bluuebunny/crossref_metadata_2025_split huggingface dataset:
Developing CLOUT: A Longitudinal, Cross-Program Chief Resident Curriculum to Increase Psychological Safety in the Clinical Learning Environment
Authors: Dunne Dana , Asnes Andrea , Berg David , Chen Alissa , Dewey Jeff , Gupta Shaili , Fernandes Claudia-Santi , Huot Stephen J. 
Published: December 2024

Abstract
Psychological safety in the clinical learning environment is essential for learning and thriving. The authors aimed to leverage the leadership position and influence that chief residents hold and invited them to participate in a longitudinal professional development curriculum designed to provide them with the tools to promote psychological safety. A total of 66 chief residents from 25 residency programs, along with 18 faculty allies, participated in 5 workshops, which were designed to increase their understanding of and effective responses to workplace mistreatment or bias directed toward trainees. These skills-based workshops focused on effective coaching, conflict management, and self-regulation of emotions for themselves and their trainees. There was a significant improvement in self-reported efficacy in these domains at the completion of the curriculum and evidence of behavior change as assessed by baseline and final case scenario responses. Additionally, the relationship building that resulted by bringing all chief residents together further enhanced the curriculum’s impact as assessed qualitatively. Providing chief residents with skills and resources to become change agents through a longitudinal curriculum in a cohort model improves individual self-efficacy and responses to exemplar cases. Assessment of the overall impact on individual programs and institutional climate is planned.
Treatment of Infection After Tibial Intramedullary Nailing With Bone Distraction Combined With Free Anterolateral Thigh Flap for Concomitant Soft-tissue Defect
Authors: Zhou Zhegang , Qin Haotian , Marei Abdelhakim Ezzat , Wen Jingjing , Yu Longbiao , Meng Fanbin , Zhou Tao , Xiao Yingfeng , Zeng Hui , Yu Fei 
Published: December 2024

Summary:
A 57-year-old man presented with a tibial shaft fracture treated with tibial intramedullary nail fixation and plate and screw fixation for fibular fracture. Two weeks postoperatively, the patient developed skin sloughing with exposed bone and metal at the fracture site. Three weeks postoperatively, a physical examination revealed swelling of the left lateral malleolus and lower leg, a skin defect of approximately 3 × 5 cm2 at the lower third of the left tibia with an exposed fracture site and hardware in between the fracture fragments. The patient underwent debridement, removal of the intramedullary nail, vacuum sealing drainage, removal of the fibular plate, repositioning, and application of an external fixator. Antibiotic-impregnated bone cement was applied at the fracture site. One week postoperatively, the medullary canal was debrided, and a free anterolateral thigh flap was designed to repair the skin defect. Approximately 5 cm of the opposed fracture fragments was removed from the tibia, and antibiotic-calcium sulfate bone substitutes were applied to the fracture site. Definitive fixation was obtained by a circular external fixation and a minimally invasive osteotomy of the proximal tibia was performed. The patient had no recurrence of infection, and his limb function has recovered well.
INTRAVITREAL BEVACIZUMAB FOR THE TREATMENT OF CHOROIDAL HEMANGIOMAS
Authors: Elkayal Hassan E. , Sagoo Mandeep S. , Negretti Guy S. 
Published: December 2024

Purpose:
To investigate the use of intravitreal bevacizumab for the treatment of subretinal fluid (SRF) and intraretinal fluid associated with circumscribed choroidal hemangiomas.

Methods:
This was a retrospective review of all patients treated with at least three bevacizumab injections for circumscribed choroidal hemangiomas–associated SRF between May 2020 and August 2023 in Moorfields eye hospital. Outcome measures included change in best-corrected visual acuity, change in patient-reported symptoms, change in SRF, and change in central subfield thickness. Data on further management after cessation of injections were analyzed.

Results:
The study included nine patients. Median best-corrected visual acuity was 6/19 before and 6/24 after injections (P = 0.41). Central subfield thickness decreased from a median of 466 to 447 µm (P = 0.11). Two thirds of (n = 6) patients did not show any reduction in foveal SRF, one third (n = 3) showed a partial reduction, and no patients had a complete resolution of SRF. Eight patients received rescue-photodynamic therapy, and one received external beam radiotherapy. Best-corrected visual acuity changed from a median of 6/60 to a median of 6/12 after rescue treatment (P = 0.63). The median central subfield thickness decreased significantly from 470 µm to 249 µm (P = 0.01).

