bluuebunny/crossref_metadata_2025 huggingface dataset:
How Do I Keep Myself Calm?
Authors: Goldstein Naomi E. S. , Serico Jennifer M. , Haney-Caron Emily , Giallella Christy L. , Kalbeitzer Rachel , Zelechoski Amanda D. , Riggs Romaine Christina L. , Kemp Kathleen
Published: February 2024

This chapter provides the facilitator materials for Session 8 of the Juvenile Justice Anger Management (JJAM) Treatment for Girls. This session focuses on using self-talk as a method to keep oneself calm. The participants are expected to think of different things they can say to themselves when they think they might lose their temper so that they can stay out of trouble. The Session 8 catch phrase is “Use self-talk at the start so I won’t fall apart.” The goal sheets aim to teach the girls how to use self-talk when they are angry. The chapter also lists the movie clips for the session, which feature self-talk. Also provided are figures for a large master (facilitator) mouth cutout and a catch phrase sign.
How Do I Stop Myself When I’m Angry?
Authors: Goldstein Naomi E. S. , Serico Jennifer M. , Haney-Caron Emily , Giallella Christy L. , Kalbeitzer Rachel , Zelechoski Amanda D. , Riggs Romaine Christina L. , Kemp Kathleen
Published: February 2024

This chapter provides the facilitator materials for Session 9 of the Juvenile Justice Anger Management (JJAM) Treatment for Girls. This session teaches the girls how to delay a reaction to anger. Girls are taught the difference between reacting to an anger-provoking situation right away and taking time to calm down before reacting. The Session 9 catch phrase is “Whatever others do or say, find a way to delay.” The goal sheet encourages participants to take time to calm down before reacting. The girls need to use their tools to try to delay their reactions to situations that make them angry. The chapter provides the materials needed for the session’s activities, such as the catch phrase sign, large master (facilitator) stopwatch cutouts, and movie clips that showcase aggressive responses to use in the discussion of coping skills.
Introduction to Problem-Solving
Authors: Goldstein Naomi E. S. , Serico Jennifer M. , Haney-Caron Emily , Giallella Christy L. , Kalbeitzer Rachel , Zelechoski Amanda D. , Riggs Romaine Christina L. , Kemp Kathleen
Published: February 2024

This chapter provides the facilitator materials for Session 11 of the Juvenile Justice Anger Management (JJAM) Treatment for Girls. This session focuses on methods for problem-solving. The facilitators help the participants put together all of the tools and skills they have learned so far to solve a problem. The girls practice using the tools and skills so they can apply them in real-life situations. The Session 11 catch phrase is “To solve the problem with ease, find the right puzzle piece.”The goal sheet’s aim is to help the participants to think through problems and figure out their best option. The chapter also discusses the session activities, including making posters and creating a catch phrase sign.
Dress Rehearsal and Play
Authors: Goldstein Naomi E. S. , Serico Jennifer M. , Haney-Caron Emily , Giallella Christy L. , Kalbeitzer Rachel , Zelechoski Amanda D. , Riggs Romaine Christina L. , Kemp Kathleen
Published: February 2024

This chapter provides the facilitator materials for Session 16, the final session of the JJAM Treatment. During the first part of this session, the participants will review the previous session’s goal sheets and then will discuss the lessons they learned in each previous session. Then the girls will hold a dress rehearsal of the problem-solving play they have created, followed by a performance in front of a live audience. The performance is followed by a closing ceremony in which each participant is awarded a completion certificate. The catch phrase for this session is “With my tools and our play, practice makes things better than OK.”
Introduction to Social Aggression
Authors: Goldstein Naomi E. S. , Serico Jennifer M. , Haney-Caron Emily , Giallella Christy L. , Kalbeitzer Rachel , Zelechoski Amanda D. , Riggs Romaine Christina L. , Kemp Kathleen
Published: February 2024

This chapter presents the participant materials for Session 3 of the Juvenile Justice Anger Management (JJAM) Treatment for Girls. This session offers an introduction to social aggression and its effects. Physical aggression and social aggression are differentiated. Social aggression can include spreading rumors, leaving someone out, talking behind someone’s back, giving the silent treatment, and making fun of someone. The participant feedback form allows participants to reflect on examples of situations of social aggression. These situations include being ignored by one’s best friend after they started hanging out with a new group of friends, and bad-mouthing one’s friend after fighting about money that they owe.
Recognition of Anger
Authors: Goldstein Naomi E. S. , Serico Jennifer M. , Haney-Caron Emily , Giallella Christy L. , Kalbeitzer Rachel , Zelechoski Amanda D. , Riggs Romaine Christina L. , Kemp Kathleen
Published: February 2024

This chapter provides the participant materials for Session 5 of the Juvenile Justice Anger Management (JJAM) Treatment for Girls. This session focuses on recognizing anger. In particular, it teaches participants to identify body signs (“hot spots”) and pay attention to their body’s reactions to anger. One’s tone of voice, body language, and facial expressions may change when one is starting to feel angry. Understanding these body signs keeps one from reacting too quickly and allows one to come up with a way to deal with the situation without getting into trouble. The participant feedback form allows participants to reflect on examples of situations where they can practice identifying body reactions to anger.
Introduction to Problem-Solving
Authors: Goldstein Naomi E. S. , Serico Jennifer M. , Haney-Caron Emily , Giallella Christy L. , Kalbeitzer Rachel , Zelechoski Amanda D. , Riggs Romaine Christina L. , Kemp Kathleen
Published: February 2024

