bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pharmacologically enabling the degradation of NaV1.8 channels to reduce neuropathic pain
Authors: Martin Molly K. , Rodriguez Raider , Guerrero Giselle , Sheehan Garrett D. , Powell Rasheen , Klein Amanda H. , Bhattacharjee Arin 
Published: November 2024

Abstract
In phase II clinical trials, NaV1.8 channels were identified as viable targets to treat acute pain. Results were modest, however, and NaV1.8 pore blockers must be given systemically, potentially leading to adverse effects, especially during prolonged use. A local, long-lasting approach is desirable, yet local anesthetics are neither specific nor long-lasting. In lieu of a pore blocker approach, we show a pharmacological method targeting the scaffolding and degradation of NaV1.8 channels, which attenuated neuropathic pain behavior in mice. NaV1.8 channels interact with the WW domain–containing scaffold protein called Magi-1. WW domains are typically found in ubiquitin ligases, and NaV1.8 channels are susceptible to degradation by ubiquitin ligases. Here, we show NaV1.8 and MAGI-1 colocalized in human tissues. We demonstrate that a lipidated peptide derived from the NaV1.8 WW binding domain, at sub-micromolar concentrations, inhibited rodent dorsal root ganglion neuronal firing. The peptide reduced NaV1.8 channel immunoreactivity and tetrodotoxin-resistant currents in human dorsal root ganglion neurons. We found that the lipidated peptide attenuated neuropathic pain behaviors in mice for multiple weeks after a single injection. Our results reveal that the NaV1.8-targeted lipidated peptide provides local and sustained analgesia, serving as a viable alternative to NaV1.8 pore blockers.
Patient Preferences for Surgical Treatments for Benign Prostatic Hyperplasia: A Discrete Choice Experiment
Authors: Vennedey Vera , Holling Heinz , Steiner Thomas , Schrader Mark , Grossmann Heiko , Hoenig Christian 
Published: November 2024

Purpose:
When symptoms of benign prostatic hyperplasia cannot or can no longer be treated by conservative treatment options adequately, various surgical treatment options are available. Different risks and benefits are associated with each type of surgery; the optimal choice depends on the patient's preference. This study analyzes patients' preferences and investigates patient characteristics that might influence patient preferences in Germany.

Materials and Methods:
We conducted an online discrete choice experiment based on 9 treatment attributes related to risks (probability of ejaculatory dysfunction, permanent incontinence, needing surgery again, and erectile dysfunction) and efficacy (frequency of daytime and nighttime urination, urgency and duration of urination, and time until symptoms improve) of surgeries. To estimate preferences, we applied a mixed-logit model. Subgroup analyses based on patients' characteristics were conducted.

Results:
Three hundred thirty participants completed the discrete choice experiment. Overall, participants preferred a lower risk of ejaculatory dysfunction, lower urgency and duration of urination, lower probability of permanent incontinence, lower frequency of nighttime and daytime urination, and lower probability of needing another surgery. Moreover, a faster onset of overall symptom reduction was preferred. Several patient characteristics especially characteristics related to a patient's sexual life seem to influence patients' preferences.

Conclusions:
Significant preference heterogeneity could be observed in this study, and subgroup analyses suggest differences in preferences in relation to patients' characteristics. These findings highlight the need for individualized treatment decisions. Physicians should evaluate patients' clinical but also inquire about a patient's personal situation and preferences to select the optimal treatment in collaboration with the individual patient.
ICU nutrition research: did the evidence get better? Remaining sources of bias
Authors: Koretz Ronald L. 
Published: November 2024

Purpose of review
To assess the quality of recently published (18 months from date of article request) randomized trials/systematic reviews of such trials that addressed the use of nutritional support in critically ill patients.

