bluuebunny/crossref_metadata_2025_split huggingface dataset:
Burden of alopecia areata in China, 1990–2021: Global Burden of Disease Study 2021
Authors: Li Xiangqian , Liu Huixin , Ren Wenhui , Zhu Qijiong , Yin Peng , Wang Lijun , Zhang Jianzhong , Qi Jinlei , Zhou Cheng 
Published: November 2024

Abstract

Background:
Research has indicated that the disease burden of alopecia areata (AA) in China exceeds the global average. Therefore, accurate and updated epidemiological information is crucial for policymakers. In this study, we aimed to comprehensively assess the disease burden of AA in China.

Methods:
The following four key indicators were utilized: the prevalence of cases; disability-adjusted life-years (DALYs); the age-standardized prevalence rate (ASPR); and the age-standardized DALY rate (ASDR) of AA according to the Global Burden of Disease (GBD) study 2021. We analyzed the epidemiological burden of AA in China during 2021, examined changes between 1990 and 2021, and performed a Bayesian age–period–cohort analysis to predict trends over the course of the next decade (2022–2030). Additionally, a Gaussian process regression model was applied to estimate the relationship between the gross domestic product (GDP) and the ASPR and ASDR of AA at the provincial level between 1992 and 2021.

Results:
In 2021, the estimated number of patients with AA in China was approximately 3.49 million (95% uncertainty interval [UI], 3.37–3.62 million); of these patients, 1.20 million (1.16–1.25 million) were male and 2.29 million (95% UI, 2.20–2.37 million) were female. This large number of patients with AA resulted in a total of 114,431.25 DALYs (95% UI, 74,780.27–160,318.96 DALYs). Additionally, the ASPR and ASDR were 224.61 per 100,000 population (95% UI, 216.73–232.65 per 100,000 population) and 7.41 per 100,000 population (95% UI, 4.85–10.44 per 100,000 population), respectively; both of these rates were higher than the global averages. The most affected demographic groups were young and female individuals 25–39 years of age. Slight regional disparities were observed, with the northern and central regions of China bearing comparatively higher burdens. Between 1990 and 2021, the health loss and disease burden caused by AA in China remained relatively stable. The ASPR and ASDR of AA increased with the GDP when the annual GDP was less than 2 trillion yuan; however, a downward trend was observed as the GDP surpassed 2 trillion yuan. A slight upward trend in the disease burden of AA in China is predicted to occur over the next decade.

Conclusions:
AA continues to be a public health concern in China that shows no signs of declining. Targeted efforts for young individuals and females are necessary because they experience a disproportionately high burden of AA.
Door-to-Diuretic Time and Short-term Outcomes in Acute Heart Failure: A Systematic Review and Meta-analysis
Authors: Tariq Muhammad Ali , Malik Minhail Khalid , Khalid Zoha , Asrar Aeman 
Published: November 2024

Introduction:
Acute heart failure (AHF) is a leading cause of unplanned hospitalization, often associated with poor outcomes. Decongestion with intravenous loop diuretics is the mainstay of treatment. Metrics such as door-to-diuretic time, the time between presentation of AHF to the hospital, and administration of intravenous diuretics, may play an important role in faster decongestion and thereby reduce mortality. We sought to investigate whether early diuretic administration [door-to-diuretic (D2D) time 60 ≤mins] was associated with improved outcomes among hospitalized heart failure patients.

Methods:
A systematic search of PubMed and Scopus databases was performed from inception until June 2023. The primary endpoints were all-cause in-hospital and 30-day mortality. Secondary endpoints were the length of hospital stay and heart failure readmission. We used a random-effects model to calculate odds ratios (OR) for binary outcomes and mean differences for continuous data.

Results:
Our meta-analysis included 6 observational studies involving 19,916 patients. No significant differences (P > 0.05) were observed between shorter D2D and delayed D2D time with respect to in-hospital mortality (OR, 0.62; 95% CI, 0.35-1.09), 30-day mortality (OR, 0.83; 95% CI, 0.51-1.33; P = 0.44), length of hospital stay (MD, −0.02; 95% CI, −0.26 to 0.22) and heart failure readmission (OR, 1.00; 95% CI, 0.86-1.20).

