bluuebunny/crossref_metadata_2025_split huggingface dataset:
Measuring Attitudes About Alcohol Misuse and Dependence Among Alaska Native People Within a Tribal Health Care System
Authors: Dillard Denise A. , Hebert Luciana E. , Shaw Jennifer L. , Trinidad Susan B. , Dirks Lisa G. , Lillie Kate , Ludman Evette J. , Donovan Dennis , Burke Wylie 
Published: September 2022

Objectives
Attitudes about alcohol misuse and dependence influence alcohol use and help-seeking behavior. Alaska Native and American Indian (AN/AI) people have higher rates of alcohol-related morbidity and mortality but engage in treatment at lower rates than the general population. No validated instruments exist to assess attitudes of AN/AI people about alcohol misuse and dependence to inform treatment and prevention efforts. This study aimed to develop an instrument to assess public attitudes among AN/AI people of alcohol misuse and dependence.

Methods
This multiphase, mixed-methods study was conducted at Southcentral Foundation, a tribally owned health system serving 65,000 AN/AI people in Alaska. We conducted focus groups and interviews with health system users, providers, and leaders to adapt the Public Attitudes About Addiction Survey. The adapted instrument was piloted with 200 people. Cognitive interviews and exploratory and confirmatory factor analyses were used to refine the instrument, which were then administered to 777 AN/AI people.

Results
Initial exploratory factor analysis identified 5 factors, including 3 from the original Public Attitudes About Addiction Survey (moral, disease, nature), a combined psychology and sociology factor (psychosocial), and a new factor (environment). A final 4-factor model (psychosocial, moral, disease, nature) with 14 items had good fit with root mean square error of approximation (0.035; comparative fit index = 0.977; Tucker-Lewis index = 0.970; standardized root mean residual = 0.040) and loadings ranging from 0.41 to 0.80.

Conclusions
This study developed the first instrument to assess AN/AI attitudes about alcohol misuse and dependence. This instrument has potential to inform alcohol-related treatment in AN/AI communities. Future research is warranted to adequately measure place-based contributors salient to AN/AI people.
Intralesional Versus Intramuscular Hepatitis B Virus Vaccine in the Treatment of Multiple Common Warts
Authors: Nofal Ahmad , Elaraby Aya , Elkholy Basma M. 
Published: September 2022

BACKGROUND
Hepatitis B virus (HBV) vaccination is associated with stimulation of humoral and cell-mediated immunity. Intralesional HBV vaccine has been recently used as an immunotherapy of common warts with relatively low success rate.

AIM
To assess the efficacy and safety of intralesional versus intramuscular (IM) HBV vaccine in the treatment of multiple common warts.

PATIENTS AND METHODS
The study included 60 patients with multiple common warts who were randomly assigned to 2 groups: intralesional HBV vaccine or IM HBV vaccine. In the intralesional HBV vaccine group, the vaccine was injected into the largest wart at 2-week intervals until complete clearance or for a maximum of 5 sessions. Intramuscular HBV vaccine group received 3 injections in the deltoid muscle at 0, 1, and 6 months.

RESULTS
Complete wart clearance was reported in 7 patients (23.3%) of the intralesional HBV vaccine group and 15 patients (50%) of the IM HBV vaccine group. The difference was statistically significant in favor of the IM group (p = .0479). Adverse effects were mild and insignificant in the 2 groups.

CONCLUSION
HBV vaccine, particularly the IM form seems to be a promising, well-tolerated therapeutic option for the treatment of warts.

LIMITATIONS
Short follow-up period and small sample size.
The Growth Factors of Subcutaneous Benign Lipoma: Consideration from Anatomical Position of Occurrence
Authors: Nakao Ko , Onishi Fumio , Kiyama Maiko , Minabe Toshiharu 
Published: September 2022

Background:
Subcutaneous lipomas are the most common benign soft-tissue tumors. Theoretically, adipocyte sites could be the primary foci; however, lipomas are likely located in the occipital, neck, shoulder, torso, and thigh areas. To date, no study has reported the anatomical relationship between these subcutaneous structures and lipomas. Therefore, we aimed to investigate the anatomical locations of lipomas and considered their growth factors. In addition, we discussed the mechanism of fat amplification to improve the success of fat grafting.

