bluuebunny/crossref_metadata_2025_split huggingface dataset:
From disease specific to universal health coverage in Lesotho: successes and challenges encountered in Lesotho’s digital health journey
Authors: Maoeng Monaheng , Bruce Kerry , Motebang Maletsatsi , Chen Carolyn Wetzel , Lecher Shirley , Gadisa Tsigereda , Saito Suzue , Ntsaba Mantebaleng 
Published: July 2024

Abstract
In Lesotho, the Ministry of Health and key donors have made significant advancements to develop digital health solutions specific to HIV services including an eRegister which is interoperable with the health management information system, pharmacy services and the laboratory information system. New investments from the Millennium Challenge Corporation will expand digital health services to all reported communicable and non-communicable disease areas at health facilities throughout the country. This paper explores how digital health interventions designed to support comprehensive HIV care can be leveraged to provide universal digital health coverage. Specifically, three priority areas will be addressed: (i) governance, security, and system architecture (ii) power, connectivity, and equipment (iii) human resources and change management.
Cultural Responsiveness in Academic Physical Therapy: An Administrative Case Report
Authors: Kennedy V Kai , Temple Sara , Pak Sang , Scheid Alison , Teherani Arianne , van der Schaaf Marieke , Fitzsimmons Amber 
Published: July 2024

Abstract

Objective
This paper describes how the administrative leadership of 1 physical therapy department curated, implemented, and evaluated a culturally responsive administrative support strategy to foster a positive working environment. Participants’ perceptions of culturally responsive practices were explored using climate survey data.

Methods
This case occurred in the physical therapy and rehabilitation science department at an academic medical center in the United States. The department administers 5 educational programs, 3 faculty practices, a community clinic, and a robust research enterprise and employs over 100 employees. After a historic sociocultural event, administrators implemented a series of actions to understand the needs of department employees and to respond in a culturally responsive manner. Interventions included supportive activities, educational opportunities, and community-building events. The department administered an annual climate survey to assess the employees’ perceptions of the working climate, perceived impacts of the culturally responsive interventions, and suggestions for improving department climate. Survey analysis included frequency statistics and thematic content analysis with sensitizing concepts from a culturally responsive practice framework previously applied in primary and secondary school settings.

Results
A total of 131 employees participated in the annual climate survey from 2020 to 2022. Employees’ confidence to identify and address microaggressions in working environments showed trends of overall improvement, and overall self-reported experiences with racial discrimination decreased. Participants reported positive trends in addressing discrimination among colleagues but also reported addressing offensive behaviors perpetrated by patients.

Conclusion
Findings suggest that culturally responsive interventions are associated with positive trends in employee climate. Interventions tailored to the audience and curated to deepen cultural knowledge, enhance self-awareness, and validate others fostered a shared commitment to cultural equity.

Impact
Administrative leaders have a role in fostering an inclusive climate by capitalizing on culturally significant teachable moments with sound culturally responsive strategy, bidirectional culturally sensitive communication, individual development, and collective action.
Requirement of Pdgfrα+ cells for calvarial bone repair
Authors: Xing Xin , Li Zhao , Xu Jiajia , Chen Austin Z , Archer Mary , Wang Yiyun , Xu Mingxin , Wang Ziyi , Zhu Manyu , Qin Qizhi , Thottappillil Neelima , Zhou Myles , James Aaron W 
Published: July 2024

Abstract
Platelet-derived growth factor receptor α (PDGFRα) is often considered as a general marker of mesenchymal cells and fibroblasts, but also shows expression in a portion of osteoprogenitor cells. Within the skeleton, Pdgfrα+ mesenchymal cells have been identified in bone marrow and periosteum of long bones, where they play a crucial role in participating in fracture repair. A similar examination of Pdgfrα+ cells in calvarial bone healing has not been examined. Here, we utilize Pdgfrα-CreERTM;mT/mG reporter animals to examine the contribution of Pdgfrα+ mesenchymal cells to calvarial bone repair through histology and single-cell RNA sequencing (scRNA-Seq). Results showed that Pdgfrα+ mesenchymal cells are present in several cell clusters by scRNA-Seq, and by histology a dramatic increase in Pdgfrα+ cells populated the defect site at early timepoints to give rise to healed bone tissue overtime. Notably, diphtheria toxin-mediated ablation of Pdgfrα reporter+ cells resulted in significantly impaired calvarial bone healing. Our findings suggest that Pdgfrα-expressing cells within the calvarial niche play a critical role in the process of calvarial bone repair.
Bacteriophage Φ21’s receptor-binding protein evolves new functions through destabilizing mutations that generate non-genetic phenotypic heterogeneity
Authors: Gerbino Krista R , Borin Joshua M , Ardell Sarah M , Lee Justin J , Corbett Kevin D , Meyer Justin R 
Published: July 2024

