bluuebunny/crossref_metadata_2025_split huggingface dataset:
Metal Allergy in Tracheostomy Tube Placement Resulting in Complete Subglottic Stenosis: A Case Report
Authors: Bui Roger , Boven Lindsay , Kaufman David , Weinberger Paul 
Published: January 2022

Objectives: Metal hypersensitivity reaction to surgical implants is a well- known phenomenon that is associated with pain, swelling, inflammation, and decreased efficacy of the implant. We present a unique case of a patient with placement a metal Jackson tracheostomy tube that led to expeditious total subglottic stenosis. Methods: The patient was a 33-year old, severely atopic woman with history of asthma exacerbations requiring several intubations for acute respiratory failure with several subsequent tracheal dilations with steroid injections, and eventual tracheostomy placement with a metal Jackson tracheostomy tube that led to expeditious total subglottic stenosis. Results: Initial intervention included performing an airway evaluation, CO2 laser, and steroid injection of the area of complete subglottic stenosis. Follow up several months later revealed little improvement in level of tracheal narrowing proximal to the tracheostomy tube. Patient did not have shortness of breath but continued to be aphonic. Cricotracheal versus tracheal resection have been proposed but surgical morbidity was deemed too high due to patient’s obesity. Conclusions: Metal hypersensitivity reactions are well known phenomena as it relates to surgical implants in other surgical specialties but are seldom reported within the ear, nose and throat literature. Oftentimes, it takes astute observation to diagnose and establish a connection. Prompt recognition and treatment can be acquired from interdisciplinary collaboration with allergy.
A descriptive study of welfare and mental health issues among health-related sciences undergraduate students at the Medical University of Gdansk
Authors: Korolkiewicz Paweł K , Skrzypkowska Paulina , Ali Shan , Grabowski Jakub 
Published: January 2022

Purpose and methods: We surveyed a large sample of health-related sciences undergraduate students at the Medical University of Gdańsk (MUG), Poland in a pilot study to assess self-reported somatic/mental health-related issues, measure the level of burnout using Oldenburg Burnout Inventory (OLBI), the presence of depressive symptoms with Patient Health Questionnaire 9-item (PHQ-9) and assess the problematic alcohol intake (CAGE questionnaire). Additionally, stress coping mechanisms were investigated. Results: A total of 864 students participated in the survey. The mean total OLBI and PHQ-9 scores equalled 43.3 ± 2.7 and 11.3±5.8 points, respectively. The CAGE questionnaire was positive in 21.6% of students. Three most prevalent stress coping mechanisms included TV binge-watching, binge-eating and cigarette chain smoking (51.0%, 45.0% and 28.0% respectively). Conclusions: Future studies are required to confirm the obtained results, assess, and monitor trends and set-up interventions to improve the welfare of health-related science MUG students.
Modulation of sugar feeding behavior by Gymnema sylvestre in Drosophila melanogaster
Authors: Kaushik Shivam , Kumar Rahul , Kumar Sachin , Sanghi Srishti , Kain Pinky 
Published: January 2022

Introduction: Sugar is the main source of energy for nearly all animals. However, consumption of a high amount of sugars can lead to many metabolic disorders hence, balancing calorie intake in the form of sugar is required. Various herbs are in use to control body weight, cure diabetes and control elevated blood sugar levels. One such herb is Gymnema sylvestre commonly called Gurmar (destroyer of sugar). Gurmar selectively inhibits sugar sensation by mechanisms that are still elusive. Objectives: The primary objective of this study is to understand the effect of gurmar on sweet taste feeding behaviour in insects using the invertebrate model system Drosophila melanogaster. Methods: For this study, we used feeding assays, spectrophotometry and Proboscis Extension Reflex (PER) assay to determine how flies detect gurmar. Additionally, life span analysis, egg-laying behaviour and developmental profiles were used to probe the role of gurmar on the overall health of the flies. During the whole study, we used only the raw powdered form of gurmar (dried leaves) to examine its effect on sweet taste feeding behaviour. Results: Our data demonstrate that whole gurmar in a raw powdered form is aversive to flies and inhibits sugar evoked PER and feeding responses. Also, we observed it takes at least 24 h of starvation time to reduce the consumption of sugar in flies pre-fed on gurmar. Flies lay a fewer number of eggs on gurmar media and show developmental defects. Our data suggest that flies detect gurmar using both taste and olfactory cues. Conclusion: Understanding how gurmar reshapes taste curves to promote reduced consumption of sugars in flies will open up avenues to help people with health issues related to high sugar consumption, but our data also highlights that its consumption should be carefully considered since gurmar is aversive to flies and has detrimental effects on development.
Learning from the report of the independent medicines and medical devices safety review: “first do no harm”
Authors: Krishnaswamy Priyanka H , Ledingham Marie-Anne , Tyagi Veenu , Guerrero Karen Lesley 
Published: January 2022