This chapter provides the participant materials for Session 11 of the Juvenile Justice Anger Management (JJAM) Treatment for Girls. This session provides an introduction to the concept of problem-solving. The material teaches participants to think through problems when they are angry and to figure out the best option. Making the best choice means thinking about all the possible prices and rewards of a decision. The participant feedback form allows participants to reflect on examples of situations where they can practice problem-solving. For instance, a possible consequence for beating up someone at school who threatened one’s friend is getting kicked out of school for fighting.
Safety and Efficacy of 25 mg/kg and 35 mg/kg vs 10 mg/kg Rifampicin in Pulmonary TB: A Phase IIb Randomized Controlled Trial
Authors: Perumal Kannabiran Bhavani , Palaniappan Natarajan Alangudi , Manoharan Tamizhselvan , Paramasivam Paul Kumaran , Saini Jitendra Kumar , Ansari Mohammed Soheb , Jayabal Lavanya , Aggarwal Ashutosh N , Garg Rajiv , Subramanyam Balaji , Thakur Deepika , Pantula Shilpa , P M Ramesh , GS Vijayachandar , Natarajan Saravanan , Ammayappan Radha Krishnan , Manpreet Bhalla , Ganesan Mangalambal , Angamuthu Dhanalakshmi , Chinnaiyan Ponnuraja , Singh Manjula , Chandrasekaran Padmapriyadarsini , Swaminathan Soumya
Published: February 2024

Background

Globally, no trial data are available on head-to-head comparison between 10 mg/kg and 25/35 mg/kg rifampicin in treating pulmonary tuberculosis during study initiation.

Methods

A multicentric, phase IIb randomized trial recruited 333 new culture-positive, drug-sensitive adult patients with pulmonary tuberculosis to compare safety and efficacy of high-dose rifampicin (R25/R35), against conventional dose (R10) given daily for 8 weeks followed by standard doses for 16 weeks. Main outcomes were treatment-emergent grade 3/4 adverse events (AEs) and time-to-culture conversion in liquid media, assessed by division of AIDS system for grading the severity of adverse events division of AIDS criteria and Kaplan-Meier methods.

Results

In a modified intention-to-treat population of 323 patients (R10: 105/R25: 112/R35: 106), grade 3/4 AEs were reported in 34 patients (R10: 9.5% [10/105], R25: 9.8% [11/112], R35: 12.3% [13/106]) during the intensive phase. Among 23 patients (R10: 3.8% [4/105], R25: 6.3% [7/112], R35: 11.3% [12/106]) with grade 3/4 hepatotoxicity, 15 (R10: 1.9% [2/105], R25: 3.6% [4/112], R35: 8.5% [9/106]) had grade 3/4 hyperbilirubinemia and 9 patients (R10: 1.0% [1/105], R25: 0.9% [1/112], R35: 6.6% [7/106]) developed clinical jaundice. Significant differences observed only between R10 and R35 with hepatotoxicity (P = .039), hyperbilirubinemia (P = .031), clinical jaundice (P = .032), and treatment interruption (P = .039). Eighteen serious AEs and 6 deaths (R10: 3/R25: 1/R35: 2) occurred during study period. Time to stable culture conversion in liquid media was faster in R25 (adjusted hazard ratio, 1.71; 95% confidence interval [CI], 1.26–2.31 [solid: 1.97; 95% CI, 1.46–2.67]) and R35 (1.81; 95% CI, 1.33–2.48 [solid: 2.24; 95% CI, 1.64–3.06]), than R10 (34 vs 44 days). R25 had no failure/relapse.

Conclusions

Hepatotoxicity, clinical jaundice, and treatment interruptions occurred significantly higher with R35 than R10. Because R25 was comparably safe as R10 and also highly efficacious than R10, it may be considered for implementation.

Clinical Trials Registration. CTRI/2017/12/010951.
The Epidemiologic and Clinical Characteristics of the 2023 Dengue Outbreak in Bangladesh
Authors: Sharif Nadim , Sharif Nazmul , Khan Afsana , Dey Shuvra Kanti
Published: February 2024

The ongoing 2023 dengue outbreak is the worst ever case reported in Bangladesh. There is a lack of epidemiological studies on the outbreak. A 2-tailed t test was performed. Multivariable logistic regression analysis was conducted. We found about 277 801 cases and 1393 deaths from the 2023 dengue outbreak. About 52% of the cases were from outside of Dhaka. The male:female ratio was about 3:2. The highest frequency of cases was found among people aged 19–29 years (28.7%, 79 673 of 277 801; P = .001). The overall case fatality rate (CFR) was 0.5%. The highest CFR was found among children aged 0–10 years (12%). Fever (99%) was the most prevalent, followed by joint pain (86%). We found significantly higher odds of fatalities (adjusted odds ratio [aOR], 4.21; 95% CI, 3.93–4.74; P = .05), cases (aOR, 3.85; 95% CI, 3.25–4.12; P = .001) and hospitalizations (aOR, 3.26; 95% CI, 3.11–4.04; P = .006) during the 2023 outbreak compared with previous outbreaks during 2008–2022. This is one of the early reports of epidemiological and clinical characteristics of ongoing dengue outbreak.
Debt relief for households in developing economies
Authors: Indarte Sasha , Kanz Martin
Published: February 2024

