bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fluoxetine and Sertraline Inhibit Height Growth and Growth Hormone Signaling During Puberty
Authors: Calarge Chadi , Amushie Chima , Dinh Stephanie , Mills James A. , Devaraj Sridevi , Barba-Villalobos Griselda , Nguyen Jacqueline , Garcia Jose M. , Sisley Stephanie , Bacha Fida , Zemel Babette 
Published: October 2024

Abstract

Purpose
The aim of this study was to examine the effect of fluoxetine and sertraline on height growth and insulin-like growth factor-1 (IGF-1) during puberty.

Methods
In this 6-month cohort study, electronic medical records were used to identify 8- to 15-year-old participants, within 1 month of starting fluoxetine (n = 39) or sertraline (n = 27), and sexual maturation stages 2 to 4 were confirmed. Conditions that interfere with height growth led to exclusion. Participants underwent anthropometric assessments and phlebotomy. Healthy, unmedicated children (n = 36) also provided anthropometric data.

Results
After the baseline height Z-score, sex, Tanner stage, daily selective serotonin reuptake inhibitor (SSRI) dose, and time were accounted for, the interaction effect of dose by time was inversely associated with height Z-score in SSRI-treated participants (β = −0.18; 95% confidence interval [CI]: −0.35, −0.02). Sertraline and fluoxetine did not differ in their effect on height growth. Compared with being unmedicated, SSRI treatment was associated with a smaller growth in height (time × dose 2-way interaction effect β = −1.30; 95% CI: −2.52, −0.09). The interaction effect of dose by time was significant for body mass index Z-score (β = 0.35; 95% CI: 0.06, 0.64) but not weight Z-score (β = 0.24; 95% CI: −0.01, 0.49). Body mass index Z-score increased more with sertraline compared with fluoxetine (time × dose × SSRI type 3-way interaction effect P < 0.05). SSRI dose was inversely associated with IGF-1 (β = −63.5; 95% CI: −112.2, −14.7) but not insulin growth factor binding protein-3 concentration (β = −207.3; 95% CI: −536.2, 121.5).

Conclusions
Fluoxetine and sertraline reduce height gain and IGF-1 concentration, in a dose-dependent manner. Longer-term studies are necessary.
Incorporating the Pillars of Lifestyle Medicine into Physician Assistant/Associate Education: A Benefit for Patients, Physician Assistants/Associate Education, and Physician Assistants/Associates
Authors: Shehade Karen A. , Broughton Adam 
Published: October 2024

Introduction
The value of using lifestyle medicine (LM) to prevent disease is well established, yet medical education about LM is inconsistent, for both physicians and physician assistants/associates (PAs). As medical providers, PAs are uniquely positioned, with careers in a variety of disciplines from primary care to intensive care, as well as an ability to move across disciplines throughout their career lifespan. Therefore, the addition of LM principles in PA education can affect patients across the lifespan and in a wide variety of clinical settings. In addition, with burnout prevalent among PA students, the addition of LM to PA education may be able to give these future clinicians the tools they need to manage stress and improve overall wellness. The purpose of this study was to share with PA educators the valuable lessons learned when introducing LM into PA curriculum in hopes of broader adoption.

Methods
The American College of Lifestyle Medicine (ACLM) provides modules for teaching LM to medical providers which was adopted into the Northeastern University PA Program's didactic curriculum in the summer of 2023. An online survey was administered to first-year PA students in July 2023 to evaluate the PA students' perspectives on the value of adding a LM curriculum as part of their education to care for patients and the content provided through ACLM and to determine their perceived value in using the information for themselves as part of preventing future provider burnout.

Results
Most respondents (91%) indicated that they were either “likely” or “very likely” to use the information learned in the LM modules as part of their future patient care, and 86.4% indicated that they would use the information as part of their own self-care.

Discussion
Most PA student respondents (88.6%) thought that the components of LM complemented the existing PA curriculum in primary care and (86.4%) indicated that they will use the information as part of their own self-care. However, given the intense volume of information provided to PA students for their general primary care education, it was suggested to pare down the volume of materials to streamline the curriculum. Overall, these PA students believe that LM should comprise a portion of their PA medical education curricula for their patients and for themselves.
Examining Nursing Medical Malpractice Cases Related to Medications
Authors: Higden Julie , Folcarelli Patricia , Schaffer Adam 
Published: October 2024

OBJECTIVE
The aim of this study was to analyze medication-related nursing medical malpractice cases to gain insights regarding how malpractice risk can be reduced.

