bluuebunny/crossref_metadata_2025 huggingface dataset:
Cancer risk in carriers of TP53 germline variants grouped into different functional categories
Authors: Müntnich Lucas John , Dutzmann Christina M , Großhennig Anika , Härter Valentina , Keymling Myriam , Mastronuzzi Angela , Montellier Emilie , Nees Juliane , Palmaers Natalie E , Penkert Judith , Pfister Stefan M , Ripperger Tim , Schott Sarah , Silchmüller Farina , Hainaut Pierre , Kratz Christian P
Published: January 2025

Li-Fraumeni syndrome is a cancer predisposition syndrome caused by pathogenic TP53 germline variants and associated with a high lifelong cancer risk. We analysed the German LFS registry that contains data on 304 individuals. Cancer phenotypes were correlated with variants grouped according to their ability to transactivate target genes in a yeast assay using a traditional (non-functional, partially-functional) and a novel (clusters A, B, C) classification of variants into different groups. Partially-functional and cluster B or C variants were enriched in patients not meeting clinical testing criteria. Time to first malignancy was longer in carriers of partially-functional variants (Hazard Ratio [HR] = 0.38; 95% CI, 0.22 to 0.66). Variants grouped within clusters B (HR = 0.45; 95% CI, 0.28 to 0.71) or C (HR = 0.34; 95% CI, 0.19 to 0.62) were associated with later cancer onset than NULL variants. These findings can be used to risk-stratify patients and inform care.
Addressing the widest answerable question: English “just” as a domain widening strategy
Authors: Deo Ashwini , Thomas William Carl
Published: January 2025

This paper offers a unified account of the English particle just that covers its exclusive, emphatic/intensifying, precisifying, unexplanatory, unelaborative, and counter-expectational uses. Drawing on an insight from another semantic domain, we claim that the chameleon-like behavior of just can be made sense of if we treat it as having a domain-widening function. The key proposal is as follows: the use of just indicates that the speaker is considering the widest set of alternative answers relevant at the context. The analysis relies on the notion of the optimal construal of an underspecified question, which makes use of a comparison between the inquisitivity of questions, modeled as the width of a question. The optimal construal of a question further depends on its answerability – i.e. whether the speaker considers a true answer to be accessible at the context (satisfying Quality) and whether the speaker considers addressing it to be relevant to discourse goals (satisfying Relevance). The diverse contextual effects of just that are observed arise from the interaction between the way in which the set of alternative answers to the underspecified question is construed and what is taken to be the speaker’s motivation for signaling that the widest answerable construal of the question is being addressed via the prejacent.
The role of religiosity and spirituality in coping with sickle cell disease clinical severity
Authors: Stewart Courtney A , Abdallah Khadijah E , Buscetta Ashley J , Galindo Corina , Ramirez Hasmin C , Williams David R , Bonham Vence L
Published: January 2025

Objectives

Religiosity and spirituality often play a role in managing chronic diseases. Sickle cell disease (SCD) is a genetic chronic disease associated with lifelong complications, but there is limited analysis of the potential impact of religiosity and spirituality on SCD. This study aims to analyze the association between constructs of religiosity and spirituality with health outcomes (disease severity, depression, and pain) in an SCD population (n = 275).

Methods

Data from the INSIGHTS Study (NCT02156102) were used for this analysis. The relationships between religious/spirituality measures (religious attendance, self-reported spirituality, religious saliency, coping, and support) and SCD outcomes (disease severity, depression, and pain scores) were analyzed through bivariate correlations and multivariable models. Models adjusted for different dimensions of religiosity and spirituality separately (Model 1) and all measures simultaneously (Model 2).

Results

In the bivariate analyses, we found a positive association between disease severity and spirituality (P < .05) and an inverse relationship between positive religious coping and depression (P = .01). In Model 1, which adjusted for individual measures separately, there was an association between SCD severity and spirituality (β = 0.07, P < .001) as well as with religious attendance (β = 0.02, P < .01). However, in the models that simultaneously adjusted for all the measures (Model 2), religious attendance was no longer associated with SCD severity (β = 0.006, P > .05), while the association with spirituality remained significant (β = 0.05, P < .05).

Conclusions

The observed associations between spirituality and disease severity among patients with SCD suggest that individuals with severe disease may beneficially use spirituality to cope with complications. Future research should rigorously evaluate this hypothesis.
Molecular mechanisms affected by boron deficiency in root and shoot meristems of plants
Authors: Chu Liuyang , Schäfer Cay Christin , Matthes Michaela S
Published: January 2025

Boron deficiency is an abiotic stress that negatively impacts plant growth and yield worldwide. Boron deficiency primarily affects the development of plant meristems, groups of stem cells critical for all postembryonic tissue growth. The link between boron and meristem development was first established in 1923, when boron’s essentiality was discovered. It remains, however, unclear whether boron directly integrates into molecular meristem pathways. In addition to its stabilizing function in the primary cell wall, growing evidence suggests roles of boron in various molecular processes including phytohormone cascades. These indications help enhance a mechanistic understanding of why boron is crucial for proper meristem development. In this review we compile and discuss molecular pathways influenced by boron availability in Arabidopsis (Arabidopsis thaliana), maize (Zea mays), rice (Oryza sativa), and oilseed rape (Brassica napus) with a focus on the auxin-, ethylene-, and cytokinin-mediated hormone cascades. We particularly compare and contrast phenotypic and molecular adaptations of shoot and root meristems to boron deficiency and pinpoint tissue-specific differences.
How digital paywalls shape news coverage
Authors: Dhillon Paramveer S , Panda Anmol , Hemphill Libby
Published: January 2025

