bluuebunny/crossref_metadata_2025_split huggingface dataset:
IMPLICATIONS OF ADOLESCENT AND PARENT PERCIEVED SKILL-BUILDING ON MISCARREID HELPING AND SELF-EFFICACY FOLLOWING A TRANSITION WORKSHOP FOR ADOLESCENTS WITH INFLAMMATORY BOWEL DISEASE
Authors: Waschmann Malika , Lin Henry , Stellway Jacklyn 
Published: January 2022

Abstract

BACKGROUND
The rising prevalence of Inflammatory Bowel Disease (IBD) in children and subsequent need for continued care into adulthood, begets the call for patient education on the transition to adult healthcare. To address this need, we designed a virtual, transition program for adolescents with IBD and their parents. The objective of this study was to assess program efficacy by examining changes in transition readiness skills, self-efficacy, and miscarried helping.

METHODS
Sixteen adolescent-parent dyads participated in the transition workshop. The program was structured around the biopsychosocial model of health and a multidisciplinary group of professionals contributed. The impact of the workshop was measured by validated self- and parent-report measures of transition readiness (transition readiness assessment questionnaire; TRAQ), self-efficacy (IBD-self efficacy scale; IBD-SES), and miscarried helping (Helping for Health Inventory; HHI) at pre-workshop and 1-year post-workshop. Median values were used to perform Wilcoxon rank sum tests and Spearman correlations for statistical analysis.

RESULTS
Adolescents gained tangible transition readiness skills as demonstrated by improvement in self- and parent-reported TRAQ scores at 12 months (median increase of 14 points and 19 points respectively, p&lt;0.05). Parents reported less miscarried helping as demonstrated by improved HHI scores, however, adolescents did not (median decrease of 2 points). Adolescent IBD-SES scores improved at 12 months (median increase of 1 point). There was weak correlation between: 1) Adolescent IBD-SES and TRAQ scores (r=0.42), and 2) Parent TRAQ and HHI scores (r=0.49).

DISCUSSION/CONCLUSIONS
Improvements in adolescent TRAQ scores indicate that following the workshop, participants more frequently performed tasks necessary to manage their disease. Improvement in parent-reported TRAQ scores suggest parents also witnessed their child taking on more responsibility and developing autonomy. Correlation between improved parent-reported TRAQ scores and improved HHI scores suggests that as adolescents gain more autonomy over the day-to-day tasks of managing their IBD, their parents more readily allow them to take the lead, but the weak correlation observed could be from the small sample size given the attrition in survey response rate at 12 months. The correlation between increased adolescent TRAQ scores and IBD-SES scores suggest that as adolescents engage in disease management tasks they develop increased self-efficacy in relation to their disease as a delayed measure of program success. Future directions include implementing more frequent topic-based workshops to allow for peer-to-peer learning and increasing our sample size to increase the power of our analysis.
SECURE ELECTRONIC DOCUMENT SIGNING UPTAKE IN BIOLOGIC PRESCRIBING FOR IMMUNE MEDIATED DISEASES
Authors: Sharma Sowmya , Jones Jennifer , Stewart Michael 
Published: January 2022

Abstract

BACKGROUND
The COVID-19 pandemic drastically impacted workflows in gastroenterology practice. Physicians managing immune-mediated diseases (IMDs) must complete special authorization (SA) and prescription renewal (Rx) forms for patients on biologic therapy. This adds significant administrative burden potentially leading to delays in therapy initiation and care continuity. Historically, document completion has largely been paper-based, with forms faxed between patient support programs (PSPs) and physician offices. Disruption of normal office processes during the pandemic necessitated the movement of existing paper-based workflows online. The use of secure electronic document signing (SEDS) platforms has allowed physicians to receive and complete documents digitally.

AIMS
To evaluate the impact of SEDS-based biologic documentation on clinical practice. Objectives were 1) to determine if the use of SEDS platforms increased timeliness of document returns compared to traditional workflows 2) assess whether SEDS usage is acceptable and sustainable and 3) assess MD satisfaction with SEDS platforms.

