs with n=20,792 patients with diabetes and/or hypertension with ≥2 encounters/year during 2019 and 2020.

Methods:
Multivariable logistic regression models estimated the association of care continuity (Modified Modified Continuity Index; MMCI) with telehealth use and care processes. Generalized linear regression models estimated the association of MMCI and intermediate outcomes. Formal mediation analyses assessed whether telehealth mediated the association of MMCI with A1c testing during 2020.

Results:
MMCI [2019: odds ratio (OR)=1.98, marginal effect=0.69, z=165.50, P<0.001; 2020: OR=1.50, marginal effect=0.63, z=147.73, P<0.001] and telehealth use (2019: OR=1.50, marginal effect=0.85, z=122.87, P<0.001; 2020: OR=10.00, marginal effect=0.90, z=155.57, P<0.001) were associated with higher odds of A1c testing. MMCI was associated with lower systolic (β=−2.90, P<0.001) and diastolic blood pressure (β=−1.44, P<0.001) in 2020, and lower A1c values (2019: β=−0.57, P=0.007; 2020: β=−0.45, P=0.008) in both years. In 2020, telehealth use mediated 38.7% of the relationship between MMCI and A1c testing.

Conclusions:
Higher care continuity is associated with telehealth use and A1c testing, and lower A1c and blood pressure. Telehealth use mediates the association of care continuity and A1c testing. Care continuity may facilitate telehealth use and resilient performance on process measures.
Spillover Effects of Prenatal Care Coordination on Older Siblings Beyond the Mother-Infant Dyad
Authors: Mallinson David C. , Elwert Felix , Ehrenthal Deborah B. 
Published: March 2023

Background:
Pregnancy care coordination increases preventive care receipt for mothers and infants. Whether such services affect other family members’ health care is unknown.

Objective:
To estimate the spillover effect of maternal exposure to Wisconsin Medicaid’s Prenatal Care Coordination (PNCC) program during pregnancy with a younger sibling on the preventive care receipt for an older child.

Research Design:
Gain-score regressions—a sibling fixed effects strategy—estimated spillover effects while controlling for unobserved family-level confounders.

Subjects:
Data came from a longitudinal cohort of linked Wisconsin birth records and Medicaid claims. We sampled 21,332 sibling pairs (one older; one younger) who were born during 2008-2015, who were <4 years apart in age, and whose births were Medicaid-covered. In all, 4773 (22.4%) mothers received PNCC during pregnancy with the younger sibling.

Measures:
The exposure was maternal PNCC receipt during pregnancy with the younger sibling (none; any). The outcome was the older sibling’s number of preventive care visits or preventive care services in the younger sibling’s first year of life.

Results:
Overall, maternal exposure to PNCC during pregnancy with the younger sibling did not affect older siblings’ preventive care. However, among siblings who were 3 to <4 years apart in age, there was a positive spillover on the older sibling’s receipt of care by 0.26 visits (95% CI: 0.11, 0.40 visits) and by 0.34 services (95% CI: 0.12, 0.55 services).

Conclusion:
PNCC may only have spillover effects on siblings’ preventive care in selected subpopulations but not in the broader population of Wisconsin families.
Enhanced Identification of Hispanic Ethnicity Using Clinical Data
Authors: Ochoa-Allemant Pedro , Tate Janet P. , Williams Emily C. , Gordon Kirsha S. , Marconi Vincent C. , Bensley Kara M.K. , Rentsch Christopher T. , Wang Karen H. , Taddei Tamar H. , Justice Amy C. ,   for the VA Family of EHR Cohorts (VACo Family)
Published: March 2023

Background:
Collection of accurate Hispanic ethnicity data is critical to evaluate disparities in health and health care. However, this information is often inconsistently recorded in electronic health record (EHR) data.

Objective:
To enhance capture of Hispanic ethnicity in the Veterans Affairs EHR and compare relative disparities in health and health care.

Methods:
We first developed an algorithm based on surname and country of birth. We then determined sensitivity and specificity using self-reported ethnicity from the 2012 Veterans Aging Cohort Study survey as the reference standard and compared this to the research triangle institute race variable from the Medicare administrative data. Finally, we compared demographic characteristics and age-adjusted and sex-adjusted prevalence of conditions in Hispanic patients among different identification methods in the Veterans Affairs EHR 2018-2019.

Results:
Our algorithm yielded higher sensitivity than either EHR-recorded ethnicity or the research triangle institute race variable. In 2018-2019, Hispanic patients identified by the algorithm were more likely to be older, had a race other than White, and foreign born. The prevalence of conditions was similar between EHR and algorithm ethnicity. Hispanic patients had higher prevalence of diabetes, gastric cancer, chronic liver disease, hepatocellular carcinoma, and human immunodeficiency virus than non-Hispanic White patients. Our approach evidenced significant differences in burden of disease among Hispanic subgroups by nativity status and country of birth.