The internet has significantly transformed how news is produced, consumed, and distributed. As a result, the news industry has transitioned from ad-supported to subscription-based models regulated by digital paywalls. In the light of this disruption, it is crucial to investigate not only how news consumers adapt to this change but also how economic incentives shape content coverage. We analyzed the staggered adoption of digital paywalls by 17 regional US newspapers over 17 years in a difference-in-difference framework to examine the impact of paywall adoption on topical news content coverage. Our results reveal a small but significant decrease in local and soft news coverage, with varying effects across different urban contexts. Specifically, local news coverage experienced a more substantial decline in smaller cities (population<500,000) and regions experiencing an influx of younger residents (age < 40 years). Conversely, soft news coverage increased in areas with a younger demographic influx, indicating a strategic shift by newspapers to cater to digital-savvy audiences and adapt to changing consumption patterns. Our findings underscore the delicate balance between financial imperatives and editorial choices in the newspaper industry and highlight the need for ongoing research into the effects of digital monetization strategies on journalistic content creation, media plurality, and civic accountability.
Exclusionary bargaining behavior in 14 countries: Prevalence and predictors
Authors: Baranski Andrzej , Haas Nicholas
Published: January 2025

Primates are known to engage in exclusionary behavior, forming alliances to block a minority from accessing scarce resources. Humans are no exception, and examples of exclusionary behavior abound in political, business, and social settings. However, despite its socio-economic relevance, little is known about the prevalence and determinants of such behavior worldwide. Conducting an experimental game in which a group divides resources by majority rule, we document considerable global heterogeneity in exclusionary behavior. Whereas exclusion is modal in some countries, inclusive behavior is the norm in others. Despite significant cross-country variability, we nevertheless find that individual-level characteristics matter similarly across contexts. Men, individuals with a deliberative reasoning style, and ideologically right-leaning individuals, are consistently and substantially more exclusionary. Cross-country differences in the formation of exclusionary alliances correlate with an original Hierarchy Tolerance Index, derived from variables measuring cultural acceptance of power inequalities. Our findings carry important implications for decision-making bodies, as they indicate that the identity of decision-makers and the culture in which they are embedded can affect how equitably resources are divided.
One loop β functions for mirror noncommutative Euclidean Yukawa sector within electroweak- scale right handed neutrinos model
Authors: Bouteldja K A , Bouayed N , Kouadik S , Ighezou F-Z
Published: January 2025

In this paper, we derive the renormalization scale dependence of noncommutative mirror Yukawa couplings. To achieve this, we first formulate an Euclidean noncommutative version of the Yukawa sector within the electroweak-scale mirror right handed neutrinos model. Then, we calculate the noncommutative one loop β functions of Yukawa couplings for mirror fermions involved in this model, by taking advantage of the Slavnov Taylor identities for the universal mirror Yukawa couplings, and by using the noncommutative vulcanised scalar and spinor propagators that prevent the UV/IR mixing. This leads us to a system of six cubic coupled first order differential equations that depend only on the mirror Yukawa couplings and not on the noncommutative deformation and vulcanised parameters. We solve this system numerically for different initial conditions to get the evolution of the mirror Yukawa couplings in terms of the renormalization scale. Furthermore, we discuss the link to the commutative case and analyze the occurrence of the Landau pole for some specific sets of initial conditions.
Melons as Lemons: Asymmetric Information, Consumer Learning and Seller Reputation
Authors: Bai Jie
Published: January 2025

Quality provision is often low in many developing markets, and firms commonly lack a reputation for quality. This article examines this issue both theoretically and empirically in the context of retail watermelon markets in China. I first demonstrate the existence of significant asymmetric information on quality between sellers and buyers, as well as the absence of a quality premium at baseline. To explain this, I develop a theoretical model that highlights the role of consumer beliefs and costly signalling in influencing sellers’ reputation incentives. I then conduct an experiment by randomly introducing two signalling technologies into different markets: a cheap sticker label and a more expensive laser-cut label. Consistent with the theoretical predictions, the laser label induces sellers to offer higher quality, resulting in increased sales and profits, while the sticker label fails to achieve the same effect. Using the experimental variation, I estimate an empirical model of consumer learning to uncover the underlying evolution of beliefs. The results show that pessimistic beliefs under the sticker label can hinder reputation building, whereas the laser label enhances consumer learning and strengthens sellers’ reputation incentives.
Barriers and facilitators to sustaining a lupus patient decision aid in regular rheumatology outpatient care in the US
Authors: Blanchard Erin E , Hall Allyson G , Gore Ezra , Jami Parvaneh Yaghoubi , Karabukayeva Aizhan , Hearld Larry R , Gontarz Shelby , Singh Jasvinder A
Published: January 2025

Objective

This study investigates the barriers and facilitators to sustaining a decision aid (DA) tool for patients with systemic lupus erythematosus (SLE) in routine rheumatology outpatient care across the U.S. The DA was initially developed for assisting Patients with SLE in making informed medication choices by providing personalized information on their treatment process.

