bluuebunny/crossref_metadata_2025_split huggingface dataset:
The role of prone positioning in patients with SARS-CoV-2-related respiratory failure in non–intensive care unit
Authors: Graziani Mara , Barbieri Greta , Maraziti Giorgio , Falcone Marco , Fiaccadori Anna , Corradi Francesco , Ghiadoni Lorenzo , Satula Katarzyna , Noumi Ghislaine , Becattini Cecilia 
Published: April 2023

Background: Prone positioning (PP) is an established and commonly used lung recruitment method for intubated patients with severe acute respiratory distress syndrome, with potential benefits in clinical outcome. The role of PP outside the intensive care unit (ICU) setting is debated. Objectives: We aimed at assessing the role of PP in death and ICU admission in non-intubated patients with acute respiratory failure related to COronaVIrus Disease-19 (COVID-19) pneumonia. Design: This is a retrospective analysis of a collaborative multicenter database obtained by merging local non-interventional cohorts. Methods: Consecutive adult patients with COVID-19-related respiratory failure were included in a collaborative cohort and classified based on the severity of respiratory failure according to the partial arterial oxygen pressure to fraction of inspired oxygen ratio (PaO2/FiO2) and on clinical severity by the quick Sequential Organ Failure Assessment (qSOFA) score. The primary study outcome was the composite of in-hospital death or ICU admission within 30 days from hospitalization. Results: PP was used in 114 of 536 study patients (21.8%), more commonly in patients with lower PaO2/FiO2 or receiving non-invasive ventilation and less commonly in patients with known comorbidities. A primary study outcome event occurred in 163 patients (30.4%) and in-hospital death in 129 (24.1%). PP was not associated with death or ICU admission (HR 1.17, 95% CI 0.78–1.74) and not with death (HR 1.01, 95% CI 0.61–1.67) at multivariable analysis; PP was an independent predictor of ICU admission (HR 2.64, 95% CI 1.53–4.40). The lack of association between PP and death or ICU admission was confirmed at propensity score-matching analysis. Conclusion: PP is used in a non-negligible proportion of non-intubated patients with COVID-19-related severe respiratory failure and is not associated with death but with ICU admission. The role of PP in this setting merits further evaluation in randomized studies.
Vedolizumab subcutaneous formulation maintenance therapy for patients with IBD: a systematic review and meta-analysis
Authors: Hu Qiong , Tang Xing-zhou , Liu Fang , Liu De-wu , Cao Bo 
Published: April 2023

Background: The application of vedolizumab (VDZ) subcutaneous (SC) formulation has brought more convenience and hope to patients with moderate-to-severe inflammatory bowel diseases (IBDs) in the coronavirus disease 2019 context. Objective: This study aimed to systematically evaluate all previous studies that used VDZ SC formulation for maintenance therapy in patients with IBD. Design: Systematic review and meta-analysis. Data Sources and Methods: The search was conducted using the subject and free terms related to ‘Vedolizumab’, ‘Subcutaneous’, and ‘IBD’, in Embase, PubMed, Web of Science, Cochrane, and at ClinicalTrials.gov databases between 2008 and 2022. The methodological quality of randomized controlled trials (RCTs) and cohort studies was assessed using the Cochrane Handbook of Systematic Reviews and the Newcastle–Ottawa Scale, respectively. The endpoints included efficacy, safety, and immunogenicity. Results: A total of 60 studies and 2 completed clinical registry trials were retrieved, of which 3 RCTs with high methodological quality, and 3 cohort studies with large heterogeneity were included in the meta-analysis. In the RCT study design, patients with ulcerative colitis (UC) under different conditions after treated with VDZ SC were significantly distinct than those for placebo (PBO) in clinical remission, endoscopic remission, and biochemical remission. In Crohn’s disease (CD), the aforementioned parameters were slightly higher than those for PBO, but there was not statistically significant in endoscopic remission and the efficacy of anti-tumor necrosis factor-naive patients. The clinical remission, endoscopic remission, and biochemical remission in patients with UC after VDZ SC treatment were similar to those after intravenous (IV) treatment. The risk ratios in patients experiencing adverse events (AEs) and serious AEs after VDZ SC and PBO treatments were 86% and 89% in UC, and 96% and 80% in CD, respectively. Compared with IV, safety was not statistically different. The risk of developing anti-VDZ antibody after VDZ SC treatment was only 20% of that after PBO in patients with UC, but it was 9.38 times in CD. Conclusion: VDZ SC treatment maintained the clinical efficacy of IV induction in patients with IBD without increasing the safety risk, and the efficacy was more pronounced in patients with UC. Immunogenicity might be a potential factor for the decrease in efficacy rate in patients with IBD. Registration: INPLASY 2022120115
The natural history of histological changes in microscopic colitis
Authors: Sehgal Kanika , Tome June , Kamboj Amrit K. , Dierkhising Ross A. , Pardi Darrell S. , Khanna Sahil 
Published: April 2023