Conclusions:
We developed and validated an algorithm to supplement Hispanic ethnicity information using clinical data in the largest integrated US health care system. Our approach enabled clearer understanding of demographic characteristics and burden of disease in the Hispanic Veteran population.
Management of Neck or Back Pain in Ambulatory Care
Authors: Roblin Douglas W. , Goodrich Glenn K. , Davis Teaniese L. , Gander Jennifer C. , McCracken Courtney E. , Weinfield Nancy S. , Ritzwoller Debra P. 
Published: March 2023

Background/Objective:
In recent years, 2 circumstances have changed provider-patient interactions in ambulatory care: (1) the replacement of virtual for in-person visits and (2) the COVID-19 pandemic. We studied the potential impact of each event on provider practice and patient adherence by comparing the frequency of the association of provider orders, and patient fulfillment of those orders, by visit mode and pandemic period, for incident neck or back pain (NBP) visits in ambulatory care.

Methods:
Data were extracted from the electronic health records of 3 Kaiser Permanente regions (Colorado, Georgia, and Mid-Atlantic States) from January 2017 to June 2021. Incident NBP visits were defined from ICD-10 coded as primary or first listed diagnoses on adult, family medicine, or urgent care visits separated by at least 180 days. Visit modes were classified as virtual or in-person. Periods were classified as prepandemic (before April 2020 or the beginning of the national emergency) or recovery (after June 2020). Percentages of provider orders for, and patient fulfillment of orders, were measured for 5 service classes and compared on: virtual versus in-person visits, and prepandemic versus recovery periods. Comparisons were balanced on patient case-mix using inverse probability of treatment weighting.

Results:
Ancillary services in all 5 categories at each of the 3 Kaiser Permanente regions were substantially ordered less frequently on virtual compared with in-person visits in both the prepandemic and recovery periods (both P ≤ 0.001). Conditional on an order, patient fulfillment within 30 days was high (typically ≥70%) and not likely meaningfully different between visit modes or pandemic periods.

Conclusions:
Ancillary services for incident NBP visits were ordered less frequently during virtual than in-person visits in both prepandemic and recovery periods. Patient fulfillment of orders was high, and not significantly different by mode or period.
Ustekinumab Use in Pediatric Inflammatory Bowel Disease: A French Multicenter Study From the Pediatric GETAID
Authors: Koudsi Mounzer , Martinez-Vinson Christine , Pigneur Bénédicte , Willot Stéphanie , Djamal Djeddi , Enaud Raphael , Rebeuh Julie , Dupont Claire , Dabadie Alain , Bertrand Valérie , Hugot Jean-Pierre , Lachaux Alain , Ruemmele Franck , Viala Jérôme , Duclaux-Loras Rémi , Pédiatrique GETAID 
Published: March 2023

Objectives:
Ustekinumab is known to be efficient in adult patients suffering from moderate to severe Crohn disease (CD) and ulcerative colitis (UC) resistant to anti-tumor necrosis factor-alpha (TNF-α). Here, we described the clinical course of treatment with ustekinumab in French pediatric inflammatory bowel disease (IBD) patients treated with ustekinumab.

Methods:
This study includes all pediatric patients treated by ustekinumab injection for IBD (CD and UC), between January 2016 and December 2019.

Results:
Fifty-three patients were enrolled, 15 males and 38 females. Forty-eight patients (90%) had a diagnosis of CD and 5 (9.4%) had UC. Sixty-five percent of CD patients presented an ileocolitis. Perineal disease was observed in 20 out of 48 CD patients (41.7%), among them 9 were treated surgically. All patients included were resistant to anti-TNF-α treatment. Fifty-one percent had presented side effects linked to anti-TNF-α, including psoriasis and anaphylactic reaction. The average Pediatric Crohn Disease Activity Index (PCDAI) at induction was 28.7 (5–85), 18.7 (0–75) at 3 months of treatment and 10 (0–35) at the last follow-up. The average Pediatric Ulcerative Colitis Activity Index at induction was 47 (25–65), 25 (15–40) at 3 months of treatment and 18.3 (0–35) at the last follow-up. No severe side effects were observed.

Conclusion:
In this retrospective, multicentral study, ustekinumab proved to be efficient in pediatric patients resistant to anti-TNF-α. PCDAI has been significantly improved in patients with severe disease, treated with ustekinumab.
In Silico Localization of Perilymph Proteins Enriched in Meńier̀e Disease Using Mammalian Cochlear Single-cell Transcriptomics
Authors: Arambula Alexandra M. , Gu Shoujun , Warnecke Athanasia , Schmitt Heike A. , Staecker Hinrich , Hoa Michael 
Published: March 2023

Hypothesis:
Proteins enriched in the perilymph proteome of Meńier̀e disease (MD) patients may identify affected cell types. Utilizing single-cell transcriptome datasets from the mammalian cochlea, we hypothesize that these enriched perilymph proteins can be localized to specific cochlear cell types.