Conclusion:
Intravitreal bevacizumab is unlikely to be an effective treatment for exudative circumscribed choroidal hemangiomas.
Anterior segment pharmacological accommodative changes and its impact on the circumferential anterior chamber angle after ICL V4c implantation
Authors: Liu Shengtao , Cheng Mingrui , Liu Fang , Lin Feng , Xiao Yichen , Wang Xiaoying , Zhou Xingtao 
Published: December 2024

Purpose:
To investigate the pharmacological accommodative changes of the anterior segment and its impact on the circumferential anterior chamber angle (ACA) after implantable collamer lens (ICL) implantation using swept-source optical coherence tomography (SS-OCT).

Setting:
Eye and ENT Hospital, Fudan University, Shanghai, China.

Design:
Prospective randomized contralateral eye study.

Methods:
8 men and 24 women (mean age, 28.2 ± 5.8 years; range, 19 to 42 years); 64 eyes were included at 3 months after ICL implantation. One eye per patient was randomly assigned to undergo tropicamide instillation (mydriasis group), and the contralateral eye underwent pilocarpine instillation (miosis group). SS-OCT examinations were performed before and after instillation to measure angle parameters. Trabecular–iris angle 500 (TIA500), angle opening distance 500 (AOD500), trabecular–iris space area (TISA500), angle opening distance circumference area 500 (AODA500), trabecular–iris circumference volume 500 (TICV500), and central vault (ICL to crystalline lens [ICL-L]) were evaluated.

Results:
Relative to baseline levels, TIA500, AOD500, and TISA500 values all increased significantly in both groups (all P < .01). AODA500 and TICV500 values increased by 19.7% and 12.1%, respectively, in the mydriasis group (all P < .001), and these values similarly increased by 23.4% and 27.7%, respectively, in the miosis group (all P < .001). After instillation, the ICL-L decrease in the miosis group was significantly larger than that in the mydriasis group (P = .004). Mean AOD500, TISA500, and TICV500 in the miosis group were significantly larger than those in the mydriasis group (all P ≤ .036), especially at 8 and 10 o'clock (all P ≤ .014). Correlation analyses indicated that the increase in ACA parameters was positively correlated with the change in ICL-L for both groups.

Conclusions:
Pilocarpine induced a more significant increase in ACA than tropicamide, because of a different mechanism of anterior segment changes. A circumferential meridian scan to assess angle status is recommended.
Acute Care Physical Therapy Literature
Authors: Toonstra Amy , Kumble Sowmya , Steinhorn Gabrielle , Skrzat Julie 
Published: December 2024

Purpose:
Acute care physical therapy (PT) is a rapidly evolving area of practice. To ensure continuity and consistency of care and advance the science effectively, communication between clinicians, researchers, and academicians is essential. This can occur in the form of literature. Unfortunately, barriers limit dissemination, integration, and progression of literature to all interested parties. The purpose of this article is to highlight selected acute care PT literature published in 2023 to share current knowledge amongst all members of the acute care PT community.

Methods:
Acute care PT literature from the year 2023 was searched for and reviewed. Articles for presentation were selected based on relevance to today’s health care environment, hot topics, and the anticipated future of acute care PT.

Results:
Articles were stratified into value-based care, clinical practice including differential diagnoses and treatment dosage, and entry level Doctor of PT didactic and clinical education. Following the summary of each topic’s articles, clinical relevance and future directions are discussed.

Conclusions:
Evidence supports the importance of intra-professional collaboration. The acute care PT community must work together to further demonstrate our value in a rapidly changing health care environment, optimize patient outcomes through progressive interventions and rigorous outcome measures, and implement novel techniques to educate the next generation of physical therapists.
Nutritional therapy for gastroparesis
Authors: Wang Zhen , Song Qin-Zhou , Jiang Jin-Xun , Wu Xiang-Hua , Chen Jun-Qiang 
Published: December 2024

Abstract
Gastroparesis is a common postoperative complication of abdominal surgery, mainly manifested by postprandial fullness, early satiety, nausea, vomiting, and bloating. Gastroparesis should be addressed with a comprehensive treatment plan that includes nutritional therapy and medications such as metoclopramide, domperidone, cisapride, and antiemetic drugs. Surgical treatment, such as pyloroplasty or partial gastrectomy, should be considered if the conservative therapy is ineffective. Enteral and parenteral nutrition therapy can promote the recovery of gastrointestinal function, maintain the mucosal integrity and immunity, and reduce complications. Thus, nutrition can play an important role in the treatment of gastroparesis.
Using the EPIS Framework to Implement a Physical Activity Promotion Intervention at a Large Academic Healthcare System
Authors: McCarthy Margaret M. , O'Neill Krista , Zhong Judy , Xia Yuhe , Heffron Sean P. 
Published: December 2024

Objectives
This study aimed to describe the implementation of a workplace health promotion to address low levels of physical activity (PA).

