bluuebunny/crossref_metadata_2025_split huggingface dataset:
Optimum Frequency for Physical Therapy Intervention in Pediatric Patients Undergoing Bone Marrow Transplantation in Acute Care Settings: A Systematic Review
Authors: Myers Abigail , Lenker Hallie , Reoli Rachel 
Published: October 2024

Background:
Bone marrow transplantation (BMT) is frequently indicated for management of multiple pathologies requiring an extensive hospitalization, which can result in immobility. The implications of immobility are well documented and lead to a loss of function which physical therapy (PT) aims to prevent or restore. The purpose of this review is to investigate the reported frequency of acute PT intervention for pediatric patients undergoing BMT during hospitalization.

Methods:
A preliminary search on the Johns Hopkins Welch Library was conducted. Experimental, quasi-experimental, and analytical observational studies were included, which consisted of children and adolescents, under 25 years old, post-BMT, and received PT or exercise during their hospitalization. One reviewer assessed the studies that met the inclusion criteria. Two additional reviewers assessed for quality.

Results:
A total of 272 articles were found, 16 met the inclusion criteria. Exercise intervention during hospitalization was found to be safe and feasible. The most reported frequency was found to be 4 to 5 times a week. Factors to be considered for frequency dosing were identified to be the patient’s autonomy, level of support, fatigue, hospital stay characteristics, prior level of function, developmental state, and anthropometrics.

Conclusion:
Our review showed that 4 to 5 sessions per week was the most reported frequency. This frequency can be prescribed to this population when patient factors are considered. Patient factors should be considered for prognosis and outcomes across a wide variety of patients.
STAT1 and STAT3 gain of function: clinically heterogenous immune regulatory disorders
Authors: Olbrich Peter , Freeman Alexandra F. 
Published: October 2024

Purpose of review
The identification of STAT1 gain-of-function (GOF) in 2011 and STAT3 GOF in 2014 has advanced our understanding of the host immunity along the JAK/STAT pathway and allowed targeted treatment approaches. We review the clinical features and pathogenesis of STAT1 and STAT3 GOF and how this has shaped new approaches to therapy.

Recent findings
STAT1 GOF, initially described in patients with chronic mucocutaneous candidiasis (CMC) and autoimmune thyroid disease, is now recognized to cause early-onset multisystem autoimmunity and a range of infections. STAT3 GOF comprises mostly lymphoproliferation and autoimmunity but also with varying severity, including some with life threatening organ dysfunction. Treatment has evolved along with the understanding of the pathogenesis, with patients now receiving JAK inhibition to block upstream of the STAT defect with good response in autoimmunity and CMC in STAT1 GOF. Blockade of IL-6 signaling has also been used in STAT3 GOF. Hematopoietic cell transplantation had initial poor outcomes, but outcomes are now improving with focus on the control of inflammation pretransplant.

Summary
Understanding the pathogenesis of STAT1 and STAT3 GOF has allowed great recent advancements in therapy, but many questions remain as to the best approach to therapy for each patient's clinical presentation as well as the durability of these therapies.
Resident Unions: Why Now and Will They Change Medical Education and Health Care?
Authors: Sklar David , Javed Britani 
Published: October 2024

Abstract
During the COVID-19 pandemic, resident unions proliferated. While unionization resulted in increased compensation and benefits, the process of union negotiations may have created adversarial relationships between residents and their institutions’ leadership, whom residents depend on for supervision and the development of clinical expertise. Such adversarial relationships could affect the learning environment, which is critical to the delivery of high-quality care. In this commentary, the authors suggest that academic medical centers should offer residents an authentic seat at the institutional care delivery leadership table, ensuring residents’ full participation in key organizational decisions. Doing so represents an alternative to unionization, with its potentially adversarial relationships, while still achieving a key goal of residents—to be included in the decisions that affect them and the care they provide. In this way, residents can use their unique understanding of the institutions’ strengths and weaknesses to improve the quality of patient care and the learning environment. Such engagement can also help residents achieve competence in systems-based practice and provide a vital link between institutions and the patients and community they serve through health policy and advocacy activities.
Pregnancy-related hormonal changes and thyroid growth: do they have an impact on the higher incidence of differentiated thyroid cancer in women?
Authors: Poppe Kris G. , Kyrilli Aglaia , Costante Giuseppe 
Published: October 2024