Households in developing economies have greater access to formal credit today than at any point in history, owing to the global expansion of microfinance and recent innovations in consumer finance, such as digital lending. While this has improved the ability to smooth consumption and invest in productive activities, it has also raised concerns about over-indebtedness. Against this background, this article reviews and extends the literature on debt relief for households in developing countries. We begin by laying out a simple stylized model that illustrates the costs and benefits of debt relief and use the model to guide our review of the evidence on various relief policies, such as debt forbearance, debt forgiveness, and personal bankruptcy. We additionally present survey evidence from a population of microfinance and bank borrowers with recent exposure to debt relief. The results highlight that an important channel through which discretionary debt relief policies, which are common in developing countries, affect credit market outcomes is their impact on borrower expectations. The development of legal bankruptcy institutions that offer a rules-based avenue to discharge unsustainable debts can reduce such distortions and alleviate the credit market inefficiencies that have often accompanied debt relief initiatives in developing economies.
Restoration of the Functional nif Gene Cluster by Complex Recombination Events during Heterocyst Development in the Nitrogen-Fixing Cyanobacterium Calothrix sp. NIES-4101
Authors: Uesaka Kazuma , Banba Mari , Chiba Sotaro , Fujita Yuichi
Published: February 2024

In the genome of the heterocystous cyanobacterium Calothrix sp. NIES-4101 (NIES-4101), the four genes essential for nitrogen fixation (nifB, nifH, nifD and nifK) are highly fragmented into 13 parts in a 350-kb chromosomal region, and four of these parts are encoded in the reverse strand. Such a complex fragmentation feature makes it difficult to restore the intact nifBHDK genes by the excision mechanism found in the nifD gene of the Anabaena sp. PCC 7120 heterocyst. To examine the nitrogen-fixing ability of NIES-4101, we confirmed that NIES-4101 grew well on a combined nitrogen-free medium and showed high nitrogenase activity, which strongly suggested that the complete nifBHDK genes are restored by a complex recombination process in heterocysts. Next, we resequenced the genome prepared from cells grown under nitrogen-fixing conditions. Two contigs covering the complete nifHDK and nifB genes were found by de novo assembly of the sequencing reads. In addition, the DNA fragments covering the nifBHDK operon were successfully amplified by PCR. We propose that the process of nifBHDK restoration occurs as follows. First, the nifD–nifK genes are restored by four excision events. Then, the complete nifH and nifB genes are restored by two excision events followed by two successive inversion events between the inverted repeat sequences and one excision event, forming the functional nif gene cluster, nifB-fdxN-nifS-nifU-nifH-nifD-nifK. All genes coding recombinases responsible for these nine recombination events are located close to the terminal repeat sequences. The restoration of the nifBHDK genes in NIES-4101 is the most complex genome reorganization reported in heterocystous cyanobacteria.
LGBTQIA+ Cultural Competence in Physical Therapy: An Exploratory Qualitative Study From the Clinician’s Perspective
Authors: Hofmann Melissa C , Mulligan Nancy F , Bell Karla A , Condran Chris , Scarince Hannah J , Gulik Eileen , He Vivian , Hill Felix , Wolff Erin , Jensen Gail
Published: February 2024

Objective

The purpose of this study was to understand the lesbian, gay, bisexual, transgender, queer, intersex, agender, and other gender and sexually diverse identities (LGBTQIA+) health care experience and associated cultural competence from the physical therapist perspective (physical therapist and physical therapist assistant).

Methods

An exploratory qualitative approach implementing semi-structured focus groups and private interviews was utilized. To further anonymity, researchers allowed subjects to keep their camera off on Zoom. An interview protocol included questions guided by Campinha-Bacote domains of cultural competence (cultural awareness, skill, knowledge, encounter, and desire) to collect individual experiences, stories, discussions, thoughts, and opinions. Physical therapist clinicians were recruited from the clinical education affiliation lists of Regis University and Thomas Jefferson University. Seventy-one practicing physical therapists from the USA agreed to be part of the study.

Results

Themes were organized using the Social Ecological Model Framework. Themes are in parentheses following each level of the Social Ecological Model and include intrapersonal level (psychological stress and implicit and explicit biases), interpersonal (acceptance and competency), organizational (experience), community (advocacy), and society and policy (explicit biases and policy).

Conclusion

Cultural competence in physical therapy is influenced by intrapersonal, interpersonal, organizational, community, and social and policy factors. Themes of psychological stress, limited awareness, decreased acceptance, and competency as well as limited exposure and experience, and a lack of advocacy and broader societal and policy issues prevent adequate LGBTQIA+ cultural competency of physical therapist providers. Further research in the physical therapist profession is needed to elaborate on the student, educator, and patient perspectives and how this information informs the LGBTQIA+ cultural competence of clinicians.

Impact

This project may have a significant impact on suggestions for the delivery of content for health profession education to best impact health equity goals and save lives. Implementation of this content may have a direct impact on health disparities in LGBTQIA+ populations by reducing stigma and discrimination from health care providers, thus improving quality of health care and decreasing rates of patient mortality for LGBTQIA+ individuals.
Racial and ethnic determinants of psoriatic arthritis phenotypes and disease activity
Authors: Haberman Rebecca H , Ahmed Tasneem , Um Seungha , Zhou Ying Yin , Catron Sydney , Jano Kathryn , Felipe Adamary , Eichman Stephanie , Rice Alexandra L , Lydon Eileen , Moussavi Sarah , Neimann Andrea L , Reddy Soumya M , Adhikari Samrachana , Scher Jose U
Published: February 2024

Objective

Individuals of racially and ethnically diverse backgrounds are underrepresented in PsA research/clinical trials, despite evidence that their disease presentation, severity and course may be distinct. Here we aim to describe how race, ethnicity and other socioeconomic factors inform disease characteristics in PsA.