Methods

We conducted semi-structured interviews with clinicians, administrators, and information technology (IT) professionals from 15 geographically diverse rheumatology clinics that participated in a large-scale DA implementation trial. Interviews were transcribed and analyzed using NVivo, with thematic coding to identify key factors influencing DA sustainability.

Results

Analysis identified several facilitators, including the DA's user-friendly design and its effectiveness in simplifying complex medical information, aiding informed decision-making for Patients with SLE. Challenges included inconsistent staff knowledge about the DA, difficulties integrating the DA into clinical workflows, a lack of executive and physician champions, and a lack of structured training and communication strategies. Additionally, concerns were raised about the availability of staff support and the technological capabilities required to maintain the DA’s use.

Conclusion

To sustain the DA in clinical practice, there is a need for enhanced training programs, better workflow integration, in-clinic physician champions, and effective use of electronic medical records for DA dissemination. Addressing these areas can improve the DA's impact on patient education and decision-making, ensuring its continued use in routine care.
Urinary Chemistry in Healthy Cross-bred Pet Rabbits (Oryctolagus cuniculus) and Rabbits with Suspected Chronic Kidney Disease
Authors: Sze-Yu Yeh , Chi-Hsuan Sung , Pin-Chen Liu , Ching-Fen Wu , Tsai-Lu Lin , Tsung-Li Cheng , Chi-Chung Chou
Published: January 2025

Renal biomarkers for early detection of decreased kidney function have been extensively studied in dogs and cats, but there is limited research for pet rabbits. Specifically, studies on urinary indices for cross-bred rabbits are scarce. Therefore, this study aimed to assess the potential use of urinalysis in cross-bred pet rabbits. Urine samples from 30 healthy crossbred pet rabbits and 11 rabbits with suspected kidney disease (KD) from three clinics were collected. Reference intervals of urinary indices, including urinary protein, creatinine (uCRE), urinary protein-to-creatinine (UPC) ratio, gamma-glutamyl transferase (uGGT), and uGGT ratio, were established and compared to two published reference intervals (RIs). The results showed that healthy rabbits consistently had low urine protein levels and abnormal UPC ratios, compared to a published study involving only pure-bred rabbits. Rabbits with KD had higher urine protein levels and significantly higher UPC ratio (p<0.001), with 63% having ratios greater than 0.4. Additionally, rabbits with KD showed significantly (p<0.001) lower uCRE levels and urine specific gravity (USG) with elevated uGGT index (p<0.05), compared to the healthy group. Significant differences (p<0.05) were also observed in urine color, turbidity, pH, and positivity of the occult blood by dipstick. This study underscores potential breed-specific variations in urinary protein levels and UPC ratio, as well as highlights the diagnostic potential of USG, UPC ratio, and uGGT index in rabbits with KD. However, the presence of breed-specific variations and technical nuances in laboratory equipment necessitate careful interpretation of results. Therefore, further studies across larger and more diverse rabbit populations are crucial to validate the diagnostic performance of urinary indices in diagnosing KD in rabbits.
Evaluation of fungicides for hop powdery mildew, Toppenish, Washington, 2024
Authors: Massie Stephan , Richardson Briana , Patel Jaimin , Gent David H.
Published: January 2025

Powdery mildew of hop is caused by Podosphaera macularis. This disease affects all green tissue of the hop plant, forming the characteristic signs of white colonies that bear mycelia and conidia and which lead to browning, shatter, and yield damage when infection occurs on the inflorescence. This report communicates efficacy data of various fungicides against powdery mildew. This trial was conducted on the hop cultivar ‘Zeus’ during the spring and summer of 2024, near Toppenish, Washington. Results from this trial will help producers develop more effective management approaches for the disease.
CRM1 regulates androgen receptor stability and impacts DNA repair pathways in prostate cancer, independent of the androgen receptor
Authors: Kumar Rajendra , Mendonca Janet , Shetty Abhishek , Yang Yuhan , Owoyemi Olutosin , Wilson Lillian , Boyapati Kavya , Topiwala Deven , Thomas Naiju , Nguyen Huong , Luo Jun , Paller Channing J. , Denmeade Samuel R. , Carducci Michael A. , Kachhap Sushant K.
Published: January 2025

Among the known nuclear exportins, CRM1 is the most studied prototype. Dysregulation of CRM1 occurs in many cancers, hence, understanding the role of CRM1 in cancer can help in developing synergistic therapeutics. The study investigates how CRM1 affects prostate cancer growth and survival. It examines the role of CRM1 in regulating androgen receptor (AR) and DNA repair in prostate cancer. Our findings reveal that CRM1 influences AR mRNA and protein stability, leading to a loss of AR protein upon CRM1 inhibition. Furthermore, it highlights the involvement of HSP90 alpha, a known AR chaperone, in the CRM1‐dependent regulation of AR protein stability. The combination of CRM1 inhibition with an HSP90 inhibitor demonstrates potent effects on decreasing prostate cancer cell growth and survival. The study further explores the influence of CRM1 on DNA repair proteins and proposes a strategy of combining CRM1 inhibitors with DNA repair pathway inhibitors to decrease prostate cancer growth. Overall, the findings suggest that CRM1 plays a crucial role in prostate cancer growth, and a combination of inhibitors targeting CRM1 and DNA repair pathways could be a promising therapeutic strategy.
Simulated microgravity predisposes kidney to injury through promoting intrarenal artery remodeling
Authors: Lyu Qiang , Zhao Delong , Liu Jiaqi , Zhang Yingjie , Wang Qian , Wang Xu , Chen Jingjing , Chi Yunxia , Li Ping , Cai Guangyan , Zhang Li , Ma Jin , Chen Xiangmei
Published: January 2025