Recent findings
Eligible papers were published between October 1, 2022 and April 7, 2024, only enrolled adults, described a comparison of a nutritional intervention to something else, and reported a clinically relevant outcome. Thirteen randomized trials and four systematic reviews of randomized trials were identified. Quality was assessed by determining the risks of bias of each trial. Two of these trials were at low risk of bias, six were rated as having some concern(s) about bias, and five were at high risk of bias. The four systematic reviews included 55 randomized trials; four were at low risk, 31 had some concerns, and 20 were at high risk. No randomized trial comparing nutritional support to a true control (no nutritional support) was identified in this search; seven older trials, all small and containing risks of bias, failed to demonstrate any consistent differences in clinical outcomes.

Summary
The quality of the trials underlying the use of nutritional support in the intensive care unit is not very high.
A nonlinear relationship between dietary inflammatory index and stroke among US adults with metabolic dysfunction-associated steatotic liver disease
Authors: Guo Renwei , Du Juan 
Published: November 2024

Background
Some studies have found that high dietary inflammatory index (DII) increases stroke risk, but previous studies have mostly been conducted in the general population, and the exact relationship between DII and stroke in patients with metabolic dysfunction-associated steatotic liver disease (MASLD) is not clear.

Methods
This cross-sectional study utilized data from the National Health and Nutrition Examination Survey (2009–2016) to investigate the association between the DII and stroke. DII was computed according to established methods. Participants were categorized into tertiles of DII (Q1–Q3). Multivariate weighted logistic regression analysis, smooth curve fitting, and subgroup analysis were employed to explore this relationship. Subgroup analyses were conducted based on demographic and clinical variables.

Results
A total of 2426 individuals were enrolled in our study. The overall prevalence of stroke in the study population was 4.66%. The smooth curve fitting analysis indicated a J-shaped relationship between DII and stroke among individuals with MASLD. In multivariate weighted logistic regression analysis, the odds ratio (OR) of DII is 1.17 (95% CI: 1.03–1.38) for stroke, with a turning point of 1.89. After the turning point, the OR (95% CI) was 1.22 (1.08–2.56). In subgroup analysis, DII still increased the risk of stroke independently.

Conclusion
Our study highlighted a J-shaped association between DII and stroke in adults with MASLD from USA.
Healthcare utilisation patterns and drivers amongst inflammatory bowel disease patients in the outpatient clinic
Authors: Koppelman Lola J.M. , Maljaars P.W. Jeroen , Voorneveld Philip W. , van der Meulen-de Jong Andrea E. 
Published: November 2024

Objective
Inflammatory bowel disease (IBD), encompassing Crohn’s disease and ulcerative colitis, impose an escalating burden on healthcare systems globally, with a rising prevalence contributing to increased costs. This study explored healthcare utilisation patterns and its drivers amongst IBD patients in an outpatient clinic.

Methods
A longitudinal cohort study was conducted at a Dutch academic teaching hospital. IBD patients (n = 180) were followed for 1 year and were categorised based on disease activity and consultation frequency. Healthcare utilisation was assessed through consultations and laboratory tests. Patient-reported outcomes and biochemical disease activity were measured, and subsequently the reasons for consultations were analysed.

Results
The frequency of outpatient healthcare utilisation exceeded the recommended IBD care guidelines by two-fold. Comorbidities were the leading reason for consultations (40.4%), followed by remission induction, medication changes and pending test results. Moreover, clinical disease activity, reported problems with self-care, daily activities and pain were predictive of an increase in annual consultations.

Conclusion
This study identified factors influencing healthcare utilisation in IBD outpatients. Personalised care pathways using eHealth technologies have the potential to reduce unnecessary consultations and optimise resource allocation.
Specific, Measurable, Action-Oriented, Realistic, and Timed Goals and the Personal Health Inventory in a Wellness Group for Veterans With GWI
Authors: McQuade Maria , Polizzi Craig P. , Katz Emma , Ting Maria , Busser Cameron , Paszkiewicz Matthew , Mori DeAnna L. , Niles Barbara L. 
Published: November 2024

Background:
Interventions based on the Veterans Health Administration’s (VHA) Whole Health (WH) initiative may be beneficial for veterans with Gulf War Illness (GWI) through specific, measurable, action-oriented, realistic, and timed (SMART) goal setting and monitoring of perceived goal attainment with the Personal Health Inventory (PHI).