METHODS
This was a retrospective audit of SEDS and paper-based biologic document workflows from a single PSP (Abbvie Care). Outcomes of interest were the number of documents completed monthly using SEDS, new monthly users, and the number of active monthly users between April 1, 2020-March 31, 2021. Time (days) to SEDS completion (vs. paper process) was determined by reviewing timepoint data for SA and Rx documents from May 2019-January 2020 (‘pre- SEDS’) and for SEDS documents from May 2020-January 2021(‘SEDS’). The return time (RT) was defined as the time between date sent to a physician’s office by the PSP to the date returned to the PSP. Documents in the pre-SEDS cohort with a RT exceeding 30 days were excluded

RESULTS
In totally, 5573 SA and Rx documents were completed by 383 physicians using the SEDS platform from April 2020-March 2021. A mean of 14.6 (sd 21.8) documents were signed per physician. The number of monthly electronic documents processed increased from 104 in April 2020 to 800 in March 2021. Active monthly users increased from 24 in April 2020 to 213 in March 2021 (31 new users monthly). A total of 19,387 paper documents were processed during the ‘pre-SEDS’ period and 3,317 electronic documents processed in the ‘SEDS’ period. The mean RT in the ‘pre-SEDS’ period was 8.03 days (Sd 8.2) and the ‘SEDS’ period was 1.11 days (sd 2.6).

CONCLUSION
This data demonstrates acceptability, appropriateness, and improved processing efficiency of an SEDS platform improving timeliness of patient care. Next steps in this research include surveying physicians to understand the work-flow impact of SEDS, functionality, long-term sustainability, satisfaction and impacts on disease related outcomes.
PEOPLE WITH IBD WANT TO TALK ABOUT SLEEP: RECOMMENDATIONS ON WHAT TO ASK AND HOW TO RESPOND TO SLEEP COMPLAINTS
Authors: Salwen-Deremer Jessica , Jagielski Christina , Smith Michael , Siegel Corey 
Published: January 2022

Abstract

BACKGROUND
Poor sleep occurs in 75% of people with IBD and is prospectively associated with increased risk for disease flare, hospitalization, surgery, and reduced quality of life. While IBD providers know the link between poor sleep and IBD, few are adequately armed to ask patients about sleep and provide concise, evidence based suggestions for management. We aimed to understand patients’ beliefs about sleep and IBD, their treatment preferences, and offer recommendations to providers on how best to ask about and address sleep problems in this population.

METHOD
We conducted an anonymous, online survey of 312 adults with Crohn’s disease or ulcerative colitis who sought treatment at the Dartmouth-Hitchcock IBD center. Participants were asked about sleep patterns, thoughts and behaviors related to sleep, and open-ended questions about sleep and IBD.

RESULTS
Participants ranged from 18-85 years old (M=48.6, SD=16.1) and were 66% women, 96% White. 61% of participants had Crohn’s and 39% had UC; mean symptom duration=20.7 years (SD=13.7). Overall, 81% of participants endorsed some interaction between sleep and IBD. Based on thematic analysis, participants thought that their sleep was worse during flares and sleeping poorly made IBD symptoms worse, while good sleep was protective. Pain, nighttime bowel movements, and general and IBD-specific anxiety all worsened sleep. Participants with poor sleep evidenced more dysfunctional beliefs about sleep (d=1.68, p&lt;.001). They also were more likely to engage in behaviors that can worsen sleep, including taking daytime naps (d=1.16, p=.03), lying in bed while in pain during the day (d=1.19, p&lt;.001), and worrying/planning in bed (d=.99, p&lt;.001). 70% of participants thought that IBD providers should ask about sleep during visits and 67% of those with poor sleep thought IBD providers should provide sleep recommendations. 83% of people with poor sleep were interested in sleep treatment and/or information, provided it was not time intensive. Access to treatment, availability, cost, lack of knowledge about treatment options, and disinterest in medication were all major barriers to seeking treatment.

CONCLUSIONS
People with IBD believe there is a link between sleep and IBD and may be engaging in thought and behavior patterns that worsen sleep, and, likely, their IBD. While access to behavioral sleep medicine specialists can be limited, patients are quite receptive to getting sleep information from their IBD providers. To address these patient needs, providers may ask about weekday/weekend sleep differences and what patients do in bed besides sleep. Patients should be encouraged to maintain consistent sleep/wake times, not take naps (or nap for 20-30 minutes before lunch), use their beds only for sleep and sex, and not spend time in bed when they are not sleeping (e.g., if resting when fatigued or in pain).
THE CROHN’S AND COLITIS DISTRESS SCALE: ASSESSING THE DOMAINS OF IMPACT IN YOUTH WITH IBD
Authors: Cummings Caroline , Stellway Jacklyn , Paternostro Jennifer , Stoeckel Maggie , Muir Linda , Harris Michael 
Published: January 2022