Conclusions:
Evidence from existing literature, which is largely limited to observational comparisons, highlights comparable outcomes between the 2 treatment strategies. Early diuretic administration, particularly within 60 minutes of hospital presentation, does not demonstrate any prognostic benefits.
Low-Power Long-Duration Versus High-Power Short-Duration Radiofrequency Ablation of the Atrioventricular Node
Authors: Zaveri Sahil , Alsaiqali Mahmoud , Yu Howard , Ahmed Rafsan , Jallad Ahmad , Budzikowski Adam S. 
Published: November 2024

Background:
Atrioventricular node (AVN) radiofrequency (RF) ablation is a highly effective treatment of atrial tachyarrhythmias that are resistant to other management modalities. To date, there is limited research that compares the properties of different RF ablation catheters. The current study aims to compare the effectiveness of several types of RF catheters in AVN ablation.

Methods:
A total of 66 patients, with a mean age of 73.27 years, underwent AVN RF ablation. The catheters used were categorized as unirrigated (UI), externally irrigated, and contact force sensing with 10 to 20 g of force. Externally-irrigated catheters were divided into 2 different settings: low-power long-duration (LPLD) (30 W, 45°C, and 60 seconds) and high-power short-duration (HPSD) (50 W, 43°C, and 12 seconds). We compared the success rate of the different RF catheters using logistic regression and lesion times using linear regression.

Results:
The distribution of the types of catheters used is UI in 48%, LPLD in 16%, and HPSD in 36% of patients. All ablation procedures were successful, with no immediate postprocedure complications. HPSD had a significantly shorter lesion time than UI catheters by 403.42 seconds (−631.67 to −175.17).

Conclusions:
UI catheters, LPLD, and HPSD were equally safe and effective in ablation procedures. The HPSD catheter had a significantly shorter lesion time and, thus, overall decreased procedure time.
Quality of Life in Patients With Acquired Anophthalmia Using an Ocular Prosthesis
Authors: Meer Elana , Miller Amanda C. , Ahmad Meleha , Arnold Benjamin F. , Kersten Robert C. , Grob Seanna R. , Winn Bryan J. , Afshar Armin R. , Vagefi M. Reza 
Published: November 2024

Purpose:
To employ a validated survey for evaluation of quality of life (QoL) outcomes and associated factors in a US cohort of adult patients with acquired anophthalmia wearing a prosthesis.

Methods:
A retrospective cohort study was performed at a single, US academic institution of patients cared for between 2012 and 2021. The electronic medical record database was queried for adult patients with a history of evisceration or enucleation surgery and placement of an orbital implant. Identified patients were asked to anonymously complete a validated QoL questionnaire from which the Global Ocular Prosthesis Score was assessed. Summary statistics were reported, and analysis of variance was used to determine surgical and demographic factors associated with QoL survey scores.

Results:
A total of 81 patients completed the questionnaire. Mean age was 45.8 years (range: 18–96 years), and 54.3% of patients identified as women. Enucleation was performed in 81.4% of eyes (n = 66), while the remaining 17.3% underwent evisceration (n = 14). The mean and median Global Ocular Prosthesis Score (out of 100) were 67.51 and 68.00, respectively. Multivariate analysis demonstrated the etiologies of glaucoma (95% confidence interval: 0.84–25.40, p = 0.04) and endophthalmitis (95% confidence interval: 0.41–23.72, p = 0.04) to be significantly associated with higher total Global Ocular Prosthesis Score. Several other factors including employment status, etiology of anophthalmia, gender, and level of education were also significantly associated with subdomain scores (p < 0.05).

Conclusions:
Among patients with anophthalmia wearing an ocular prosthesis, the etiology of anophthalmia was significantly associated with the Global Ocular Prosthesis Score. Employment status, etiology of anophthalmia, gender, and level of education were also observed to have statistically significant associations with subdomain scores. Knowledge of these factors moving forward may help the surgeon manage expectations, mitigate challenges, and promote higher QoL outcomes for patients with acquired anophthalmia.
Pain catastrophizing and pain anxiety mediate changes in physical function in a mind–body intervention for adults with traumatic orthopedic injuries
Authors: Gnall Katherine E. , Jochimsen Kate N. , Brewer Julie R. , Bakhshaie Jafar , Vranceanu Ana-Maria 
Published: November 2024

