bluuebunny/crossref_metadata_2025_split huggingface dataset:
Healing Baltimore: Creating Support for VALUE (Vaccine Access & Acceptance, Lives in Unity, Education & Engagement) Baltimore Ambassadors as They Serve During the COVID-19 Pandemic
Authors: Holt Mackessa , Ruiz-Aguilera Evelyn , Ngeno Gloria , Bronner Yvonne 
Published: April 2023

VALUE (Vaccine Acceptance & Access Lives in Unity, Engagement & Education) Baltimore began in February 2021 with the vision of helping underserved communities in Baltimore City value COVID-19 vaccination and have access to the vaccine. VALUE dispatched ambassadors to provide COVID-19 education and risk-mitigation strategies in their communities. Once the project was implemented, we noticed that our ambassadors were often overwhelmed by misinformation in the community and our priority populations faced deeper issues relating to the social determinants of health (SDOH) and social needs such as food, transportation, job loss, and housing. To help our ambassadors cope with and address these issues, we created Healing Baltimore in April 2021. Healing Baltimore aims to support our VALUE ambassadors as they contribute toward improving the wellbeing of Baltimore now and after COVID. Healing Baltimore has four elements: (1) Weekly Self-Care Tips, (2) Weekly Positive Facts about Baltimore, (3) SDOH Referral to Baltimore City Health Department Services, and (4) Webinars to teach us about the VALUE communities while offering the opportunity to discuss historical trauma. We share our lessons learned from Healing Baltimore, which include (1) increasing ambassador input, (2) engagement, (3) co-creation, (4) collaboration, and (5) community appreciation.
Vertebral-Venous fistulas: Single center experience and practical treatment approach
Authors: Costa Matias , Basamh Mohammed , Vivanco-Suarez Juan , Casanova Daniel , Baldoncini Matias , Alobaid Abdullah , Loh Yince , Patel Akshal , McDougall Cameron G , Monteith Stephen J 
Published: April 2023

Background Vertebral-venous fistulas (VVFs) are rare. Scarce literature exists to guide our understanding and management. We report our experience and propose a classification based on flow, feeder number, and involvement of accessible veins. Additionally, we include a practical treatment approach. Methods Retrospective chart and imaging review of cerebrovascular arteriovenous fistulas treated in our center between July 2013 and April 2022. We reviewed patient demographics, presentation, imaging, treatment strategies, and outcomes. Results Nine patients with VVFs were identified, six were females. Ages ranged between 38–83 years. There were six high-flow and three low-flow. Most VVFs originated at the level of V3. Additional feeders from the internal carotid artery, external carotid artery, and/or subclavian artery were present in four cases (two were high-flow). Four cases had multiple arterial feeders. All cases were symptomatic. Origin was spontaneous in eight and iatrogenic in one case. Most common presenting symptoms were pain (7) and pulsatile tinnitus (4). Neurological deficits were present in two cases (1 high- and 1 low-flow). Four cases were treated with vertebral artery segmental sacrifice alone, three required multiple transarterial embolizations with or without VA sacrifice, one case had single transvenous approach, and one was treated with single targeted transarterial embolization. One patient had a minor transient neurological complication. No treatment-related mortality was seen. Conclusion Treatment of high-flow and symptomatic low-flow VVFs is feasible and safe. Our classification and treatment approach might help guide patient selection and choice of endovascular approach. However, our approach warrants further validation with a larger number of patients.
Anti-fibrotic therapy and lung transplant outcomes in patients with idiopathic pulmonary fibrosis
Authors: Astor Todd L. , Goldberg Hilary J. , Snyder Laurie D. , Courtwright Andrew , Hachem Ramsey , Pena Tahuanty , Zaffiri Lorenzo , Criner Gerard J. , Budev Marie M. , Thaniyavarn Tany , Leonard Thomas B. , Bender Shaun , Barakat Aliaa , Breeze Janis L. , LaCamera Peter 
Published: April 2023

