bluuebunny/crossref_metadata_2025_split huggingface dataset:
Gonorrhea and Early Syphilis Treatment Practices Among Community Health Care Providers in Baltimore City, Maryland
Authors: Padiernos Renee , Thornton Nicole , Muvva Ravikiran , Marcell Arik V. , Jennings Jacky M. , Schumacher Christina M. 
Published: November 2024

Background
Ensuring patients receive appropriate (Centers for Disease Control and Prevention–recommended) and prompt (≤14 days of specimen collection) treatment is critical to decrease gonorrhea and early syphilis (ES) incidence. The objectives were to (1) quantify treatment performance among community health care providers (CHPs), (2) compare CHP treatment performance to local health department goals, and (3) describe variation in treatment performance by CHP characteristics in Baltimore City, Maryland.

Methods
Surveillance data for gonorrhea and ES diagnoses reported between January 2018 and December 2019 were used. Treatment performance measures were calculated for each CHP (gonorrhea: 171 CHPs; ES: 122 CHPs). Measures were (1) percent treated among all diagnoses (goal: ≥90%), (2) percent appropriately treated among diagnoses treated (goal: ≥90% gonorrhea, ≥95% ES), and (3) percent promptly treated among diagnoses appropriately treated (goal: ≥85%). Treatment performance measures and achievement of goals were compared across CHP characteristics.

Results
For gonorrhea, median percent treated, appropriately treated, and promptly treated were 71.4%, 95.0%, and 100.0%, respectively; 29.8% met treated goals. The majority achieved appropriately treated (62.9%) and promptly treated (76.8%) goals. Community health care practices reporting high (vs. low) volume of gonorrhea diagnoses less frequently achieved percent-treated goals (12.2% vs. 35.4%, P = 0.008). Median value for all ES treatment performance measures was 100.0%. Most achieved treated (90.2%) and appropriately treated (95.9%) goals. Less than half (49.2%) achieved the promptly treated goal. Community health care practices reporting high (vs. low) volumes of ES less frequently achieved promptly treated goals (33.3% vs. 54.4%, P = 0.045).

Conclusions
Substantial gaps in reporting gonorrhea treatment and prompt ES treatment were observed. Practice-level interventions to facilitate reporting gonorrhea treatment and provide prompt ES treatment are needed.
Simulation-Based Training in Clinical Event Debriefing Improves Leadership Performance
Authors: Baker Arianne “Cuff” L. , Monuteaux Michael C. , Mullan Paul C. , Nagler Joshua , Dorney Kate 
Published: November 2024

Objectives
Clinical event debriefing (CED) improves healthcare team performance and patient outcomes. Most pediatric emergency medicine (PEM) physicians do not receive formal training in leading CED. Our objectives were to develop a CED curriculum and evaluate its effect on performance, knowledge, comfort, and clinical practice.

Methods
This was a single group pre-post-retention study. We developed a hybrid curriculum with simulation, an interactive module, and individual feedback. We invited faculty and fellows from the PEM division of our hospital to participate. During an in-person training day, participants led standardized clinical simulation scenarios followed by simulated CED with immediate feedback on their leadership performance. They watched an interactive module between scenarios. Participants returned for a retention assessment 2–6 months later with a third simulation and debrief. Participants completed surveys measuring attitudes, experiences, and knowledge. Participants also evaluated the curriculum.
The primary outcome was CED leadership performance using a novel 21-item tool that we developed, the Debrief Leadership Tool for Assessment (DELTA). A blinded, trained rater measured performance with DELTA. Secondary outcomes included changes in knowledge and comfort and changes in clinical practice.

Results
Twenty-seven participants enrolled and completed all parts of the curriculum and assessments. Debrief leadership performance improved by a mean of 3.7 points on DELTA pre-training to post-training (95% confidence interval = 2.7, 4.6, P < 0.01) and by 1.4 points from pre-training to retention (95% confidence interval = 0.1, 2.8, P = 0.03). Knowledge and comfort also significantly improved from pre-training to post-training and were sustained at retention. Most (67%) participants changed their clinical practice of CED after completing the curriculum. All participants would recommend the training to other PEM physicians.