Objectives:
This secondary analysis of 2 randomized controlled trials focused on (1) categorizing SMART goals set during a wellness intervention based on the VHA’s WH approach to identify goals most relevant for veterans with GWI and chronic pain and (2) descriptively examining the PHI over a course of treatment to assess its preliminary sensitivity to change. Also, changes in PHI for those who engaged in the intervention in-person versus remotely were compared.

Subjects:
Participants were 49 veterans with GWI and chronic pain who received a 12-week, 24-session group wellness intervention delivered in-person or remotely due to the COVID-19 pandemic.

Results:
SMART goal themes mapped onto the 8 areas of self-care presented in the WH program’s circle of health with high categorical adherence. Most participants set goals in categories for working the body, food and drink, and personal development. The wellness intervention was related to improvements in perceived goal attainment as measured by the PHI in both in-person and remote participants, which indicates that the PHI may be sensitive to change over time.

Conclusions:
These preliminary findings set the stage for future research on wellness interventions for veterans with GWI and chronic pain and the measurement of whole-person outcomes.
Assessing Whole-Person Outcomes During Routine Clinical Care
Authors: Parr Nicholas J. , Young Sarah , Baltich Nelson Becky 
Published: November 2024

Objective:
To identify and describe research conducted on the implementation, validity, and utility of whole-person outcome measures administered during routine inpatient or outpatient care.

Background:
Incorporating information about patients’ overall health, health-related quality of life, and global well-being into health care delivery has the potential to increase referral rates, enhance doctor-patient communication, and improve the detection of untreated symptoms. Assessment of these whole-person outcomes during routine clinical care is of broad interest to health care providers and health systems.

Methods:
We employed a scoping review design and searched Ovid MEDLINE, APA PsycINFO, and CINAHL for relevant English-language primary studies and systematic reviews published through November 13, 2023. Screening for inclusion and data abstraction were conducted by 1 investigator then checked by another. Study risks of bias and the strength of available evidence were not assessed.

Results:
Of 1327 potentially relevant publications, 44 primary studies and 5 systematic reviews met eligibility criteria. Assessment of global well-being was comparatively less researched than overall health or health-related quality of life. Available research provided a range of perspectives on the performance, feasibility, acceptability, implementation, and clinical utility of whole-person outcome measures. No studies reported change in patient health or disease outcomes attributed to whole person outcome assessment (directly or through changes to care delivery).

Conclusions:
Currently available evidence provides insights about the performance and implementation of whole-person outcome measures during routine clinical care, but no studies are available that examine the impact of assessing whole-person outcomes on clinical or patient outcomes.
Is the PHQ-2 a Good Measure to Inform Providers About Patient Well-Being and Functioning? Data From the Veterans Health and Life Survey
Authors: Reed David E. , Engel Charles C. , Coggeshall Scott , Michel Martha , Etingen Bella , Bolton Rendelle E. , Kroenke Kurt , Bokhour Barbara G. , Zeliadt Steven B. 
Published: November 2024

Background:
Health care systems are increasingly focused on assessing patient well-being and functioning. The objective of the current analysis was to evaluate a pragmatic question: to what extent and in what way can the PHQ-2, a routinely collected screening measure, be used to help clinicians and a learning health system understand the well-being and functioning of its beneficiaries?

Methods:
The current analysis focused on 2872 Veterans who completed a large-scale longitudinal survey about health and wellness for whom we were able to link survey responses to PHQ-2 scores recorded in their electronic health records (EHR). Regression analyses examined the cross-sectional and longitudinal associations between PHQ-2 scores recorded in the EHR and measures of well-being (life satisfaction, purpose in life, and social health) and functioning (pain severity and interference, physical and mental health, and perceived stress).

Results:
Veterans were aged 65 years on average (11% women). PHQ-2 scores were correlated cross-sectionally with all well-being and functioning measures; however, there was minimal variance accounted for. Changes in the PHQ-2 over time were associated with 3 measures: purpose in life (b = −0.19; 95% CI: −0.34, −0.04), mental health functioning (b = −0.29, 95% CI: −0.54, −0.04), and perceived stress (b = 0.13; 95% CI: 0.02, 0.24).

