bluuebunny/crossref_metadata_2025_split huggingface dataset:
Emergency Clinician Buprenorphine Initiation, Subsequent Prescriptions, and Continuous Prescriptions
Authors: Dekker Annette M. , Schriger David L. , Herring Andrew A. , Samuels Elizabeth A. 
Published: February 2025

ImportanceRates of opioid use disorder (OUD) and associated mortality in the US remain high. Treatment of OUD with buprenorphine reduces morbidity and mortality. There have been national efforts to expand buprenorphine initiation to the emergency department (ED), where many patients with low treatment access seek medical care. Adoption and trends of emergency clinician buprenorphine prescribing are unknown.ObjectiveTo describe emergency clinician buprenorphine initiation for OUD, subsequent prescriptions, and changes over time in California.Design, Setting, and ParticipantsObservational retrospective study of buprenorphine prescriptions in the California Controlled Substance Utilization Review and Evaluation System (CURES) database from January 1, 2017, to December 31, 2022. Any patient aged 18 to 79 years with a California zip code who filled a buprenorphine prescription in CURES and their California prescribers were eligible for inclusion.ExposureBuprenorphine prescription by an emergency clinician.Main Outcomes and MeasuresOutcomes included (1) the number of patients prescribed buprenorphine; (2) the number of clinicians prescribing buprenorphine; (3) the number and characteristics of buprenorphine prescriptions; (4) the percentage of emergency clinician buprenorphine initiation prescriptions with subsequent linkage to a second prescription and continuous prescriptions, also reported as a continuation ratio; and (5) days and number of initiation prescriptions prior to continuous prescriptions.ResultsIn this retrospective observational study, 345 024 patients received 3.8 million buprenorphine prescriptions from 21 099 clinicians in California from 2017 to 2022. The mean age of patients at the time of first buprenorphine prescription was 37 years; 8187 (67%) were male. Emergency clinicians increased from 2% (n = 78) to 16% (n = 1789) of buprenorphine prescribers in 2017 and 2022, respectively (P &amp;lt; .001). Buprenorphine initiation prescriptions by emergency clinicians increased from 0.1% (n = 53) to 5% (n = 4493) of all initiation prescriptions in 2017 and 2022, respectively (P = .001). The continuation ratio for patients to receive a second prescription within 40 days of an ED initiation was 2.8 (10 823/3916). The continuation ratio for patients to start 180 days or more of continuous prescriptions within 40 days of ED buprenorphine initiation was 18.3 (10 823/593) and 9.1 within 1 year (5989/655 [2017-2021 data]).Conclusions and RelevanceThese findings suggest increasing prescription of buprenorphine for OUD by California emergency clinicians from 2017 to 2022, with approximately 1 in 9 patients going on to receive continuous buprenorphine prescriptions within 1 year.
Risk of Cardiovascular Morbidity and Mortality in Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis Survivors
Authors: Chiu Hsien-Yi , Chiu Ying-Ming 
Published: February 2025

ImportanceStevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) cause diffuse epidermal detachment and necrosis. Patients who survive the initial SJS/TEN episodes are affected by various sequelae.ObjectiveTo investigate the risks of cardiovascular morbidity and mortality in SJS/TEN survivors.Design, Setting, and ParticipantsThis was a nationwide population-based cohort study using data from Taiwan’s National Health Research Institute Database linked to the National Register of Death databases for 1998 to 2021. Survivors of SJS/TEN were identified and matched with non-SJS/TEN participants by age, sex, and Charlson Comorbidity Index. Data analysis was performed from November 2023 to June 2024.ExposureCerebrovascular accidents (CVA) or ischemic heart disease (IHD) after SJS/TEN survival.Main Outcomes and MeasuresCox proportional hazards models were used to estimate the hazard ratios (HRs) of CVA and IHD morbidity and mortality after SJS/TEN survival.ResultsThe CVA cohort included 10 571 SJS/TEN survivors (mean [SD] age, 56.1 [18.5] years; 5358 females [50.7%] and 5213 males [49.3%]). The IHD cohort included 11 084 SJS/TEN survivors (mean [SD] age, 56.6 [18.6] years; 5561 females [50.2%] and 5523 males [49.8%]). The Cox proportional hazards model and competing risk regression model showed that compared with non-SJS/TEN participants, patients with SJS/TEN had higher risks of cardiovascular morbidity (CVA: HR, 1.65 [95% CI, 1.57-1.72] and subdistribution HR [sHR], 1.40 [95% CI, 1.33-1.46]; IHD: HR, 1.58 [95% CI, 1.51-1.65] and sHR, 1.32 [95% CI, 1.26-1.38]) and death due to cardiovascular disease (CVA: HR, 1.69; 95% CI, 1.46-1.96; IHD: HR, 1.55; 95% CI, 1.32-1.82). The increased cardiovascular mortality risks peaked at 1 year after SJS/TEN and persisted for 4 to 7 years. Older survivors and survivors admitted to an intensive care unit at SJS/TEN diagnosis had significantly higher cardiovascular mortality risk.Conclusions and RelevanceIn this cohort study, SJS/TEN had a lasting association with cardiovascular function after the acute phase. This suggests a need to mitigate the elevated cardiovascular morbidity and mortality risks among survivors. Further research using databases or registries with more comprehensive clinical data are needed to validate these results.
Patient-Physician Language Concordance and Cardiovascular Outcomes Among Patients With Hypertension
Authors: Reaume Michael , Labossière Mathieu N. , Batista Ricardo , Van Haute Stephanie , Tangri Navdeep , Rigatto Claudio , Bohm Clara , Prud’homme Denis , Tanuseputro Peter , Lix Lisa M. 
Published: February 2025

ImportancePatients who live in minority language communities often receive health care services of lower quality and safety compared with patients who speak the majority language. Yet the outcomes associated with care provided by physicians who speak a patient’s primary language remain unknown.ObjectiveTo examine patient-physician language concordance and the risk of major adverse cardiovascular events (MACEs) among patients with hypertension.Design, Setting, and ParticipantsThis retrospective cohort study identified adults with self-reported hypertension in the Canadian Community Health Survey, a national survey that collects data from a representative sample of Canadians, from January 1, 2003, to December 31, 2014. Respondents (excluding those living in Quebec) had their hospitalization and mortality records linked to their survey responses. Data were analyzed from October 2023 to May 2024.ExposuresRespondents’ primary home language was defined using language spoken most often at home. Language spoken with a regular physician was used to measure patient-physician language concordance. Respondents who spoke to their regular physician in their primary home language were classified as having received language-concordant care, while all other respondents were classified as having received language-discordant care.Main Outcomes and MeasuresMACEs within 5 years of survey completion.ResultsAmong the 124 583 patients included in this study, 114 239 (91.7%) spoke English, 4790 (3.8%) spoke French, 325 (0.3%) spoke an Indigenous language, and 5229 (4.2%) spoke an allophone (ie, other) language. The mean (SD) age of the cohort was 63.7 (14.8) years; 57.1% of the patients reported their sex as female. Very few respondents who spoke an Indigenous language at home (&amp;lt;4.6%) received language-concordant care. For French-speaking patients, there was no statistically significant difference in the risk of MACE between those who received language-concordant care and those who received language-discordant care (hazard ratio [HR], 1.09; 95% CI, 0.86-1.36). Allophone-speaking patients who received language-concordant care were 36% less likely to experience MACE (HR, 0.64; 95% CI, 0.51–0.80) compared with allophone-speaking patients who received language-discordant care.Conclusions and RelevanceThis retrospective cohort study found large disparities in both access to language-concordant care and risk of MACEs. These findings suggest that language-concordant care could potentially improve the health of individuals in minority language communities.
Socioeconomic Differences in Vaccination Coverage After a Mandatory Vaccination Law, 1855-1900
Authors: Ukonaho Susanna , Lummaa Virpi , Briga Michael 
Published: February 2025