Background: Microscopic colitis (MC) causes chronic diarrhea. It has two histologic subtypes: lymphocytic colitis (LC) and collagenous colitis (CC). Little is known about the natural progression of disease with time and with treatment. Objectives: We aimed to assess histological changes over time. Design: We designed a retrospective study including adults diagnosed with MC from January 1992 to January 2020 at Mayo Clinic. Methods: Pathology reports were reviewed until 31 October 2020. Histological assessments at least 8 weeks apart were considered as adequate follow-up. Histological change from one subtype to the other and resolution were tracked with univariate and multivariable Cox proportional hazards models. Results: Overall, 416 patients with a median age at diagnosis of 63.9 years with >1 histopathological assessment were identified. Histology at initial diagnosis was CC in 218 (52.4%) patients and LC in 198 (47.6%). No medications were associated with a histological change. However, histological resolution was more likely with the use of aspirin [hazard ratio (HR): 2.10, 95% confidence interval (CI): 1.34–3.31, p = 0.001) and proton-pump inhibitors (PPIs; HR: 2.01, 95% CI: 1.34–3.02, p = 0.001). Histological resolution was more likely with budesonide treatment (HR: 1.86, 95% CI: 1.16–3.00, p = 0.010) and less likely with mesalamine (HR: 0.40, 95% CI: 0.19–0.83, p = 0.014), compared to medications such as prednisone, loperamide, and bismuth. Patients with CC were less likely to change their histology compared to patients with LC (HR: 0.24, 95% CI: 0.14–0.42, p < 0.001). There was no difference in histological resolution between the two subtypes (HR: 0.70, 95% CI: 0.47–1.05, p = 0.084). Conclusion: Patients with LC have a higher chance of changing their histology as compared to CC. However, histological resolution was associated with the use of PPIs and aspirin, and treatment with budesonide.
Effect of peripartum Clostridioides difficile infection on pregnancy and neonatal outcomes: an observational study
Authors: Saha Srishti , Pardi Ryan , Theiler Regan N. , Pardi Darrell S. , Khanna Sahil 
Published: April 2023

Background: The incidence of Clostridioides difficile infection (CDI) in peripartum women is rising, but limited data on its effect on maternal and neonatal outcomes are available. Objective: To study the effect of peripartum CDI on pregnancy and neonatal outcomes. Design: Retrospective cohort study. Methods: Patients with peripartum CDI 12 weeks before pregnancy through 6 weeks postpartum (January 1996–February 2018) were matched with controls (peripartum women without CDI) 1:1 by age, year of delivery, and prior pregnancies. McNemar’s test and conditional logistic regression were used to analyze the effect of CDI on pregnancy and neonatal outcomes (complications, mode of delivery). p < 0.05 was considered statistically significant. Results: Overall, 101 cases and 100 controls (1997–2018) were included; median age 27 (range, 20–41) years. Timing of CDI was as follows: pre-pregnancy: 15.8% ( n = 16), during pregnancy: 51.5% ( n = 52), and postpartum: 32.7% ( n = 33). The commonest risk factor was outpatient/emergency room visits. Pregnancy and neonatal outcomes were analyzed for 67 matched pairs with CDI before or during pregnancy. Cases had higher odds of cesarean delivery ( p = 0.02) and lower odds of Group B Streptococcus (GBS) infection/colonization ( p = 0.03). Odds of cesarean delivery remained high after controlling for labor arrest disorders [odds ratio (OR): 17.23 (95% confidence interval (CI), 2.19–543.19; p = 0.004)]; odds of GBS remained low after controlling for antibiotic use (OR: 0.25, 95% CI, 0.04–0.99; p = 0.049). Neonatal outcomes were similar in cases and controls. CDI treatment did not affect treatment-related or delivery outcomes. Conclusion: Peripartum CDI was associated with higher odds of cesarean delivery and lower odds of GBS infections. Larger studies exploring the effect of CDI on pregnancy and neonatal outcomes are needed.
Impact of clinical note format on diagnostic accuracy and efficiency
Authors: Payton Evita M , Graber Mark L , Bachiashvili Vasil , Mehta Tapan , Dissanayake P Irushi , Berner Eta S 
Published: April 2023