Background:
The limited understanding of human inner ear pathologies and their associated biomolecular variations hinder efforts to develop disease-specific diagnostics and therapeutics. Perilymph sampling and analysis is now enabling further characterization of the cochlear microenvironment. Recently, enriched inner ear protein expression has been demonstrated in patients with MD compared to patients with other inner ear diseases. Localizing expression of these proteins to cochlear cell types can further our knowledge of potential disease pathways and subsequent development of targeted therapeutics.

Methods:
We compiled previously published data regarding differential perilymph proteome profiles amongst patients with MD, otosclerosis, enlarged vestibular aqueduct, sudden hearing loss, and hearing loss of undefined etiology (controls). Enriched proteins in MD were cross-referenced against published single-cell/single-nucleus RNA-sequencing datasets to localize gene expression to specific cochlear cell types.

Results:
In silico analysis of single-cell transcriptomic datasets demonstrates enrichment of a unique group of perilymph proteins associated with MD in a variety of intracochlear cells, and some exogeneous hematologic and immune effector cells. This suggests that these cell types may play an important role in the pathology associated with late MD, suggesting potential future areas of investigation for MD pathophysiology and treatment.

Conclusions:
Perilymph proteins enriched in MD are expressed by specific cochlear cell types based on in silico localization, potentially facilitating development of disease-specific diagnostic markers and therapeutics.
Post-ictal Rhythmic Thalamic Activity of the Centromedian Nucleus
Authors: Arredondo Kristen , Ostendorf Adam P. , Ahrens Stephanie , Beatty Christopher W. , Pindrik Jonathan , Shaikhouni Ammar 
Published: March 2023

Introduction:
Deep brain stimulation of the centromedian nucleus of the thalamus (CMN) to treat drug-resistant epilepsy has been of interest for decades. However, little is known about the electrophysiological activity of the CMN during seizures. We describe a novel CMN EEG finding associated with seizure: post-ictal rhythmic thalamic activity.

Methods:
Five patients with drug-resistant epilepsy of unknown etiology with focal onset seizures underwent stereoelectroencephalography monitoring as part of evaluation for potential resective surgery or neuromodulation. Two patients had previously undergone complete corpus callosotomy and vagus nerve stimulation. A standardized plan for implantation included targets in the bilateral CMN.

Results:
Each patient had frontal onset seizures, and two patients had additional insular, parietal, or mesial temporal onset seizures. Contacts of CMN were involved synchronously or rapidly after onset in most recorded seizures, particularly those with frontal onset. Focal onset hemiclonic and bilateral tonic–clonic seizures spread to involve cortical contacts with high-amplitude rhythmic spiking followed by abrupt offset with diffuse voltage attenuation. A post-ictal rhythmic 1.5 to 2.5 Hz delta frequency pattern, post-ictal rhythmic thalamic activity, emerged in CMN contacts amid the suppression of background activity in cortical contacts. In the two patients with corpus callosotomy, unilateral seizure spread and ipsilateral post-ictal rhythmic thalamic activity were observed.

Conclusions:
We observed post-ictal rhythmic thalamic activity in five patients with stereoelectroencephalography monitoring of the CMN with convulsive seizures. This rhythm appears late in ictal evolution and may signal an important role of the CMN in seizure termination. Furthermore, this rhythm may help identify CMN involvement in the epileptic network.
Clinical and microbiological characteristics of Chryseobacterium species isolates from bloodstream infections from a university hospital: a descriptive, retrospective study
Authors: Chaudhary Radhika , Kar Mitra , Jamwal Ashima , Dubey Akanksha , Singh Romya , Tejan Nidhi , Sahu Chinmoy , Patel Sangram Singh , Kumari Pooja , Ghar Malay 
Published: March 2023

