bluuebunny/crossref_metadata_2025_split huggingface dataset:
An Exploration of Young Adults With Opioid Use Disorder and How Their Perceptions of Family Members’ Beliefs Affects Medication Treatment
Authors: Bagley Sarah M. , Schoenberger Samantha F. , dellaBitta Vanessa , Lunze Karsten , Barron Kendyl , Hadland Scott E. , Park Tae Woo 
Published: June 2022

Background
Young adults with opioid use disorder (OUD) have low engagement and retention in medication treatment. Families are uniquely situated to play an important role in treatment decisions. This qualitative study explored how young adults with OUD perceive their families’ beliefs about OUD and medication treatment, and how those beliefs impacted young adults’ beliefs about their own treatment decisions.

Methods
We conducted a qualitative study of a convenience sample of 20 English-speaking young adults with OUD receiving care from an urban safety net hospital in Massachusetts. We explored young adults’ perceptions of how families viewed medication treatment. We conducted semi-structured interviews that were recorded and transcribed. We analyzed interviews using hybrid inductive and deductive categorization to support thematic analysis.

Results
We identified 3 themes. First, family history of substance use disorder and treatment negatively impacted how young adults perceive their OUD and medication treatment. Second, young adults shared that many families held negative or stigmatizing views of medication treatment. Finally, acceptance by family was important but young adults acknowledged that keeping treatment decisions from family was sometimes necessary.

Conclusions
In this qualitative exploration of young adults with OUD, we found that young adults felt that their families held important beliefs about the kind of treatment family members found most appropriate, and these perceived family beliefs impacted their treatment choices. Future research to improve engagement and retention of youth adults with OUD could target the beliefs of family members.
Therapeutic bronchoscopy for malignant central airway obstruction: impact on quality of life and risk-benefit analysis
Authors: Bashour Sami I. , Lazarus Donald R. 
Published: June 2022

Purpose of review
Malignant central airway obstruction (CAO) is a common complication in cancer and confers significant symptom burden and reduction in quality of life. Multiple bronchoscopic interventions exist for malignant CAO. In this review, we discuss the role of therapeutic bronchoscopy in the management of malignant CAO, emphasizing its impact on symptom control and quality of life while balancing the risks and benefits of intervention.

Recent findings
Significant practice variations exist among practitioners of therapeutic bronchoscopy, and limited data exist to guide real-time clinical decision-making. Recent analyses demonstrate that therapeutic bronchoscopy is effective for symptoms associated with malignant CAO with infrequent complications. These studies also show that many of the improvements in symptoms and quality of life are sustained after intervention and are associated with improved overall survival in patients with malignant CAO. Recent data have also shown that the improvement in symptoms associated with therapeutic bronchoscopy may enable more definitive cancer treatment, further improving patient outcomes.

Summary
Therapeutic bronchoscopy is safe and effective at improving patient-centered outcomes in malignant CAO. Research is ongoing to better understand its optimal role in this setting, refine decision-making regarding advanced bronchoscopic interventions, and further improve patient outcomes.
Effects of diabetes on osteocytes
Authors: Kaur Japneet , Khosla Sundeep , Farr Joshua N. 
Published: June 2022

Purpose of review
Better understanding of the mechanisms underlying skeletal dysfunction in the context of diabetes is needed to guide the development of therapeutic interventions to reduce the burden of diabetic fractures. Osteocytes, the ‘master regulators’ of bone remodeling, have emerged as key culprits in the pathogenesis of diabetes-related skeletal fragility.

Recent findings
Both type 1 diabetes and type 2 diabetes cause chronic hyperglycemia that, over time, reduces bone quality and bone formation. In addition to acting as mechanosensors, osteocytes are important regulators of osteoblast and osteoclast activities; however, diabetes leads to osteocyte dysfunction. Indeed, diabetes causes the accumulation of advanced glycation end-products and senescent cells that can affect osteocyte viability and functions via increased receptor for advanced glycation endproducts (RAGE) signaling or the production of a pro-inflammatory senescence-associated secretory phenotype. These changes may increase osteocyte-derived sclerostin production and decrease the ability of osteocytes to sense mechanical stimuli thereby contributing to poor bone quality in humans with diabetes.