Purpose of review
To analyze whether pregnancy could play a role in the higher prevalence of differentiated thyroid carcinoma (DTC) in women. Estrogens strongly modify thyroid economy by increasing iodine clearance, thyroid hormone requirement and production. Human chorionic gonadotropin (hCG) contributes to the increased thyroid hormone synthesis. Both estrogens and hCG can interfere with the regulation of thyroid volume and with thyroid nodule development and progression. The potential effect of hCG is exclusively related to its weak agonistic activity on TSH receptor. Estrogen implication on normal and nodule-derived thyrocyte growth has been demonstrated in vitro and in animal models. Furthermore, there is solid clinical evidence showing a promoting effect of pregnancy on thyroid volume and nodule development. Two metaanalyses, one including retrospective and another prospective observational studies, failed to show an association between pregnancy and DTC.

Recent findings
A large pooled prospective analysis using multivariable-adjusted Cox proportional hazard models did not demonstrate an association between DTC and parity. Similarly, no association between PTC occurrence and parity was observed in a prospective cohort analysis by linkage to the statewide Surveillance, Epidemiology, and End Results (SEER).

Summary
The presently available evidence does not support an involvement of pregnancy in DTC etiology.
Cataract surgery with endothelial keratoplasty
Authors: Ahad Muhammad A. , AlHilali Sara M. , Jomar Deema E. 
Published: October 2024

Purpose of review
This review aims to provide an updated summary of the combined approach of cataract surgery with endothelial keratoplasty (EK), addressing key considerations, including intraocular lens (IOL) choice and calculation, decision between sequential and triple EK, and modifications in surgical techniques and postoperative management.

Recent findings
Advances in imaging techniques (Scheimpflug tomography and anterior segment optical coherence tomography) have improved the ability to detect subclinical corneal edema, aiding in surgical decision-making for EK. Recent studies comparing sequential and triple-EK indicate that both methods yield similar visual outcomes. Though triple-EK offers quicker recovery, it may have higher complication rates. The use of gases like SF6 and C3F8 for anterior chamber tamponade is evolving, with conflicting findings on their efficacy in preventing graft detachment. Furthermore, IOL selection remains crucial, as hyperopic refractive surprises are common, and hydrophilic lenses should be avoided owing to the risk of opacification after EK.

Summary
The combination of cataract surgery with EK has emerged as an effective treatment for patients with corneal endothelial diseases and cataract. Careful preoperative evaluation, appropriate IOL selection, and advances in surgical techniques contribute to better outcomes, although patient-specific factors must guide the choice between sequential and triple-EK procedures.
Relationships Between Working From Home, Sitting Postures, and Low Back Pain During COVID-19
Authors: Snodgrass Suzanne J. , Kang Chris J. W. , Edwards Suzi , Heneghan Nicola R. , Puentedura Emilio J. , James Carole 
Published: October 2024

Objective
The aim of the study is to investigate the effects of working from home on musculoskeletal pain.

Methods
An e-survey of computer workers was conducted. Multinomial logistic regression modeling examined relationships between work location (work or home office desk, dining table, other), sitting posture (diagrams with descriptors), depressive symptoms (Center for Epidemiologic Studies Short Depression Scale), sleep quality (good/average vs poor) and pain (low back pain [LBP]), and other pain without LBP (asymptomatic).

Results
Of 634 respondents, most (91%, n = 578) worked partially at home and had pain (91%, n = 576; 342 LBP, 234 other pain, 58 asymptomatic). Sitting posture (“trunk a little bent forward” vs “straight up, back against back rest”: odds ratio = 2.9; 95% confidence interval = 1.3–6.5, P = 0.008), being female (2.2; 1.2–4.1, P = 0.008), and depressive symptoms (3.4; 1.7–6.6; P < 0.001) were associated with LBP. Poor sleep quality related to LBP but correlated with depressive symptoms. Working from home and location were not associated with pain.