Conclusions
A hybrid simulation-based curriculum in leading CED for PEM physicians was associated with improvement in CED leadership performance, knowledge, and comfort. PEM physicians incorporated training into their clinical practice.
Epineural Scarring Visualization and Noninvasive Quantification of a Severe Posttraumatic Complication
Authors: Brunnée Merle , Aman Martin , Mayrhofer-Schmid Maximilian , Fischer Manuel , Daeschler Simeon C. , Klemm Tess , Kneser Ulrich , Karimian-Jazi Kianush , Breckwoldt Michael O. , Harhaus Leila , Heiland Sabine , Bendszus Martin , Boecker Arne H. , Schwarz Daniel 
Published: November 2024

Aim
Peripheral nerve scarring is a severe yet common complication following nerve injury or surgery that can lead to impaired nerve function, including chronic pain and sensory or motor deficits. In this study, we aimed to establish high-resolution magnetic resonance neurography (MRN) to accurately visualize and monitor de novo–formed epineural fibrotic adhesions (EFAs) of the sciatic nerve in a rat nerve injury model.

Methods
Employing an established model to induce overshooting EFA, the study included 3 experimental groups of animals (n = 6 each): a positive control group (PC), an intervention group (IG), and a sham group. All groups underwent surgical nerve exposure: both PC and IG received an application of 10 μL 2.5% glutaraldehyde to induce EFA, but only IG received an additional preventive wrapping of the nerve with a collagen-containing matrix. Magnetic resonance imaging was performed 6, 8, and 12 weeks postoperatively using a standardized protocol including T2w and T1w without and with contrast media. Motor function and nerve regeneration was assessed using the visual static sciatic index. Histological specimens were obtained 12 weeks postoperatively and correlated with imaging.

Results
On high-resolution MRN, prominently contrast-enhancing epineural sleeves were present in vivo, which corresponded to histologically confirmed EFA (ratio of EFA to nerve area MRN 1.512 ± 0.106 vs histological ratio 1.459 ± 0.208, nonsignificant). As expected, average EFA in IG (0.310 ± 0.118 mm2) was smaller than in PC (0.909 ± 0.212 mm2, P < 0.01). Also, the average EFA in sham (0.386 ± 0.030 mm2) was less pronounced than in PC (P < 0.01). There was no significant difference in the average EFA between IG und sham. The EFA correlated with the functional outcome, which was measured by visual static sciatic index (correlation coefficient −0.59, P < 0.05).

Conclusions
The results of the present study for the first time confirm the clinical observation that epineural thickening on contrast-enhanced T1w imaging following manipulation to a nerve indeed corresponds to overshooting epineural scarring, which may be linked to impaired nerve function. This can be followed noninvasively in vivo over time providing an important basis for clinical decision-making in cases where further invasive therapies may be necessary.
Photon-Counting CT Iodine Maps for Diagnosing Chronic Pulmonary Thromboembolism
Authors: Kerber Bjarne , Flohr Thomas , Ulrich Silvia , Lichtblau Mona , Frauenfelder Thomas , Franckenberg Sabine 
Published: November 2024

Objectives
The aim of this study was to evaluate the feasibility and efficacy of chronic pulmonary thromboembolism assessment using photon-counting detector computed tomography (PCD-CT) iodine maps of the lung parenchyma.

Materials and Methods
This institutional review board–approved retrospective study included 83 subjects (49.4% male, aged 62.4 ± 13.4 years; 50.6% female, aged 59.9 ± 17.1 years) who underwent clinically indicated PCD-CT scan to rule out chronic thromboembolic pulmonary hypertension (CTEPH). Two blinded readers used iodine maps and corresponding sharp-kernel CT reconstructions in the lung window to evaluate perfusion defects and identify patients with chronic pulmonary thromboembolism (CTEPH, CTEPH overlap with other causes of pulmonary hypertension [PH], chronic thromboembolic disease [CTED]). No other clinical or imaging information was given. Discordance was resolved in a subsequent consensus read. The clinical diagnosis was reviewed in an interdisciplinary clinical setting. The accuracy, sensitivity, and specificity of radiologic evaluation and clinical diagnosis were calculated.

Results
Of the 83 subjects included, 32 were diagnosed with CTEPH, CTEPH overlap, or CTED, 35 were diagnosed with PH caused by other pathologic mechanisms, 10 had no PH, and 6 had suffered previous acute pulmonary embolism, which resolved. The interreader agreement was good (Cohen κ = 0.74). The consensus reached high accuracy (0.88), sensitivity (0.94), and specificity (0.84), as well as good agreement with interdisciplinary clinical diagnosis (Cohen κ = 0.75). No cases with confirmed CTEPH as the primary cause of PH or CTED were missed. Patients with pulmonary arterial hypertension were most frequently rated false-positive. The mean effective dose (±standard deviation) was 1.3 (±0.76) mSv.