Background: It is unclear whether continuing anti-fibrotic therapy until the time of lung transplant increases the risk of complications in patients with idiopathic pulmonary fibrosis. Objectives: To investigate whether the time between discontinuation of anti-fibrotic therapy and lung transplant in patients with idiopathic pulmonary fibrosis affects the risk of complications. Methods: We assessed intra-operative and post-transplant complications among patients with idiopathic pulmonary fibrosis who underwent lung transplant and had been treated with nintedanib or pirfenidone continuously for ⩾ 90 days at listing. Patients were grouped according to whether they had a shorter (⩽ 5 medication half-lives) or longer (> 5 medication half-lives) time between discontinuation of anti-fibrotic medication and transplant. Five half-lives corresponded to 2 days for nintedanib and 1 day for pirfenidone. Results: Among patients taking nintedanib ( n = 107) or pirfenidone ( n = 190), 211 (71.0%) had discontinued anti-fibrotic therapy ⩽ 5 medication half-lives before transplant. Anastomotic and sternal dehiscence occurred only in this group (anastomotic: 11 patients [5.2%], p = 0.031 vs patients with longer time between discontinuation of anti-fibrotic medication and transplant; sternal: 12 patients [5.7%], p = 0.024). No differences were observed in surgical wound dehiscence, length of hospital stay, or survival to discharge between groups with a shorter versus longer time between discontinuation of anti-fibrotic therapy and transplant. Conclusion: Anastomotic and sternal dehiscence only occurred in patients with idiopathic pulmonary fibrosis who discontinued anti-fibrotic therapy < 5 medication half-lives before transplant. The frequency of other intra-operative and post-transplant complications did not appear to differ depending on when anti-fibrotic therapy was discontinued. Registration: clinicaltrials.gov NCT04316780: https://clinicaltrials.gov/ct2/show/NCT04316780
Airway morphological abnormalities of bronchiolitis assessed by endobronchial optical coherence tomography
Authors: Su Zhu-Quan , Zhong Ming-Lu , Fan Ming-Yue , Rao Wan-Yuan , Zhou Zi-Qing , Chen Yu , Chen Xiao-Bo , Tang Chun-Li , Zhong Chang-Hao , Li Shi-Yue 
Published: April 2023

Background: A few studies have reported the medium-sized and small airway morphological abnormalities of bronchiolitis. Whether spirometry or impulse oscillometry (IOS) is correlated with airway remodeling of bronchiolitis remains unclear. Objectives: Aiming to demonstrate the airway morphological abnormalities of bronchiolitis obliterans (BO) and diffuse panbronchiolitis (DPB) assessed by endobronchial optical coherence tomography (EB-OCT), and elucidate whether spirometric and IOS parameters have correlation with the airway remodeling of bronchiolitis. Methods: We recruited 18 patients with bronchiolitis (BO, n = 9; DPB, n = 9) and 17 control subjects. Assessments of clinical features, St. George’s respiratory questionnaire (SGRQ), chest computed tomography (CT), spirometry, IOS, and EB-OCT were performed in all enrolled subjects. The correlation between EB-OCT and lung function parameters was studied and analyzed. Results: The magnitude of abnormalities of spirometric and IOS parameters was significantly greater in patients with bronchiolitis than that in control subjects ( p < 0.05). Patients with BO had notably lower forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), FEV1/FVC, maximal mid-expiratory flow (MMEF)% pred and higher resonant frequency (Fres), and area of reactance (AX) than those with DPB ( p < 0.05). The EB-OCT measurement among patients with bronchiolitis and between the bronchus in the left and the right lung demonstrated a heterogeneous distribution of airway calibers, presenting a high intra- and inter-individual variability. Patients with bronchiolitis had notably greater airway wall area ( p < 0.05) compared with control, while BO presented greater magnitude of airway abnormalities than DPB. Fres and the difference in airway resistance at 5 and 20 Hz (R5–R20) correlated negatively with medium-sized and small airway inner area, and correlated positively with airway wall area ( p < 0.05), whose correlation coefficients were higher than those of spirometric parameters. Conclusion: Bronchiolitis, BO and DPB, manifested a heterogeneous distribution of airway calibers with significant intra- and inter-individual variability. IOS parameters, rather than spirometry, correlated better with medium-sized and small airway remodeling in bronchiolitis assessed by EB-OCT measurement.
Endovascular treatment of acute basilar artery occlusion in patients with and without atrial fibrillation: results from the ATTENTION registry
Authors: Feng Shuo , Li Tong , Wu Yingchun , Shi Hongchao , Liu Yongchang , Xu Bo , Xu Chenghua , Zhou Qingqing , Qu Fengling , Li Rui , Tao Chunrong , Sun Wen , Hu Wei , Liu Xinfeng 
Published: April 2023