This is a review of the learning points from the Independent Medicines and Medical Devices Safety Review, 1 chaired by Baroness Julia Cumberlege CBE DL. This system-wide review was initiated by the then Secretary of State for Health and Social Care, following patient-led campaigns. It looked at how the “healthcare system reacted as a whole, and how that response can be made more robust, speedy and appropriate”. We aim to highlight the learning points for doctors in Obstetrics and Gynaecology as these are relevant to our current practice and future changes in our healthcare system. These are: Aims of the review: why it was initiated and how it was conducted Overarching themes and missed opportunities to prevent avoidable harm Three clinical scenarios: their histories, issues and adverse events associated with their use and the current response in Scotland The hormone pregnancy test - Primodos The anti-epileptic drug - sodium valproate Surgical mesh for prolapse & incontinence The recommendations made by the review and implementation guidance Responses to the review, such as apologies issued by BSUG 2 /BAUS 3 /RCOG, 4 and compensations schemes such as the Scottish scheme as recommended by the review
Acute Portal and Superior Mesenteric Vein Thrombosis with Topical Testosterone Therapy: An Adverse Drug Event Case Report
Authors: Adams Megan R. , Pijut Kyle D. , Uttal-Veroff Kelsey C. , Davis George A. 
Published: January 2022

This is a case report of a 55-year-old Caucasian male prescribed topical testosterone therapy for 12 months prior to admission, when he was diagnosed with acute thrombosis in the portal vein (PVT) and superior mesenteric vein (SMV). The patient had a negative thrombophilia workup, including Factor V Leiden, Prothrombin G20210A, and JAK2 V617F mutations. There were no other pertinent laboratory markers that raised concern for the cause of thrombus. No strong familial history of venous thromboembolism (VTE) was reported during the patient’s initial workup. With this in mind, the patient’s use of topical testosterone therapy was considered the most likely risk factor for the PVT and SMV thrombus. During hospitalization, the patient was initiated on therapeutic anticoagulation with a heparin drip and discharged to home on apixaban for 3 months with extended therapy to be determined by outpatient hematologist. With no other identified VTE risk factors, probability that this patient’s VTE was attributed to testosterone was evaluated using the Naranjo scale with a calculated score of 6, which classifies the adverse reaction as “likely.” Clinicians should be aware of the possibility that topical testosterone therapy may be a risk factor for venous thrombosis in unusual sites.
Race/Ethnicity Differences in COVID-19 Vaccine Uptake Among Nurses
Authors: Choi Kristen , Rondinelli June , Cuenca Emma , Lewin Bruno , Chang John , Luo Yi X. , Bronstein David , Bruxvoort Katia 
Published: January 2022

Introduction: There is evidence for relatively lower COVID-19 vaccine uptake among people of color in the United States. The purpose of this study was to investigate associations between race/ethnicity and COVID-19 vaccine uptake among nurses. Methods: Nurses in Southern California ( N = 1183) completed a one-time, web-based survey to assess COVID-19 vaccine perceptions and uptake. Results: In all, 82.8% of respondents ( N = 979) received at least one COVID-19 vaccine dose. Identifying as East Asian was associated with 14% higher odds of COVID-19 vaccine uptake relative to identifying as White (odds ratio [OR] = 1.14/95% confidence interval [CI] = [1.06, 1.24]); identifying as Filipino was associated with 14% higher odds of uptake (OR = 1.14/95% CI = [1.08, 1.20]); and identifying as Hispanic/Latinx was associated with 6% higher odds of uptake (OR = 1.06/95% CI = [1.00, 1.12]). Discussion: Although nurses and people of color have been identified as groups with low levels of COVID-19 vaccine uptake, this study found that nurses of color received the vaccine at higher levels than their White counterparts.
A Retrospective Characterization of Dexmedetomidine-Suspected Fever and Its Consequences in Adult Critically Ill Patients
Authors: Schranz Emily , Rappaport Stephen , Groth Christine , Prasad Paritosh , Cooper Kevin , Connor Kathryn 
Published: January 2022