Conclusions
Accurate, sensitive, and specific diagnosis of pulmonary chronic thromboembolism at low radiation dose is possible using iodine maps reconstructed from PCD-CT scans.
Comparative Analysis of Patient-reported Outcomes After Cranial Vault Remodeling and Strip Craniectomy With the FACE-Q Craniofacial Module
Authors: Bello Margaret A. , Mercho Patrick F. , Gupta Salil , Shirrell Mariah , Tran Khoa D. , Cordes Emma J. , Tholpady Sunil , Ackerman Laurie L. , Makar Katelyn G. 
Published: November 2024

Background:
The debate continues among craniofacial surgeons regarding the effectiveness of strip craniectomy (SC) compared with cranial vault remodeling (CVR) in achieving optimal functional and aesthetic outcomes in patients with single-suture craniosynostosis. This study aimed to compare long-term patient-reported outcomes (PROs) between SC and CVR procedures at a single institution using the validated FACE-Q Craniofacial module.

Methods:
Patients older than or equal to 8 years of age and parents of patients younger than 8 years of age who underwent SC or CVR for single-suture craniosynostosis were eligible. Patients with <2 years of follow-up, lambdoid synostosis, and syndromes were excluded. Primary endpoints were PROs as measured by the FACE-Q, with higher scores indicating increased health-related quality of life. Linear regression was used to control for covariates.

Results:
Sixty-two participants completed the module (response rate 33.3%). SC was performed in 29 patients (46.8%), and CVR in 33 patients (53.2%). On unadjusted bivariate analysis, SC patients had higher eye (P=0.03) and forehead (P=0.05) scores. On regression analysis, controlling for sex, race, craniosynostosis type, and follow-up, there were no significant differences between operation types in any domain. Metopic and sagittal synostosis were associated with higher Eye (metopic: 17.61, P=0.049; sagittal: 41.44, P<0.001) and Head scores (metopic: 48.12, P=0.001; sagittal: 49.35, P<0.001), and sagittal synostosis was associated with higher Face (38.16, P<0.001), Forehead (55.93, P<0.001), and Nose scores (19.28, P=0.003).

Conclusions:
From patients’ and parents’ perspectives at a single institution, SC and CVR were equivalent regarding aesthetics and health-related quality of life.
Dementia and Its Profound Impact on Family Members and Partners
Authors: Shah R. , Salek M.S. , Ali F.M. , Nixon S.J. , Otwombe K. , Ingram J.R. , Finlay A.Y. 
Published: November 2024

Introduction:
Dementia can adversely affect the quality of life (QoL) of family members/partners of those affected. Measuring this often-neglected burden is critical to planning and providing appropriate support services. This study measures this impact using the Family-Reported Outcome Measure (FROM-16).

Methods:
A large UK cross-sectional online study through patient research platforms, recruited family members/partners of people with dementia, to complete the FROM-16.

Results:
Totally, 711 family members/partners (mean age=58.7 y, SD=12.5; females=81.3%) of patients (mean age=81.6, SD=9.6; females=66.9) with dementia completed the FROM-16. The FROM-16 mean total score was 17.5 (SD=6.8), meaning “a very large effect” on QoL of family members, with females being more adversely impacted.

Conclusions:
Dementia profoundly impacts the QoL of family members/partners of patients. Routine use of FROM-16 could signpost provision of care support, reducing family members’ burnout. Such routine data could be used in economic analysis of the burden of dementia as well as in predicting institutionalization.
Accuracy of the Image Interpretation Capability of ChatGPT-4 Vision in Analysis of Hess Screen and Visual Field Abnormalities
Authors: Nikdel Mojgan , Ghadimi Hadi , Suh Donny W. , Tavakoli Mehdi 
Published: November 2024

Background:
OpenAI, the owner of ChatGPT, publicly released the GPT-4 Vision in September 2023. This multimedia chatbot has the capability to receive and analyze various images presented to it by the user. We assessed the accuracy of its interpretation of 2 of the images commonly used in neuro-ophthalmology, namely Hess screen and automated visual field images.

Methods:
We separately uploaded typical images of 5 abnormal Hess screen charts related to third, fourth, and sixth cranial nerve palsy, Brown syndrome, and inferior orbital wall fracture with entrapment of the inferior rectus muscle. Likewise, 5 classic images of automated visual field grayscale maps related to lesions of the optic nerve, the chiasma, the optic tract, the optic radiations, and the occipital lobe were presented. The chatbot was instructed to select the best option among the 5 choices presented in each question.

Results:
The GPT-4 Vision was able to select the right choice in 2/5 questions on Hess screens and 3/5 of the visual field questions. Despite selection of the correct option, qualitative evaluation of GPT-4 responses revealed flawed analysis of certain aspects of some image findings, such as the side of involvement or the misinterpretation of the physiologic blind spot as a central scotoma.