Methods

A total of 817 consecutive patients with PsA from a large, diverse metropolitan area were enrolled in an observational, longitudinal registry. Demographics, medical history, medication use and psoriatic disease phenotype and activity were all recorded and analysed.

Results

The population was 77.4% non-Hispanic White, 2.2% Black, 7.1% Asian and 9.9% identified as other races or multiracial, and 11.8% identified as Hispanic. Hispanic and non-white individuals had higher tender joint counts (P = 0.033), with similar swollen joint counts (P = 0.308) and medication use (P = 0.171). They also had high rates of radiographic axial disease. Hispanic individuals were significantly more likely to have higher tender joint counts (P = 0.029), higher RAPID3 (Routine Assessment of Patient Index Data 3) scores (P = 0.004) and moderate–severe psoriasis (P = 0.010) compared with non-Hispanic White individuals.

Conclusion

In this diverse cohort, 22.6% of patients identified as underrepresented racial and/or ethnic groups, mostly Asian or Hispanic. Despite similar swollen joint counts and medication use, non-white individuals have higher tender joint counts compared with White individuals. Phenotypically, they also were more likely to have radiographic axial involvement. These findings may reflect differences in PsA presentation, experience and outcomes in individuals of various racial and ethnic groups, which need to be taken into consideration in clinical care and research design.
Roadmap to the ‘Chronic Pain GPS for Adolescents’ Intervention
Authors: Linkiewich Delane , Dib Katherine C. , Forgeron Paula A. , Dick Bruce D. , McMurtry C. Meghan
Published: February 2024

Objectives:

A biopsychosocial approach to understand and treat pain is crucial; however, there are limited socially-targeted interventions for adolescents with chronic pain. Peer support interventions implemented with other populations are associated with positive outcomes. Adolescents with chronic pain perceive peer support to have high potential value. This study explored the preferences of adolescents with chronic pain regarding the content and design of a group peer support intervention.

Methods:

Fourteen adolescents with chronic pain (Mage: 15.21 y; 9 females; 3 males, 1 non-binary, 1 gender questioning) completed a virtual interview and survey. Interviews were analyzed using inductive qualitative content analysis and surveys were analyzed using descriptive statistics.

Results:

Adolescents described how they want to both talk and do activities together within a fun and casual environment with a facilitator present - ideally someone with lived experience of chronic pain. Preferences were for a medium sized group intervention that was in-person, at a consistent time on a weekday after school, and semi-structured. Barriers to attending and engaging in the potential group peer intervention were also discussed.

Discussion:

Adolescents with chronic pain desire a facilitated socially-focused intervention that provides them with the opportunity to spend time with other adolescents with chronic pain. A group peer support environment where adolescents with chronic pain can provide and receive peer support through sharing their experiences with others who understand them as well as engage in activities was described. The findings from this study provide insights for the development of a group peer support intervention.
Natural History of IntraDiscal Vacuum Phenomenon and its role in Advanced Disc Degeneration
Authors: Cawley Derek T , Simpkin Andrew , Abrahim Elizabeth , Doyle Thomas , Elsheikh Nada , Fallon John , Habash Mohammed , Phua Rou Jiing , Langille Jaimie , Matini Elvis , McNamee Conor , Mohamed Fayhaa , Nic Gabhann Cliona , Noorani Ali , Oh Jieun , O’Reilly Padraig , O’Sullivan David , Devitt Aiden
Published: February 2024

Study Design.

Observational serial CT analysis of the lumbar spine in a normal-aging population.

Objective.

Assess the natural history of IntraDiscal Vacuum Phenomenon and its role in disc degeneration. Summary of Background Data: The natural history of disc degeneration is well described but our understanding of the end stage of pathogenesis remains incomplete. MRI loses accuracy with advanced degeneration, becoming hyporesonant and indistinct. Cadaveric specimens display adaptive changes in the disc with loss of the hydrostatic capacity of the nucleus, increased intra-discal clefts and end-plate impermeability. IDVP is associated with advanced disc degeneration and CT is the optimal modality to visualise this, yet these insights remain unreported.

Methods.

Subjects only included historic CT abdomen scans of those over 60 years of age without acute or relevant spinal pathology, with a diagnosis of at least one level with IDVP on the original CT scan and all of whom had a similar scan >7 years later. A history of clinically significant back pain was also recorded.

Results.

CT scans included 360 levels in 29 males and 31 females (mean 68.9 years), displaying 82 levels of IDVP, with a second scan included after a mean of 10.3 years, Most levels displayed the same level of severity (persisted, 45) compared to where some progressed (26), regressed (8) and fused (3) (P<0.01). There was also an increased incidence, 37/60 (62%) of developing IDVP at another level. Disc heights were reduced with increased severity of IDVP. A record of back pain was evident in 31/60 subjects, which was not significantly worse in those with worsening severity or additional level involvement over the study period.

Conclusion.