BACKGROUND
The criminal prosecution and verdict of nurse RaDonda Vaught focused attention on the potential medicolegal risk for nurses related to medications.

METHODS
Medication-related medical malpractice cases involving nurses were obtained from a national database. Various attributes of these cases were examined, including contributing factors, injury severity, and case outcomes.

RESULTS
Authors identified 231 nursing medication-related medical malpractice cases closed from 2017 to 2021. The most frequent adverse events involved medication administration. Not following policies or protocols was the most common contributing factor. Opioids and epinephrine were the medications most frequently involved in the cases. Indemnity payments were made in 56.3% of the cases, with an average indemnity payment of $366 002.

CONCLUSIONS
Nursing medication-related medical malpractice cases are relatively uncommon, which may reassure nurses regarding medicolegal risk. Medications and contributing factors involved in the cases suggest patient safety interventions including education related to policies, procedures, and protocols.
Are Ameloblastic Fibroma-related Lesions True Tumors?
Authors: Guo Xiaowen , Xue Jiang , Sun Lisha , Li Tiejun 
Published: October 2024

Ameloblastic fibroma (AF) and related lesions, namely ameloblastic fibrodentinoma (AFD) and ameloblastic fibro-odontoma (AFO), span a spectrum from true neoplasms to hamartomas. The 2017 World Health Organization classification proposes that AFD and AFO are precursors to odontomas, yet their precise nature remains uncertain. This study examined 19 AF cases, 4 AFD, 15 AFO, 19 odontomas (OD, 14 complex, 5 compound), and 2 ameloblastic fibrosarcomas (AFS), focusing on clinical characteristics, recurrence, and molecular profiles. AF primarily affected individuals under 20 years (60.0% of cases), mainly in the mandible (68.4%), with a recurrence rate of 21.1% in the followed cases. AFD and AFO appeared in younger patients (average age 15.7 y) without any recurrence observed. Notable differences in site and size distribution were observed between AF, its related lesions, and odontomas. Copy number alterations (CNAs) were detected in the mesenchymal component in 9 of 19 AF (47.4%), 2 of 4 AFD (50.0%), 6 of 14 AFO (42.9%), and 2 of 2 AFS (100%). In contrast, all odontomas exhibited normal CNAs, highlighting the specificity of CNAs in mesenchymal elements of AF and related lesions. BRAF p.V600E mutation was identified in the mesenchymal component in 13 of 19 AF (68.4%), 2 of 4 AFD (50.0%), 8 of 15 AFO (53.3%), and 2 of 2 AFS (100%), whereas all 19 odontomas were BRAF wild type. No mutations were found in the epithelial component. Our analysis reveals that AF and its related lesions present a spectrum of biological behaviors, from true neoplasms to hamartomas. The presence of BRAF p.V600E mutations and CNAs in their mesenchymal components, as opposed to odontomas, indicates potential neoplastic characteristics. Profiling copy number alterations in AF and related lesions emerge as a valuable tool for enhancing their differential diagnosis and facilitating the anticipation of disease progression. Our findings underscore the efficacy of copy number alteration analysis in determining the nature of lesions within AF and related lesions.
Physical, Cognitive, Emotional, and Social Health Outcomes of Children in the First 6 Months After Childhood Critical Illness: A Prospective Single-Center Study
Authors: Poh Pei-Fen , Lee Jan Hau , Sultana Rehena , Manning Joseph C. , Carey Matthew C. , Latour Jos M. 
Published: October 2024

OBJECTIVES:
To describe physical, cognitive, emotional, and social health outcomes of children and their trajectory in the first 6 months after PICU discharge.

DESIGN:
Prospective, longitudinal observational cohort study.

SETTING:
PICU in a tertiary pediatric hospital in Singapore from January 2021 to June 2022.