Abstract
How viruses evolve to expand their host range is a major question with implications for predicting the next pandemic. Gain-of-function experiments have revealed that host-range expansions can occur through relatively few mutations in viral receptor-binding proteins, and the search for molecular mechanisms that explain such expansions is underway. Previous research on expansions of receptor use in bacteriophage λ has shown that mutations that destabilize λ’s receptor-binding protein cause it to fold into new conformations that can utilize novel receptors but have weakened thermostability. These observations led us to hypothesize that other viruses may take similar paths to expand their host range. Here, we find support for our hypothesis by studying another virus, bacteriophage 21 (Φ21), which evolves to use two new host receptors within 2 weeks of laboratory evolution. By measuring the thermodynamic stability of Φ21 and its descendants, we show that as Φ21 evolves to use new receptors and expands its host range, it becomes less stable and produces viral particles that are genetically identical but vary in their thermostabilities. Next, we show that this non-genetic heterogeneity between particles is directly associated with receptor use innovation, as phage particles with more derived receptor-use capabilities are more unstable and decay faster. Lastly, by manipulating the expression of protein chaperones during Φ21 infection, we demonstrate that heterogeneity in receptor use of phage particles arises during protein folding. Altogether, our results provide support for the hypothesis that viruses can evolve new receptor-use tropisms through mutations that destabilize the receptor-binding protein and produce multiple protein conformers.
Spontaneous Resolution of Congenital Insufficiency of the Extensor Tendon Central Slip
Authors: Soldado Francisco , Nguyen Trong-Quynh , Rojas-Neira Juliana , Rodriguez-Ostuni Daniel , Cherqaoui Abdelmounim , Díaz-Gallardo Paula 
Published: July 2024

Background:
The congenital insufficiency of the extensor tendon central slip of the fingers is a relatively rare condition, with only a few reported cases in pediatric patients, as described in 2 clinical series. In this study, we aimed to present the natural history of a significant number of untreated patients with this deformity.

Methods:
This study has received institutional review board approval, and parents provided informed consent following the Declaration of Helsinki guidelines for biomedical research involving humans. A retrospective analysis of children with this deformity, ranging from June 2008 to July 2021, was collected by 1 surgeon. The inclusion criteria included children with a supple PIP flexion deformity, characterized by MP hyperextension and PIP extension lag, which had been present since birth. Complete passive PIP extension and the absence of volar skin webbing differentiated this condition from camptodactyly.

Results:
The mean age of 24 children with 57 involved digits at diagnosis was 7 months (range, 1 to 17) and the mean follow-up was 6 years to 9 months (2 yr to 1 mo to 13 yr). Six patients had an incorrect previous diagnosis of camptodactyly.
Active PIP extension recovered progressively. At the final follow-up, complete PIP extension occurred in all except 4 cases in which a residual 10° extension lag. The mean time for a complete active PIP extension was 2 years to 7 months (20 mo to 3 yr to 9 mo). Nineteen cases (79%) showed a mild FDS contracture of the involved digits at the final follow-up.
The deformity was bilateral in 15 children (62.5%) and involved only 1 finger (unilaterally or bilaterally) in 15 cases (62.5%), and 2 fingers in 6 (25%). Little and ring fingers were most commonly involved. In 7 cases, there was a family history of finger deformity.