Methods:
In the present study, lipomas measuring more than 5 cm in diameter from patients hospitalized between 2017 and 2021 were retrospectively examined using preoperative computed tomography and magnetic resonance imaging as well as clinical records with intraoperative pictures.

Results:
In total, 22 lipomas of 22 patients were examined. All lesions (100%) were accompanied by neurovascular perforators. Nineteen lesions (86%) were located deep in the superficial fascia, where it was clearly defined. Moreover, all lesions were located at the mobile adipofascial layer adjacent to an anchored fixed or less mobile structure.

Conclusions:
Lipoma growth might require neurovascular perforators that supply both blood flow and continuous stretching stimuli. The mobile adipofascial layer with bones adjacent to a fixed or less mobile area might also be necessary to grow lipomas. If these findings can be used as clues to elucidate the mechanism of fat amplification in the future, it may lead to an improvement in the survival rate of fat grafts.
Retinal vasculopathy following varicella zoster virus infection
Authors: Sutra Plern , Pokawattana Itsara 
Published: September 2022

Purpose of review
Varicella zoster virus (VZV) ocular infection can manifest purely as a vasculopathy that leads to retinal arteriole occlusion, without any retinitis or vasculitis. This review summarizes our current knowledge of such VZV ocular infection phenotype, incorporating initial descriptions from 1988. We describe the pathogenesis and VZV's manifestations in the retina using fundus photography, fundus fluorescein angiography, optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA). Laboratory investigations, diagnostic procedures, prognoses, and treatment options are also being reviewed.

Recent findings
Ten case reports where VZV retinal vasculopathy was the primary feature observed after varicella or zoster rash are described. The retinal arteriole, cilioretinal artery, branches of retinal artery, central retinal artery and ophthalmic artery were found to be areas of more rarely affected, neither in the form of vasculitis nor retinitis. Diagnosis is typically made from positive polymerase chain reaction (PCR) for VZV from extracted intraocular fluid or positive serum or cerebrospinal fluid (CSF) anti-VZV immunoglobulin G antibody in the context of compatible ocular findings. In addition, retinal vasculopathy occurring in the setting of confirmed varicella or zoster rashes could be considered potentially pathognomonic. Pathological concepts, including direct VZV infection of affected tissue, persistent inflammation, and/or virus-induced hypercoagulability are also discussed.

Summary
VZV may produce a wide spectrum of ocular manifestations with isolated VZV retinal vasculopathy being a rarer presentation. A prompt diagnosis followed by an early treatment of systemic acyclovir with or without corticosteroids is the mainstay of treatment.
Implementation of Early Rehabilitation in Severe COVID-19 Respiratory Failure
Authors: Miner Daniel , Smith Kellen , Foroozesh Mahtab , Price Justin H. 
Published: September 2022

Purpose:
The purpose of this scoping review is to describe current clinical practice guidelines (CPGs) for early rehabilitation for individuals hospitalized in an intensive care unit with COVID-19 and examine practice patterns for implementation of mobility-related interventions.

Methods:
PubMed, EMBASE, and CINAHL databases were searched from January 1, 2020, through April 1, 2022. Selected studies included individuals hospitalized with severe COVID-19 and provided objective criteria for clinical decision making for mobility interventions. A total of 1464 publications were assessed for eligibility and data extraction. The PRISMA-ScR Checklist and established guidelines for reporting for scoping reviews were followed.

Results:
Twelve articles met inclusion criteria: 5 CPGs and 7 implementation articles. Objective clinical criteria and guidelines for implementation of early rehabilitation demonstrated variable agreement across systems. No significant adverse events were reported.

Conclusions:
Sixty percent (3/5) of CPGs restrict mobility for individuals requiring ventilatory support of more than 60% Fio
2 (fraction of inspired oxygen) and/or positive end-expiratory pressure (PEEP) greater than 10-cm H2O (positive end-expiratory pressure). Preliminary evidence from implementation studies may suggest that some individuals with COVID-19 requiring enhanced ventilatory support outside of established parameters may be able to safely participate in mobility-related interventions, though further research is needed to determine safety and feasibility to guide clinical decision making.
The Effects of Work Satisfaction and Work Flexibility on Burnout in Nurses
Authors: LEE Huan-Fang , CHANG Ying-Ju 
Published: September 2022

ABSTRACT

Background
The World Health Organization has encouraged improving working conditions for nurses to decrease turnover and increase nurse staffing and nursing capacity. The International Council of Nurses has pointed out that a positive work environment can improve satisfaction and decrease burnout in nurses. However, the effects of working conditions and work satisfaction on burnout in nurses remain unclear.