Abstract

INTRODUCTION
Youth with Inflammatory Bowel Disease (IBD) are at significantly increased risk for depression and anxiety, with 25%-40% of youth with IBD reporting internalizing symptoms. These data are based on general measures of anxiety and depression without accounting for the confounds of disease-related processes. Disease-distress, on the other hand, disentangles disease-related processes, including medication sides effects, and the emotional experience of managing a chronic illness. Harris et al. developed a measure of IBD-related distress, the Crohn’s and Colitis Distress Scale (CCDS), to assess the expected worries, concerns, and fears associated with having IBD. This study involved an exploratory factor analysis (EFA) of the CCDS to better categorize IBD distress.

METHODS
Participants (N=120, ages 12-18, diagnosis of IBD) completed the 27-item CCDS. About half of participants were male (n=66; 55%) and majority were White (n=104; 86.7%). Eighty participants were diagnosed with Crohn’s disease (66.7%) and forty with ulcerative colitis (33.3%). Average length of time since diagnosis was 3.31 years (SD=2.77 years) and average length of time since participants’ last flare was 18.03 months (SD=24.65 months). A subsample of participants reported currently being symptomatic (n=44; 36.7%) and currently flaring (n=27; 22.5%). An EFA with varimax rotation was conducted to assess the factor structure of the CCDS.

RESULTS
The CCDS yielded a five-factor structure, with three to seven items per factor. Factor loadings ranged from .44 to .83 (see Table). Five factors were extracted from the EFA: emotional burden, physician-related, disease-related interpersonal, regimen-related, and disease-related functional impairment. An item-to-total analysis indicated 23 of 27 total items correlated strongly with the total (r &gt; .5), four items were moderately correlated with the total (r= .43, r= .42, r= .38, and r= .49), and no items were largely uncorrelated with the total. Based on the factor analysis results, only items with an adequate factor loading, or were face valid or unique items for their respective factor domain, were retained. A final 22-item CCDS was supported.

CONCLUSIONS
The CCDS demonstrated a five-factor structure and the 22-item version was psychometrically sound. The factors that emerged are consistent with the disease-specific distress domains identified in other pediatric health populations (e.g., type 1 diabetes), as well as symptom-related distress as found in adults with IBD. Further validation of the measure is warranted, including assessment of the psychometric soundness of the regimen-related subscale. To our knowledge, the CCDS is the first multifaceted IBD-specific distress instrument to be developed for use with pediatric patients and may allow for further specificity in the identification of IBD-specific distress in this population.
Riding the Wave: Reactive Vector-Borne Disease Policy Renders the United States Vulnerable to Outbreaks and Insecticide Resistance
Authors: Dye-Braumuller Kyndall C , Gordon Jennifer R , McCoy Kaci , Johnson Danielle , Dinglasan Rhoel , Nolan Melissa S 
Published: January 2022

Abstract
Funding for vector-borne disease surveillance, management, and research is cyclical and reactive in the United States. The subsequent effects have yielded gross inequities nationally that unintentionally support recurrent outbreaks. This policy forum is comprised of four primary subsections that collectively identify specific areas for improvement and offer innovative solutions to address national inadequacies in vector borne disease policy and infrastructure.
Spatial Distribution of PCR-Identified Species ofAnopheles gambiae senu lato(Diptera: Culicidae) Across Three Eco-Vegetational Zones in Cross River State, Nigeria
Authors: Thabet H S , TagEldin R A , Fahmy N T , Diclaro J W , Alaribe A A , Ezedinachi E , Nwachuku N S , Odey F O , Arimoto H 
Published: January 2022