Summary
Osteocyte dysfunction exists at the nexus of diabetic skeletal disease. Therefore, interventions targeting the RAGE signaling pathway, senescent cells, and those that inhibit sclerostin or mechanically stimulate osteocytes may alleviate the deleterious effects of diabetes on osteocytes and bone quality.
Trends in outpatient versus inpatient urologic surgery at a university academic medical center
Authors: Madhusoodanan Vinayak , Carto Chase , Parmar Madhumita , Ritch Chad , Parekh Dipen J. , Ramasamy Ranjith 
Published: June 2022

Purpose of review
To analyze trends in outpatient and inpatient urologic surgeries at a large university academic medical center and test the hypothesis that the proportion of outpatient surgeries has been increasing as compared to inpatient surgeries in urology.

Recent findings
We analyzed a total of 33,054 claims for urologic surgeries at a large university academic medical center from 2010 to 2020, of which 23.2% met inpatient criteria (n = 7695), whereas 76.7% were outpatient (n = 25,359). Although outpatient claims increased yearly by an average of 24%, inpatient claims increased yearly by an average of only 1%. Over the same period, Medicare-specific outpatient claims mirrored these trends, and Medicare-specific inpatient claims decreased.

Summary
Outcomes of inpatient surgeries are used as a metric for quality by the Centers for Medicare and Medicaid Services (CMS) as well as US News and World Report (USNWR) rankings. However, with increasing numbers of minimally invasive operations, a large proportion of urologic surgeries are performed on an outpatient basis. As this trend continues, it will be important for organizations like CMS and USNWR to incorporate methods of measuring quality that better reflect outpatient surgical outcomes for the urologic subspecialty.
Nonmuscle-invasive bladder cancer, old problems, new insights
Authors: Compérat Eva , Wasinger Gabriel , Oszwald André , Pradere Benjamin , Shariat Shahrokh 
Published: June 2022

Purpose of review
Nonmuscle-invasive bladder cancer (NMIBC) is the most frequent bladder cancer and represents around 75% of bladder cancers. This review will discuss known challenges and recent advances in staging, grading and treatment stratification based on pathology.

Recent findings
Pathological staging and grading in NMIBC remains challenging and different techniques exist. Substaging has been shown to be of prognostic relevance and to help predict treatment response in patients receiving Bacillus Calmette-Guérin (BCG) therapy, which is the treatment of choice for high-grade NMIBC. Recent advances in molecular classification and artificial intelligence were also able to show promising results in the stratification of patients.

Summary
Many challenges in the diagnosis of NMIBC are still unresolved and ask for more prospective research. New technologies, molecular insights and AI will help in the upcoming years to better stratify and manage these patients.
Surviving a Cyberattack in Anatomic Pathology: Disaster Response and Creation of an Incident Command System
Authors: Stowman Anne M. , Kalof Alexandra N. 
Published: June 2022

Abstract
Laboratories are increasingly reliant on networked electronic health information systems and therefore especially vulnerable to prolonged downtimes for a variety of reasons, which can be planned or unanticipated events. Our hospital was the victim of a cyberattack causing a complete shutdown of all computer systems, a downtime that lasted 25 days. The effects were devastating for patients, hospital employees, financials, public opinion, and hospital operations. After a week of downtime in the anatomic pathology laboratory, it became evident that our laboratory needed to rethink our organizational structure in order to regain operational status. It was then that we developed an Incident Command System, which allowed for 2-way communication and provided the adaptability and support needed to respond to the rapid process changes needed during the crisis.
The Value and Challenges of Internal Error Tracking in Anatomic Pathology Quality Management
Authors: Jacobs Jonathan , Staats Paul N. 
Published: June 2022