Spaceflight‐induced multi‐organ dysfunction affects the health of astronauts and the safety of in‐orbit flight. However, the effect of microgravity on the kidney and the underlying mechanisms are unknown. In the current study, we used a hindlimb unweighting (HU) animal model to simulate microgravity and employed histological analysis, ischemia–reperfusion experiments, renal ultrasonography, bioinformatics analysis, isometric force measurement, and other molecular experimental settings to evaluate the effects of microgravity on the kidneys and the underlying mechanisms involved in this transition. Relative to controls, 31‐day hindlimb unweighting had no obvious effect on serum creatinine and urea nitrogen levels as well as on renal injury scores; however, animals in the HU group showed an impaired renal recovery to ischemia–reperfusion injury. Ultrasonography showed that renal resistive index was increased, which indicated an altered renal hemodynamics induced by simulated microgravity. The enhanced vasoconstriction mediated by the Rho‐kinase pathway and impaired vasodilation mediated by NO‐eNOS of the intrarenal artery contributed to the altered renal hemodynamics. Simulated microgravity predisposes the kidney to ischemia–reperfusion injury. The altered renal hemodynamics induced by renal arterial remodeling may account for the increased renal injury susceptibility, providing a target for early intervention in kidney dysfunction under microgravity.
Segment specific loss of NFAT5 function in the kidneys is sufficient to induce a global kidney injury like phenotype
Authors: Engel Kristina , Kulow Vera Anna , Chernyakov Dmitry , Willscher Edith , Fähling Michael , Edemir Bayram
Published: January 2025

Nuclear factor of activated T‐cells 5 (NFAT5) is a transcription factor known for its role in osmotic stress adaptation in the renal inner medulla, due to the osmotic gradient that is generated between the renal cortex and renal inner medulla. However, its broader implications in kidney injury and chronic kidney disease (CKD) are less understood. Here we used two different Cre deleter mice (Ksp1.3‐Cre and Aqp2‐Cre) to generate tubule segment and even cell type‐specific NFAT5‐deficient mice and performed extensive gene expression profiling. In both Nfat5 knockout models, we observed massive changes in gene expression pattern, with heightened inflammatory responses and renal injury, culminating in renal fibrosis. Interestingly, inflammatory responses were much more prominent in the Aqp2Cre+/−Nfat5fl/fl mice that lack NFAT5 only in the collecting duct. By analyzing gene expression in the medullary and cortical regions of the kidney separately, we confirmed that the loss of NFAT5 results in kidney injury that extends beyond hypertonic areas. Renal injury correlates with the expression level of genes involved in inflammatory response, injury severity, and cytokine signaling. Thus, NFAT5 is essential not only for adapting to osmotic stress but also for its loss of function, which induces activation of inflammatory response and cytokine signaling that might affect regions with functional NFAT5 expression.
Interprofessional Debrief on Racism, Equity, and Microaggressions (I-DREAM): Using Simulation to Change Awareness, Attitudes, and Abilities Across an Institution
Authors: Sran Simranjeet S. , Walsh Heather , Agrawal Dewesh , Dwivedi Pallavi , Ho Brandon , King Simmy , Lindgren Christina , Manuel Rosalyn , Nicholson Laura , Yurasek Gregory , Zaveri Pavan
Published: January 2025

Purpose

Effective diversity, equity, and inclusion (DEI) education is imperative to combat bias across health care organizations. The authors evaluated the effectiveness of interprofessional, simulation-based DEI training in improving clinicians’ awareness, attitudes, and abilities regarding bias, racism, inclusion, microaggressions, and equity in the workforce.

Method

From October 2021 to June 2022, interprofessional clinicians at Children’s National Hospital in Washington, DC, completed the Interprofessional Debrief on Racism, Equity, and Microaggressions (I-DREAM) training. Participants underwent small group training that included debriefing prerecorded simulations depicting language barriers, microaggressions, and other biased interactions. They were offered optional surveys before training, after training, and at 3-month follow-up. Participants’ awareness and attitudes of the events were assessed. Additional data were collected from monthly use of telephone interpreter services.

Results

A total of 1,811 interprofessional participants completed the I-DREAM training. Through user-generated codes, 759 presurveys and postsurveys and 276 presurveys and 3-month follow-up surveys were linked. Among these participants, 451 (60%) witnessed bias events before training and 629 (83%) after training (odds ratio [OR], 9.37; 95% CI, 5.77-15.22; P < .001), and 278 (37%) reported personally experiencing these events before training vs 496 (66%) after training (OR, 7.86; 95% CI 5.45-11.33; P < .001). Participants reporting confidence responding to bias events increased from 388 (45%) to 556 (73%) (OR, 3.28; 95% CI, 2.52-4.27; P < .001). At 3 months, 199 participants (72%) continued to express confidence in responding (OR, 3.98; 95% CI, 2.56-6.18; P < .001). Use of language interpretation increased during training (mean difference in calls per month, 261; 95% CI, 124-398; P < .001; mean difference in minutes per month, 2,249; 95% CI, 616-3,882; P = .009).