Abstract
Traumatic orthopedic injuries are common and frequently associated with persistent pain, disability, and emotional distress. Risk factors of persistent pain and disability include pain catastrophizing and pain anxiety, though most interventions for orthopedic injuries are primarily biomedical (eg, surgeries, pharmacology, physiotherapy/exercise). The Toolkit for Optimal Recovery (TOR) is a brief, live video mind–body program designed to directly target pain catastrophizing and anxiety in patients with recent traumatic orthopedic injury to prevent persistent disability. This study was a secondary analysis from a recently completed multisite feasibility RCT of TOR compared with Minimally Enhanced Usual Care (MEUC). We examined the extent to which the purported mechanisms of change in TOR (ie, reductions in pain catastrophizing and anxiety) mediate improvement in physical function. Participants with a recent orthopedic trauma (N = 195; M

age
= 44.01) recruited from 4 Level I trauma centers were randomized to TOR or MEUC and completed self-report surveys at baseline, postintervention, and follow-up (3 months after baseline). A multiple mediation analysis using multilevel structural equation modeling (MSEM) demonstrated that pain catastrophizing (b = −5.22, SE = 3.02, Bootstrapped 95% CIs = -0.04, -12.37) and pain anxiety (b = −8.45, SE = 3.59, Bootstrapped 95% CIs = -0.04, -12.37) each significantly mediated improvement in physical function. Overall, findings elucidate the mechanistic role of TOR's primary treatment targets (ie, reductions in pain catastrophizing and anxiety) in improving physical function. Findings highlight the importance of targeting pain catastrophizing and pain anxiety early after orthopedic injury through psychosocial interventions such as TOR.
Individual differences in conditioned pain modulation are associated with functional connectivity within the descending antinociceptive pathway
Authors: Li Janet Z. , Mills Emily P. , Osborne Natalie R. , Cheng Joshua C. , Sanmugananthan Vaidhehi V. , El-Sayed Rima , Besik Ariana , Kim Junseok A. , Bosma Rachael L. , Rogachov Anton , Davis Karen D. 
Published: November 2024

Abstract
The perception of pain and ability to cope with it varies widely amongst people, which in part could be due to the presence of inhibitory (antinociceptive) or facilitatory (pronociceptive) effects in conditioned pain modulation (CPM). This study examined whether individual differences in CPM reflect functional connectivity (FC) strengths within nodes of the descending antinociceptive pathway (DAP). A heat-based CPM paradigm and resting-state functional magnetic resonance imaging (rs-fMRI) were used to test the hypothesis that an individual's capacity to exhibit inhibitory CPM (changes in test stimuli [TS] pain due to a conditioning stimulus [CS]) reflects FC of the subgenual anterior cingulate cortex (sgACC), periaqueductal gray (PAG), and rostral ventromedial medulla (RVM). A total of 151 healthy participants (72 men, 79 women) underwent CPM testing and rs-fMRI. Three types of CPM were identified based on the effect of the CS on TS pain: (1) Antinociception: CS reduced TS pain in 45% of participants, (2) No-CPM: CS did not change TS pain in 15% of participants, and (3) Pronociception: CS increased TS pain in 40% of participants. Only the Antinociceptive subgroup exhibited FC between the left sgACC and PAG, right sgACC and PAG, and RVM and PAG. Furthermore, only the Antinociceptive subgroup exhibited a correlation of both left and right sgACC-RVM FC (medium effect sizes) with CPM effect magnitude. Women, compared with men were more likely to be categorized as pronociceptive. These data support the proposition that FC of the DAP reflects or contributes to inhibitory CPM.
Minimally invasive versus open surgery for nonfunctioning pancreatic neuroendocrine tumors: a systematic review and meta-analysis
Authors: Wei Kongyuan , Zheng Qingyong , Cheng Luying , li Wei , Nießen Anna , Uzunoglu Faik G. , Nickel Felix , Tian Jinhui , Wang Zheng , Hackert Thilo 
Published: November 2024

Introduction:
Nonfunctioning pancreatic neuroendocrine tumors (NF-PNETs) have been diagnosed increasingly often but still represent rare pancreatic neoplasms. Surgery is a potentially curative approach for patients with NF-PNETs. In recent years, minimally invasive surgery (MIS) has been applied more frequently for surgical resection of NF-PNETs. The evidence for using MIS for NF-PNETs is still being determined and controversial.

Materials and Methods:
PubMed, Cochrane Library, and the Web of Science database were searched systematically from its inception to July 2023. All studies comparing MIS versus open surgery (OPS) of NF-PNETs were included. The primary outcomes were the incidence of overall postoperative complications and pancreas-specific complications [postoperative pancreatic fistula (POPF) and delayed gastric emptying (DGE)]. The secondary measures were duration of operation, intraoperative blood loss, and length of postoperative hospital stay. Pooled results are presented as odds ratios (OR) or mean difference (MD) with a 95% CI.