Methods
Using the Exploration, Preparation, Implementation, Sustainment (EPIS) framework, we implemented and evaluated a 10-week workplace step-count challenge to promote PA. All health system employees invited to participate. Data were collected on the exploration, preparation, and implementation phases.

Results
During exploration, we recognized inadequate PA among employees. Meetings with key personnel were held to determine details of the health promotion and obtain support. We pursued a step-count PA intervention, capitalizing on employee ownership of smartphones with accelerometers. Vendors to host the intervention were evaluated. All employees were invited to participate. Participants received weekly messages about improving PA and notifications of weekly challenges. Exit interviews provided feedback and suggestions.

Conclusions
A workplace health promotion focused on employee PA is feasible using EPIS.
Prevalence and Intriguing Clinical Profiles of Autoimmune Inner Ear Diseases in Sudden Sensorineural Hearing Loss
Authors: Arunthanachaikul Thunyawarin , Osothsinlp Sornwit , Nivatwongs Saisuree , Narongroeknawin Pongthorn 
Published: December 2024

Introduction
Sudden sensorineural hearing loss (SSNHL) is idiopathic in 70–90% of cases with 10–30% linked to vascular injuries, viral infections, or autoimmune inner ear disease (AIED). AIED contributes to less than 1% of all hearing losses, categorized into primary, affecting only the inner ear, and secondary, associated with systemic autoimmune diseases (SAID). This study examines the prevalence and features of AIED in SSNHL in a tertiary referral center.

Materials and Methods
We conducted a prospective study from November 2021 to December 2022 including SSNHL patients who exhibited symptoms like hearing loss or tinnitus. Evaluations included tympanometry, pure tone audiometry, and blood tests, with suspected AIED cases further assessed by rheumatologists using Lobo's diagnostic criteria. Treatment responses were monitored through regular audiometry updates.

Results
Out of 694 SSNHL patients, 43 (6.2%) were diagnosed with AIED, of which 36 (83.7%) had primary AIED and 7 (16.3%) had secondary AIED linked to conditions like Sjögren's syndrome and systemic lupus erythematosus. Treatment response was seen in 19.4% of primary and 42.9% of secondary AIED cases.

Conclusion
The prevalence of AIED in SSNHL patients was found to be 6.2%, with a notable fraction also suffering from SAID. Responses to treatment were positive in about a third of these cases, highlighting the importance of interdisciplinary management for this rare yet significant cause of SSNHL.
Is Vestibular Rehabilitation as Effective for Persistent Postural-Perceptual Dizziness as for Chronic Unilateral Vestibular Hypofunction?
Authors: Yamato Akiyuki , Yagi Chihiro , Kimura Akira , Kai Ryota , Kitazawa Meiko , Yamagishi Tatsuya , Ohshima Shinsuke , Izumi Shuji , Imai Takao , Inohara Hidenori , Horii Arata 
Published: December 2024

Objective
To compare the feasibility and outcomes of vestibular rehabilitation (VR) for persistent postural-perceptual dizziness (PPPD) with those for chronic unilateral vestibular hypofunction (UVH).

Study Design
Prospective study.

Setting
Tertiary referral center.

Patients
Nineteen consecutive patients with chronic UVH lasting for >3 months and 15 with PPPD.

Interventions
The VR program consisted of gaze stabilization exercises, static or dynamic balance exercises and gait training, and habituation exercises that exposed patients to a provocative stimulus. Patients were asked to perform VR for at least 20 min a day.

Main Outcome Measures
Status of VR (i.e., continuation/discontinuation) and outcomes were assessed 1 month after the introduction of VR using the Dizziness Handicap Inventory for handicaps in daily life due to dizziness, the Niigata PPPD Questionnaire (NPQ) for symptom exacerbations of PPPD, and the Hospital Anxiety and Depression Scale for anxiety and depression.