ImportanceMandatory vaccination is a major tool to combat increasing vaccine hesitancy. In principle, a vaccination law, ie, a mandatory vaccination law without exemptions, applies equally to everyone, but its effects across different socioeconomic groups (SEGs) remain unknown.ObjectiveTo examine the association of a vaccination law with vaccination coverage in different SEGs during 1855 to 1900.Design, Setting, and ParticipantsThis population-based cohort study monitored 45 years (1855-1900) of Finland’s first vaccination campaign against smallpox to estimate the association of the 1883 vaccination law with vaccination coverage in infants (age &amp;lt;1 year) across different SEGs. Data were analyzed from October 2023 to January 2024.ExposureA mandatory smallpox vaccination law for all children.Main Outcomes and MeasuresVaccination status was determined from vaccination records and defined as receiving 1 dose of the smallpox vaccine. The primary outcome was the annual vaccination coverage in different SEGs and its change before vs after the vaccination law.ResultsA total of 40 008 children aged less than 1 year were included. The high SEG had high vaccination coverage, at a mean (SD) of 90% (49 percentage points), and the law was associated with halting its declining trend. For the middle SEG, the law was associated with a 26-percentage point increase in coverage, to a mean (SD) of 83% (50 percentage points). For the low SEG, the law had no association with vaccination coverage, which always remained below 35% (mean [SD]: prelaw, 26% [22 percentage points]; postlaw, 32% [23 percentage points]).Conclusions and RelevanceIn this cohort study, a historic vaccination law was not associated with increased vaccination in the SEG with the lowest vaccination coverage, emphasizing the need for additional interventions to increase vaccine uptake in low-coverage communities.
Clinician Experiences With Ambient Scribe Technology to Assist With Documentation Burden and Efficiency
Authors: Duggan Matthew J. , Gervase Julietta , Schoenbaum Anna , Hanson William , Howell John T. , Sheinberg Michael , Johnson Kevin B. 
Published: February 2025

ImportanceTimely evaluation of ambient scribing technology is warranted to assess whether this technology can lessen the burden of clinical documentation on clinicians.ObjectiveTo investigate the association of ambient scribing technology with efficiency, quality, and perceived burden of clinical documentation in the outpatient setting.Design, Setting, and ParticipantsThis prospective, single-group pre-post quality improvement study was conducted between April and June 2024 in the outpatient setting of an academic health system in Philadelphia, Pennsylvania. Participants included physicians, nurse practitioners, and physician assistants. Data were analyzed from July to August 2024.ExposureAccess to an artificial intelligence–driven ambient scribing tool for outpatient notes.Main Outcomes and MeasuresThe primary outcomes were time in notes per appointment, same-day appointment closure, after-hours work time, perceived burden of clinical documentation, and comments on clinicians’ experiences using ambient scribing. A mixed-effects model was used. Both objective metrics and survey feedback were obtained. Targeted perspective questions, designed to assess clinician-perceived patient engagement and perceived documentation burden, were assessed on a 7-point Likert scale. Standard System Usability Scale (SUS) and net promoter score (NPS) formulas were used to analyze usability and recommendability data.ResultsThis study included 46 clinicians from 17 different medical specialties, with a mean (SD) of 11.1 (8.7) years in practice. From baseline to post intervention, use of the ambient scribing tool was associated with 20.4% less time in notes per appointment (from 10.3 to 8.2 minutes; P &amp;lt; .001), 9.3% greater same-day appointment closure (from 66.2% to 72.4%; P &amp;lt;.001), and 30.0% less after-hours work time per workday (from 50.6 to 35.4 minutes per workday; P = .02). Targeted perspective questions showed more favorable scores. Open-ended qualitative feedback from clinicians showed a range of positive, negative, and mixed feedback regarding their use of ambient scribing technology. SUS scores showed that the ambient scribing tool was easy to use. NPSs reflected the mixed qualitative feedback.Conclusions and RelevanceIn this quality improvement study, the use of ambient scribe technology was associated with greater efficiency of outpatient clinical documentation, lower mental burden of documentation for clinicians, and greater sense of engagement with patients during outpatient appointments. Additional studies exploring urgent care settings, examining patient experience, and comparing multiple tools will be important to better understand the effect of ambient scribing on ambulatory care.
Predicting Diagnostic Progression to Schizophrenia or Bipolar Disorder via Machine Learning
Authors: Hansen Lasse , Bernstorff Martin , Enevoldsen Kenneth , Kolding Sara , Damgaard Jakob Grøhn , Perfalk Erik , Nielbo Kristoffer Laigaard , Danielsen Andreas Aalkjær , Østergaard Søren Dinesen 
Published: February 2025