PATIENTS:
One hundred thirty-five children (1 mo to 18 yr), admitted for greater than or equal to 48 hours with at least one organ dysfunction and received PICU therapy.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
Serial self/parent proxy-reported assessments were obtained at: PICU admission, PICU discharge, and 1, 3, and 6 months after PICU discharge. The Pediatric Quality of Life Inventory (PedsQL) scale, Functional Status Scale (FSS), and measures of post-traumatic stress disorder (PTSD) using the Young Child PTSD Screen and the Child and Adolescent PTSD Screen-Parent Version were used. Trajectory groups were identified using group-based trajectory model. One hundred thirty-five children (mean [sd] age, 5.6 yr [5.5 yr]) were recruited. Seventy-eight (52%) were male. The mean (sd) Pediatric Index of Mortality III score was 3.2 (4.1) and PICU length of stay was 10.0 days (21.0 d). The mean (sd) PedsQL total scores were 66.5 (21.1) at baseline, 69.7 (21.4), 75.6 (19.7), and 78.4 (19.8) at 1, 3, and 6 months after PICU discharge, respectively. Overall, the PedsQL and FSS plateaued at 3 months. Our model revealed three distinct trajectory groups. Seventeen and 103 children in the mild and moderate trajectory groups, respectively, demonstrated recovery to baseline. Fifteen children in the severe trajectory group were older in age (mean [sd] 8.3 yr [6.4 yr]), with higher proportion (11/15) of preexisting illness. Five of 15 children in the severe group experienced posttraumatic stress syndrome (PTSS) at 6 months post-discharge.

CONCLUSIONS:
In our cohort of PICU patients, we found three unique trajectory groups. Children in the severe group were older, more likely to have preexisting conditions and at increased risk for PTSS. Early identification and intervention may improve recovery in patients with severe PICU trajectories.
The relationship between changes in inflammation and locomotor function in sensory phenotypes of central neuropathic pain after spinal cord injury
Authors: Avonts Brittany L. , Shen Quan , Wrobel Neal J. , Fessler Richard G. , David Brian T. 
Published: October 2024

Abstract

Introduction:
Central neuropathic pain (CNP) commonly develops in patients after spinal cord injury (SCI), causing debilitating symptoms and sensory abnormalities to mechanical and thermal stimuli. The biological variability of pain phenotypes in individuals has limited the number of positive outcomes. Thus, it is necessary to investigate the physiological processes contributing to sensory changes that develop over time.

Objective:
To investigate the physiological processes contributing to neuropathic pain sensory changes and locomotor impairments with sensory phenotypes that develop over time.

Methods:
Using the tail flick and von Frey tests, we performed hierarchical clustering to determine the subpopulation of rats that developed thermal and mechanical sensory abnormalities. To measure inflammation as a potential mediator of CNP phenotypes, we used flow cytometry and immunohistochemistry. Finally, to assess the secondary effects on locomotor recovery, up to 8 weeks after injury, we used the CatWalk test to assess multiple parameters of gait.

Results:
The von Frey test showed a subpopulation of SCI rats that were hyposensitive to mechanical stimuli from 6 to 8 weeks after injury. The tail flick test showed a subpopulation of SCI rats that were hypersensitive to thermal stimuli at 1 week and 3 to 8 weeks after injury. Although there were no differences in inflammatory cells between subpopulations, we did see significant changes in locomotor recovery between rats with and without sensory abnormalities.

Conclusion:
The myeloid cell population at large is not affected by mechanical or thermal phenotypes of pain in this model; however, locomotor recovery is impaired depending on the pain phenotype present. Further investigation into acute inflammatory cells may be insightful for predicting the development of pain phenotypes.
Opposite effects of isometric exercise on pain sensitivity of healthy individuals: the role of pain modulation
Authors: Liebermann Paz , Defrin Ruth 
Published: October 2024

Abstract

Introduction:
Exercise-induced hypoalgesia (EIHypo) among healthy individuals is well documented; however, the opposite effect of exercise, ie, exercise-induced hyperalgesia (EIHyper), has mainly been described in patients with chronic pain or after intense/painful exercise.

Objectives:
We investigated the extent to which EIHypo and/or EIHyper occur among healthy participants and whether these responses are associated with individuals' pain modulation capacity.

Methods:
Fifty-seven participants (mean age 29.20 ± 5.21 years) underwent testing of pressure pain threshold as an index of EIHypo/EIHyper: pain adaptation, offset analgesia (OA), and conditioned pain modulation as indices of pain modulation, prior to and immediately postsubmaximal isometric exercise (n = 40) or rest (n = 17, control group). Body awareness and exercise-evoked stress were also evaluated. Test–retest repeatability of the pain modulation indices was performed as well.

Results:
Twenty-four participants (60%) exhibited EIHypo, whereas 16 (40%) exhibited EIHyper. Pressure pain threshold did not change in the control group. Baseline (preexercise) OA efficacy predicted EIHypo/EIHyper. Furthermore, OA significantly decreased postexercise in the EIHyper subgroup and slightly increased in the EIHypo subgroup. Exercise-induced hypoalgesia was associated with magnitude of daily exercise while EIHyper was associated with increased exercise-evoked stress and body awareness.