Abstract
Introduction: Chryseobacterium species are emerging bacteria capable of causing nosocomial infections in immunocompromised patients or patients with indwelling medical devices.
Hypothesis/ Gap statement: Information about the incidence of Chryseobacterium bacteremia from worldwide literature is limited.
Aim: We aimed to recognize the clinical characteristics, frequency of distribution of different Chryseobacterium species isolates, and their antimicrobial susceptibility profile from bloodstream infections.
Methods: We performed a retrospective cohort study to identify all isolates of Chryseobacterium species from bloodstream infection from January 2018 to November 2022 at a university hospital in North India.
Results: We identified 42 non-duplicate isolates of Chryseobacterium species from bloodstream infection in the duration of our study. Mean age of the patients was 48.35 ± 16.63 years. Men (22/42, 52.2%) were more commonly affected in comparison to women (20/42, 47.6%) but the difference was not significant. The most common species identified was C.indologenes (40/42, 95.24%) followed by C. gleum (2/42, 4.76%). The co-morbidities commonly encountered in our study were chronic kidney disease (21/42, 50.0%) followed by diabetes mellitus (12/42, 28.6%) and chronic obstructive pulmonary disease (8/42, 19.05%). All patients had intravenous access to medications or fluid management via a central or peripheral line and mechanical ventilation was observed in 39 (39/42, 92.86%) patients. All the isolates were susceptible to minocycline (100%), followed by doxycycline (97.6%) and trimethoprim-sulfamethoxazole (95.2%).
Conclusion: Chryseobacterium species are capable of causing pneumonia, bacteremia and urinary tract infection in immunocompromised patients. Early diagnosis and prompt treatment with appropriate antibiotics can prevent progression to septicemia.
Anatomical Substrates and Connectivity for Parkinson’s Disease Bradykinesia Components after STN-DBS
Authors: Kim Min Jae , Shi Yiwen , Lee Jasmine , Salimpour Yousef , Anderson William S. , Mills Kelly A. 
Published: March 2023

ABSTRACTBackgroundParkinsonian bradykinesia is rated using a composite scale incorporating slowed frequency of repetitive movements, decrement amplitude, and arrhythmicity. Differential localization of these movement components within basal ganglia would drive the development of more personalized network-targeted symptomatic therapies.MethodsUsing an optical motion sensor, amplitude and frequency of hand movements during grasping task were evaluated with subthalamic nucleus (STN)-Deep Brain Stimulation (DBS) “on” or “off” in 15 patients with Parkinson’s disease (PD). The severity of bradykinesia was assessed blindly using the MDS-UPDRS Part-III scale. Volumes of activated tissue (VAT) of each subject were estimated where changes in amplitude and frequency were mapped to identify distinct anatomical substrates of each component in the STN. VATs were used to seed a normative functional connectome to generate connectivity maps associated with amplitude and frequency changes.ResultsSTN-DBS-induced change in amplitude was negatively correlated with change in MDS-UPDRS-III right (r = -0.65, p < 0.05) and left hand grasping scores (r = -0.63, p < 0.05). The change in frequency was negatively correlated with amplitude for both right (r = -0.63, p < 0.05) and left hand (r = -0.57, p < 0.05). The amplitude and frequency changes were represented as a spatial gradient with overlapping and non-overlapping regions spanning the dorsolateral-ventromedial axis of the STN. Whole-brain correlation maps between functional connectivity and motor changes were also inverted between amplitude and frequency changes.ConclusionDBS-associated changes in frequency and amplitude were topographically and distinctly represented both locally in STN and in whole-brain functional connectivity.
Establishing the relationships between adiposity and reproductive factors: a multivariable Mendelian randomization analysis
Authors: Prince Claire , Howe Laura D , Sharp Gemma C , Fraser Abigail , Richmond Rebecca C 
Published: March 2023

AbstractBackgroundFew studies have investigated associations between adiposity and reproductive factors using causal methods, both of which have a number of consequences on disease. Here we assess whether adiposity at different points in the lifecourse affects reproductive factors differently and independently, and the plausibility of the impact of reproductive factors on adiposity.MethodsWe used genetic data from UK Biobank and other consortia for eight reproductive factors: age at menarche, age at menopause, age at first birth, age at last birth, number of births, being parous, age first had sexual intercourse and lifetime number of sexual partners, and two adiposity traits: childhood body size and adulthood body mass index (BMI). We applied multivariable mendelian randomization to account for genetic correlation and estimate causal effects of childhood and adulthood adiposity, independently of each other, on reproductive factors. Additionally, we estimated the effects of reproductive factors, independently of other relevant reproductive factors, on adulthood adiposity.FindingsWe found a higher childhood body size leads to an earlier age at menarche, which in turn leads to higher adulthood BMI. Furthermore, we find contrasting and independent effects of childhood body size and adulthood BMI on age at first birth (Beta 0.22 SD (95% confidence interval:0.14,0.31) vs -2.49 (−2.93,-2.06) per 1 SD increase), age at last birth (0.13 (0.06,0.21) vs -1.86 (−2.23,-1.48) per 1 SD increase), age at menopause (0.17 (0.09,0.25) vs -0.99 (−1.39,-0.59) per 1 SD increase), and likelihood of having children (Odds ratio 0.97 (0.95,1.00) vs 1.20 (1.06,1.37) per 1 SD increase).ConclusionsWe highlight the importance of untangling the effects of exposures at different timepoints across the lifecourse, as demonstrated with adiposity, where accounting for measures at one point in the lifecourse can alter the direction and magnitude of effects at another time point and should therefore be considered in further studies.