Conclusions:
Congenital insufficiency of the extensor tendon central slip typically resolves spontaneously within the first 4 years of life. Literature suggests that splinting can expedite the correction of the deformity and thus, if possible, it can be used. In most cases, a residual, clinically insignificant FDS contracture may be present. This condition is often misdiagnosed as camptodactyly.

Level of Evidence:
IV.
Early Findings of a Preterm Twin Cohort Study Examining the Effect of General Anesthesia on Developmental Outcomes
Authors: Escobar Natalie , Levy-Lambert Dina , Fisher Jason , DiMaggio Charles , Kazmi Sadaf , Tomita Sandra 
Published: July 2024

ABSTRACT:

Purpose:
The premature infant brain may be particularly vulnerable to anesthesia effects, but there is conflicting evidence on the association between anesthesia exposure and developmental outcomes. Twin studies can control for confounding factors. A twin cohort of premature twins provides internal control of difficulty to measure confounders and delivers added power to a study examining the effects of anesthesia on neurodevelopmental outcomes.

Methods:
We conducted a retrospective cohort study of sets of premature twins and multiples born at an academic medical center, in which 1 member of the set was exposed to general anesthesia. The primary outcome was the composite scores using Bayley Scale of Infant and Toddler Development III performed at age 6 months to 18 months. Unpaired and paired analyses were performed with linear regression models, Wilcoxon signed rank test, and Mann–Whitney U test.

Results:
We identified 81 children born at less than 32 weeks gestation within 39 sets of twins and 1 set of triplets for a total of 18 paired observations. All of the exposed infants had a single exposure to general anesthesia. There was no significant association between anesthesia exposure and a diagnosis of developmental delay (OR = 0.8; 95% confidence interval, 0.2–3.2; p = 0.99). Regression models demonstrated no association between anesthesia exposure and cognitive (96.67 vs 97.50; p = 0.74), language (98.33 vs 98.61; p = 0.94), or motor (96.25 vs 96.44; p = 0.91) composite Bayley scores. There was no association between duration of anesthesia and the 3 composite Bayley scores (p = 0.33; p = 0.40; p = 0.74).

Conclusion:
Using a premature twin cohort with discordant exposure to anesthesia, our data did not demonstrate any association between anesthesia exposure and developmental delay in this vulnerable population of premature infants.
Artificial Intelligence for Mohs and Dermatologic Surgery: A Systematic Review and Meta-Analysis
Authors: Mirza Fatima N. , Haq Zaim , Abdi Parsa , Diaz Michael J. , Libby Tiffany J. 
Published: July 2024

BACKGROUND
Over the past decade, several studies have shown that potential of artificial intelligence (AI) in dermatology. However, there has yet to be a systematic review evaluating the usage of AI specifically within the field of Mohs micrographic surgery (MMS).

OBJECTIVE
In this review, we aimed to comprehensively evaluate the current state, efficacy, and future implications of AI when applied to MMS for the treatment of nonmelanoma skin cancers (NMSC).

MATERIALS AND METHODS
A systematic review and meta-analysis was conducted following PRISMA guidelines across several databases, including PubMed/MEDLINE, Embase, and Cochrane libraries. A predefined protocol was registered in PROSPERO, with literature search involving specific keywords related to AI and Mohs surgery for NMSC.

RESULTS
From 23 studies evaluated, our results find that AI shows promise as a prediction tool for precisely identifying NMSC in tissue sections during MMS. Furthermore, high AUC and concordance values were also found across the various usages of AI in MMS, including margin control, surgical recommendations, similarity metrics, and in the prediction of stage and construction complexity.

CONCLUSION
The findings of this review suggest promising potential for AI to enhance the accuracy and efficiency of Mohs surgery, particularly for NMSC.
Finding Our Lanes: A Roadmap for Collaboration Between Academic Medical Centers and Behavioral Telehealth Companies
Authors: Eden Daniel J. , Hermann Alison , Sombrotto Lisa B. , Wilner Philip J. , Chen Justin A. 
Published: July 2024