Conclusions:
The PHQ-2 was minimally associated with patient well-being and functioning, with more work needed on how the PHQ-2 may be used in large health care settings within the context of VA Whole Health. Assessment of well-being is critical as VA’s Whole Health transformation continues, and identifying strategies for well-being measurement is an integral next step.
Planned Home Births in the United States Have Outcomes Comparable to Planned Birth Center Births for Low-Risk Birthing Individuals
Authors: Bovbjerg Marit L. , Cheyney Melissa , Hoehn-Velasco Lauren , Jolles Diana , Brown Jennifer , Stapleton Jennifer , Everson Courtney , Stapleton Susan , Vedam Saraswathi 
Published: November 2024

Objective:
There are lingering concerns in the United States about home birth. We used 2 large (n = 50,043; n = 62,984), national community birth registries to compare maternal and neonatal outcomes for planned home versus planned birth center births.

Methods:
To compare outcomes by intended birth site, we used logistic regressions, controlling for demographic and pregnancy risk variables. Maternal outcomes included intrapartum or postpartum transfer to hospital, hospitalization, cesarean, and hemorrhage; neonatal outcomes included neonatal transfer, hospitalization, neonatal intensive care unit admission, and intrapartum or neonatal death. Analyses were conducted twice, once in each dataset.

Results:
Individuals who planned home births had a lower incidence of all types of transfers, compared with those who planned birth center births, but in one dataset only, experienced more cesareans [adjusted odds ratio (95% CI): 1.32 (1.02–1.70); 0.95 (0.88–1.03)]. Planned home birth was associated with lower adjusted odds of maternal hospitalization in one dataset but not the other [0.97 (0.54–1.74); 0.85 (0.76–0.95)], and was not associated with hemorrhage. Neonatal outcomes likewise were either not associated with a planned birthplace or suggested home birth was safer: hospitalization [0.77 (0.53–1.11), 0.90 (0.82–0.98)], neonatal intensive care unit admission [0.54 (0.28–1.00), 0.97 (0.86–1.10)]. There was no observable association with intrapartum or neonatal death: 1.07 (0.68–1.67; only calculated once because of small numbers of events).

Conclusions:
Planned home births are as safe as planned birth center births for low-risk pregnancies. Current guidelines advising against planned home births are not supported by these data.
Measuring the Well-Being of the Whole Person in Clinical Care, Health Research, and Population Health Evaluation
Authors: Vogt Dawne , Kligler Benjamin , Darchuk Kathleen , Elbogen Eric , List Justin M. , McMullen Tara , Murphy Jennifer L. , Bokhour Barbara 
Published: November 2024

Objectives:
In 2023, the U.S. Veterans Health Administration convened a State of the Art meeting to evaluate the existing evidence and make recommendations for measuring the well-being of the whole person in clinical care, health research, and population health evaluation. In this article, we describe findings and recommendations concerning each of these health care system functions, as well as key takeaways from the meeting as a whole.

Background:
There has been a growing call for health care organizations to expand their focus beyond disease-based concepts to consider both positive aspects of health and indicators of well-being that extend beyond the health domain. Yet, knowledge remains limited regarding how best to integrate these types of measurements in clinical care, health research, and population health evaluation efforts.

Method:
State of the Art activities were organized into 3 workstreams, each focused on a core health care system function (clinical care, health research, and population health evaluation). Drawing from existing literature on the measurement of the well-being of the whole person in the assigned health care function, workgroups evaluated the existing state of knowledge and made recommendations for future work on well-being measurement in the health care setting.

Results:
Cross-cutting themes included: (1) difficulty evaluating the current state of knowledge due to varied use of terminology in this literature; (2) appreciation for the value of well-being measurement in each health care function; (3) need for additional research on the use and benefits of well-being measures, including their role as predictors and moderators of health and health care outcomes; (4) importance of ensuring that measures are applicable for diverse patient groups and adequately reflect the “patient voice;” and (5) need for additional leadership investment and resource allocation to support use of these measures in the health care setting.