Results
No patients in the chronic UVH group discontinued VR, whereas six patients in the PPPD group discontinued VR owing to symptom exacerbations, showing a significant difference. VR did not decrease any symptom scale, except for the NPQ-motion subscore, in patients with PPPD who continued VR, whereas it decreased all clinical symptom scales, except for the NPQ-motion subscore, in patients with chronic UVH.

Conclusions
Patients with PPPD had a higher rate of VR discontinuation than those with chronic UVH, and VR was less effective in patients with PPPD who even continued treatment than in those with chronic UVH. Therefore, VR on PPPD should be optimized.
Dr Saul Hertz
Authors: Hertz Barbara 
Published: December 2024

Abstract
Dr Saul Hertz (1905–1950) conceived and brought from bench to bedside the medical uses of radioiodine. The early history of radioiodine has been compromised with inaccuracies. This article uses primary-source verification to put forth an evidence-based history of the origin of nuclear medicine. Hertz’s paradigm-changing work is a seminal medical discovery of the 20th century. Dr Hertz’s legacy continues to evolve.
Spinal Anatomy Ultrasound in Young Infants With Implications for Lumbar Puncture
Authors: Rinaldi Margaret B. , Lipton Matthew , Kidd Rebecca , Arnold Donald H. , Levine Marla C. 
Published: December 2024

Background:
Lumbar puncture (LP) in young infants may challenge clinicians due to the infrequency of the procedure and anatomic variability. The use of ultrasound (US) to characterize young infant spinal anatomy prior to performing an LP may help determine the most favorable site for intervention.

Objectives:
1) Evaluate potential sites for LP in young infants with US at L2/L3 through L5/S1 to determine differences in needle insertion depth (NID), spinal canal width (SCW), and subarachnoid fluid width (SAW).
2) Describe the location of the conus medullaris.
3) Predict NID of L2/L3 through L5/S1 based on variables including age, gestational age, height, and weight.

Methods:
We studied a convenience sample of participants aged 0–6 months in a tertiary children's emergency department. We recorded characteristic data and used a Sonosite PX US with a linear 15-MHz transducer to image each participant's spine. We used the paired t-test to examine univariate differences in NID, SCW, and SAW and multiple linear regression models to derive predictive equations for NID.

Results:
Among 50 participants, the mean NID for sites L2/L3 through L5/S1 did not differ significantly; however, at sites L2/L3 through L5/S1, there were statistically significant differences in the mean SCW and mean SAW, which were both consistently measured to be larger the more cephalad the site. Weight was the only statistically significant variable associated with NID after adjusting for other covariates.

Conclusions:
Spinal canal width and SAW were consistently measured to be larger at more cephalad sites, suggesting there is a larger target fluid volume available at higher interspaces. Subarachnoid fluid width was measured to be small, highlighting the importance of precise movements. Location of the needle site did not change expected needle depth (approximately 1 cm across all sites). The conus medullaris was not often visualized while scanning the L2/L3–L5/S1 interspaces. Weight can be used to estimate optimal NID; although, it is unclear such small differences would have clinical significance.
Firearm Injury Risk Prediction Among Children Transported by 9-1-1 Emergency Medical Services
Authors: Newgard Craig D. , Babcock Sean , Malveau Susan , Lin Amber , Goldstick Jason , Carter Patrick , Cook Jennifer N.B. , Song Xubo , Wei Ran , Salvi Apoorva , Fallat Mary E. , Kuppermann Nathan , Jenkins Peter C. , Fein Joel A. , Mann N. Clay 
Published: December 2024

Objective:
Among children transported by ambulance across the United States, we used machine learning models to develop a risk prediction tool for firearm injury using basic demographic information and home ZIP code matched to publicly available data sources.

Methods:
We included children and adolescents 0–17 years transported by ambulance to acute care hospitals in 47 states from January 1, 2014 through December 31, 2022. We used 96 predictors, including basic demographic information and neighborhood measures matched to home ZIP code from 5 data sources: EMS records, American Community Survey, Child Opportunity Index, County Health Rankings, and Social Vulnerability Index. We separated children into 0–10 years (preadolescent) and 11–17 years (adolescent) cohorts and used machine learning to develop high-specificity risk prediction models for each age group to minimize false positives.