Conclusions
Sitting postures, but not working from home, are associated with LBP.
Developing a Job-Exposure Matrix for Sedentary Behavior
Authors: Fukai Kota , Sano Kei , Terauchi Ryo , Furuya Yuko , Nakazawa Shoko , Kojimahara Noriko , Hoshi Keika , Nakano Tadashi , Toyota Akihiro , Tatemichi Masayuki 
Published: October 2024

Objective
The aim of the study is to develop a job-exposure matrix for sedentary behavior and assess its relationship with noncommunicable diseases.

Methods
We constructed a job-exposure matrix using occupational and industry classifications combined with data on daily average sitting durations from 41,718 individuals. This matrix was then applied to a cohort of 706,939 participants in a case-control study to explore the link between sedentary behavior and noncommunicable disease risks.

Results
The matrix effectively identified sedentary behavior across different occupational groups. Using the matrix to assess sedentary behavior, associations were found between increased sedentary activity and heightened risks of diabetes, acute myocardial infarction, and endometrial cancer, while a reduced risk was observed for stroke.

Conclusions
The job-exposure matrix provides valuable insights into the health impacts of sedentary behavior in the workplace, underscoring significant disease risks associated with prolonged inactivity.
Effectiveness of Using Checklist in Preventing Facial, Nasal and Head Pressure Injuries in Preterm Infants in Nasal Noninvasive Mechanic Ventilation
Authors: Güner Başara Sultan , Çalışır Hüsniye , Kaynak Türkmen Münevver 
Published: October 2024

Background:
Noninvasive mechanical ventilation (NIMV), when in synchronized intermittent mandatory ventilation, continuous positive airway pressure, or patient-triggered ventilation modes, is known to be a cause of facial, nasal, head, and skin pressure injuries in preterm infants.

Objective:
The objective of this study is to examine the efficacy of using a checklist with preterm infants under nasal NIMV in preventing facial, nasal, and head pressure injuries.

Method:
The study was conducted quasi-experimentally on preterm infants under NIMV. The sampling comprised a total of 104 infants, an intervention group of n = 52 and a control group of n = 52. All procedural steps of NIMV of the infants in the intervention group were performed in accordance with a checklist. The checklist covered: (1) preparation of the ventilation device and cannula placement; (2) care; and (3) monitoring and assessment.

Result:
There was a statistically significant difference in nasal tip, septal, intranasal, upper lip, and right-left cheek pressure injury scores between the intervention and control groups (P < .05).

Conclusion:
Performing all procedural steps of nasal NIMV in accordance with a checklist is effective in preventing pressure injuries on the face, nose, and head of preterm infants, reducing the severity of pressure injuries.

Implications for Practice:
It is recommended to use a checklist covering the ventilation device preparation, cannula placement, care, observation, and assessment steps to prevent any pressure injuries in the face, nose, and head, as well as to reduce the severity of pressure injuries and improve the skin condition of preterm infants under nasal NIMV support.
Comorbid Diabetes Is Associated With Dyspnea Severity and Cardiometabolic Biomarkers in Black Adults With Heart Failure
Authors: Butts Brittany , Kamara Julia , Morris Alanna A. , Davis Erica , Higgins Melinda K. , Dunbar Sandra B. 
Published: October 2024

Background
Comorbidities such as Type 2 diabetes mellitus significantly and adversely influence heart failure outcomes, especially in Black adult populations. Likewise, heart failure has a negative effect on diabetes and cardiometabolic outcomes. Dyspnea, a common symptom of heart failure, often correlates with disease severity and prognosis. However, the relationship between comorbid diabetes, dyspnea severity, and cardiometabolic biomarkers in Black adults with heart failure remains understudied.