Conclusions:
The performance of GPT-4 Vision in the interpretation of abnormalities of Hess screen and visual field involvement was highly variable, even with simple typical cases of classic disorders. As the chatbot's image recognition is currently evolving, its capacity to accurately interpret ophthalmologic images is still limited at this time.
Immunologic and Biophysical Features of the BNT162b2 JN.1- and KP.2-Adapted COVID-19 Vaccines
Authors: Chen Wei , Tompkins Kristin R. , Windsor Ian W. , Martinez Lyndsey T. , Ramos Minah , Li Weiqiang , Shrivastava Shikha , Rajput Swati , Chang Jeanne S. , Sahasrabudhe Parag , Fennell Kimberly F. , McLellan Thomas J. , West Graham M. , Dizon Kristianne P. , Yam Aaron , Mitra Siddartha , Saha Subrata , Sharaf Daiana , McKeen Andrew P. , Cadima Carla I. , Muik Alexander , Swanson Wesley , Moreno Raquel Munoz , Daroca Pilar Mendoza , Sahin Ugur , Anderson Annaliesa S. , Wu Huixian , Swanson Kena A. , Modjarrad Kayvon 
Published: November 2024

ABSTRACTVaccines remain a vital public health tool to reduce the burden of COVID-19. COVID-19 vaccines that are more closely matched to circulating SARS-CoV-2 lineages elicit more potent and relevant immune responses that translate to improved real-world vaccine effectiveness. The rise in prevalence of the Omicron JN.1 lineage, and subsequent derivative sublineages such as KP.2 and KP.3, coincided with reduced neutralizing activity and effectiveness of Omicron XBB.1.5-adapted vaccines. Here, we characterized the biophysical and immunologic attributes of BNT162b2 JN.1- and KP.2-adapted mRNA vaccine-encoded spike (S) protein immunogens. Biophysical interrogations of S revealed the structural consequences of hallmark amino acid substitutions and a potential molecular mechanism of immune escape employed by JN.1 and KP.2. The vaccine candidates were evaluated for their immunogenicity when administered as fourth or fifth doses in BNT162b2-experienced mice or as a primary series in naïve mice. In both vaccine-experienced and naïve settings, JN.1- and KP.2-adapted vaccines conferred improved neutralizing responses over the BNT162b2 XBB.1.5 vaccine against a broad panel of emerging JN.1 sublineages, including the predominant KP.3.1.1 and emerging XEC lineages. Antigenic mapping of neutralizing responses indicated greater antigenic overlap of JN.1- and KP.2-adapted vaccine responses with currently circulating sublineages compared to an XBB.1.5-adapted vaccine. CD4+and CD8+T cell responses were generally conserved across all three vaccines. Together, the data support the selection of JN.1- or KP.2-adapted vaccines for the 2024-25 COVID-19 vaccine formula.ONE-SENTENCE SUMMARYThe Omicron JN.1- and KP.2-adapted BNT162b2 mRNA vaccines encoding prefusion S proteins elicit similar preclinical neutralizing antibody responses against circulating JN.1 sublineage pseudoviruses that are more potent than those elicited by past iterations of BNT162b2 licensed vaccines, thus demonstrating the importance of annual strain changes to the COVID-19 vaccine.
TRPV4-mediated Mechanotransduction Regulates the Differentiation of Valvular Interstitial Cells to Myofibroblasts: Implications for Aortic Stenosis
Authors: Mukherjee Pritha , Mahanty Manisha , Dutta Bidisha , Rahaman Suneha G. , Sankaran Karunakaran R. , Rahaman Shaik O. 
Published: November 2024

ABSTRACTAs aortic valve stenosis (AVS) progresses, the valve tissue also stiffens. This increase in tissue stiffness causes the valvular interstitial cells (VICs) to transform into myofibroblasts in response. VIC-to-myofibroblast differentiation is critically involved in the development of AVS. Herein, we investigated the role of mechanosensitive Ca2+-permeant transient receptor potential vanilloid 4 (Trpv4) channels in matrix stiffness- and transforming growth factor β1 (TGFβ1)-induced VIC-myofibroblast activation. We confirmed Trpv4 functionality in primary mouse wild-type VICs compared to Trpv4 null VICs using live Ca2+influx detection during application of its selective agonist and antagonist. Using physiologically relevant hydrogels of varying stiffness that respectively mimic healthy or diseased aortic valve tissue stiffness, we found that genetic ablation of Trpv4 blocked matrix stiffness- and TGFβ1-induced VIC-myofibroblast activation as determined by changes in morphology, alterations of expression of α-smooth muscle actin, and modulations of F-actin generation. Our results showed that N-terminal residues 30-130 in Trpv4 were crucial for cellular force generation and VIC-myofibroblast activation, while deletion of residues 1-30 had no noticeable negative effect on these processes. Collectively, these data suggest a differential regulatory role for Trpv4 in stiffness/TGFβ1-induced VIC-myofibroblast activation. Our data further showed that Trpv4 regulates stiffness/TGFβ1-induced PI3K-AKT activity that is required for VIC-myofibroblast differentiation and cellular force generation, suggesting a mechanism by which Trpv4 activity regulates VIC-myofibroblast activation. Altogether, these data identify a novel role for Trpv4 mechanotransduction in regulating VIC-myofibroblast activation, implicating Trpv4 as a potential therapeutic target to slow and/or reverse AVS development.
Development of glowing plastic bricks from waste plastic and florescent pyoverdine pigment ofPseudomonas aeruginosa
Authors: Pandey Kshipra , Oderdara Rushita , Patel Ritu 
Published: November 2024