Conclusion:
Submaximal isometric exercise can induce opposite effects on pain sensitivity among healthy participants—EIHypo or EIHyper. Descending pain inhibition pathways, and top-down influences over these pathways, seem to be involved in EIHypo/EIHyper effects. As such isometric exercise is often preferred in early stages of rehabilitation, preliminary screening individuals' vulnerability to this exercise is important; OA test may be used for this purpose.
Impact of Surgical Timing on Postoperative Complications Following Open Reduction Internal Fixation of Mandibular Fractures
Authors: Hassan Bashar A. , Resnick Eric , Er Seray , Pope Pharibe , Lamaris Gregory , Grant Michael P. , Pan Judy 
Published: October 2024

Purpose:
The mandible is the second most fractured facial bone. The timing of open reduction internal fixation (ORIF) has been a subject of debate for decades. The authors sought to investigate the association between the timing of ORIF and the incidence of postoperative complications.

Methods:
The authors retrospectively reviewed adult trauma patients who underwent ORIF in 2018 and 2019. The authors excluded patients who underwent mandibulomaxillary fixation (MMF) only and those with postoperative follow-up <2 weeks. The duration between injury and ORIF was categorized into: <4, 4 to 7, and >7 days. The association between surgical timing categories and the incidence of postoperative complications was assessed using bivariate analyses and multivariable logistic regression.

Results:
Of 226 patients included, the median (interquartile range) age was 32 (25–42) years, and the median (interquartile range) follow-up was 49 (25–118) days. Most patients [207 (92%)] underwent both ORIF and MMF. Most patients had ORIF within 3 days of injury [168 (74%)]. Major postoperative complications included unplanned re-operation [n=25 (11.1%)], malocclusion [n=20 (8.8%)], and malunion [n=7 (3.1%)]. Minor postoperative complications included mental nerve paresthesia [n=79 (35%)], infection [n=30 (13.3%)], TMJ complications [n=17 (7.5%)], and wound dehiscence [n=14 (6.2%)]. Delayed ORIF >7 days of injury was associated with significantly greater odds of unplanned re-operation [adjusted odds ratio (aOR) 95% CI 10.43 (2.16–50.44), P=0.004], malocclusion [aOR (95% CI) 8.17 (1.31–51.03), P=0.025], and malunion [aOR (95% CI) 23.04 (1.18–>10), P=0.039].

Conclusion:
The authors recommend early ORIF in the management of mandibular fractures to minimize postoperative complications.
The Impact of Pudendal Nerve Injection in Vaginal Surgery: A Secondary Analysis
Authors: Le Neveu Margot , Sears Sarah , Rhodes Stephen , Slopnick Emily , Petrikovets Andrey , Mangel Jeffrey , Sheyn David 
Published: October 2024

Importance
Evidence regarding the effect of pudendal nerve blockade during vaginal surgery is conflicting. Previous studies compared pudendal nerve blockade to either normal saline placebo injection or no injection, demonstrating small or no difference in pain outcomes. Studies investigating nerve blocks at the time of vaginal surgery have not evaluated the effect of infiltration of the space around the pudendal nerve.

Objective
The aim of the study was to determine whether intraoperative pudendal nerve injection (bupivacaine or normal saline) will result in improved pain scores and satisfaction compared with patients who receive no pudendal injection.

Study Design
We performed a secondary analysis of 2 randomized controlled trials investigating postoperative pain after vaginal reconstructive surgery, comparing the outcomes of the following 3 groups: control (no pudendal injection), intervention (bilateral pudendal nerve blockade), and placebo (bilateral normal saline pudendal injections). The primary outcome was postoperative pain scores. Secondary outcomes were opioid use, patient satisfaction, and postoperative complications. Linear mixed effects models were applied to outcomes, and treatment effects with 95% confidence intervals were estimated at each time point from the model.

Results
One hundred four patients who underwent vaginal surgery were included: 36 pudendal nerve block, 35 normal saline pudendal injection, and 33 no injection. The groups were well-matched. Linear mixed effects models demonstrated no significant differences between treatment groups for postoperative pain severity scores, opioid use, and patient-reported satisfaction at each time point.