Background Clinician notes are structured in a variety of ways. This research pilot tested an innovative study design and explored the impact of note formats on diagnostic accuracy and documentation review time. Objective To compare two formats for clinical documentation (narrative format vs. list of findings) on clinician diagnostic accuracy and documentation review time. Method Participants diagnosed written clinical cases, half in narrative format, and half in list format. Diagnostic accuracy (defined as including correct case diagnosis among top three diagnoses) and time spent processing the case scenario were measured for each format. Generalised linear mixed regression models and bias-corrected bootstrap percentile confidence intervals for mean paired differences were used to analyse the primary research questions. Results Odds of correctly diagnosing list format notes were 26% greater than with narrative notes. However, there is insufficient evidence that this difference is significant (75% CI 0.8–1.99). On average the list format notes required 85.6 more seconds to process and arrive at a diagnosis compared to narrative notes (95% CI -162.3, −2.77). Of cases where participants included the correct diagnosis, on average the list format notes required 94.17 more seconds compared to narrative notes (75% CI -195.9, −8.83). Conclusion This study offers note format considerations for those interested in improving clinical documentation and suggests directions for future research. Balancing the priority of clinician preference with value of structured data may be necessary. Implications This study provides a method and suggestive results for further investigation in usability of electronic documentation formats.
The role of arachnoid granulations in idiopathic intracranial hypertension
Authors: Huda Fahimul , Abdelmonem Ahmed , Dehghani Firouzabadi Fatemeh , Srinivas Dola Venkata Naga , Sheikhy Ali , Taheri M Reza 
Published: April 2023

Objectives Idiopathic intracranial hypertension (IIH) is a disease defined by elevated intracranial pressure (ICP) without an established etiology. Arachnoid granulations (AG) are conduits for CSF resorption from the subarachnoid space to the venous system. AG have been implicated to play a central role in maintaining CSF homeostasis. We tested the hypothesis that patients with fewer visible AG on MRI are more likely to present with IIH. Methods In this institutional review board (Institutional Review Board)-approved retrospective chart review study, 65 patients with a clinical diagnosis of idiopathic intracranial hypertension were compared to 144 control patients who met inclusion/exclusion criteria. Patients’ signs and symptoms pertaining to IIH were obtained through the electronic medical record Brain MR images were reviewed for the number and distribution of AGs indenting the dural venous sinuses. The presence of imaging and clinical findings associated with long standing increased ICP was noted. Propensity score method (with inverse probability weighting technique) was used to compare case and control groups. Results In the control group, the number of AG indenting the dural venous sinuses on MRI (NAG) was lower in women compared to men when matched for age (20–45 yo) and BMI (>30 kg/m2). The NAG was lower in 20–45 yo females in the IIH group as compared to the 20–45 yo females in the control group. This statistically significant difference persists when controlled for BMI. In contrast, the NAG in >45 yo females in the IIH group trended higher compared to the >45 yo females in the control group. Conclusion Our results suggest that alterations in arachnoid granulations could play a role in the development of IIH.
Multifocal cutaneous phaeohyphomycosis caused by Exophiala spinifera with clinical resolution in an immunocompromised cat
Authors: Kondratjeva Jevgenija , Pressanti Charline , Reynolds Brice S , Trumel Catherine , Delverdier Maxence , Normand Anne-Cécile , Soetart Nicolas , Guillot Jacques , Cadiergues Marie Christine 
Published: April 2023