Results:
Five observational studies with a total of 1178 patients were included in the final analysis. The meta-analysis indicated that MIS attained less intraoperative blood loss (MD=−58.59, 95% CI [−92.76 to −24.41], P<0.01) and shorter length of hospital stay (MD=−3.07, 95% CI [−5.28 to −0.87], P<0.01) in contrast to open surgery for NF-PNETs. There were no significant differences concerning operative time (MD=52.04, 95% CI [−8.74 to 112.81], P=0.67), overall postoperative complications (OR=0.78, 95% CI [0.59–1.03], P=0.08), POPF (OR=0.99, 95% CI [0.66–1.47], P=0.94), and DGE (OR=0.58, 95% CI [0.58–1.42], P=0.67).

Conclusions:
This study demonstrates that minimally invasive surgery for NF-PNETs is safe and associated with a considerably shorter postoperative hospital stay. Further studies are needed to verify the evidence.
Long-term mortality of coronavirus disease 2019 critically ill patients that required percutaneous tracheostomy in Chile: A multicenter cohort study
Authors: Ulloa-Morrison Rodrigo , Escalona José , Navarrete Pablo , Espinoza Javiera , Bravo Sebastián , Pastore Antonia , Reyes Sebastián , Bozinovic Milan , Abbott Francisco , Pairumani Ronald , Noguera Roselyn , Vera Magdalena , González Felipe , Valle Felipe , Bakker Jan , Bugedo Guillermo , Kattan Eduardo 
Published: November 2024

Background:
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection leads to mechanical ventilation (MV) in approximately 20% of hospitalized patients. Tracheostomy expedites weaning of respiratory support. Moreover, there is a paucity of data regarding long-term outcomes of tracheostomized coronavirus disease 2019 (COVID-19) patients. The objective of this study was to describe 1-year mortality in a cohort of COVID-19 critically ill patients who required percutaneous tracheostomy in Chile and to assess the impact of age on outcomes.

Methods:
A multicenter prospective observational study was conducted in 4 hospitals in Chile between March 2020 and July 2021. Patients with confirmed SARS-CoV-2 infection connected to MV and required percutaneous tracheostomy were included. Baseline data, relevant perioperative and long-term outcomes, such as 1-year mortality, MV duration, intensive care unit (ICU), and hospital length of stay were registered. Patients were dichotomized according to age group (< and ≥ 70 years). Univariate and multivariate logistic regressions were performed to identify predictors of 1-year mortality.

Results:
Of 1319 COVID-19 ventilated critically ill patients, 23% (304) required a percutaneous tracheostomy. One-year mortality of the study group was 25% (20.2%-30.3%). ICU and hospital length of stay (LOS) were of 37 (27-49) and 52 (40-72) days. One-year mortality was higher in patients ≥ 70 years (36.9% vs. 21.2%, P = 0.012). Multivariate analysis confirmed age and baseline sequential organ failure assessment (SOFA) score as independent predictors, while time from intubation to tracheostomy was not.

Conclusion:
In COVID-19 critically ill patients who required percutaneous tracheostomy in Chile, the 1-year mortality rate was 25%, with a relevant impact of age on outcomes. An appropriate patient selection likely accounted for the low mortality rate. Future studies should confirm these results.
The persistent problem of persistent air-leaks: approach to management
Authors: Mundanchira George , Frye Laura , Reisenauer Janani , Agrawal Abhinav 
Published: November 2024

Purpose of review
Persistent air leaks, defined as an air leak extending beyond 5 days, pose a significant challenge for cardiothoracic surgeons and pulmonologists. Although current guidelines advocate for surgical intervention as the primary treatment, many patients may not suitable candidates for immediate return to the operating room. Alternatively, conservative management, which involves watchful waiting for pleural healing, often results in prolonged hospital stays and increased morbidity.

Recent findings
Although current guidelines advocate for surgical intervention as the primary treatment, many patients may not suitable candidates for immediate return to the operating room. Alternatively, conservative management, which involves watchful waiting for pleural healing, often results in prolonged hospital stays and increased morbidity. For patients who are not surgical candidates, use of autologous blood patch, pleurodesis or endobronchial valves may offer a viable alternative to conservatively manage air leak.

Summary
This review evaluates the various noninvasive therapies that have been explored, including sealants, Heimlich valves, chemical and autologous blood patch pleurodesis, and endo and intrabronchial valves. Although these alternatives show promise, further research is needed to compare these treatments before they can be recommended in new guidelines.
Psychological Distress as a Mediator Between Work-Family Conflict and Nurse Managers' Professional and Organizational Turnover Intentions
Authors: Labrague Leodoro J. 
Published: November 2024

OBJECTIVE
This study aimed to investigate the mediating role of psychological distress in the relationship between work-family conflict and nurse managers' (NMs') professional and organizational turnover intentions.