Conclusions
Normal saline injection and no injection seem to have no clinically meaningful difference in effect, and either could reasonably serve as control for pudendal blockade during vaginal surgery.
Quantitative Electroencephalography Biomarkers in Patients With Anti-N-methyl-D-aspartate Receptor Encephalitis: A Case–Control Study
Authors: David Cancino César Alejandro , Trenado Carlos , Kaplan Peter W. , Gómez Ávila Felipe Alberto , Fernández González-Aragón María del Carmen , Moreno Avellán Álvaro José , Soto Rincón Carlos Alberto , Quiñones Pesqueira Gerardo Arturo , San-Juan Daniel 
Published: October 2024

Purpose:
Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is an autoimmune reaction involving Immunoglobulin G antibodies against GluN1 subunit of NMDAR. Absence of biomarkers for early diagnosis and prognosis poses a challenge. Several small case–control studies have emphasized the prospect of quantitative EEG measurements. This study aimed to analyze and identify novel scalp quantitative EEG biomarkers and their implications on outcome of NMDRA encephalitis compared with a control group.

Methods:
Retrospective (2012–2021) case–control study of patients with NMDRA encephalitis and with acute/subacute encephalitis from other causes. Clinical variables and outcomes were assessed with modified Rankin Scale at admission, discharge, and follow-up. All patients underwent extensive diagnostic workup, including scalp EEG within 72 hours of admission. Quantitative EEG was calculated for Renyi, Tsalis entropy, Hjorth complexity, mean energy, and spectral power of the following frequency bands and ratios: delta (0.5–4 Hz), theta (5–8 Hz), alpha (9–14 Hz), beta (15–30 Hz), gamma (31–45 Hz), gamma-beta, beta/alpha, beta/theta, and beta/delta. Descriptive statistics, power frequency bands, complexity measures, and Wilcoxon rank sum test were used.

Results:
Patients with anti-NMDAR encephalitis had significantly higher delta frequency peak power, higher beta/alpha and gamma/beta frequency ratios, lower alpha and beta peak power, and lower beta/delta frequency ratio than the control group. In patients with anti-NMDAR encephalitis, higher delta and alpha peak power had the worst clinical outcome, at discharge and follow-up, and patients with higher gamma peak power had better outcomes.

Conclusions:
Quantitative EEG is a valuable tool to differentiate anti-NMDAR encephalitis from other inflammatory encephalitis and predict outcomes in patients with anti-NMDAR encephalitis.
Fronto-motor circuits linked to effort-based decision-making and apathy in healthy subjects
Authors: Derosiere Gerard , Vassiliadis Pierre , Dricot Laurence , Dessain Quentin , Delinte Nicolas , Zénon Alexandre , Duque Julie 
Published: October 2024

SUMMARYApathy is a syndrome characterized by a disruption in effort-reward decision-making, accompanied by structural and functional changes in a related fronto-basal ganglia (BG) network. While activity changes in the primary motor cortex (M1) during effort and reward valuation have been repeatedly observed, previous work on apathy has largely overlooked the connections between the fronto-BG network and M1, potentially missing key circuits in the apathy network. This study addresses this gap by investigating structural and effective connectivity in fronto-M1, fronto-BG-M1, and intra-M1 circuits in relation to apathy in 45 healthy subjects. Behavior was assessed using a battery of apathy-related questionnaires and computational modeling of effort and reward valuation in a decision-making task. Fronto-motor circuits were examined through a combination of MRI-derived tractography and paired-pulse transcranial magnetic stimulation, which probed structural and effective connectivity, respectively. The data reveal that apathy scores are associated with both structural and effective connectivity in fronto-M1 and fronto-BG-M1 circuits. Circuits originating from the supplementary motor area primarily index effort valuation, while connectivity in intra-M1 GABAergic circuits correlates exclusively with reward valuation. These findings suggest that distinct fronto-motor circuits are linked to different dimensions of motivated behavior and may constitute specific neuromodulation targets for patients suffering from apathy.
Controlling heterologous protein synthesis through a plant RNA ThermoSwitch
Authors: Lastovka Filip , Peyret Hadrien , Thomas Sherine Elizabeth , Lomonossoff George P. , Chung Betty Y.-W. 
Published: October 2024

AbstractPlants have evolved sophisticated mechanisms to adapt to temperature fluctuations, including transcriptional, post-transcriptional, and post-translational processes. Recent discoveries highlight RNA ThermoSwitches, cis-acting elements in several plant mRNAs that regulate protein synthesis based on temperature changes. These mechanisms, first identified in Arabidopsis thaliana, offer a promising tool for biotechnology by enabling temperature-sensitive control of protein expression. This study demonstrates, for the first time, the feasibility the application of plant RNA ThermoSwitches in Agrobacterium-mediated transient expression systems, presenting a novel method for controlled gene expression in plants. This system is particularly advantageous due to its homogeneous nature and independence from chemical inducers or suppressors.