Conclusions:
Knowledge from this meeting can be applied to enhance the use and application of measurement of well-being to improve patients’ health and health care outcomes.
Pain and small fiber pathology in men with fibromyalgia syndrome
Authors: Feulner Betty , Gross Franziska , Evdokimov Dimitar , Malik Rayaz A. , Kampik Daniel , Üçeyler Nurcan 
Published: November 2024

Abstract

Introduction:
Small fiber pathology may be involved in the pathophysiology of pain in women with fibromyalgia syndrome (FMS).

Objectives:
This prospective single-center case-control study provides detailed pain phenotyping and small fiber pathology data in a cohort of men with FMS on a morphological and functional level.

Methods:
Forty-two men with FMS underwent a comprehensive pain-related interview and neurological examination, a questionnaire and neurophysiological assessment, and specialized small fiber tests: skin punch biopsy, quantitative sensory testing including C-tactile afferents, and corneal confocal microscopy. Data were compared with those of healthy male controls.

Results:
Men with FMS reported generalized and permanent pain with additional pain attacks and a mostly pressing pain character. Intraepidermal nerve fiber density was reduced at ≥1 biopsy site in 35 of 42 (83%) men with FMS (controls: 32/65, 49%). Compared with male controls, men with FMS had elevated cold (P < 0.05) and warm detection thresholds (P < 0.001) and an increased mechanical pain threshold (P < 0.05) as well as an impairment of C-tactile afferents (P < 0.05). Corneal nerve fiber density was lower in male patients with FMS vs healthy men (P < 0.01). Male FMS patients with pathological skin innervation at ≥1 biopsy site compared with those with normal skin innervation had a higher clinical Widespread Pain Index (P < 0.05) indicating an association between the severity of cutaneous denervation and symptom load.

Conclusion:
We show a distinct pain phenotype and small nerve fiber dysfunction and pathology in male patients with FMS. These findings may have implications for the diagnosis and management of men with FMS.
Unexpected Pathology During Pelvic Organ Prolapse Repair in an Urban Population
Authors: Gandelsman-Ginis Johanna , Bentley Stephanie , Khan Fareesa , Brincat Cynthia , O’Shea Michele 
Published: November 2024

Importance
This study quantifies the occult pathology risk among our urogynecologic patient population and highlights the importance of preoperative counseling, particularly in patients who have been underrepresented in prior studies.

Objective
The aim of the study was to estimate unexpected gynecologic pathology incidence among a low-risk, racially, and ethnically representative patient population undergoing surgery for symptomatic pelvic organ (POP) prolapse.

Study Design
This was a retrospective study of patients undergoing hysterectomy for POP at an urban academic medical center. Patients with abnormal preoperative pathologic evaluation were excluded. Data were abstracted from the electronic health record, including demographic and clinical history, preoperative laboratory evaluation, and clinical risk factors for gynecologic malignancy.

Results
Two hundred ninety-nine nononcologic patients who underwent POP repair with hysterectomy were assessed. Thirty-six percent of patients identified as Hispanic, 17% as non-Hispanic Black, and 38% as non-Hispanic White. Twenty-three percent of patients reported abnormal uterine bleeding, 36% underwent a preoperative ultrasound examination, and 15% underwent endometrial biopsy. Two patients (0.9%) were diagnosed with endometrial carcinoma. Two patients (0.9%) were diagnosed with cervical dysplasia. No patients with concurrent oophorectomy or salpingectomy had ovarian or tubal pathology. The overall incidence of unexpected gynecologic pathology at the time of hysterectomy for prolapse was 1.7%.

Conclusions
The rate of endometrial cancer in our cohort is on the higher end of previously published data, although absolute rates of unanticipated malignancy remain low. Future studies should examine the pathological findings of larger, racially, and ethnically diverse cohorts of patients undergoing POP surgery with hysterectomy, which can aid in providing relevant estimates for preoperative counseling.