BACKGROUND
Work-family conflict is prevalent among NMs. It can have a significant impact on their intent to leave their organization and the profession. However, the role of psychological distress as a potential mediator in the relationship between work-family conflict and turnover intentions has not been studied in the context of NMs.

METHODS
A cross-sectional design was used, and data were collected from a sample of 260 NMs using self-report questionnaires.

RESULTS
NMs experienced a moderate level of work-family conflict and psychological distress. Organizational turnover intention was moderate, whereas professional turnover intention was low. Higher levels of work-family conflict among NMs contributed to increased psychological distress, which, in effect, influenced their desire to leave the organization.

CONCLUSION
To support NMs and mitigate turnover intentions, healthcare organizations need to prioritize the creation of a work environment that promotes work-life balance and reduces psychological distress.
A Preliminary Qualitative Exploration of the Lived Experiences of Presenteeism Among Taiwanese Nursing Staff
Authors: Hung Shiao-Pei , Ming Jin-Lain , Tsao Lee-Ing , Jeng Chii 
Published: November 2024

OBJECTIVE
The aim of this study was to explore the lived experiences of presenteeism among Taiwanese nursing staffs.

BACKGROUND
Presenteeism is a subjective and multifaceted experience, but nurses have rarely been invited to provide their own views of presenteeism.

METHODS
A qualitative study based on content analysis was conducted. Fifteen participants were recruited. Data were collected through face-to-face interviews and analyzed using the constant comparative method.

RESULTS
Four key categories and their subcategories were identified: 1) burden of being forced to attend work; 2) physical or mental discomfort; 3) predisposing factors; and 4) binding duty.

CONCLUSION
This preliminary study provides guidance for administrators to establish a healthy workplace and maintain quality patient care. Managers should understand the predisposing factors that lead to absenteeism, such as insufficient staffing, and propose effective measures. This study contributes to the development of research and measurement tools, adds preliminary data, and explores nursing staff presenteeism.
The Importance of Frailty in Older Adults With Benign Paroxysmal Positioning Vertigo
Authors: Pauwels Sara , Lemkens Nele , Lemmens Winde , Meijer Kenneth , Meyns Pieter , Berg Raymond V. D. , Spildooren Joke 
Published: November 2024

Background and Purpose:
Even though Benign Paroxysmal Positioning Vertigo (BPPV) is one of the most reported vestibular disorders, its interaction with frailty and postural control in older adults is hardly or not investigated.

Methods:
Thirty-seven older adults (≥65 years) with a diagnosis of BPPV (oaBPPV) (mean age 73.13 (4.8)) were compared to 22 age-, weight-, and height-matched controls (mean age 73.5 (4.5)). Modified Fried criteria were used to assess frailty. Postural control was assessed with the timed chair stand test, mini Balance Systems Evaluation test (mini-BESTest), a Clinical Test of Sensory Interaction on Balance (CTSIB), and 10-m walk test. Falls were inquired. The Dizziness Handicap Inventory, Falls Efficacy Scale, and 15-item Geriatric Depression Scale assessed dizziness-related handicap, fear of falling, and feelings of depression, respectively. To assess the importance of frailty, all variables were also compared between frail oaBPPV, robust oaBPPV, and robust controls in a sub-analysis. The significance level was set at α = 0.05.

Results:
oaBPPV reported significantly more multiple falls (P = 0.05) and difficulties to remain standing with increasing task difficulty of the CTSIB (P = 0.004). They were significantly more (pre-)frail compared to controls (P < 0.001). Moreover, frail oaBPPV had a significantly decreased reactive postural control (P < 0.001) and dynamic gait (P < 0.001). Their fear of falling (P < 0.001) and dizziness-related handicap (P < 0.001) were significantly higher compared to robust oaBPPV.

Discussion and Conclusions:
oaBPPV were less healthy and more (pre-)frail compared to controls, impacting their daily functioning. Future research should investigate whether frailty and postural control were already decreased before the BPPV onset and if this recovers after treatment with repositioning maneuvers or if additional rehabilitation is necessary.

Impact Statement:
Older adults with Benign Paroxysmal Positional Vertigo (BPPV) can present with an impaired sensory orientation, declined cognition, significantly more multiple falls, and (pre-)frailty compared to controls. Moreover, frail older adults with BPPV also had a significantly decreased reactive postural control and dynamic gait, and an increased odds of falling compared to robust controls. BPPV and frailty appear to be linked with each other, which cannot be ignored in future research and clinicians treating older adults with BPPV.