As disc degeneration advances, the associated IDVP persists in most cases, displaying a plateauing of severity over long periods, but rarely with progression to autofusion.
Simultaneous Versus Staged Surgery for Double Crush Syndrome of Cervical Radiculopathy and Peripheral Nerve Compression at the Wrist
Authors: Byvaltsev Vadim A. , Kalinin Andrei A. , Polkin Roman A. , Kuharev Alexander V. , Almatov Marat S. , Aliyev Marat A. , Riew K. Daniel
Published: February 2024

Study Design.

Retrospective single-center study.

Objectives.

To evaluate the results of surgical treatment in patients with double crush syndrome associated with cervical radiculopathy and upper limb peripheral nerve compression after staged and simultaneous operations.

Summary of Background Data.

Currently, choosing the optimal diagnostic and therapeutic modalities for treating patients with double crush syndrome remains unresolved.

Methods.

The study included 79 patients with double crush syndrome (cervical radiculopathy and syndrome of Guyon’s canal or Carpal tunnel syndrome). Two independent groups were studied: In the Staged Group (n=35), we performed a cervical decompression with stabilization and peripheral nerve decompression at separate days due to ongoing clinical symptoms (average interval between interventions being 22 (18;26) days). In the simultaneous group (n=33), we performed both the cervical spine surgery as well as the peripheral nerve procedures in one surgical session. Total operative time, estimated blood loss, length of hospitalization, complications, and clinical data (NDI score, SF-36, VAS neck pain score, VAS arm pain score, Disabilities of Arm, Shoulder, and Hand (DASH) score, and Macnab scale) were compared. We used the Mann-Whitney (MW) test for intergroup comparisons, the Wilcoxon criterion for dependent samples, and the Fisher exact test for binomial parameters.

Results.

There was a significantly lower operative time, duration of inpatient treatment, and temporary disability in the simultaneous group (P=0.01, P=0.04, and P=0.006, respectively). Comparative analysis did not reveal significant intergroup differences using NDI, VAS, and DASH (P>0.05), whereas, at discharge, significantly better clinical parameters were appreciated for the simultaneous group using SF-36 and Macnab scores (P=0.04 and P=0.03, respectively). At the last follow-up, an intra-group analysis revealed comparable clinical effectiveness between the two approaches (P>0.05).

Conclusion.

Comparison of the effectiveness of simultaneous and staged surgery revealed comparable long-term clinical outcomes. However, simultaneous surgery conveys clinically important advantages in terms of surgical time, anesthesia duration, length of hospitalization, and patient disability.

Level of Evidence.

3
Associations between short-term exposure to ambient temperature and renal disease mortality in Japan during 1979–2019: A time-stratified case-crossover analysis
Authors: Htay Zin Wai , Ng Chris Fook Sheng , Kim Yoonhee , Lim Youn-Hee , Iwagami Masao , Hashizume Masahiro
Published: February 2024

Background:

Previous studies have indicated that renal disease mortality is sensitive to ambient temperatures. However, most have been limited to the summer season with inconclusive evidence for changes in population vulnerability over time.

Objective:

This study aims to examine the association between short-term exposure to ambient temperatures and mortality due to renal diseases in Japan, and how this association varied over time.

Methods:

We conducted a two-stage, time-stratified case-crossover study from 1979 to 2019 across 47 prefectures of Japan. We obtained the data of daily mortality counts for all renal diseases, acute renal failure, and chronic renal disease. We fitted a conditional quasi-Poisson regression model with a distributed lag nonlinear model. A random-effects meta-analysis was applied to calculate national averages. We performed additional analyses by four subperiods, sex, and age groups.

Results:

We analyzed 997,590 renal mortality cases and observed a reversed J-shaped association. Lower temperatures were associated with increased mortality in all renal disease categories. The cumulative relative risks at 2.5th percentile compared to the minimum mortality temperature percentile were 1.34 (95% confidence interval [CI] = 1.29, 1.40), 1.51 (95% CI = 1.33, 1.71), and 1.33 (95% CI = 1.24, 1.43) for all renal, acute renal failure, and chronic renal disease mortality, respectively. The associations were observed in individuals of both sexes and aged 65 years and above. The associations of kidney mortality with low temperature remained consistent, while the associations with high temperature were pronounced in the past, but not in recent periods.

Conclusions:

Protection for individuals with impaired renal function from exposure to low temperatures during cold seasons is warranted.
Socioeconomic Disparities in Research Participation: Bias in Plastic Surgery Residency Match
Authors: Lin Lawrence O. , Huttinger Allyson L. , Butler Paris , Gosman Amanda A. , Janis Jeffrey E.
Published: February 2024

Background:

Integrated plastic surgery residency applicants have increased at a rate disproportionate to available positions. Research productivity has become a surrogate marker for competitiveness, and many applicants pursue it to distinguish themselves. To date, no study has investigated socioeconomic disparities in extended research experience (ERE) participation.

Methods:

A 35-question cross-sectional survey was distributed to applicants to United States-based integrated plastic surgery residency programs during the 2019–2022 application cycles. Summary tables, student t test, and chi-square tests were used for statistical analysis.

Results:

A total of 161 responses (response rate: 20.9%) were recorded. Fifty-nine (40.7%) respondents participated in an ERE. The most common reason for ERE participation was strengthening one’s application. The most common reason against participation was avoiding delays in career progression. A greater percentage of respondents from Northeastern medical schools participated in EREs (P = 0.019). There were no significant differences in debt burden between those who did or did not participate in an ERE. A greater percentage of applicants whose parents had advanced degrees participated in EREs (P = 0.053).