AbstractAnopheles gambiae sensu lato complex (An. gambiae s.l.) describes a group of nine morphologically indistinguishable members that vary in their distribution, ability to transmit malaria, and susceptibility to pyrethroids. Here, we recorded the spatial patterns of PCR-identified An. gambiae s.l. complex species collected from four sites in Cross River State, Nigeria that represented three different ecological zones. Trapping was conducted between October 2015 and June 2016. Anopheles gambiae s.l. complex species identification was performed using species-specific primers followed by An. gambiae and An. coluzzii differentiation using the restriction fragment length polymorphism (RFLP) method. Bivariate and multivariate logistic regression models were used to identify ecological and seasonal variables closely associated with An. coluzzii and An. gambiae distribution. Out of 1,388 An. gambiae s.l. successfully amplified, 1,074 (77.4%) were An. coluzzii, 278 (20%) were An. gambiae, and 25 (1.8%) were hybrids (An. coluzzii/An. gambiae). A very small number of An. arabiensis (0.8%, n = 11) were also collected. Statistical analysis indicated that An. coluzzii is predominant in Guinea-savannah and tropical rainforest, and is highly associated with rainy seasons, while, An. gambiae is prevalent in mangrove swamp forest during dry seasons. Only 13 An. gambiae s.l. females were infected with Plasmodium falciparum (P. falciparum). The sporozoite infection rate was higher in mangrove swamp forest (53.8%, n = 7) than in rain forest (38.5%, n = 5) followed by Guinea-savannah (7.7%, n = 1) ecological zones. These results provide important insights for strategic planning of malaria control programs in Nigeria.
Perspectives on Cervical Arthroplasty in Navy and Marine Corps Tactical Jet Aircrew
Authors: Lang Richard W , Yoder Adam J , Porensky Paul 
Published: January 2022

ABSTRACT
Symptomatic cervical spondylosis is a progressive degenerative condition of the cervical spine commonly resulting in functionally-limiting pain, weakness, and/or limited dexterity. Symptomatic cervical spondylosis is believed to occur at higher rates in military aviators than civilian counterparts and is a disqualifying condition for all Navy and Marine Corps aircrew. This condition is non-waiverable for tactical jet (ejection-seat-based) aviators. Medical attrition of experienced tactical jet aircrew from the military aviation community results in substantial cost to the U.S. Government, reduces fleet combat capability, and adversely impacts career progression and retention. The clinical maturation of cervical total disc replacement (TDR) technology over the last 2 decades has revolutionized the treatment of symptomatic cervical spondylosis and enabled a return to duty for hundreds of military service members in non-aviation fields. TDR studies demonstrate equal or superior functional outcomes, rates of symptom resolution, reduced complication and reoperation rates, and lower long-term cost compared to traditional Anterior Cervical Discectomy and Fusion (ACDF). Although initial computational modeling studies have evaluated cervical arthroplasty performance during rotary-wing crash impacts, safety within the dynamic tactical jet environment has not yet been established. The purpose of this article is to review factors relevant to TDR safety and outcomes and to propose a framework to evaluate the safety of TDR in Navy and Marine Corps tactical jet aircrew, to ultimately inform aeromedical algorithms regarding return to flight after TDR.
Associations Between Vancomycin Exposure and Acute Kidney Injury Within the Recommended Area Under the Curve Therapeutic Exposure Range Among Patients With Methicillin-Resistant Staphylococcus aureus Bloodstream Infections
Authors: Lodise Thomas P , Scheetz Marc , Carreno Joseph J , Chambers Henry , Fowler Vance , Holland Thomas L 
Published: January 2022

Abstract
Among patients with methicillin-resistant Staphylococcus aureus bacteremia, vancomycin-associated acute kidney injury increased as a function of the day 2 area under the curve (AUC), even for daily AUCs within the recommended therapeutic range (400–600). Further data are needed to determine if daily AUCs &lt;400 can be maintained without compromising efficacy.
Sustained Reduction in Urgent Care Antibiotic Prescribing During the Coronavirus Disease 2019 Pandemic: An Academic Medical Center’s Experience
Authors: Ha David , Ong’uti Sharon , Chang Amy , Mui Emily , Nelligan Ian , Betts Brooke , Lentz Christopher , Alegria William , Fox Emily , Meng Lina , Stenehjem Edward , Hersh Adam L , Deresinski Stanley , Artandi Maja , Holubar Marisa 
Published: January 2022

Abstract
We compared antibiotic prescribing before and during the ­coronavirus disease 2019 (COVID-19) pandemic at 2 academic urgent care clinics and found a sustained decrease in prescribing driven by respiratory encounters and despite transitioning to telemedicine. Antibiotics were rarely prescribed during encounters for COVID-19 or COVID-19 symptoms. COVID-19 revealed opportunities for outpatient stewardship programs.
Long-term policy impacts of the coronavirus: normalization, adaptation, and acceleration in the post-COVID state
Authors: Capano Giliberto , Howlett Michael , Jarvis Darryl S L , Ramesh M 
Published: January 2022