Objectives
The purpose of this pilot study was to examine differences in the distressing heart failure symptom of dyspnea and in cardiometabolic and inflammatory biomarkers in Black adults living with heart failure with and without diabetes.

Methods
Black adults with heart failure were enrolled in this cross-sectional pilot study. Cardiometabolic and inflammatory biomarkers were measured via multiplex immunoassay. Univariate general liner models were used to identify group differences between persons with heart failure with comorbid diabetes and those without, controlling for age, sex, and comorbid burden.

Results
Participants were mostly female with a mean age of 55 years and mean left ventricular ejection fraction of 33%. Participants with diabetes exhibited higher dyspnea scores compared to those without diabetes, indicating greater symptom burden. Moreover, individuals with comorbid diabetes demonstrated higher levels of cardiometabolic and inflammatory markers.

Discussion
Comorbid diabetes was associated with higher dyspnea severity and adverse cardiometabolic profiles in Black adults with heart failure. These findings underscore the importance of targeted interventions addressing diabetes management and cardiometabolic risk factors to improve symptom control and outcomes in this high-risk population. Further research is warranted to elucidate the underlying mechanisms and develop tailored therapeutic strategies for managing comorbidities in persons with heart failure, particularly in minoritized communities.
Poorer Nurse Staffing in Black-Serving Hospitals
Authors: Lake Eileen T. , Iroegbu Christin , Smith Jessica G. , Staiger Douglas O. , Li Kimi , Chen Hal , Weldeab Nehemiah , Rogowski Jeannette A. 
Published: October 2024

Background
Patients in hospitals that serve disproportionately patients of Black race have worse outcomes than patients in other hospitals, but the modifiable nursing factors that may contribute to such disparities have not been explored.

Objective
The study objective was to examine whether nurse staffing differs in hospitals that serve predominantly patients of Black race (Black-serving hospitals) as compared to other hospitals.

Methods
A cross-sectional correlational design using a nurse survey in a national hospital sample was used to fulfill the study objective. Nurse staffing was measured as the maximum number of patients cared for on the last shift from the 2015 annual registered nurse survey conducted in National Database of Nursing Quality Indicators hospitals. Hospitals were classified into subgroups of low, medium, and high percentages of patients of Black race using the 2019 Medicare Provider Analysis and Review database.

Results
In survey data from 179,336 registered nurses in 574 hospitals, nurse staffing was significantly worse in high-Black-serving hospitals as compared to medium- and low-Black-serving hospitals. In Poisson regression models that adjusted for nursing unit type and hospital characteristics, nurses in high-Black-serving hospitals and medium-Black-serving hospitals had more patients-per-nurse than did nurses in low-Black-serving hospitals.

Discussion
Small, statistically significant differences in nurse staffing that are worse in hospitals where Black patients disproportionately access their care were found using nurse survey data accounting for nursing unit type. The poorer nurse staffing in Black-serving hospitals may compromise the care and outcomes of the seven in 10 hospitalized Black older adults who receive care in Black-serving hospitals. The consequences for patient outcome disparities of poorer nurse staffing in Black-serving hospitals deserve investigation. Policies to increase nurse staffing in hospitals serving a higher proportion of patients of Black race are needed to contribute to efforts to reduce health disparities.
Acid suppressive therapy for gastroesophageal reflux disease
Authors: Ballinger Avery , Letsa Victor , Sheridan Dan 
Published: October 2024

ABSTRACT:
Gastrointestinal (GI) disorders range from intermittent heartburn to life-threatening GI hemorrhage. One of the most common GI disorders is gastroesophageal reflux disease (GERD), which affects an estimated 19% of adults in North America. This article discusses the advantages and disadvantages of acid-suppressive therapy for patients with GERD as well as relevant nursing considerations.
Low-grade Nasopharyngeal Papillary Adenocarcinoma
Authors: Jin Zhe , Ye Min , Sheng Yaru , Sun Ji , Zhang Jiahao , Chen Yueying , Lin Lan , Bai Qianming , Hu Chunyan 
Published: October 2024