Background: Current evidence for dexmedetomidine-suspected fever (DSF) is limited. Lack of recognition may lead to costly or potentially harmful interventions for critically ill patients. Objective: The primary objective was to characterize escalations of care related to DSF. Secondary objectives were to describe the incidence, severity, and consequences associated with DSF. Methods: A retrospective review was conducted in critically ill adults who developed fever ≥39°C within 12 h from initiation of dexmedetomidine, with resolution of fever to <39°C within 12 h after discontinuation. The primary outcome was percentage of patients who received an escalation of care due to fever. Secondary outcomes included the percentage of patients who developed a multidrug-resistant organism or Clostridium difficile infection. Results: Eighteen of 3943 patients screened in 4099 encounters met criteria for DSF (0.4%). The majority were white (83.3%), male (66.7%), and underwent cardiac surgery (61.1%). Median (interquartile range [IQR]) time to fever onset and resolution were 5.5 (3.6-7.6) and 1.3 (1.0-2.9) h. Nine patients (50%) underwent infectious workup including antimicrobial initiation (n = 1, 5.6%), broadening of antimicrobials (n = 4, 22.2%), or culture collection (n = 9, 50%). Eleven patients (61.1%) underwent attempted temperature reduction. Twelve patients (66.7%) underwent diagnostic imaging. Incidence of multidrug-resistant organism and C. difficile infection were low (11.1 and 16.7% of fever patients, respectively). Conclusion and Relevance: Incidence of DSF was low and more common in cardiac surgery patients. Unrecognized DSF led to an escalation of care in most patients. Dexmedetomidine exposure should be considered as a potential cause of fever in critically ill adults.
Association Between Pre-delivery Coagulation Indicators and Invasive Placenta Accreta Spectrum
Authors: Guo Zhirong , Han Xueyan , Zhang Huijing , Zheng Weiran , Yang Huixia , Ma Jingmei 
Published: January 2022

Objectives To analyze the association between pre-operational coagulation indicators and the severity of placenta accreta spectrum (PAS), as well as blood loss volume during operation. Methods Hospitalized patients of the obstetric department in a major hospital from 2018 to 2020 who were clinically and/or pathologically diagnosed with invasive PAS were included. Univariate and multivariate logistic regression and Poisson regression models were used to quantify the association between each of the 6 coagulation indicators and PAS severity (measured by FIGO grade) as well as maternal outcomes. Results Ninety-five patients (46 FIGO grade 2 and 49 FIGO grade 3) were included. Higher PT [adjusted OR (aOR): 5.54; 95% CI, 1.80 to 17.07] and FDP (aOR: 1.19; 95% CI, 1.01–1.42) levels were associated with an increased risk of FIGO grade 3 after adjusting for covariates. D-dimer [incidence rate ratio (IRR): 1.19; 95% CI, 1.05 to 1.35)] and FDP (IRR: 1.03; 95% CI, 1.01–1.04) levels were significantly associated with higher blood loss volume after adjusting for covariates. Conclusion Preoperative coagulation indicators, especially PT, D-dimer and FDP, are associated with disease severity and blood loss volume during operation of invasive PAS. The underlying mechanism for the coagulation profile of PAS patients warrants further analysis. Synopsis Preoperative coagulation indicators, especially PT, D-dimer and FDP, are associated with disease severity and blood loss volume during operation among invasive placenta accreta spectrum patients.
Drinking Water Source, Chlorinated Water, and Colorectal Cancer: A Matched Case-Control Study in Ethiopia
Authors: Tafesse Nebiyou , Porcelli Massimiliano , Robele Gari Sirak , Ambelu Argaw 
Published: January 2022