Purpose
The purpose of this study was to explore the effects of working-condition-related flexibility and work satisfaction on burnout in nurses.

Methods
A cross-sectional design was employed, and 450 nurses from a single medical center participated in this study. In addition to demographic information, three survey instruments, including the Taiwanese Hospital Nurses' Job Satisfaction Scale, the Working Conditions and Flexible System Scale, and the Maslach Burnout Inventory-Chinese Version, were used to measure working condition flexibility, work satisfaction, and burnout. Descriptive statistics, the Pearson correlation coefficient, and hierarchical linear regression were used to analyze the data.

Results
Four hundred thirty-five nurses were enrolled as participants. Most were female, with a mean age of 29 years. Over four fifths (83.1%) were unmarried, and 65.5% had at least 2 years of prior experience working at other hospitals. Although the participants reported experiencing burnout several times per month, they reported feeling satisfied with their work. They noted flexibility related to working conditions, especially task-related flexibility, as important. Four variables (satisfaction/professional autonomy, interpersonal interaction, workload, and working condition flexibility/task flexibility) were found to be significant predictors of emotional exhaustion (adjusted R
2 = 0.212). However, only professional autonomy was found to significantly predict a sense of low personal accomplishment (adjusted R
2 = .077), whereas nursing competence significantly predicted depersonalization (adjusted R
2 = .086).

Conclusions
Work satisfaction and flexibility related to working conditions were shown to relate negatively to burnout. Nursing managers should improve the level of satisfaction related to professional autonomy, interpersonal interaction, and workload as well as task flexibility for nurses.
Safety and effectiveness of ustekinumab in elderly Crohn’s disease patients
Authors: Fiske Joseph , Liu Eleanor , Limdi Jimmy K. , Conley Thomas E. , Townsend Tristan , Davies Mike , Brockwell Robert , Baig Daniyal , Abdelbadiee Sherif , Uney Anastasia , Liaros Angela , Gaba Waqas , Smith Philip J. , Flanagan Paul K. , Subramanian Sreedhar 
Published: September 2022

Objective
Anti-tumour necrosis factor (TNF) agents are associated with increased infection risk among elderly IBD patients, but little is known about non anti-TNF biologics in this cohort. We examined the safety and effectiveness of ustekinumab in elderly Crohn’s patients.

Methods
This retrospective multi-centre cohort study included Crohn’s patients ≥60-years old who commenced ustekinumab. We recorded Harvey-Bradshaw index (HBI), concomitant steroid therapy, treatment persistence and new infections or malignancies. Primary outcome was serious infections requiring hospitalisation.

Results
Seventy patients were included, with median age of 68 years. 43 (61.4%) had prior anti-TNF exposure, and 15 (21.4%) vedolizumab. Median treatment duration was 12 months, totalling 84 patient-years. Nine serious infections were reported, incidence 106.7/1000 patient-years. Systemic steroids were associated with increased risk of serious infections [odds ratio (OR) 7.83, 95% confidence interval (CI): 1.44–44.32, P = 0.02]. There were 27 “non-serious” infections; 321.4/1000 patient-years. Charlson co-morbidity index (OR 1.49, 95% CI: 1.05–2.12, P = 0.03) and steroid exposure (OR 44.10, 95% CI: 1.75–1112.10, P = 0.02) increased non-serious infection risk (P < 0.05). Mean HBI improved from 8.13 to 4.64 at 6 months and 4.10 at last follow up (P < 0.0001). 12-month treatment persistence was 55.7% (N = 39); 34 (48.6%) were steroid-free.

Conclusion
Ustekinumab was safe and effective in a cohort of elderly Crohn’s disease patients. Infections were mostly mild, not resulting in therapy discontinuation. Serious infection risk was comparable to previously reported rates with anti-TNF agents. Steroid exposure was associated with an increased serious infection risk.
Comparison of liver function test- and inflammation-based prognostic scores for coronavirus disease 2019: a single center study
Authors: Cholongitas Evangelos , Bali Triada , Georgakopoulou Vasiliki E , Kamiliou Aikaterini , Vergos Ioannis , Makrodimitri Sotiria , Samara Stamatia , Triantafylou Maria , Basoulis Dimitrios , Eliadi Irene , Karamanakos Georgios , Sipsas Nikolaos V. , Samarkos Michael 
Published: September 2022

Background
Although several liver- and inflammation-based scores to predict the clinical course of patients with coronavirus disease 2019 (COVID-19) have been evaluated, no direct comparison regarding their predictive ability has been performed.