Results:
There were 6,191,909 children transported by ambulance, including 21,625 (0.35%) with firearm injuries. Among children 0–10 years (n = 3,149,430 children, 2,840 [0.09%] with firearm injuries), the model had 95.1% specificity, 22.4% sensitivity, area under the curve 0.761, and positive predictive value 0.41% for identifying children with firearm injuries. Among adolescents 11–17 years (n = 3,042,479 children, 18,785 [0.62%] with firearm injuries), the model had 94.8% specificity, 39.0% sensitivity, area under the curve 0.818, and positive predictive value 4.47% for identifying patients with firearm injury. There were 7 high-yield predictors among children and 3 predictors among adolescents, with little overlap.

Conclusions:
Among pediatric patients transported by ambulance, basic demographic information and neighborhood measures can identify children and adolescents at elevated risk of firearm injuries, which may guide focused injury prevention resources and interventions.
The T﻿urkish Version of the Revised Nottingham Sensory Assessment: Validity and Reliability in Chronic Stroke Survivors
Authors: Bilgin Nurten , Akyurek Gokcen 
Published: December 2024

Background:
Evaluation of sensory functions in chronic stroke survivors is essential to plan and implement effective treatment and rehabilitation.

Objective:
To investigate the validity and reliability of the Turkish version of the Revised Nottingham Sensory Assessment (rNSA-T) in chronic stroke survivors.

Methods:
We applied the World Health Organization’s translation protocols to develop the rNAS-T. We then tested its validity and reliability in 85 chronic stroke survivors using criterion validity and consistency for demographic variables, as well as﻿ test-retest and inter-rater reliability analyses﻿.

Results:
The criterion validity of the rNSA-T was supported by significant correlation between participants’ scores on the rNSA-T, the Katz Index of Independence in Activities of Daily Living (Katz-AD) (r = 0.430–0.674, P < 0.05), and the Rivermead Motor Assessment (RMA) (r = 0.528–0.773, P < 0.05). rNSA-T results remained consistent across variables of sex and side affected by stroke (P > 0.05). The test-retest reliability of the rNSA-T was excellent in all subdimensions (ICC = 0.865–1.000), as was the inter-rater reliability (κ = 0.875–1.000).

Conclusion:
The rNSA-T is a valid and reliable tool for evaluation of sensory functions in chronic stroke survivors.
Stress internalization associated with cognitive decline among older U.S. Chinese
Authors: Chen Michelle H , Ma Yiming , Verma Charu , Bergren Stephanie , Dong XinQi , Hu William T 
Published: December 2024

AbstractINTRODUCTIONBehavioral and sociocultural factors in minority populations in the U.S. are commonly examined as independent contributors or buffers to health disparities in cognitive decline, but can demonstrate significant inter-relatedness due to broader contextual factors (e.g., acculturation). Analyzing influence of correlated behavioral and sociocultural traits can better identify targets for future intervention. The current study aimed to account for interdependent risk and resilience factors associated with cognitive decline in non-demented older U.S.-dwelling Chinese adults.METHODSThe sample consisted of 1,528 older U.S. Chinese (60 and older) with normal cognition and function at baseline who attended three waves of the Population Study of ChINese Elderly (PINE). We used principal component analysis to generate memory and executive functioning outcomes; factor analysis to reduce behavioral and sociocultural variables into latent constructs; and linear mixed-effects models to evaluate the impact of these constructs, as well as of demographic and medical factors (e.g., cardiovascular disease), on longitudinal rates of cognitive decline.RESULTSFactor analysis identified three main behavioral/sociocultural constructs: stress internalization, neighborhood/community cohesion, and external social support. Among these, only stress internalization – consisting of greater perceived stress, greater hopelessness, and lower conscientiousness – was associated with longitudinal decline in memory, while none with decline in executive functioning. Neither acculturation nor social engagement was related to decline in memory or executive function, even though participants with greater acculturation or social engagement had better baseline cognitive performance.DISCUSSIONUsing a psychometrically and statistically robust model, we found that only the factor underlying stress processing, hopelessness, and conscientiousness was associated with rates of memory decline in this older non-demented U.S. Chinese cohort. These maladaptive traits have been linked to the Asian model minority stereotype but all the same potentially modifiable. Future studies examining disparate health outcomes must account for inter-relatedness among behavioral and sociocultural factors to identify root causes.