Background: There is no study conducted on the association between disinfection byproducts (DBPs) in chlorinated drinking water and colorectal cancer (CRC) in Ethiopia. Therefore, this study aimed to determine the relation between chlorine based DBPs in drinking water and CRC in Addis Ababa, Ethiopia. Methods: A facility based matched case control study was conducted involving 224 cases and 448 population controls from June 2020 to May 2021. Cases were defined as histologically confirmed CRC cases. Cases were matched with controls by residence, age, and sex using frequency and individual matching. Geocoding of cases, health facility, and georeferencing of controls were carried out. Data was collected using a pretested structured questionnaire. Pearson Chi square and Fisher’s exact tests were employed to assess associations. Stratified analysis was used to detect confounding factors and effect modification. A multivariable conditional logistic regression was used to identify risk factors of CRC. Results: Of 214 CRC cases, 148 (69.2%) used chlorinated water whereas out of 428 controls 161 (37.6%) used chlorinated water. In the final regression model, drinking chlorinated surface water (adjusted matched odds ratio [adjusted mOR] = 2.6; 95% CI 1.7-4.0), history of swimming (adjusted mOR = 2.4; 95% CI 1.4-4.1), years at the place of current residence (adjusted mOR = 1.5; 95% CI 1.1-2.2), hot tap water use for showering (adjusted mOR; 3.8 = 95% CI 2.5-5.9) were significantly associated with CRC. The stratified analysis confirmed that smoking and meat ingestion were not effect modifiers and confounders. Conclusion: Drinking chlorinated water for extended years is a significant risk factor for CRC in Addis Ababa, Ethiopia. In addition, hot tap water use for showering, and swimming history are risk factors for CRC. This information is essential to design integrated interventions that consider chlorination by-products and exposure routes toward the prevention and control of CRC in Ethiopia. Initiating alternative methods to chlorine disinfection of drinking water is also essential.
Modulation of Human Hydrogen Sulfide Metabolism by Micronutrients, Preliminary Data
Authors: Dattilo Maurizio , Fontanarosa Carolina , Spinelli Michele , Bini Vittorio , Amoresano Angela 
Published: January 2022

Background: Hydrogen sulfide (H2S) is a pivotal gasotransmitter networking with nitric oxide (NO) and carbon monoxide (CO) to regulate basic homeostatic functions. It is released by the alternative pathways of transulfuration by the enzymes Cystathionine Beta Synthase (CBS) and Cystathionine Gamma Lyase (CSE), and by Cysteine AminoTransferase (CAT)/ 3-Mercaptopyruvate Sulfur Transferase (3MPST). A non-enzymatic, intravascular release is also in place. We retrospectively investigated the possibility to modulate the endogenous H2S release and signaling in humans by a dietary manipulation with supplemented micronutrients (L-cystine, Taurine and pyridoxal 5-phopsphate/P5P). Methods: Patients referring for antiaging purposes underwent a 10-day supplementation. Blood was collected at baseline and after treatment and the metabolome was investigated by mass spectrometry to monitor the changes in the metabolites reporting on H2S metabolism and related pathways. Results: Data were available from 6 middle aged subjects (2 women). Micronutrients increased 3-mercaptopyruvate ( P = .03), reporting on the activity of CAT that provides the substrate for H2S release within mitochondria by 3MPST, decreased lanthionine ( P = .024), reporting the release of H2S from CBS, and had no significant effect of H2S release from CSE. This is compatible with a homeostatic balancing. We also recorded a strong increase of reporters of H2S-induced pathways including 5-MethylTHF ( P = .001) and SAME ( P = .022), reporting on methylation capacity, and of BH4 ( P = .021) and BH2 ( P = .028) reporting on nitric oxide metabolism. These activations may be explained by the concomitant induction of non-enzymatic release of H2S. Conclusions: Although the current evidences are weak and will need to be confirmed, the effect of micronutrients was compatible with an increase of the H2S endogenous release and signaling within the control of homeostatic mechanisms, further endorsing the role of feeding in health and disease. These effects might result in a H2S boosting effect in case of defective activity of pathologic origin, which should be checked in duly designed clinical trials.
E-cigarette Use Among Middle and High School Students in New York City Before and After Passage of Tobacco 21
Authors: Debchoudhury Indira , Farley Shannon M , Roods Kristi , Talati Achala , Jasek John 
Published: January 2022