Abstract
A case of a sudden increase in reports of a specific error in the anatomic pathology laboratory is evaluated, yielding insights into the value, challenges, and limitations of using error reports as a quality management tool. The discussion considers the utility of a robust error-reporting system for anatomic pathology laboratories and identifies key factors at each step to improve success. Initial reporting must be easy and rewarding to reporters, and they must have confidence that reporting will not result in adverse impacts on coworkers. Categorization of common errors simplifies reporting, investigation, tracking, and data presentation. Response to errors should focus on addressing system design failures, while also providing nonjudgmental, nonpunitive feedback to individuals. Error categories can be chosen for systematic quality improvement projects based on severity and frequency of the error. When monitoring trends in error data, it is important to remember that the data are very sensitive to changes in reporting rates as well as changes in error rates, so they must be interpreted with great caution.
A Framework for Utilization of Turnaround Time as a Quality Metric in Surgical Pathology
Authors: DeSimone Mia S. , Heher Yael K. 
Published: June 2022

Abstract
Timeliness of surgical pathology result reporting is a critical quality metric for patients and treating clinicians. Over the past several decades, studies have sought to define laboratory turnaround time (TAT) in the context of the surgical pathology workflow, investigate the various factors that influence TAT, and develop a framework to monitor, measure, and track TAT within and across laboratories. However, the complexity of health care delivery and health information technology creates barriers to tracking TAT that should be considered in the context of local environments. We seek to provide background and context as well as a framework for tracking TAT as a key quality metric in surgical pathology. We outline a roadmap to monitoring local TAT to maximize efficiency and customer satisfaction while reducing diagnostic error and near-miss safety events.
Pediatric Penile Bee Sting
Authors: Huseynov Mirzaman , Cebisli Ali , Ozturk Atiye , Sahin Mahmut , Akin Ozdemir Merve , Polat Mustafa 
Published: June 2022

Objectives
The aims of this study, for the first time in the literature, are to evaluate the symptoms, clinical course, and treatment management of penile bee stings in children and to discuss whether bee stings can be evaluated within the scope of summer penile syndrome.

Methods
Records of all pediatric patients presented to the emergency department of our hospital from June 2020 to October 2021 due to bee sting of penis were reviewed. Only patients with isolated penile bee stings were included in the study. Patients were evaluated in terms of the age at presentation, time of occurrence, symptoms, and treatment modality.

Results
There were 10 patients treated for penile bee sting. Patients ranged in age from 3 to 7 years (mean, 4.2 years). The most common complaints of the patients at presentation were pain (100%), swelling (100%), and dysuria (70%). Three of the patients were unable to void. The gauze moistened with warm saline was applied to the penis of these patients who developed glob, and all of these patients urinated after the warm application. Three of the patients had progressive erythema on the penile skin. These patients were admitted to the pediatric surgery department to monitor whether skin necrosis would develop. In all patients, the erythema regressed significantly within 48 hours and regained its completely normal appearance at the end of 72 hours.

Conclusions
The probability of the development of serious local reactions and urological problems in penile bee stings is low. Oral nonsteroidal anti-inflammatory drug and warm, wet dressing are usually sufficient to treat local reactions. Penile bee stings may be evaluated within the scope of summer penile syndrome because their symptoms, clinical findings, and treatments are almost similar.
Low Relevancy of Outcome Measurements of Studies of Pediatric Pain in the Emergency Department
Authors: de Vries Tjalling W. 
Published: June 2022

Many children visiting the emergency department (ED) experience pain. Several pharmacological and nonpharmacological interventions are used for pain control. Little is known about the outcome measurements in studies about pain in children in the ED.
Furthermore, it is not known if complete pain relief was reached.

Methods
PubMed, the Cochrane Database of Systematic Reviews, and EMBASE were searched for articles on clinical trials for pain relief in children in the ED. Inclusion criteria contained predictable and identifiable pain such as after trauma or during procedures.

Results
Of 620 articles found, 45 fulfilled the criteria. Twenty studies (44%) used pharmacological interventions, and 25 (56%) studied nonpharmacological interventions. In 24 studies (53%), a statistically significant pain reduction was described in the intervention group. In 21 studies (47%), a clinically relevant reduction in pain was found. In only 1 study, the reported aim was to reach absence of pain.