Methods
1038 patients (608 males, age 63.5 ± 17 years) hospitalized with documented COVID-19 infection to the non-ICU ward, were included retrospectively. Clinical and laboratory characteristics on admission including evaluation of Fibrosis-4 (FIB-4) score and C-Reactive Protein (CRP) to albumin ratio (CAR) were recorded.

Results
One hundred and twenty-four patients (11.9%) died during hospitalization after 8 (3–72) days. In multivariate analysis, FIB-4 (hazard ratio, 1.11; 95% confidence interval (CI), 1.034–1.19; P = 0.004), was independently associated with mortality, with very good discriminative ability (area under the receiver operating characteristic curve curve, 0.76). The patients with FIB-4 >2.67 (n = 377), compared to those with ≤2.67 (n = 661), had worse survival (log-rank 32.6; P < 0.001). Twenty-four (6.8%) of 352 patients with possible nonalcoholic fatty liver disease (NAFLD) (defined as Hepatic Steatosis Index >36) died during hospitalization. In multivariate analysis, CAR was an independent risk factor (1) for mortality (hazard ratio, 1.014; 95% CI, 1.002–1.025; P = 0.021), (2) the need for high-flow nasal cannula with or without intubation (hazard ratio, 1.016; 95% CI, 1.004–1.027; P = 0.007) and (3) development of acute kidney injury (hazard ratio, 1.017; 95% CI, 1.006–1.028; P = 0.002). In addition, the patients with possible NAFLD and CAR >12 (n = 154), compared to those with CAR ≤12 (n = 198), had worse survival (log-rank 5.1; P = 0.024).

Conclusions
FIB-4 was an independent factor for mortality with better performance compared to other liver function test- and inflammation-based scores in patients with COVID-19, while CAR was the only score independently associated with the clinical course in COVID-19 patients with possible NAFLD.
Role of mast cells in eosinophilic esophagitis
Authors: Janarthanam Rethavathi , Bolton Scott M. , Wechsler Joshua B. 
Published: September 2022

Purpose of review
This review will present what is known from recent research on the involvement of mast cells in eosinophilic esophagitis and identify questions requiring further investigation.

Recent findings
In the adults and children with eosinophilic esophagitis, there is increasing evidence that mastocytosis can persist, despite resolution of eosinophilia and is associated with persistent mucosal abnormalities and symptoms. Despite, treatment mast cells have an activated transcriptome. Mast cells likely contribute to epithelial barrier dysfunction, smooth muscle hypertrophy and contraction, and subepithelial fibrosis. Targeting mast cells alone is not effective at improving the tissue damage.

Summary
Mast cells appear to play a key role in eosinophilic esophagitis and serve as a biomarker of mucosal healing in conjunction with eosinophils. Excessive mast cell activation likely contributes to tissue damage in eosinophilic esophagitis and need to be considered as a target of therapy along with eosinophils.
Immunologic effects of red blood cell and platelet transfusions in neonates
Authors: Davenport Patricia , Sola-Visner Martha 
Published: September 2022

Purpose of Review
Premature neonates are frequently transfused red blood cells (RBCs) or platelets to raise hemoglobin or platelet counts. However, these transfusions may have unintended effects on the immune system. This review will summarize the newest discoveries on the immunologic effects of RBC and platelet transfusions in neonates, and their potential impact on neonatal outcomes.

Recent Findings
Neonatal RBC transfusions are associated with increases in plasma pro-inflammatory cytokines, but recent findings suggest sex-specific differential responses. At least one cytokine (monocyte chemoattractant protein-1) rises in females receiving RBC transfusions, but not in males. These inflammatory responses correlate with poorer neurodevelopmental outcomes in heavily transfused female infants, while preterm male infants seem to be more sensitive to severe anemia. Platelet transfusions in preterm neonates are associated with increased neonatal mortality and morbidity. The underlying mechanisms are unknown, but likely related to the immune/inflammatory effects of transfused platelets. Adult platelets are different from neonatal platelets, with the potential to be more pro-inflammatory. Early preclinical data suggest that platelet transfusions alter the neonatal systemic inflammatory response and enhance immune cell migration.