AbstractOutpatient mental health care in the United States is delivered by an uncoordinated patchwork of public and private entities that struggle to effectively differentiate the care they provide. The COVID-19 pandemic catalyzed transformative changes in this space, including rapid adoption of telehealth and escalating private sector investment to provide services for individuals wishing to obtain care through insurance. In this article, we briefly review the current landscape of ambulatory mental health care. Utilizing Kissick’s Iron Triangle model of health care delivery, we compare the relative strengths and weaknesses of academic medical centers and the growing private sector, entities potentially positioned to synergistically foster a mental health ecosystem with improved quality, access, and cost-effectiveness. A roadmap for strategic integration is presented for how academic centers—institutions frequently overwhelmed by patient volume—might leverage partnerships with a private sector eager to utilize novel technology to improve access, demonstrate data-driven outcomes, and advocate for improved reimbursement from payers. We also assess the potential risks and pitfalls of such collaboration. In return, academic institutions can refocus on their strengths, including research, systems knowledge, quality-improvement initiatives, education and training, and specialty clinical care.
Dysphoric Milk Ejection Reflex (D-MER): A Novel Neuroendocrine Condition with Psychiatric Manifestations
Authors: Schildkrout Barbara , MacGillivray Lindsey , Raj Shreya , Lauterbach Margo 
Published: July 2024

Learning Objectives: After participating in this CME activity, readers should be better able to:
• Describe how the symptoms of dysphoric milk ejection reflex (D-MER) affect nursing patients.
• Discuss how physicians, psychologists, and clinicians can support their patients experiencing D-MER.

Abstract
Dysphoric milk ejection reflex (D-MER) is characterized by a sudden onset of profoundly negative emotions that are temporally linked to milk letdown when breastfeeding or pumping breast milk. These affective experiences have no psychological precipitants and only last for minutes. D-MER is relatively underappreciated in the physician-oriented medical literature, although there are important clinical and public health consequences when a nursing parent experiences unwanted, negative emotions paired with breastfeeding. D-MER can undermine the parent’s confidence and may affect bonding with their infant; it may also contribute to weaning earlier than planned. It is especially important for psychiatrists and other health care professionals who may be called upon to evaluate postpartum patients or nursing parents to be knowledgeable about D-MER. This perspective article aims to provide information about D-MER to the psychiatric and broader medical communities, and to underscore the need for additional research on this topic. Drawing on a literature search, the article first traces historical recognition of D-MER as a clinical entity, then summarizes the clinical characteristics of D-MER and recommends an assessment and management approach that emphasizes psychoeducation. The article also discusses factors that have contributed to the underappreciation of this condition, outlines gaps in our understanding, and suggests next steps for epidemiological and clinical research. D-MER is likely a neuroendocrine condition with psychiatric manifestations. Given that it is episodic but with predictable timing, this condition presents a unique opportunity for scientific investigation.
Pain Assessment in the Outpatient Pediatric Burn Patient: An Integrative Review
Authors: Colson Cindy , Ascenzi Judy , Waibel Elizabeth , Busch Deborah 
Published: July 2024

Background:
There is no standardized practice in pediatric pain assessment with burn injuries in the outpatient clinic setting.

Objective:
This review aims to identify reliable, validated tools to measure pain in the pediatric burn clinic population.

Methods:
The literature search for this integrative review was conducted using the databases of PubMed, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Cochrane, and Embase from 2011 to 2023. Quality and relevance were appraised using the Johns Hopkins Nursing Evidence-Based Practice Model. Reporting was done according to a Preferred Reporting Items for Systemic Reviews and Meta-Analysis checklist.

Results:
Fourteen articles and two clinical practice guidelines met inclusion criteria and were included in this review.

Conclusion:
The Pain Observation Scale for Young Children and the COMFORT Behavior Scale tools have shown good reliability and construct validity and can be safely used to measure background and procedural pain in daily burn practice. Further research on reliable, validated pain assessment techniques in the pediatric burn population is needed.
Using natural language processing to link patients' narratives to visual capabilities and sentiments
Authors: He Dongcheng , Chung Susana T. L. 
Published: July 2024

SIGNIFICANCE
Analyzing narratives in patients' medical records using a framework that combines natural language processing (NLP) and machine learning may help uncover the underlying patterns of patients' visual capabilities and challenges that they are facing and could be useful in analyzing big data in optometric research.