Conclusions

I-DREAM training was associated with improved clinicians’ awareness of bias events in the workplace, confidence in ability to respond to these events, and delivery of language-equitable care.
Concordance Between Trainee Self-Assessment and Expert Assessment of Cold Snare Polypectomy Competence: Results From a Randomized Clinical Study
Authors: Patel Swati G. , Muething Larissa , Kaltenbach Tonya , Nguyen-Vu Tiffany , Malvar Carmel , Keswani Rajesh N. , Hall Matthew , Aagaard Eva , Asokkumar Ravishankar , Chin Yung Ka , Hammad Hazem , Rastogi Amit , Shergill Amandeep , Simon Violet , Soetikno Alan , Soetikno Roy , Wani Sachin
Published: January 2025

Purpose

Many trainees lack competence in performing cold snare polypectomy (CSP), and longer observation periods using assessment tools, such as the Cold Snare Polypectomy Assessment Tool (CSPAT), may be required. However, these tools are not commonly used in busy academic endoscopy practices. This study evaluates the concordance between trainee self-assessment of CSP with expert assessment and assesses factors associated with concordance.

Method

Consecutive CSPs performed by gastroenterology trainees from 2 institutions were video recorded and rated by 8 blinded experts from 4 different academic institutions in the United States and Singapore using the CSPAT from August 2017 to February 2020. Trainees self-assessed competence for each CSP immediately after the procedure. Concordance between trainee and trainer was reported as percentage of agreement in competence (score of 3 or 4) or not yet competent (score of 1 or 2).

Results

Twenty-two trainees performed 765 colonoscopies with 2,267 CSPs. Concordance was found between expert and trainee assessment of competence for 1,380 CSPs (60.9%; 95% CI, 58.8%-62.9%; weighted κ = 0.12; 95% CI, 0.08-0.16). Trainees underassessed competence for 541 CSPs (23.9%; 95% CI, 22.1%-25.7%) and overassessed competence for 326 CSPs (15.3%; 95% CI, 13.8%-16.8%). Career plan of private practice general gastroenterology (adjusted odds ratio, 0.40; 95% CI, 0.17-0.92) and lower colonoscopy volume before study (adjusted odds ratio, 0.35; 95% CI, 0.22-0.62) were independently associated with lower likelihood of concordance between expert and trainee assessment of competence. Structured feedback was not associated with concordance, and there was no change as trainees gained experience; however, feedback decreased the proportion of overassessments.

Conclusions

There is poor concordance between trainee self-assessment and trainer assessment of CSP. Self-assessment can be used as an initial part of competency assessment, which should then be reconciled with external assessments to improve concordance in assessments.
Applications of Artificial Intelligence for Non–Psychomotor Skills Training in Health Professions Education: A Scoping Review
Authors: Costa-Dookhan Kenya A. , Adirim Zachary , Maslej Marta , Donner Kayle , Rodak Terri , Soklaridis Sophie , Sockalingam Sanjeev , Thakur Anupam
Published: January 2025

Purpose

This study explores uses of artificial intelligence (AI) in health professions education for non–psychomotor skills training at undergraduate, postgraduate, and continuing health professions education levels for education program development, delivery, and evaluation.

Method

This scoping review was conducted in 5 stages: (1) planning and research, (2) search strategy, (3) screening and selection, (4) review and recording data, and (5) synthesis. Seven bibliographic databases were searched using the main search terms artificial intelligence and continuing health professional education for articles that used AI for the purposes of non–psychomotor skills training for health professions education and involved health care professionals and/or trainees. Databases were searched for articles published from January 1, 2001, to March 26, 2024. The original searches were performed on July 26, 2021, and again on March 26, 2024. Two reviewers independently screened, reviewed, and extracted data. Data extraction was performed using Kern’s 6-step curriculum development framework to guide analysis.

Results

In total, 9,914 studies related to AI in health professions education for non–psychomotor skills training were screened. Of these, 103 studies were identified that met inclusion criteria. Of these 103 studies, 52 (50%) were cohort studies. The most common learner population was health care professional students (67 studies [65%]). Most studies (76 [74%]) were set in nonclinical settings. Sixty-eight studies (66%) fit under step 6 of Kern’s criteria (evaluation and assessment), illustrating that AI is predominantly being used for the purposes of evaluation and assessment of learners and programs.

Conclusions

Most studies in the literature illustrate that AI is being applied in a non–psychomotor context to evaluate health professional education programs and assess learners. Additional opportunities to use AI in curriculum design and implementation could include identification of learning needs for training, personalizing learning with AI principles, and evaluating health care professional education programs.
Exploring the clinical, psychological, and social relevance of menopause for trans and gender diverse people: a qualitative study
Authors: Xin Michelle Qian Lin , Lane Riki
Published: January 2025

Objective

The aim of this study was to explore the meanings and experiences of menopause for trans and gender diverse (TGD) people and how menopause affects clinical practice.

Methods

For this qualitative study in 2021‐2022, a scoping literature review informed interview schedule development. Following email invitations, online semi-structured interviews were conducted in March‐April 2021 in Australia with three prominent TGD community leaders (trans male, trans female, nonbinary person) and three experienced medical practitioners (general practitioner, endocrinologist, psychiatrist), which were audio-recorded and transcribed. Inductive, iterative thematic analysis of transcripts was conducted. A further literature search was completed in 2024.