Summary
RBC and platelet transfusions alter neonatal immune and inflammatory responses. Their pro-inflammatory effects might worsen neonatal disease or affect neurodevelopmental outcomes.
N6-methyladenosine in hematological malignancies: a concise review
Authors: Wang Wan-Jie , Xu Ting-Ting , Bao Jing 
Published: September 2022

Purpose of reviewHematological malignancies are a kind of systemic cancers mostly related to abnormal differentiation of blood stem cells. Because of the poor prognosis, chemotherapy resistance and common recurrence, new mechanisms and treatment therapies are looking forward to be discovered.Recent findingsOver the years, epigenetic abnormalities have been known to act a key part in occurrence and development of hematological tumors. In the internal modifications on long noncoding eukaryotic mRNA, there is a common type called N6-methyladenosine that can change the expression of target genes and participate in the translation, degradation and splicing of mRNA. M6A is related to a wealth of cancers, such as HNRNPA2B1's elevation in multiple myeloma, METTLE3's elevation in acute myeloid leukemia and lung cancer. Immune cells, playing a significant role in hematological cancers, can also be regulated by m6A.SummaryIn the review, we summarized the recent progress on hematological malignancies associating with m6A and immune cells, which may offer a new road for the treatment of them.
Hot Air Balloon Fatalities in New Mexico
Authors: Gallego Daniel F. , Zuluaga Ruiz Maria E. , Bodor Garon , Lathrop Sarah , Proe Lori 
Published: September 2022

Introduction
Albuquerque New Mexico is the “hot air balloon capital of the world,” with balloons flying throughout the year and during the Albuquerque International Balloon Fiesta. The medical literature regarding morbidity and mortality in hot air balloon accidents is relatively scarce.

Methods
A series of fatal, hot air balloon accidents were identified by querying and analyzing the databases of the Office of the Medical Investigator in New Mexico from 1972 to 2021.

Results
Twenty-one lethal cases from 11 hot air balloon accidents were evaluated. Fifty-seven percent of decedents were male, the age range was 29 to 74 years, and all the decedents were White. Causes of death were certified as multiple injuries (52.4%), blunt trauma (42.9%), and electrocution (4.76%). The manner of death was accidental in all cases. Most common autopsy findings were rib fractures (100%), pelvic fractures (81.8%), and subarachnoid hemorrhage (72.7%). October was the month with the most accidents (63.63%), the most common cause was the pilot's failure to maintain clearance from obstacles (14.3%), and the most frequent collision was with power lines (63.6%).

Conclusions
Hot air balloon fatalities are rare, and the patterns of injury resemble those seen in free falls from significant heights with extensive blunt trauma.
Evaluation of “Real-Time” Fatal Drug Overdose Surveillance by King County Medical Examiner's Office, Seattle, Washington
Authors: Harruff Richard , Simpson Celia M. , Gifford Amy L. , Yarid Nicole , Barbour William L. , Heidere Catherine 
Published: September 2022

Abstract
To address the challenges in monitoring the continuously accelerating drug overdose epidemic, the King County Medical Examiner's Office in Seattle, Washington, instituted a “real-time” fatal drug overdose surveillance project, depending on scene investigations, autopsy findings, and in-house testing of blood, urine, and drug evidence collected from death scenes. Validation of the project's rapid death certification methodology from 2019 through 2021 was performed at the following 3 levels: blood testing, urine testing, and death certification, and for the following 4 drugs: fentanyl, opiate, methamphetamine, and cocaine. For blood testing, sensitivity ranged from 90% to 99%, and specificity ranged from 86% to 97%. For urine testing, sensitivity ranged from 91% to 92%, and specificity ranged from 87% to 97%. The positive predictive value for cocaine was poor for both blood testing (57%) and urine testing (72%). Of 1034 deaths, 807 were certified as overdose by rapid methodology, and 803 (99.5%) were confirmed by formal toxicology results. Manners of death were changed from accident to natural in 3 of 1034 cases (0.29%). Results of this study indicate that the rapid overdose surveillance methodology described in this study offers benefits to families and provides useful, timely information for responding law enforcement and public health agencies.