Conclusion
Half of the interventions decreased pain in children in the ED. However, most studies did not aim at complete pain relief. Even in intervention groups with statistically significant decrease in pain, children still had pain. Children in the ED deserve better.
Complete pain relief should be the goal of any intervention for these children in the ED.
Studies on pain treatment in the ED should have complete pain relief as primary end point.
Color-matching techniques for creating esthetic hand and finger prostheses
Authors: Leow Michael E. L. , Puhaindran Mark E. , Chong Alphonsus K. S. 
Published: June 2022

Background:
Color matching is a critically important part of, and by far, also the most challenging aspect of producing esthetic silicone prosthesis. There is a knowledge gap in the literature and a lack of opportunities for training in the expertise, particularly regarding color-matching techniques.

Objective:
This article details a color-matching technique that is able to achieve life-like coloration in esthetic prosthesis.

Technique:
Each prosthesis is molded in an outer and inner layers of silicone tinted to different shades and opacities incorporating an intermediate touch-up layer to reproduce the detailed coloration of the hand (because of the presence of veins, finger joint/dermal pigmentations, a vascularized nail bed, and pinkish palm). This method of color-matching prosthesis combining intrinsic and extrinsic techniques simulates the layered anatomy and optical properties of the human skin to effectively replicate its esthetic and life-like coloration. Technical tips for achieving an accurate color match to the patient’s skin, including pigment formulation adjustments for a tanned vs. a fair skin, and for painting the touch-up details are discussed. Methods for modifying the color tones of completed prosthesis and for minimizing metameric color differences when the prosthesis is viewed under different light sources are also presented.

Discussion:
The technique is instrumental in achieving good outcomes for life-likeness and esthetic coloration in the prostheses fitted at our center. Studies previously published that investigated patients’ evaluation of important esthetic characteristics of their prosthesis after a period of adjustment to fitting have shown a generally high level of patient satisfaction.
Derivation and validation of an improved pediatric shock index for predicting need for early intervention and outcomes in pediatric trauma
Authors: Georgette Nathan , Keskey Robert , Hampton David , Alberto Emily , Chokshi Nikunj , Zakrison Tanya L. , Wilson Kenneth , McQueen Alisa , Burd Randall S. , Slidell Mark B. 
Published: June 2022

BACKGROUND
Shock index, pediatric age adjusted (SIPA), has been widely applied in pediatric trauma but has limited precision because of the reference ranges used in its derivation. We hypothesized that a pediatric shock index (PSI) equation based on age-based vital signs would outperform SIPA.

METHODS
A retrospective cohort of trauma patients aged 1 to 18 years from Trauma Quality Programs — Participant Use File 2010 to 2018 was performed. A random 70% training subset was used to derive Youden index–optimizing shock index (SI) cutoffs by age for blood transfusion within 4 hours. We used linear regression to derive equations representing the PSI cutoff for children 12 years or younger and 13 years or older. For children 13 years or older, the well-established SI of 0.9 remained optimal, consistent with SIPA and other indices. For children 12 years or younger in the 30% validation subset, we compared our age-based PSI to SIPA as predictors of early transfusion, mortality, pediatric intensive care unit admission, and injury severity score of ≥25. For bedside use, a simplified “rapid” pediatric shock index (rPSI) equation was also derived and compared with SIPA.

RESULTS
A total of 439,699 patients aged 1 to 12 years met the inclusion criteria with 2,718 (1.3% of those with available outcome data) requiring transfusion within 4 hours of presentation. In the validation set, positive predictive values for early transfusion were higher for PSI (8.3%; 95% confidence interval [CI], 7.5–9.1%) and rPSI (6.3%; 95% CI, 5.7–6.9%) than SIPA (4.3%; 95% CI, 3.9–4.7%). For early transfusion, negative predictive values for both PSI (99.3%; 95% CI, 99.2–99.3%) and rPSI (99.3%; 95% CI, 99.2–99.4%) were similar to SIPA (99.4%; 95% CI, 99.3–99.4%).