Conclusions:

There may be geographic and socioeconomic biases present in access to ERE for students interested in plastic surgery. The growing popularity of EREs may have unintended consequences for applicant diversity. As most plastic surgeons ultimately practice in nonacademic settings, applicants and plastic surgeons may consider the financial hardships and possible socioeconomic disparities in research opportunities before participating in or recommending them.
The Current State of Plastic Surgery Residency Wellness Programs: Benefits and Barriers
Authors: Fanning James E. , Patel Ashit , Janis Jeffrey E.
Published: February 2024

Background:

Wellness programs are especially important in residency. However, the resources available to plastic surgery residents through residency wellness programs have not been described. This study reports current plastic surgery residency wellness programs’ organization, leadership, and resources.

Methods:

An anonymous and voluntary e-mail survey was sent to 106 plastic surgery residency program directors through May and June 2022. Features of residency wellness programs were detailed, and program directors’ sentiments towards residency wellness programs were evaluated.

Results:

A 30.2% (32 of 106) complete response rate was achieved. Nearly 90% (87.5%, 28 of 32) of program directors indicated the presence of a wellness program. More than 75% (21 of 28) of programs are supported by the Office of Graduate Medical Education. Wellness events were offered by 92.9% (26 of 28) of programs. More than half of programs offered resources for mental health, physical health, mentorship, and protected time. Several resources were associated with the presence of wellness leadership roles, suggesting residents can positively shape wellness program offerings. Program directors strongly indicated that wellness programs are important, relevant, and effective. Additionally, 75% (24 of 32) report a desire to learn about wellness programs at other plastic surgery residency programs.

Conclusions:

Resources offered through plastic surgery residency wellness programs are comparable to those in other specialties. However, plastic surgery programs vary in the resources offered to residents and barriers to access exist. Greater involvement of residents in plastic surgery wellness programs may better support physician wellness.
Effectiveness of Dermal Regeneration Templates in Managing Acute Full-thickness and Deep Dermal Burn Injuries: A Comparison with Split-thickness Skin Grafts
Authors: Alkhonizy Sarah W. , Sabbah Belal Nedal , Khader Majd S. , Abdul Rab Saleha , Chaudhri Eman Naeem , Safar Alsofyani Khalid M. , Raheel Hiba Muhammad , Alhassoun Mohamad , Alabdulkarim Abdulaziz
Published: February 2024

Background:

The therapeutic challenge of managing acute full-thickness burns is significantly ameliorated with the introduction of dermal regeneration templates (DRTs). However, an updated synthesis of evidence-based data on the efficacy and safety of different DRTs is required.

Methods:

This systematic review and meta-analysis conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines aims to evaluate the role of various DRTs in comparison with split-thickness skin grafting in managing acute burn injuries after excision and debridement. A total of 28 randomized clinical trials were assessed, encompassing a wide array of DRTs.

Results:

The study outcomes pointed to the diverse effectiveness of DRTs, with Integra demonstrating peripheral nerve reinnervation potential and TransCyte promoting rapid re-epithelialization. Some DRTs showed scar formation and skin quality comparable to those of autologous skin grafts. In terms of wound infection, certain treatments, including TransCyte, exhibited a significantly low infection rate. The evaluation of scar quality suggested that various interventions produced acceptable or improved outcomes without hypertrophic scarring. Recovery rates after the interventions displayed a range, with certain treatments showing rapid recovery and satisfactory results.

Conclusions:

The current systematic review points to the potential benefits of DRTs in managing burn wounds. Further research is necessary to shed light on the long-term impacts of these interventions on wound healing, scar quality, and patient recovery.
Artificial Intelligence as a Triage Tool during the Perioperative Period: Pilot Study of Accuracy and Accessibility for Clinical Application
Authors: Boyd Carter J. , Hemal Kshipra , Sorenson Thomas J. , Patel Parth A. , Bekisz Jonathan M. , Choi Mihye , Karp Nolan S.
Published: February 2024

Background:

Given the dialogistic properties of ChatGPT, we hypothesized that this artificial intelligence (AI) function can be used as a self-service tool where clinical questions can be directly answered by AI. Our objective was to assess the content, accuracy, and accessibility of AI-generated content regarding common perioperative questions for reduction mammaplasty.

Methods:

ChatGPT (OpenAI, February Version, San Francisco, Calif.) was used to query 20 common patient concerns that arise in the perioperative period of a reduction mammaplasty. Searches were performed in duplicate for both a general term and a specific clinical question. Query outputs were analyzed both objectively and subjectively. Descriptive statistics,ttests, and chi-square tests were performed where appropriate with a predetermined level of significance ofPless than 0.05.

Results:

From a total of 40 AI-generated outputs, mean word length was 191.8 words. Readability was at the thirteenth grade level. Regarding content, of all query outputs, 97.5% were on the appropriate topic. Medical advice was deemed to be reasonable in 100% of cases. General queries more frequently reported overarching background information, whereas specific queries more frequently reported prescriptive information (P< 0.0001). AI outputs specifically recommended following surgeon provided postoperative instructions in 82.5% of instances.