Results

Themes identified included the following: (1) no consensus on the definition of menopause for TGD individuals; (2) diverse menopause experiences existing in the TGD community; (3) large variations present regarding perimenopausal hormone therapy for older TGD patients: maintain dose, taper to low dose, or cease hormones; and (4) minimal support for TGD people to discuss menopause and concerns around aging. Saturation was not reached with the sample size.

Conclusions

There is a paucity of relevant research and no consensus on definitions, management, or impacts of menopause for TGD people. Therefore, current management approaches should be individually tailored and guided by clinical expertise. To formulate practical and realistic recommendations for clinical practice, future research could include the following: (1) a broader literature review into varied gender-affirming hormone treatment (GAHT) regimens among aging TGD people; (2) utilizing the Delphi technique to achieve expert consensus regarding GAHT in older TGD individuals; and (3) a prospective study design of TGD participants on different GAHT regimens over time.
Evaluation of the association between thyroid-stimulating hormone with handgrip strength and dynapenia in euthyroid postmenopausal women
Authors: García-Alfaro Pascual , Pérez-López Faustino R. , Sulé María Angela , Rodríguez Ignacio
Published: January 2025

Objective

To examine the association between serum thyroid-stimulating hormone (TSH) levels with handgrip strength (HGS) and dynapenia in euthyroid postmenopausal women.

Methods

This was an exploratory cross-sectional study among 385 participants from the Department of Obstetrics, Gynecology, and Reproduction of the Dexeus Women's University Hospital, Barcelona, Spain. Age, age at menopause, adiposity, alcohol consumption, body mass index (BMI), and smoking status were recorded. TSH was determined by electrochemiluminescence immunoassay. HGS was measured using a digital dynamometer, and physical activity was assessed by the International Physical Activity Questionnaire. Dynapenia was considered when HGS was <20 kg. A directed acyclic graph was designed to identify confounding variables. Multivariable linear and logistic regression models were adjusted by age, age at menopause, adiposity, BMI, glomerular filtration rate, glycated hemoglobin, physical activity, and smoking status.

Results

Multivariable linear regression model showed that age (β = −0.22; 95% CI, −0.28 to −0.16), adiposity (β = −0.15; 95% CI, −0.22 to −0.07), BMI (β = 0.15; 95% CI, 0.04-0.25), glomerular filtration rate (β = −0.04; 95% CI, −0.07 to −0.01), and physical activity (β = 0.79; 95% CI, 0.07-1.5) were significantly associated with HGS. Instead, serum TSH levels were not significantly associated (β = 0.21; 95% CI, −0.10 to 0.51). Multivariable logistic regression model showed that dynapenia was associated with age (OR, 1.20; 95% CI, 1.12-1.31) and glomerular filtration rate (OR, 1.03; 95% CI, 1.00-1.05). No significant association between TSH and dynapenia was observed (OR, 0.98; 95% CI, 0.78-1.23).

Conclusions

In this study of postmenopausal women, normal TSH levels were not associated with low HGS or dynapenia.
Health-related quality of life across menopausal stages among middle-aged Korean women
Authors: Choi Hye Rin , Chang Yoosoo , Kang Danbee , Lee Jiseon , Jang Yoonyoung , Kim Hoon , Ryu Seungho , Park Hyun-Young , Cho Juhee
Published: January 2025

Objectives

We examined the health-related quality of life (HRQoL) during menopause transition (MT) among middle-aged Korean women.

Methods

This cross-sectional study comprised 2,290 middle-aged women who completed web-based questionnaires between 2020 and 2022. Based on self-reported menstrual cycle patterns, menopause status was classified as premenopausal, early or late transition, or postmenopausal. HRQoL was assessed using the Patient-Reported Outcomes Measurement Information system, with all 29 items scored using a T-score metric. Multiple linear regression analyses were performed to investigate whether HRQoL varied based on MT stages. Antimüllerian hormone levels were used as an objective measure instead of self-reported menstrual status in the sensitivity analysis. Logistic regression models were used to estimate the prevalence ratios for moderate or severe HRQoL symptoms across menopausal stages.

Results

The mean T-scores for anxiety, depression, and pain interference and intensity were significantly higher with advancing menopausal stage. Anxiety, depression, sleep disturbances, pain interference, and intensity were significantly and linearly positively correlated with MT stages after adjusting for potential confounders. Physical function significantly worsened in the late transition stage compared with premenopausal status (β = −1.51 [95% CI, −2.72 to −0.31] in late MT and β = −1.92 [95% CI, −3.46 to −0.37] in postmenopause, P for trend = 0.007). However, no significant trends were observed in the sensitivity analysis using antimüllerian hormone levels. Women with moderate or severe symptoms in all domains except physical function had significantly higher prevalence ratios according to MT.