Abstract
This paper offers an analysis of the theoretical and empirical challenges the coronavirus pandemic poses for theories of policy change. Critical events like coronavirus disease are potentially powerful destabilizers that can trigger discontinuity in policy trajectories and thus are an opportunity for accentuating path shifts. In this paper, we argue that three dynamic pathways of change are possible and must be considered when analysing post-COVID policymaking: normalization, adaptation, and acceleration. These different pathways need to be explored in order to understand the mid- and long-term policy effects of the pandemic. This introduction contextualizes the articles in this special issue, situating them broadly within two broad categories: (a) assessment of how the coronavirus disease pandemic should be understood as a crisis event, and its role in relationship to mechanisms of policy change; and (b) mapping the future contours of the pandemic’s impact on substantive policy areas, including education, health care, public finance, social protection, population ageing, the future of work, and violence against women.
Heterosis and Combining Ability in Pumpkin Inbreds (Cucurbita moschataDuch. ex Poir.)
Authors: Shafin Most. Shaika , Parvin Most. Shanaj , Haque Md Ehsanul , Akhter Fahmida 
Published: January 2022

ABSTRACTTwenty hybrids along with five parents evaluated in the study were mainly contemplated to find out the best cross combinations and the best general and specific combiners as well as to estimate the nature and magnitude of the gene action for different qualitative traits. Using Griffing’s and Hayman’s approach through a 5 × 5 full diallel cross fashion, an investigation on heterosis and combining ability in pumpkin was undertaken following RCBD design with three replications at the experimental field. Both positive and negative significant GCA and SCA variances were obtained from few parents and hybrids. Predominance of additive-additive gene action was noted for most of the characters except hollowness and dry matter content, where additive-dominance gene action was predominant; flesh thickness and brix (%), where dominance-dominance gene action were predominant. A single parent was not found as good combiner for more than two characters. The best specific combiners were IBD 40 X IBD 47 for beta carotene, total sugar and fruit yield; IBD23 X IBD40 for brix (%), hollowness and flesh thickness; IBD40 X IBD57 for fruit breadth; IBD47 X IBD50 for non reducing sugar; and IBD47 X IBD57 for reducing sugar. The Vr-Wr graphs exhibited complete, partial and over dominance effect of genes for different characters. Complete dominance was observed only for beta carotene whereas over dominance was noticed for hollowness and flesh thickness. Partial dominance was ensured for fruit breadth, dry matter, brix (%), reducing sugar, non-reducing sugar, total sugar and fruit yield. Significant heterosis of some crosses against mid parent and better parents were observed for some characters.
Tissue-intrinsic γδ T cells critically regulate Tissue-Resident Memory CD8 T cells
Authors: Muñoz-Ruiz Miguel , Llorian Miriam , D’Antuono Rocco , Pavlova Anna , Mavrigiannaki Anna Maria , McKenzie Duncan , García-Cassani Bethania , Iannitto Maria Luisa , Jandke Anett , Ushakov Dmitry S. , Hayday Adrian C 
Published: January 2022

SummaryBecause Tissue-Resident Memory T (TRM) cells contribute critically to body-surface immunoprotection and/or immunopathology in multiple settings, their regulation is biologically and clinically important. Interestingly, TRMcommonly develop in epithelia part-shaped by innate-like lymphocytes that become tissue-intrinsic during development. Here we show that polyclonal TRMcells induced by allergic contact dermatitis (ACD) interact with signature intraepidermal γδ T cells, facilitating a feedback-loop wherein TRM-derived IFNγ upregulates PD-L1 on γδ cells that can thereupon regulate PD1+TRM. Thus, TRMinduced by ACD in mice lacking either local γδ cells, or lacking a single gene (IFNγR) expressed by local γδ cells, displayed enhanced proliferative and effector potentials. Those phenotypes were associated with strikingly limited motility, reduced TRMquality. and an impaired capacity to restrain melanoma. Thus, inter-individual and tissue-specific variation in how tissue-intrinsic lymphocytes integrate with TRMmay sit upstream of variation in responses to cancer, allergens and other challenges, and may likewise underpin inflammatory pathologies repeatedly observed in γδ-deficient animals.