Conclusions:

Currently available AI tools, in their nascent form, can provide recommendations for common perioperative questions and concerns for reduction mammaplasty. With further calibration, AI interfaces may serve as a tool for fielding patient queries in the future; however, patients must always retain the ability to bypass technology and be able to contact their surgeon.
NMR-based metabolomic signature: An important tool for the diagnosis and study of pathogenesis of autoimmune hepatitis
Authors: Dimou Aikaterini , Zachou Kalliopi , Kostara Christina , Azariadis Kalliopi , Giannoulis George , Lyberopoulou Aggeliki , Bairaktari Eleni , Dalekos George N.
Published: February 2024

Background and Aims:

Metabolomics is used to predict, diagnose, and monitor metabolic disorders but altered metabolomic signatures have also been reported in diverse diseases, including autoimmune disorders. However, the metabolomic profile in autoimmune hepatitis (AIH) has not been investigated in depth. Therefore, we investigated the metabolomic signature of AIH and its significance as a diagnostic and pathogenetic tool.

Approach and Results:

Metabolites in plasma samples from 50 patients with AIH at diagnosis, 43 healthy controls, 72 patients with primary biliary cholangitis (PBC), 26 patients with metabolic dysfunction–associated liver disease, and 101 patients with chronic viral hepatitis were determined by1H NMR (nuclear magnetic resonance) spectroscopy. Fifty-two metabolites were quantified, and metabolic pathway analysis was performed. Multivariate analysis revealed that AIH could be differentiated from healthy controls and each of the disease controls (p<0.001). Fifteen metabolites differentiated AIH from disease controls (PBC+chronic viral hepatitis+metabolic dysfunction–associated liver disease) (95% sensitivity and 92% specificity). Ten distinct metabolic pathways were altered in AIH compared to disease controls. The metabolic pathway of branched-chain amino acids (lower valine, leucine, and isoleucine levels and their catabolic intermediates in PBC), methionine (lower methionine, 2-aminobutyrate, and 2-hydroxybutyrate levels in PBC), alanine-aspartate-glutamate (lower metabolites in PBC), and that of metabolites associated with gut microbiota (lower choline, betaine, and dimethylamine levels in PBC) were significantly different between AIH and PBC (p<0.01).

Conclusions:

1H NMR spectroscopy could be a promising novel tool to diagnose and study AIH pathogenesis as there is no need for much sample handling, is highly reproducible with high sensitivity and specificity, and low cost.
In Vitro Evaluation of Soft Contact Lens Wettability With a Nonmodified Commercial Videokeratoscope
Authors: Carpena-Torres Carlos , Ferrando Elena , García-García Carla , Romaguera María , Huete-Toral Fernando , Carracedo Gonzalo
Published: February 2024

Purpose:

To evaluate a new in vitro technique for measuring soft contact lens wettability using a nonmodified commercial videokeratoscope, the Medmont E300. To this end, the capability of different artificial tears containing hyaluronic acid (HA) to improve soft contact lens wettability in vitro was investigated.

Methods:

An experimental in vitro study was conducted to assess the wetting properties of three artificial tears containing different concentrations of HA (0.1%, 0.2%, and 0.3%) on soft contact lenses. A saline solution was used as the control. For each solution, 15 hydrogel (Ocufilcon D) contact lenses and 15 silicone-hydrogel (Somofilcon A) contact lenses were evaluated. The in vitro wettability of the lenses was measured using the Medmont E300 with a self-developed technique, which involved measuring the tear film surface quality (TFSQ) mean, TFSQ area, TFSQ central, and TFSQ inferior.

Results:

Compared with the saline solution, all the concentration of HA (0.1%, 0.2%, and 0.3%) improved the in vitro wettability of both soft contact lenses by decreasing their TFSQ mean and TFSQ area (P<0.05). Regression models revealed an exponential relationship between contact lens wettability and the concentration of HA for both soft contact lenses (R>0.5, P<0.05). Furthermore, the hydrogel contact lens presented a wetter surface than the silicone-hydrogel contact lens (P<0.05).

Conclusions:

The measurement of in vitro wettability of soft contact lenses with a nonmodified Medmont E300 seems to be a useful technique to evaluate the wetting properties of contact lens products.
Effectiveness and Safety of Direct-acting Antivirals for Treatment of Adolescents With HCV/HIV Coinfection: Real-world Data From Europe
Authors: Malik Farihah , Crichton Siobhan , Plotnikova Yulia , Latysheva Inga , Samarina Anna , Pokorska-Śpiewak Maria , Gomez Marisa Navarro , Bailey Heather , Thorne Claire , Judd Ali , Turkova Anna , Collins Intira Jeannie
Published: February 2024

We evaluated the effectiveness and safety of direct-acting antivirals in adolescents with hepatitis C (HCV)/HIV coinfection using pooled individual patient-level data from 5 European cohorts. Of 122 participants in follow-up from November 2013 to August 2021, 19 were treated <18 years of age; of 15 with HCV RNA available at/after 12 weeks post-treatment, all had sustained virologic response with acceptable safety. This evidence addresses an important gap in knowledge of treatment outcomes in adolescents with HCV/HIV coinfection in real-life settings.
Hereditary factor X deficiency in America survey: impact on quality of life and burden of disease in patients and caregivers
Authors: Branchford Brian , Clark Kim , Stanford Richard H. , Garner Denise A. , Huang Shirley P. , Wolford Eric
Published: February 2024

Hereditary factor X deficiency (HFXD) is a rare bleeding disorder causing delayed haemostasis and potentially life-threatening bleeds. Patient/caregiver burden and diagnosis path have not been well characterized.