Background: Previous studies have shown a potential beneficial effect of endovascular therapy (EVT) in patients with acute basilar artery occlusion (BAO). It was unclear that whether atrial fibrillation (AF) can affect the clinical outcomes for BAO patients treated with EVT. Objectives: To investigate the association between AF and clinical outcomes, and whether AF can modify the efficacy and safety of EVT in patients with BAO. Design: We conducted a multicenter, nationwide, retrospective analysis to investigate how the presence of AF affects treatment allocation for BAO patients. Methods: The endovascular treatment for acute basilar artery occlusion (ATTENTION) registry was a multicenter, prospective study in China that included acute BAO patients who underwent EVT or received best medical management (BMM) between 2017 and 2021. The outcomes include the distribution of 3-month modified Rankin scale (mRS) score, functional independence (defined as mRS 0–3), symptomatic intracerebral hemorrhage, and mortality. Results: 2134 patients were included in the study, of which 619 had AF and 1515 did not have AF. The median age was 65 (interquartile range [IQR]: 56–73) years, and 689 (32.3%) patients were female. Multivariate regression analysis indicated no significant association existed between AF and the distribution of mRS (adjusted common odds ratio, 1.05 [95% CI: 0.88, 1.25]; p = 0.564) at 90 days. Similarly, AF was not found to have a significant association with and other measured outcomes, or with the effects of EVT in AF subgroups for at 90 days as measured by ordinal mRS ( p for heterogeneity = 0.247). Finally, no significant differences were found for symptomatic intracerebral hemorrhage and mortality within 90 days between the EVT and BMM groups across AF subgroups. Conclusions: Our results illustrated that the effect of EVT did not differ statistically in acute ischemic stroke patients with and without AF. Moreover, no significant association between AF and functional or safety outcomes could be detected at 90 days.
The severity of corneal nerve loss differentiates motor subtypes in patients with Parkinson’s disease
Authors: Che Ning-Ning , Jiang Qiu-Huan , Chen Shuai , Chen Si-Yuan , Zhao Zhen-Xiang , Li Xue , Ma Jian-Jun , Zhang Jie-Wen , Malik Rayaz A. , Yang Hong-Qi 
Published: April 2023

Background: Parkinson’s disease (PD) is a heterogeneous movement disorder with patients manifesting with either tremor-dominant (TD) or postural instability and gait disturbance (PIGD) motor subtypes. Small nerve fiber damage occurs in patients with PD and may predict motor progression, but it is not known whether it differs between patients with different motor subtypes. Objective: The aim of this study was to explore whether there was an association between the extent of corneal nerve loss and different motor subtypes. Methods: Patients with PD classified as TD, PIGD, or mixed subtype underwent detailed clinical and neurological evaluation and corneal confocal microscopy (CCM). Corneal nerve fiber density (CNFD), corneal nerve branch density (CNBD), and corneal nerve fiber length (CNFL) were compared between groups, and the association between corneal nerve fiber loss and motor subtypes was investigated. Results: Of the 73 patients studied, 29 (40%) had TD, 34 (46%) had PIGD, and 10 (14%) had a mixed subtype. CNFD (no./mm2, 24.09 ± 4.58 versus 28.66 ± 4.27; p < 0.001), CNBD (no./mm2, 28.22 ± 11.11 versus 37.37 ± 12.76; p = 0.015), and CNFL (mm/mm2, 13.11 ± 2.79 versus 16.17 ± 2.37; p < 0.001) were significantly lower in the PIGD group compared with the TD group. Multivariate logistic regression showed that higher CNFD (OR = 1.265, p = 0.019) and CNFL (OR = 1.7060, p = 0.003) were significantly associated with the TD motor subtype. The receiver operating characteristic (ROC) analysis demonstrated that combined corneal nerve metrics showed excellent discrimination between TD and PIGD, with an area under the curve (AUC) of 0.832. Conclusion: Greater corneal nerve loss occurs in patients with PIGD compared with TD, and patients with a higher CNFD or CNFL were more likely to have the TD subtype. CCM may have clinical utility in differentiating different motor subtypes in PD.
Characteristics of Coronial Autopsy Cases in the London Area of the United Kingdom, Pre and Post COVID-19 Lockdown
Authors: Bates Alan W. H. 
Published: April 2023