ImportanceThe diagnosis of schizophrenia and bipolar disorder is often delayed several years despite illness typically emerging in late adolescence or early adulthood, which impedes initiation of targeted treatment.ObjectiveTo investigate whether machine learning models trained on routine clinical data from electronic health records (EHRs) can predict diagnostic progression to schizophrenia or bipolar disorder among patients undergoing treatment in psychiatric services for other mental illness.Design, Setting, and ParticipantsThis cohort study was based on data from EHRs from the Psychiatric Services of the Central Denmark Region. All patients aged 15 to 60 years with at least 2 contacts (at least 3 months apart) with the Psychiatric Services of the Central Denmark Region between January 1, 2013, and November 21, 2016, were included. Analysis occurred from December 2022 to November 2024.ExposuresPredictors based on EHR data, including medications, diagnoses, and clinical notes.Main Outcomes and MeasuresDiagnostic transition to schizophrenia or bipolar disorder within 5 years, predicted 1 day before outpatient contacts by means of elastic net regularized logistic regression and extreme gradient boosting (XGBoost) models. The area under the receiver operating characteristic curve (AUROC) was used to determine the best performing model.ResultsThe study included 24 449 patients (median [Q1-Q3] age at time of prediction, 32.2 [24.2-42.5] years; 13 843 female [56.6%]) and 398 922 outpatient contacts. Transition to the first occurrence of either schizophrenia or bipolar disorder was predicted by the XGBoost model, with an AUROC of 0.70 (95% CI, 0.70-0.70) on the training set and 0.64 (95% CI, 0.63-0.65) on the test set, which consisted of 2 held-out hospital sites. At a predicted positive rate of 4%, the XGBoost model had a sensitivity of 9.3%, a specificity of 96.3%, and a positive predictive value (PPV) of 13.0%. Predicting schizophrenia separately yielded better performance (AUROC, 0.80; 95% CI, 0.79-0.81; sensitivity, 19.4%; specificity, 96.3%; PPV, 10.8%) than was the case for bipolar disorder (AUROC, 0.62, 95% CI, 0.61-0.63; sensitivity, 9.9%; specificity, 96.2%; PPV, 8.4%). Clinical notes proved particularly informative for prediction.Conclusions and RelevanceThese findings suggest that it is possible to predict diagnostic transition to schizophrenia and bipolar disorder from routine clinical data extracted from EHRs, with schizophrenia being notably easier to predict than bipolar disorder.
Comparing International Revision Incidence of Commonly Used Breast Implants
Authors: Vrolijk J. Juliët , Becherer Babette E. , Garduce Patrick , Pourghaderi Ahmad Reza , Young-Afat Danny A. , van der Hulst René R. J. W. , Farrell Gillian , Walker Melanie , Tansley Patrick , Mureau Marc A. M. , Earnest Arul , Ahern Susannah , Rakhorst Hinne A. 
Published: February 2025

ImportanceDespite the widespread use of breast implants, to date, no large-scale international studies on long-term revision incidence of different implant types have been conducted.ObjectiveTo determine whether international data could be combined using a harmonized dataset to increase power and investigate clinically relevant differences in complication-related revision incidence between breast implant types.Design, Setting, and ParticipantsThis multicenter, population-based cohort study used data from the Australian Breast Device Registry and the Dutch Breast Implant Registry from 2016 to 2021. Time-to-event analysis was performed using a frailty Cox proportional hazards regression model with pooled data. The study included all permanent breast implants that were inserted for primary postmastectomy or benign breast reconstruction or cosmetic augmentation. Data were analyzed from January 1, 2016, through December 31, 2021.ExposurePermanent breast implants grouped based on implant shape, shell, and fill.Main outcomes and measuresComplication-related revision incidence between breast implant types.ResultsData exchange between registries was successful. In total, 21 115 reconstructive and 129 854 cosmetic breast implants inserted in patients with a median (IQR) age of 47 (38-55) years and 31 (25-38) years, respectively, were included. Overall complication-related revision was 6.3% for reconstructive and 1.2% for cosmetic implants. For reconstructive implants, hazard ratios (HRs) for implant types showed no significant differences compared with anatomical textured-silicone implants. For cosmetic implants, anatomical polyurethane-silicone implants showed a lower risk of revision (HR, 0.38; 95% CI, 0.22-0.64) compared with anatomical-textured-silicone implants. At 5 years, no significant differences in cumulative revision incidence were observed between implant types for either reconstructive or cosmetic implants.Conclusions and relevanceThis study showed that international datasets can be pooled to assess real-world incidence of breast implant revision, which is anticipated to generate a foundation on which future breast implant studies can be based.
Cybernationalism
Authors: LaSaine Emma‐Claire 
Published: February 2025