PURPOSE
The primary goal of this study was to demonstrate the feasibility of applying a framework that combines NLP and machine learning to analyze narratives in patients' medical records. To test and validate our framework, we applied it to analyze records of low vision patients and to address two questions: Was there association between patients' narratives related to activities of daily living and the quality of their vision? Was there association between patients' narratives related to activities of daily living and their sentiments toward certain “assistive items”?

METHODS
Our dataset consisted of 616 records of low vision patients. From patients' complaint history, we selected multiple keywords that were related to common activities of daily living. Sentences related to each keyword were converted to numerical data using NLP techniques. Machine learning was then applied to classify the narratives related to each keyword into two categories, labeled based on different “factors of interest” (acuity, contrast sensitivity, and sentiments of patients toward certain “assistive items”).

RESULTS
Using our proposed framework, when patients' narratives related to specific keywords were used as input, our model effectively predicted the categories of different factors of interest with promising performance. For example, we found strong associations between patients' narratives and their acuity or contrast sensitivity for certain activities of daily living (e.g., “drive” in association with acuity and contrast sensitivity).

CONCLUSIONS
Despite our limited dataset, our results show that the proposed framework was able to extract the semantic patterns stored in medical narratives and to predict patients' sentiments and quality of vision.
Digital clinics for diagnosing and treating migraine
Authors: Nyberg Johan , Rosenbacke Rikard , Ben-Menachem Elinor 
Published: July 2024

Purpose of reviewSeveral innovative digital technologies have begun to be applied to diagnosing and treating migraine. We reviewed the potential benefits and opportunities from delivering migraine care through comprehensive digital clinics.Recent findingsThere are increasing applications of digitization to migraine diagnosis and management, including e-diaries, and patient self-management, especially after the COVID-19 pandemic. Digital care delivery appears to better engage chronic migraine sufferers who may struggle to present to physical clinics.SummaryDigital clinics appear to be a promising treatment modality for patients with chronic migraine. They potentially minimize travel time, shorten waiting periods, improve usability, and increase access to neurologists. Additionally, they have the potential to provide care at a much lower cost than traditional physical clinics. However, the current state of evidence mostly draws on case-reports, suggesting a need for future randomized trials comparing digital interventions with standard care pathways.
Fluorogenic Aptamer Optimizations on a Massively Parallel Sequencing Platform
Authors: Kuo Yu-An , Chen Yuan-I , Wang Yanxing , Korkmaz Zeynep , Yonas Siem , He Yujie , Nguyen Trung D. , Hong Soonwoo , Nguyen Anh-Thu , Kim Sohyun , Seifi Saeed , Fan Po-Hsun , Wu Yuting , Yang Zhenglin , Liu Hung-Wen , Lu Yi , Ren Pengyu , Yeh Hsin-Chih 
Published: July 2024

AbstractFluorogenicaptamers (FAPs) have become an increasingly important tool in cellular sensing and pathogen diagnostics. However, fine-tuning FAPs for enhanced performance remains challenging even with the structural details provided by X-ray crystallography. Here we present a novel approach to optimize a DNA-based FAP (D-FAP), Lettuce, on repurposed Illumina next-generation sequencing (NGS) chips. When substituting its cognate chromophore, DFHBI-1T, with TO1-biotin, Lettuce not only shows a red-shifted emission peak by 53 nm (from 505 to 558 nm), but also a 4-fold bulk fluorescence enhancement. After screening 8,821 Lettuce variants complexed with TO1-biotin, the C14T mutation is found to exhibit an improved apparent dissociated constant (vs. 0.82 µM), an increased quantum yield (QY: 0.62 vs. 0.59) and an elongated fluorescence lifetime (τ: 6.00 vs. 5.77 ns), giving 45% more ensemble fluorescence than the canonical Lettuce/TO1-biotin complex. Molecular dynamic simulations further indicate that the π-π stacking interaction is key to determining the coordination structure of TO1-biotin in Lettuce. Our screening-and-simulation pipeline can effectively optimize FAPs without any prior structural knowledge of the canonical FAP/chromophore complexes, providing not only improved molecular probes for fluorescence sensing but also insights into aptamer-chromophore interactions.