Conclusions

Overall HRQoL was lower with advancing menopausal stages. All symptoms should be monitored to control early transition symptoms. Thus, women undergoing MT should consistently assess and manage not only menopausal symptoms but also the overall quality of their health to prevent both menopause-specific and nonspecific conditions and their consequences.
Vascular Effects of Botulinum Toxin in Human Skin
Authors: Moreno Rozo Natalia K. , Gómez Díaz Oswaldo J. , Beltran Pachon Paloma , Restrepo Daniel , Gómez Santiago
Published: January 2025

Botulinum toxin-A (BTX-A) is widely used for aesthetic purposes and is recognized for its vasomotor actions. However, new medical applications have emerged. This study aims to describe the effect of BTX-A on human skin perfusion, particularly vessel diameter, blood flow, and blood vessel density in regions with known low vessel density. This case series involved 40 patients who were treated with subcutaneous injections of BTX-A and sodium chloride 0.9% into marked skin areas on their backs. Skin blood flow, vessel diameter, and density were measured using infrared thermography and Doppler ultrasound before the injection and on days 1, 7, and 21 posttreatment. BTX-A-treated areas exhibited higher blood flow, larger blood vessel diameter, increased blood vessel density, and the emergence of new detectable perforators. In contrast, areas receiving sodium chloride 0.9% showed no significant changes. Data analysis was conducted using an independent t test and Jeffreys interval. BTX-A injection appears to boost human skin blood circulation, potentially prompting the emergence of new detectable perforators, gradual widening of vessel diameter, and increased blood flow and temperature. These observations suggest potential benefits of BTX-A in areas with compromised blood supply to stimulate the emergence of new detectable perforators.
Autologous Fat Grafting in Hand Surgery: A Systematic Review
Authors: Henderson Brennon , Cushman Caroline J. , Price Ashley D. , Hoffpauir Lauren A. , Jain Neil , Hernandez Evan J. , Idicula Anceslo , MacKay Brendan J.
Published: January 2025

Background:

Autologous fat grafting (AFG) has gained popularity in both cosmetic and reconstructive surgery, including hand surgery, due to its regenerative potential and dual benefits of enhancing aesthetics and function. This systematic review aims to evaluate the efficacy of AFG in treating various hand pathologies.

Methods:

A systematic review was conducted following PRISMA guidelines. PubMed, Cochrane Library, and Embase databases were searched for studies published between January 2001 and October 2022 using the terms “(autologous fat grafting) AND (hand).” Of 224 studies identified, 14 met the inclusion criteria. These studies were analyzed based on study design, pathology treated, type of AFG used, and primary outcomes.

Results:

The review included 14 studies: 9 prospective/retrospective studies, 3 case reports, and 2 randomized control trials. Digital ulcers related to systemic sclerosis and hand osteoarthritis were the most frequently treated pathologies. AFG was predominantly used to address symptoms/pain (71.4%), with aesthetics as a secondary benefit in 21.4% of cases. The studies reported improvements in pain, functionality, and patient satisfaction. However, the variability in techniques and outcomes limited the ability to perform a meta-analysis.

Conclusions:

AFG shows promise as a minimally invasive treatment option for various hand pathologies, offering both symptomatic relief and aesthetic enhancement. Although initial findings are favorable, further high-quality studies are needed to standardize techniques and confirm long-term efficacy. The versatility and safety profile of AFG suggest it has the potential to become a widely adopted technique in hand surgery.
Graded Anterior Partial-thickness Blepharotomy for the Correction of Idiopathic Unilateral Upper Eyelid Retraction: A Case Report and Literature Review
Authors: Liu Wentao , Lu Menglin , Lin Wentao , Shen Xiao
Published: January 2025

Idiopathic upper eyelid retraction is a rare ocular symptom characterized by abnormal upward displacement of the upper eyelid, often without any identifiable systemic disease. This condition not only affects the patient’s appearance but may also have a certain impact on their daily life and mental health. We report a case of adult idiopathic unilateral upper eyelid retraction, and based on the patient’s specific condition, we used graded anterior plate blepharoplasty for treatment. This surgical method aims to restore the normal position and facial symmetry of the eyelids by finely adjusting the eyelid tissue, especially correcting abnormalities in the levator and Miller muscles. After undergoing graded anterior plate blepharoplasty, the patient’s eyelid position and facial symmetry were significantly improved. Postoperative observation showed that the patient’s upper eyelid retraction symptoms were effectively corrected, and the correction effect was stable without recurrence. This study confirmed the effectiveness and safety of graded anterior lamellar blepharoplasty in the treatment of idiopathic unilateral upper eyelid retraction in an adult. This surgical method not only significantly improves the eyelid position and facial symmetry of patients but also has fast postoperative recovery and fewer complications, providing valuable insights for the management of idiopathic upper eyelid retraction.
Preoperative and early postoperative factors associated with visual outcome after macular-off retinal detachment surgery
Authors: Zhao Yuan , Sheng Yan
Published: January 2025

Purpose:

To evaluate preoperative and early postoperative factors associated with changes in visual acuity in macula-off rhegmatogenous retinal detachment (RRD) patients.

Methods:

A retrospective review of 59 eyes from 59 patients who underwent pars plana vitrectomy (PPV) and silicone oil (SiO) tamponade for macula-off RRD. Preoperative and early postoperative characteristics were analyzed using the classification and regression tree (CART) analysis.

Results:

The baseline preoperative BCVA improved from 1.67 ± 0.97 logMAR to 0.21 ± 0.22 logMAR at final visit. Central foveal thickness (CFT) and BCVA showed significant increases from 1 week post-surgery onward. Mean CFT significantly increased from 136.97 ± 40.17 μm to 192.54 ± 34.09 μm (p < 0.001). The percentage of eyes with integrated external limiting membrane (ELM) and ellipsoid zone (EZ) was progressively increased from 45.76% and 10.17% to 98.31% and 71.19%, respectively (p < 0.001). BCVA at 1week after surgery, ELM integrity, preoperative intraretinal cysts, and macula-off duration were significantly associated with final visual recovery after surgery.