The aim of this study was to

describe the diagnosis path, disease burden, and HFXD impact on quality of life (QoL) in patients and caregivers.

This was a prospective, cross-sectional, web-based survey of patients with HFXD and caregivers addressing the patient/caregiver experience, QoL, humanistic and unmet needs.

Thirty patients and 38 caregivers completed the survey with mean ages 24.7 and 44.6 years, respectively. Mean age at diagnosis was 4.1 years. The diagnostic process was somewhat/very difficult for 23% of patients and 26% of caregivers. Approximately half (53%) received single factor replacement (SFR) as prophylaxis or on-demand. Most patients (71%) reported regular prophylaxis treatment. Over one-fourth (27%) reported treatment with fresh frozen plasma. Bleeding episodes were less common in patients using SFR versus non-SFR: three bleeds or fewer were reported by 92% SFR and 75% non-SFR patients. HFXD patients reported low well being in work/school/social activities with mean HFXD-adapted Hemophilia Well being Index. Patient symptoms negatively impacted caregiver burden with a mean HFXD-adapted Hemophilia Caregiver Index (±SD) of 15.9 (4.6), but also unexpectedly had a positive impact on self-worth and inner strength.

To our knowledge, this is the first study to assess patient and caregiver burden of HFXD and impact on QoL. Improvements in symptom recognition, prompt diagnosis, and adherence to expert recommendations for treatment could improve QoL and decrease burden on HFXD patients and caregivers.
The diagnosis and management of chronic lung allograft dysfunction
Authors: Verleden Geert M. , Hendriks Jeroen M. H. , Verleden Stijn E.
Published: February 2024

Purpose of review

Chronic lung allograft dysfunction (CLAD) remains a life-threatening complication following lung transplantation. Different CLAD phenotypes have recently been defined, based on the combination of pulmonary function testing and chest computed tomography (CT) scanning and spurred renewed interests in differential diagnosis, risk factors and management of CLAD.

Recent findings

Given their crucial importance in the differential diagnosis, we will discuss the latest development in assessing the pulmonary function and chest CT scan, but also their limitations in proper CLAD phenotyping, especially with regards to patients with baseline allograft dysfunction. Since no definitive treatment exists, it remains important to timely identify clinical risk factors, but also to assess the presence of specific patterns or biomarkers in tissue or in broncho alveolar lavage in relation to CLAD (phenotypes). We will provide a comprehensive overview of the latest advances in risk factors and biomarker research in CLAD. Lastly, we will also review novel preventive and curative treatment strategies for CLAD.

Although this knowledge has significantly advanced the field of lung transplantation, more research is warranted because CLAD remains a life-threatening complication for all lung transplant recipients.
Artificial intelligence for the optimal management of community-acquired pneumonia
Authors: Barbieri Maria Antonietta , Battini Vera , Sessa Maurizio
Published: February 2024

Purpose of review

This timely review explores the integration of artificial intelligence (AI) into community-acquired pneumonia (CAP) management, emphasizing its relevance in predicting the risk of hospitalization. With CAP remaining a global public health concern, the review highlights the need for efficient and reliable AI tools to optimize resource allocation and improve patient outcomes.

Recent findings

Challenges in CAP management delve into the application of AI in predicting CAP-related hospitalization risks, and complications, and mortality. The integration of AI-based risk scores in managing CAP has the potential to enhance the accuracy of predicting patients at higher risk, facilitating timely intervention and resource allocation. Moreover, AI algorithms reduce variability associated with subjective clinical judgment, promoting consistency in decision-making, and provide real-time risk assessments, aiding in the dynamic management of patients with CAP.

The development and implementation of AI-tools for hospitalization in CAP represent a transformative approach to improving patient outcomes. The integration of AI into healthcare has the potential to revolutionize the way we identify and manage individuals at risk of severe outcomes, ultimately leading to more efficient resource utilization and better overall patient care.
Unusual case of retroperitoneal hematoma and duodenal ulcerative bleeding after nephrectomy: Case report
Authors: Luo Yong , Li Qing , Liao Zhanchen , Luo Zhigang
Published: February 2024

Rationale:

Retroperitoneal hematomas are relatively common in patients undergoing nephrectomy. Herein, we report an unusual case involving a giant retroperitoneal hematoma and subsequent duodenal ulcerative bleeding following a radical nephrectomy.

Patient concerns:

A 77-year-old woman was admitted to our hospital for lower back pain, and she had severe right hydronephrosis and a urinary tract infection.

Diagnoses:

The patient was diagnosed and confirmed as high-grade urothelial carcinoma.

Interventions:

After ineffective conservative treatments, a right radical nephrectomy and ureteral stump resection were performed. The patient received proton pump inhibitors to prevent stress ulcer formation and bleeding. On the first day post-surgery, she had normal gastrointestinal (GI) endoscopy findings. On the second day post-surgery, abdominal computed tomography revealed a retroperitoneal hematoma. Notably, 14 days post-surgery, massive GI bleeding occurred, and GI endoscopy identified an almost perforated ulcer in the bulbar and descending duodenum.

Outcomes:

The patient died on day 15 after surgery.

Lessons:

Duodenal ulceration and bleeding might occur following a retroperitoneal hematoma in patients treated with nephrectomy. Timely intervention may prevent duodenal ulcers and complications, and thus could be a promising life-saving intercession.