Introduction: In order to reduce transmission of COVID-19, in March 2020 the UK national and devolved governments imposed restrictions including spatial distancing, stay-at-home orders, and travel restrictions. The aim of this study is to compare the characteristics of cases referred to the Coronial system for autopsy in the months before and during the lockdown period. Methods: In all, 580 autopsy cases, performed in the London area between January and June 2020 were included in the study. Results: In the postlockdown period, there was an increase in the proportion of black individuals referred for autopsy, which just attained statistical significance ( p = 0.047). The proportion of decomposed bodies submitted for examination was significantly increased ( p = 0.011). The study did not show a significant increase in the proportion of out-of-hospital (community) deaths, traumatic deaths, or deaths due to alcohol or drug abuse or overdose. Conclusion: The study shows no evidence that COVID-19 preventative measures led to a change in the causes of death referred to the Coroner, except, of course, for COVID-related deaths. The proportion of black people among subjects for autopsy increased, probably because of a relatively higher incidence of COVID deaths among this group. Decomposed subjects were more common, probably due to social isolation.
Total Knee Arthroplasty (TKA): When Do the Risks of TKA Overcome the Benefits? Double Risk of Failure in Patients up to 65 Years Old
Authors: Perdisa Francesco , Bordini Barbara , Salerno Manuela , Traina Francesco , Zaffagnini Stefano , Filardo Giuseppe 
Published: April 2023

Objective The aim of this study was to document the survival rate in the middle-aged patient group up to 65 years old and to compare it with other age groups of patients undergoing total knee arthroplasty (TKA) for knee osteoarthritis (OA). Design The Register of Orthopaedic Prosthetic Implants (RIPO) regional registry was used to analyze the results of patients <80 years old affected by primary OA and treated with TKA from 2000 to 2019. The database was investigated according to the age group: younger than 50 years, 50-65 years, or 66-79 years, with the aim to estimate revision surgeries and implant survivorship. Results A total of 45,488 TKAs for primary OA were included in the analysis (M: 11,388; F: 27,846). The percentage of patients <65 years old increased from 13.5% to 24.8% between 2000 and 2019 ( P < 0.0001). The survival analysis showed an overall influence of age on the implant revision rate ( P < 0.0001), with an estimated survival rate of 78.7%, 89.4%, and 94.8% at 15 years in the 3 groups, respectively. Compared with the older-aged group, the relative risk of failure was 3.1 (95% confidence interval [CI] = 2.2-4.3; P < 0.001) higher in patients <50 years old and 1.8 (95% CI = 1.6-2.0; P < 0.001) higher in patients 50-65 years old. Conclusions TKA use in the middle-aged patient population up to 65 years old increased significantly over time. These patients present a double risk of failure with respect to older patients. This is particularly important considering the increasing life expectancy and the emergence of new joint preserving strategies, which could postpone the need for TKA to an older age.
Variegated Roles of and Relationships Between Private Tutoring and Schooling: Insights From the State of Maharashtra, India
Authors: Bhorkar Shalini 
Published: April 2023