AbstractThe extensive increase in non-biodegradable plastic waste is leading to heightened pollution and severe impacts on the climate. The marine environment withstands the worst of plastic pollution, with a documented accumulation of 86 million tons of plastic debris globally. Humans are directly impacted by degraded plastic waste through direct consumption (e.g., in tap water), indirect consumption (via the consumption of contaminated animals), and interference with various hormonal mechanisms. In the 20th century, human-produced plastics constituted approximately 3% of the world’s total biomass. In addressing this issue, we embarked on the development of plastic bricks, emphasizing the repurposing of plastic waste. To distinguish our approach, we incorporated a luminescent quality using the inherent fluorescent property of the pyoverdine pigment produced byPseudomonas aeruginosa. This luminescence aims to mitigate nocturnal visibility issues, which contribute to accidents involving both human and speechless fauna.
Scaling Laws in Healthcare Delivery. A Network Analysis Approach to Outpatient Referral Networks Across the Veterans Health Administration
Authors: Ben-Ari Alon , George Harry L. , Bigeleisen Paul E. 
Published: November 2024

BACKGROUNDWe studied clinical referral networks across the Veterans Health Administration. Network attributes, referral counts and timeliness of services rendered were estimated and used to predict outpatient care performance. A scaling law for outpatient referrals was derived, predicting an economy of scale.METHODSNetwork topology and operational statistics were estimated and their relationships were studied. A comparative study of multiple networks was undertaken.RESULTSWe observed similarities both in network structure and in the referral patterns. These are invariant of the healthcare system size. A power scaling law for referrals was inferred with an infra-linear exponent.CONCLUSIONStudy of referral networks across multiple healthcare systems shows an economy of scale and self-similarity between network attributes that are patient size invariant.
A single dose of cannabidiol modulates the coupling between hippocampal glutamate and learning-related prefrontal activation in individuals at Clinical High Risk of Psychosis
Authors: Shi Yiling , Davies Cathy , Wilson Robin , Appiah-Kusi Elizabeth , Lythgoe David J. , Modinos Gemma , Bhattacharyya Sagnik 
Published: November 2024

AbstractBackgroundCannabidiol (CBD) is being studied as a potential intervention for the people at clinical high risk for psychosis (CHR), though the mechanisms underlying its effects are not fully understood. Previous studies indicate that a single dose of CBD can normalize alterations in memory-related brain activation and modulate hippocampal glutamate levels in the early stages of psychosis. This study aimed to examine the acute effects of CBD on the coupling between hippocampal glutamate levels and brain activation during verbal memory in individuals at CHR.Methods33 participants at CHR participants were randomly assigned to receive either a single dose of 600 mg CBD (CHR-CBD) or an identical placebo capsule (CHR-PLB). 19 age-matched healthy controls (HC) received no study drugs. Participants underwent MRI scanning while performing a verbal learning task, and proton magnetic resonance spectroscopy to measure hippocampal glutamate levels. Group x hippocampal glutamate x brain activation interactions were tested.ResultsCHR-PLB showed positive correlation between hippocampal glutamate levels and dorsolateral prefrontal cortex (dlPFC) (Pcorr. = 0.0039) activation compared to HC during both verbal encoding and recall. Under a single dose of CBD, the glutamate-dlPFC activation coupling was negative and significantly different compared to placebo in CHR individuals (Pcorr. = 0.0001). The reversed correlation in CBD group also observed in the parahippocampal gyrus (Pcorr. = 0.0022) and amygdala (Pcorr. = 0.0019).ConclusionsThese findings suggest that the mechanism underlying the effect of CBD in CHR may involve reversing of altered coupling between hippocampal glutamate levels and prefrontal and mediotemporal activation.