Abstract

Cybernationalism refers to the expression, construction, or organization of nationalism through use of the Internet. Alternately called
digital nationalism
,
Internet nationalism
, and
virtual nationalism
, this form of nationalism is unique to the information age. Internet communication differs from traditional print media in terms of its geographical reach and temporality, its participatory nature and the opportunities it offers for anonymity, and the dominance of English‐language and US‐based digital technology companies. These features influence the process of national identity formation, organizing opportunities for insurgent nationalist movements, and opportunities for states to solidify hegemonic nationalisms through the Internet.
Race, Racism, and Mental Health
Authors: Talbert Ryan D. , Ren Junlan 
Published: February 2025

Abstract
Informed by insights from the stress process model and critical race theory, this entry offers a concise synthesis of sociological inquiry into associations between race/ethnicity and mental health. As a racialized social system and fundamental determinant of health, racism shapes ethnoracial variation in mental health via inequitable stress exposure, access to resources, and institutional responses. Research generally identifies more similarities than differences in mental health across races/ethnicities, though patterns often depend on the measure used. When differences arise, Asian, Latinx, and Black Americans typically have a lower prevalence of mental illness than white Americans and Native Americans, though extensive variation exists within all of these groups. Future inquiry can benefit from critically examining the social determinants of mental health that extend from systemic racism (e.g., racialized stressors). The diversifying ethnoracial composition and heterogeneity within groups provide an opportunity for scholarship to enhance understanding and theorizing of associations between race/ethnicity and mental health.
Corrections
Authors: Moraro Piero 
Published: February 2025

Abstract
This entry outlines the history of the correctional system, focusing on the evolution in prison design from the eighteenth to the twenty‐first century. It presents the main arguments in the debate about the aims and justifications of state punishment. It also covers current trends in corrections, including the dominance of managerialism and risk management, and the rise of trauma‐informed approaches to prisons. Finally, recent arguments for reform of the correctional system, including penal abolitionism, are discussed.
Economic Development
Authors: Beamish Rob 
Published: February 2025

Abstract
Economic development studies are concerned with how nation‐states have, could, and/or should improve their populations' quality of life, reduce the infant mortality rate, and increase life expectancy through economic development. Despite the assessments of different development initiatives after World War II and the rise of development studies, there is no consensus on how best to pursue these goals. Nonetheless, the politically and socially important pursuit of economic development continues, and involves scholars, nation‐states, regional and international organizations, nongovernmental organizations, and philanthropic foundations. This entry examines six different phases of economic development and their theoretical perspectives during the post‐World War II period: the theory of modernization, which extended from 1945 into the 1960s; the development theory of Andre Gunder Frank and world‐systems theories of Immanuel Wallerstein that dominated in the 1960s and 1970s; the 1980s “developmental state” or “hard state” approach following the development successes of the East Asian Tigers; the neoliberal approach that took hold in the 1980s; the neoinstitutional approach beginning in the 1990s; and the rethinking of economic development in terms of genuine progress indicators rather than gross domestic product.
Media and the Public Sphere
Authors: Carpentier Nico 
Published: February 2025

Abstract
Reflections on media and the public sphere draw heavily on Habermas's definition of the concept. Alternative models have been developed, that build on the Habermasian approach, such as Nancy Fraser's counterpublics, although the concept is declining in popularity. This entry argues that how the field of communication and media studies uses the concept to make sense of the role of communication in noninstitutionalized politics is characterized by three dimensions: the normative versus the neutralized‐descriptive, the media‐centric versus the society‐centric, and the structural(ist) versus the cultural(ist).
Poverty and Free Trade
Authors: Henning Christoph 
Published: February 2025

Abstract
This entry discusses the dominant approaches to poverty in economic theory and argues that they are fundamentally flawed: they do not work in practice and rely on questionable models of ideal markets. Neoliberalism has led to increasing poverty worldwide and needs to be overcome by a more substantial understanding of poverty (not only relying on money and markets, but on real functions and the good life).