CONCLUSION
We derived the PSI and rPSI for use in pediatric trauma using empiric, age-based SI cutoffs. The PSI and rPSI achieved higher positive predictive values and similar negative predictive values to SIPA in predicting the need for early blood transfusion and mortality.

LEVEL OF EVIDENCE
Prognostic/Epidemiological; level III.
High Altitude as a Risk Factor for the Development of Nonarteritic Anterior Ischemic Optic Neuropathy
Authors: Liu Yin A. , Mesentier-Louro Louise A. , Shariati Mohammad A. , Moss Heather E. , Beres Shannon J. , Liao Yaping Joyce 
Published: June 2022

Background:
Episodic high-altitude exposure leads to optic disc edema and retinopathy. It is uncertain whether high-altitude exposure is a risk factor for nonarteritic anterior ischemic optic neuropathy (NAION).

Methods:
We performed a single-center, retrospective, cross-sectional case study of 5 patients with high-altitude–associated NAION (HA-NAION) from April 2014 to April 2019. Main study parameters included known vascular risk factors for NAION, evolution of visual acuity, visual field, optic disc, and macula measurements.

Results:
We studied 5 eyes of 5 patients with HA-NAION that occurred at 7,000–9,000 ft above sea level, 28 patients with classic NAION that developed at sea level (normal altitude NAION or NA-NAION), and 40 controls. All 5 patients with HA-NAION had clinically confirmed NAION by a neuro-ophthalmologist within 3–21 days of onset and comprehensive follow-up evaluations (average follow-up of 23 months). Other than high-altitude exposure, 4 of 5 patients had undiagnosed obstructive sleep apnea (OSA, apnea–hypopnea index 5.4–22.2) and 1 had systemic vascular risk factors. All patients had disc-at-risk in the contralateral eye. The best-corrected distance visual acuity was 20/20 to 20/70 (median logMAR 0) at presentation and 20/70 to counting finger (median logMAR 0) at ≥6 months. Automated static perimetry revealed average mean deviation of −18.6 dB at presentation and −22.1 dB at ≥6 months. The average retinal nerve fiber layer was 244 µm (80–348 µm) at onset and 59 µm (55–80 µm) at ≥6 months. The average ganglion cell complex thickness was 50 µm (43–54 µm) at onset and 52 µm (50–55 µm) at ≥6 months. The patients with OSA were started on home continuous positive airway pressure treatment. Visual outcomes were similar in patients with HA-NAION and NA-NAION. - After addressing all NAION risk factors, no new events occurred in the HA-NAION group within 2-8 years with or without repeat high-altitude exposure.

Conclusions:
NAION can occur under high-altitude conditions. HA-NAION is associated with relatively younger age at onset, disc-at-risk, and OSA. These patients exhibit a relatively progressive course of vision loss after initial onset and severe thinning of optic nerves on optical coherence tomography. Treatment for OSA is recommended, especially with repeated high-altitude exposure.
A taste for numbers:Caenorhabditis elegansforaging follows a low-dimensional rule of thumb
Authors: Madirolas Gabriel , Al-Asmar Alid , Gaouar Lydia , Marie-Louise Leslie , Garza-Enriquez Andrea , Khona Mikail , Ratzke Christoph , Gore Jeff , Pérez-Escudero Alfonso 
Published: June 2022

AbstractRules of thumb are behavioral algorithms that approximate optimal behavior while lowering cognitive and sensory costs. One way to reduce these costs is by reducing dimensionality: While the theoretically optimal behavior may depend on many environmental variables, a rule of thumb may use a low-dimensional combination of variables that performs reasonably well. Experimental proof of a dimensionality reduction requires an exhaustive mapping of all relevant combinations of several environmental parameters, which we performed forCaenorhabditis elegansforaging by covering all combinations of food density (across 4 orders of magnitude) and food type (across 12 bacterial strains). We found a one-dimensional rule: Worms respond to food density measured as number of bacteria per unit surface, disregarding other factors such as biomass content or bacterial strain. We also measured fitness experimentally, determining that the rule is near-optimal and therefore constitutes a rule of thumb that leverages the most informative environmental variable.