Low-grade nasopharyngeal papillary adenocarcinoma (LGNPPA) is a rare neoplasm originating from the surface mucosal epithelium in the nasopharynx. To clarify its clinicopathologic, immunohistochemical, and molecular features, we retrospectively enrolled 35 patients diagnosed with LGNPPA between May 2016 and March 2024. Our cohort consisted of 14 male and 21 female patients aged 11 to 71 years (median: 37 y). The most common symptoms were rhinorrhea and nasal obstruction. Most tumors originated from the roof of the nasopharynx and were clinically staged as T1N0M0. None of the patients had a history of thyroid tumors. Microscopically, most of the LGNPPA were composed of irregular papillary structures covered with single-layer columnar or cuboidal epithelium. Eighteen cases (18/35, 51.4%) showed squamous epithelium coverage, and 9 cases (9/35, 25.7%) showed the characteristic transformation of squamous epithelium into neoplasm. Squamous differentiation and a significant spindle cell component were noted in 9 cases (9/35, 25.7%) and 26 cases (26/35, 74.3%), respectively. All cases were positive for thyroid transcription factor-1 protein, CK7, EMA, and Galectin-3 but negative for thyroglobulin, PAX8, and Napsin A. Ki-67 labeling was low and ranged from 2% to 5%. The Epstein-Barr virus or human papilloma virus infection and BRAF V600E mutation were not detected in any of the cases. All patients underwent endoscopic surgical resection, and 4 patients received radiotherapy followed by endoscopic surgery. Complete follow-up data were available for 33 patients. All patients had no recurrent or metastatic disease in the last follow-up (3 to 88 mo). A definitive diagnosis depends on histopathology and immunohistochemistry studies. The optimal treatment for patients with LGNPPA is total excision. Given the extremely indolent biological behavior of LGNPPA, it may be more appropriate to classify it as a primary papillary epithelial tumor rather than an adenocarcinoma of the nasopharynx.
Computer-Aided Design and Manufacturing in Free Fibula Reconstruction of the Mandible: Comparison of Long-Term Outcomes with the Conventional Technique
Authors: Bengur Fuat Baris , Humar Pooja , Saadoun Rakan , Khan Nayel , Anstadt Erin , Dang Sophia , Fadia Neil , Moroni Elizabeth A. , Bottegal Matthew T. , Acarturk Tahsin Oguz , Sridharan Shaum , Kubik Mark , Solari Mario G. 
Published: October 2024

Background:
Pre-operative computer-aided design and manufacturing (CAD/CAM) revolutionized head and neck reconstruction after extirpative surgery. However, studies performing head-to-head comparison to the conventional technique have limited long-term follow-up. We aimed to compare short and long-term outcomes between conventional and CAD/CAM approaches for mandibular reconstruction with free fibula flaps.

Methods:
Patients undergoing free flap reconstruction from 2012 to 2021 were included. Data regarding patient demographics, past medical history, surgical details, complications, and reconstructive outcomes were collected. Patients who had CAD/CAM were compared with the patients who underwent reconstruction with the conventional technique. The cumulative incidence of hardware maintenance was displayed using the Kaplan-Meier method.

Results:
A total of 215 patients (n=79 conventional, n=136 CAD/CAM) were included. Both cohorts had similar demographics except the CAD/CAM cohort was younger (p=0.043). The mean operative duration was 54 minutes shorter with the use of CAD/CAM (p=0.014). Total and partial flap loss rates were similar. Patients with CAD/CAM had significantly lower rates of early wound dehiscence (p=0.037). Median [interquartile range] follow-up duration was similar (931 [1854] days in conventional vs 728 [841] days in CAD/CAM, p=0.084). After excluding patients with major surgical complications in the first 30-days, CAD/CAM cohort had a lower hardware removal rate (28.8% vs 13.9%, p=0.011). The significance persisted after including only the patients with more than 2 years of follow-up.

Conclusion:
The use of preoperative CAD/CAM may reduce operative duration, while allowing for longer maintenance of hardware with reduced removal rates due to complications.