Conclusion:

The first week postoperative BCVA is the most powerful predictor for final BCVA. ELM integrity, intraretinal cysts, and macula-off duration are also significantly associated with final visual recovery.
Assessing response to stressful emotions: a controlled crossover study using pupillometry
Authors: Noronha Ana Carolina , Castro Mendes Francisca , Carvalho Pedro , Fonseca Mafalda , Paciência Inês , Moreira André
Published: January 2025

Background:

Fear and horror induce autonomic protective responses, acting as “survival intelligence.” Pupillometry is an innovative method that captures real-time autonomic nervous system reactions to stress.

Objective:

To evaluate the feasibility of pupillometry to assess the acute response to a passive real-life stressor—viewing a truthful war scene.

Methods:

Thirteen medical students (10 women) with an average age of 20.4 years were enrolled in a nonrandomized controlled crossover trial. Selected clips from two different audiovisual stimuli (M1: Saving Private Ryan as a fear and horror inducer and M2: Life Is Beautiful as a control) were watched for 15 minutes, separated by a washout period of 48–72 hours. The differences in pupillometry parameters between the exposure movie and the assessment time (T0 and T1 for M1 and T0 and T1 for M2) were evaluated using a Wilcoxon test. The Wilcoxon test was also used to assess the difference between M1 and M2 within each assessment time point (T0 and T1).

Results:

A significant difference in response to acute fear and horror-induced stress was observed in pupillometry parameters {baseline [6.90 (5.95; 7.40) vs. 6.60 (5.55; 7.10), P = 0.030] and final pupil diameter [4.50 (3.90; 5.20) vs. 4.10 (3.50; 4.60), P = 0.012]} between M1 and M2 in T1, suggesting the acute increase in sympathetic parameters. Although not significant, there was also a difference in pupillometry parameters (final pupil diameter [P = 0.060], average constriction velocity [P = 0.059]) after watching M1 compared with T0.

Conclusion:

Our proof-of-concept study suggests that pupillometry may be used to evaluate changes in the activity of the autonomic nervous system induced by an acute passive stress stimulus.
Systematic Review and Meta-Analysis of 24-Hour Ambulatory Blood Pressure Monitoring in Pregnancy and Postpartum Periods
Authors: Sommer Sadie B. , Muchira James M. , Garrison Etoi A. , Walden Rachel L. , Chinni Riya , van der Eerden Joshua H. , Mogos Mulubrhan F.
Published: January 2025

Purpose:

Early detection and management of hypertensive disorders during pregnancy and postpartum are essential. This systematic review and meta analysis aimed: (1) to examine the state of 24-hour ambulatory blood pressure (ABP) use, and (2) in a subset of studies, evaluate 24-hour ABP parameters in the prediction and identification of Hypertensive Disorders of Pregnancy (HDP).

Methods:

A comprehensive literature search was conducted in March of 2022 for English language studies published after 2000. In a subset of studies in this review, we conducted a meta analysis summarizing 24-hour, day, and night standardized mean difference (hedge’s g) in systolic and diastolic blood pressure during pregnancy for individuals later diagnosed with HDP and those without.

Results:

A total of 69 articles met all established criteria and were included in this systematic review, and a subgroup of studies that reported HDP outcomes (n=14) were included in the meta analysis. Out of the 69 studies, 31 (45.61%) used 24-hour ABP devices that are not validated for pregnant individuals. Birthing individuals diagnosed with HDP had elevated 24-hour, day, and night systolic and diastolic blood pressure during second and third trimesters of pregnancy.

Conclusion:

A noticeable gap exists in the utilization of validated 24-hour ABP devices for pregnant and postpartum populations. Variations exist regarding the timing of 24-hour ABP measurements, particularly across trimesters.

Implications for practice:

24-hour ABP monitoring could serve as one of the tools to identify and manage pregnant individuals at risk of HDP and ultimately reverse the current trend in maternal mortality.
A Multihospital Exploration Into the Utilization of Nursing Professional Development Practitioners in the Clinical Environment
Authors: Pate Kimberly , Brown Heather , Evans Kara Hedvig , Cochran Allyson
Published: January 2025

Nursing professional development practice is guided by the Association for Nursing Professional Development's Nursing Professional Development Scope and Standards of Practice, but practice varies with years of experience, practice setting, span of areas covered, and certification in nursing professional development. This study aims to explore practice in a multihospital system over 12 months utilizing the throughputs or responsibilities of the NPD Practice Model: collaborative partnerships, competency management, education, onboarding/orientation, inquiry (research/evidence-based practice/quality improvement), and role development.
The Nursing Station Podcast
Authors: Laurent Kelly , Coughlin Vincenza , Wan Julie , Rasmussen Michele , Moran Lauren , Estrella Karla , Bolanos Gabby , Grossman Nikki-Jo
Published: January 2025

Podcasting is an innovative methodology for information exchange and storytelling. Podcasts in nursing can promote communication, education, and recognition across an expansive workforce. A nurse-focused podcast was created at an academic health system in efforts to enhance diversity of information exchange and promote consistency in nursing professional practice. Findings of the implementation of podcasts support their use as relevant, convenient, and satisfactory for clinical nurses in attaining new knowledge.