Purpose The relationship between private tutoring (PT) and mainstream education is among the complex themes characterizing PT discourses in the literature. This study examined the complications of practices and processes in tutoring and schooling to elucidate different roles played by PT and its relationship with mainstream education. Design/Approach/Methods This study used qualitative data from a diverse set of 37 PT providers from the State of Maharashtra, India, to delineate their roles and explore their relationship with schooling in this context. Findings The classification of PT providers’ roles into complementary, accommodating, competing, and substitutive ones demonstrated a diverse range of relationships between PT and mainstream education. Further analysis showed that these relationships are dynamic in nature, and the boundaries between them are blurred. Originality/Value Research in the field of PT has been consistently pointing toward a perplexing mixture of positive and negative outcomes resulting from its relationship with mainstream education. This study transcended the positive vis-à-vis negative binary approach by contributing to the deeper understanding of PT relationships. Furthermore, it exemplified how future studies can disentangle the complexities of such relationships by deploying flexible, context-specific theoretical approaches.
Identifying and Decreasing Sharps Injuries Through Root Cause Analysis in a Large Urban Hospital System
Authors: Stallard Christopher , Heaton Karen , Montgomery Aoyjai P. , Trimble Roseann , Hammond Stephanie 
Published: April 2023

Background: Despite safety mandates and interventions, sharps injuries remain an occupational risk for registered nurses (RNs). Sharps and needlestick injuries increase the risk of exposure to blood-borne pathogens. Post-exposure direct and indirect costs of these percutaneous injuries have been estimated at about US$700 per incident. The goal of this quality improvement project was to identify root causes of sharps injuries for RNs at a large urban hospital system. Methods: A retrospective evaluation of sharps injuries sustained by RNs, identification epsication of themes or root causes, and the development of a fishbone diagram to sort the causes into categories to identify workable solutions were conducted. Fisher’s exact tests were performed to identify association between variables and root causes. Findings: A total of 47 sharps injuries were reported from January 2020 through June 2020. Among sharps injuries sustained by nurses, 68.1% were among nurses 19 to 25 years of age and 57.4% reported job tenure of 1 to 2 years. There was a statistically significant association between root causes and tenure range, gender, and procedure type ( p < .05) with moderate effect size (Cramer’s V = 0.35-0.60). Technique also was a primary cause of sharps injuries for blood draw (77%), discontinuing line (75%), injection (46%), intravenous (IV) start (100%), and suturing (50%). Conclusions/Applications to Practice: Technique and patient behavior were primary root causes of sharps injuries in this study. More sharps injuries caused by technique occurred among nurses with job tenure of 1 to 10 years, female, blood draw, discontinuing line, injection, IV start, and suturing procedures. The root cause analysis identified tenure, technique, and behavior as potential root causes of sharps injuries specifically occurring most during blood draw and injections at a large urban hospital system. These findings will inform nurses, especially new nurses in the proper use of safety devices and behaviors to prevent injury.
Health Status, Health Care Access, and Health Information Sources Among Latino Immigrant Cattle Feedyard Workers in the Midwest
Authors: Rowland Sheri A. , Ramos Athena K. , Maiya Sahitya , Carlo Gustavo 
Published: April 2023

Background: Cattle production in the United States is heavily supported by Latino/a workers. Beyond injury rates, our understanding of the health status of cattle feedyard workers is limited. The purpose of this study was to describe the health status and health care access among Latino immigrant cattle feedyard workers in the Midwest. Methods: A cross-sectional design using face-to-face structured interviews with Latino immigrant cattle feedyard workers in Kansas and Nebraska was conducted between May 2017 and February 2020. Findings: A total of 243 workers completed interviews; 91% were men. Over half (58%) had health insurance but few (36%) had a regular health care provider. Few chronic health conditions were reported despite most being overweight (53%) or obese (37%). The sample mean of sleep hours/24 hours was 7.1 ± 1.1. Problem drinking was moderate (42%), cigarette smoking was low (14%), and drug use was extremely low (<1%). Receiving health information from work was associated with less problem drinking, less obesity, lower blood pressure, and better sleep. Conclusions: Although few workers reported having a chronic health condition, most workers had chronic disease risk (i.e., elevated body mass index, problem drinking) and few had a regular health care provider. Receiving health information at work may have protective health effects. Applications to Practice: Occupational health professionals can partner with feedyard employers to expand current health and safety training programs beyond injury prevention to focus on health more broadly and to connect workers with local health care resources.