Case summary A 3-year-old neutered domestic shorthair cat with a long history of idiopathic immune-mediated haemolytic anaemia and thrombocytopenia treated with ciclosporin and prednisolone was referred 2 months after the appearance of nodular dermatitis. A single pigmented nodule was present in the lateral carpal region of the right foreleg. The lesion was 7 mm in diameter, non-exudative and cutaneous to subcutaneous. Fine-needle aspiration of the mass revealed the presence of pigmented fungal elements. Excisional surgery was planned; in the meantime, a plaque-like lesion developed in the interorbital region. Histopathological examination confirmed the presumptive diagnosis of phaeohyphomycosis, and Exophiala spinifera was identified as the aetiological agent. Itraconazole, given orally at a dose of 10 mg/kg for 8 weeks following surgery, enabled clinical resolution despite continued use of immunosuppressants. The follow-up was carried out over 14 weeks. Relevance and novel information This case report provides the first evidence of multifocal cutaneous phaeohyphomycosis caused by E spinifera with clinical resolution after combined surgical and itraconazole treatment in an immunocompromised cat.
Screen time, phone usage, and social media usage: Before and during the COVID-19 pandemic
Authors: Voss Claire , Shorter Phoebe , Mueller-Coyne Jessica , Turner Katherine 
Published: April 2023

Objective Technology use has increased in the past several years, especially among younger generations. The COVID-19 pandemic drastically changed how people work, learn, and interact, with many utilizing technology for daily tasks and socializing. Methods The current study investigated a sample of college students using a cross-sectional design to determine whether there was a change in how much time students spent on screens, phones, and social media. Results Findings indicated that time on screens and phones was significantly higher during the pandemic; however, time spent on social media did not differ significantly. Conclusion These findings suggest that students are spending more time working and socializing on their screens and phones, yet social media may not be the platform in which students are doing this. Future studies should further explore technology usage and whether these trends during the COVID-19 pandemic will be lasting.
Policies, Strategies, and the Evolutionary Logic of Large-Scale Teacher Training in China
Authors: Li (李宝敏) Baomin , Yang (杨风雷) Fenglei , Wang (王倩) Qian 
Published: April 2023

Purpose Based on a systematic review of policy documents in China related to teacher training over the past four decades, this paper identifies and analyzes the main policy shifts and strategies in terms of teacher training in China. Design/Approach/Methods Using quantitative trend analysis, high-frequency word analysis, and content analysis, this study presents the policy changes in and reform of China's national teacher training system and elucidates the reasons for such changes. Findings Chinese teacher training and practice reforms resonate with the paradigm shifts of international teacher training and development, particularly those based on real-world scenarios. However, innovations have also been made in response to the problems of Chinese in-service teacher training and development, such as the lack of time for teachers and the separation between learning and practice. Such innovations reflect the government's efforts to narrow the gaps between theory, policy, and practice by improving China's macro policy design. Originality/Value This study contributes to the longitudinal study of policy shifts in teacher training in China.
Relationship Between Patient-Centered Primary Care Provider Communication and Emergency Room Visits in the Medicaid Population in North Carolina, United States
Authors: Platonova Elena A. , Carnes Keith J. 
Published: April 2023

Introduction: Medicaid, a joint federal-state program, finances health care for eligible low-income individuals and families in the United States. Medicaid patients use disproportionately more emergency room (ER) services than other patients in the United States. Inadequate provider communication during primary care visits might be one reason for this well-documented phenomenon. The goal of the study was to examine how patient-centered provider communication related to ER use by Medicaid patients in North Carolina. Methods: A 2015 state-wide cross-sectional telephone survey of NC adult Medicaid patients (n = 2652) was based on the CAHPS methodology. Predictors were 4 patient-centered provider communication characteristics assessed by patients. The outcome was the number of ER visits during 6 months prior to the survey. We used negative binomial regression to examine the relationship. Results: Effective patient-centered provider communication index was associated with 19% fewer ER visits ( P < .05). Provider’s respect for patients had the biggest impact on the number of visits (37% fewer ER visits, P < .001). Easy to understand provider explanations were associated with 18% fewer ER visits ( P < .05). Longer (>1 year) patient continuity with the current primary care provider was associated with 36% to 38% fewer ER visits ( P < .001). Conclusions: Health care quality improvement should focus on training providers how to show respect, give easily understood explanations, and maintain good interpersonal relationships with patients. Relevant agencies should emphasize training and accreditation with a specific emphasis on communication of providers delivering care to Medicaid patients.
Effects of Slide Sheet Use and Bed Position on Muscle Activities in the Low Back and Extremities: A Pilot Experimental Simulation Study
Authors: Higuchi Daisuke , Takahashi Yuko , Tomita Yosuke 
Published: April 2023