Introduction Despite declines in cigarette smoking in the US, electronic cigarette (e-cigarette) use has increased among middle and high school students. In 2014, New York City (NYC) implemented Tobacco 21 (T21) to prohibit sales to anyone under age 21. Our study goal was to measure the effectiveness of T21 on e-cigarette use. Methods We used the New York State (NYS) Youth Tobacco Survey—a biennial, school-based, self-administered survey. We explored middle (N = 5249) and high (N = 7296) school NYC students’ (male and female) current (past 30 days’) e-cigarette use from 2014 (pre-T21) to 2018 (post-T21). Results were compared with students in the rest of NYS (ROS). Bivariate and multivariable logistic regression analyses assessed correlates of e-cigarette use, beliefs about harmfulness, addictiveness, and susceptibility. Results NYC high school students’ current e-cigarette use increased from 2014 to 2018 (8.1% vs 23.5%, P < .001). Middle school students’ use increased between 2014 (4.8%) and 2016 (9.0%) yet reversed by 2018 (5.7%) (2014 vs 2018, P = .576). ROS middle school (2.2% vs 7.4%, P < .001) and high school (12.0% vs 29.3%, ( P < .001) use increased from 2014 to 2018. Willingness to try e-cigarettes among those who had never tried an e-cigarette was twice as high (AOR = 2.19, 95% CI = 1.15-3.17) among NYC high school students in 2018 compared with 2014. Conclusions E-cigarette use increased among NYC high school students despite T21. T21 may have reduced use among middle school students over time. Programs that denormalize e-cigarettes and policies that further restrict access are needed to decrease youth e-cigarette use.
Sufficient sleep duration in autistic children and the role of physical activity
Authors: Elkhatib Smidt Stacey D , Gooneratne Nalaka , Brodkin Edward S , Bucan Maja , Mitchell Jonathan A 
Published: January 2022

Emerging evidence suggests that physical activity may be associated with improved sleep in autistic children. We aimed to determine whether physical activity associated with sufficient sleep duration in children and whether this association was modified by reported autism spectrum disorder (ASD) status. We analyzed existing data of children 6–17 years old whose caregivers completed the 2018 National Survey of Children’s Health (nonautistic N = 20,845; ASD N = 681). Logistic regression determined whether physical activity (days active in the past week) associated with sufficient sleep duration. Physical activity-by-ASD interactions were included to determine whether the association differed for autistic children. Physical activity-by-ASD-by-sex and physical activity-by-ASD-by-age-group interactions were also modeled. Physical activity was associated with increased odds of sufficient sleep duration (e.g. 0 days vs 4–6 days: odds ratio (OR) = 1.85; 95% confidence interval (CI): 1.48–2.32). We did not observe an overall statistically significant interaction between physical activity and reported ASD status; however, the positive association between physical activity and sufficient sleep duration was weaker in autistic children, especially those with more severe ASD, female autistic children, and autistic children ages 6–12 years old. In conclusion, physical activity is a promising approach to improve sufficient sleep duration but with nuanced findings in autistic children. Lay abstract Higher levels of physical activity may be associated with improved sleep in children, but this relationship is still being determined, especially in autistic children. In this study, we used existing data from the 2018 National Survey of Children’s Health. Caregivers of children 6–17 years old, including caregivers of autistic children, completed a questionnaire that included questions about physical activity (days active in the past week) and sleep duration. We then determined if children were obtaining the recommended hours of sleep for their age (i.e. sufficient sleep). We found that higher physical activity levels were associated with sufficient sleep duration, but this finding was weaker in autistic children. In particular, this association was not observed in autistic children with more severe autism spectrum disorder, female autistic children, and autistic children 6–12 years old. In conclusion, physical activity is a promising approach to help children obtain sufficient sleep duration. However, more personalized approaches to improving sleep may be needed for certain groups of autistic children.