Background: Low-friction slide sheets (SS) are designed to reduce compression loads on the body during manual handling tasks, such as boosting patients. Using SS has been shown to decrease muscle activity in the lower back and upper extremities. However, it is unclear if this effect varies with different bed positions. To investigate this, we studied the effects of SS use, bed height, and their combination on muscle activity during a simulated patient boost. Methods: Thirty-three Japanese undergraduate students (age 21.0 ± 1.1 years; 14 men, 19 women) participated. Participants were asked to boost a dummy figure on the bed three times each using four conditions. During the repositioning task, electromyography of eight muscles of the lower back and upper and lower extremities, hip and knee joint flexion angles, pelvic forward tilt angle, and position of the center of mass based on the posterior superior iliac spine were evaluated. Findings: Electrophysiological activities of muscles of lower back and upper extremities were significantly lower with SS than without it in both bed positions (30% and 40% of body height); the reduction in muscle activities with SS use was 20% to 40%. Lowering the bed did not affect the SS effect magnitude on reducing muscle activities, although postural changes, including hip and knee joint flexion, were observed. Conclusions/Application to Practice: SS reduced muscle activities in the back, upper, and lower extremities when the bed was in the low position, and this effect persisted at a bed height of ≥30% of the participant’s height.
Augmenting ACL Repair With Suture Tape Improves Knee Laxity: A Biomechanical Study
Authors: He Jinshen , Kanto Ryo , Fayed Aly M. , Price Taylor M. , DiNenna Michael A. , Linde Monica A. , Smolinski Patrick , van Eck Carola F. 
Published: April 2023

Background: Anterior cruciate ligament (ACL) repair is an alternative to reconstruction; however, suture tape support may be necessary to achieve adequate outcomes. Purposes: To investigate the influence of suture tape augmentation (STA) of proximal ACL repair on knee kinematics and to evaluate the effect of the 2 flexion angles of suture tape fixation. Study Design: Controlled laboratory study. Methods: Fourteen cadaveric knees were tested using a 6 degrees of freedom robotic testing system under anterior tibial (AT) load, simulated pivot-shift (PS) load, and internal rotation (IR) and external rotation loads. Kinematics and in situ tissue forces were evaluated. Knee states tested were (1) ACL intact, (2) ACL cut, (3) ACL repair with suture only, (4) ACL repair with STA fixed at 0° of knee flexion, and (5) ACL repair with STA fixed at 20° of knee flexion. Results: ACL repair alone did not restore the intact ACL AT translation at 0°, 15°, 30°, or 60° of flexion. Adding suture tape to the repair significantly decreased AT translation at 0°, 15°, and 30° of knee flexion but not to the level of the intact ACL. With PS and IR loadings, only ACL repair with STA fixed at 20° of flexion was not significantly different from the intact state at all knee flexion angles. ACL suture repair had significantly lower in situ forces than the intact ACL with AT, PS, and IR loadings. With AT, PS, and IR loadings, adding suture tape significantly increased the in situ force in the repaired ACL at all knee flexion angles to become closer to that of the intact ACL state. Conclusion: For complete proximal ACL tears, suture repair alone did not restore normal knee laxity or normal ACL in situ force. However, adding suture tape to augment the repair resulted in knee laxity closer to that of the intact ACL. STA with fixation at 20° of knee flexion was superior to fixation with the knee in full extension. Clinical Relevance: The study findings suggest that ACL repair with STA fixed at 20° could be considered in the treatment of femoral sided ACL tears in the appropriate patient population.