bluuebunny/crossref_metadata_2025_split huggingface dataset:
A sociodemographic index identifies sex-related effects on insomnia in the Hispanic Community Health Study/Study of Latinos
Authors: Sorajja Natali , Chung Joon , Alcántara Carmela , Wassertheil-Smoller Sylvia , Penedo Frank J , Ramos Alberto R , Perreira Krista M , Daviglus Martha L , Suglia Shakira F , Gallo Linda C , Liu Peter Y , Redline Susan , Isasi Carmen R , Sofer Tamar 
Published: August 2024

Abstract

Study Objectives
Sex differences are related to both biological factors and the gendered environment. We constructed measures to model sex-related differences beyond binary sex.

Methods
Data came from the baseline visit of the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). We applied the least absolute shrinkage and selection operator penalized logistic regression of male versus female sex over sociodemographic, acculturation, and psychological factors jointly. Two “gendered indices,” the gendered index of sociodemographic environment (GISE) and gendered index of psychological and sociodemographic environment, summarizing the sociodemographic environment (GISE) and psychosocial and sociodemographic environment (GIPSE) associated with sex, were calculated by summing these variables, weighted by their regression coefficients. We examined the association of these indices with insomnia, a phenotype with strong sex differences, in sex-adjusted and sex-stratified analyses.

Results
The distribution of GISE and GIPSE differed by sex with higher values in male individuals. In an association model with insomnia, male sex was associated with a lower likelihood of insomnia (odds ratio [OR] = 0.60, 95% CI [0.53, 0.67]). Including GISE in the model, the association was slightly weaker (OR = 0.63, 95% CI [0.56, 0.70]), and weaker when including instead GIPSE in the association model (OR = 0.78, 95% CI [0.69, 0.88]). Higher values of GISE and of GIPSE, more common in the male sex, were associated with a lower likelihood of insomnia, in analyses adjusted for sex (per 1 standard deviation of the index, GISE OR = 0.92, 95% CI [0.87, 0.99], GIPSE OR = 0.65, 95% CI [0.61, 0.70]).

Conclusions
New measures such as GISE and GIPSE capture sex-related differences beyond binary sex and have the potential to better model and inform research studies of sleep health.
Evaluating the Role of Competency-Based Behavioral Interviewing in Holistic Medical School Admissions
Authors: Davidson Mario A. , Russell Regina G. , Walker Philip D. , Zic John A. , Churchill Larry R. , Fuchs D. Catherine , Miller Bonnie M. 
Published: August 2024

Abstract

Problem
Holistic review is a multifaceted concept that aims to increase diversity and applicant fit with program needs by complementing traditional academic requirements with appraisal of a wider range of personal characteristics and experiences. Behavioral interviewing has been practiced and studied in human resources, business, and organizational psychology for over 50 years. Its premise is that future performance can be anticipated from past actions. However, many of the interview approaches within the holistic framework are resource intensive and logistically challenging.

Approach
The Vanderbilt University School of Medicine instituted a competency-based behavioral interview (CBBI) to augment the selection process in 2012. Behavioral interviews are based on key competencies needed for entering students and require applicants to reflect on their actual experiences and what they learned from them. The authors reviewed 5 years of experience (2015–2019) to evaluate how CBBI scores contributed to the overall assessment of applicants for admission.

Outcomes
The final admission committee decision for each applicant was determined by reviewing multiple factors, with no single assessment determining the final score. The CBBI and summary interview scores showed a strong association (P < .005), suggesting that the summary interviewer, who had access to the full applicant file, and the CBBI interviewer, who did not, assessed similar strengths despite the 2 different approaches, or that the strengths assessed tracked in the same direction. Students whose 2 interview scores were not aligned were less likely to be accepted to the school.

Next Steps
The review raised awareness about the cultural aspects of interpreting the competencies and the need to expand our cultural framework throughout interviewer training. Findings indicate that CBBIs have the potential to reduce bias related to overreliance on standardized metrics; however, additional innovation and research are needed.
Guiding Principles for Patient and Public Engagement in the Educational Missions of Medical Schools
Authors: Towle Angela , Wang Lucy , Ong Kenneth , Kline Cathy C. 
Published: August 2024

Abstract

Purpose
The purpose of this research was to cocreate with patients and the public a set of evidence-informed guiding principles for their authentic, responsive, ongoing, and sustainable engagement in the mission, goals, curriculum, and delivery of medical education.

Method
A set of guiding principles of relevance to medical education was identified from the literature. Eight focus groups with patients and community members representing a wide variety of perspectives were conducted in April and May 2022. Participants reviewed, prioritized, and discussed the principles and described successful engagement, resulting in 8 guiding principles in priority order. A summary report was circulated to participants for feedback. The principles were reviewed and endorsed by senior leaders in the medical school.

Results
The 8 focus groups were attended by 38 people (age range, mid-20s to postretirement; 7 male, 27 female, and 4 unknown gender). Accountability (19%), inclusion (18%), reciprocity (17%), and partnership and shared decision-making (14%) were chosen as the most important principles. Participants want evidence that their contributions are valued and have made a difference. They want the medical school to include and support a diversity of perspectives that reflect the populations being served by the health care system. They want the medical school to invest in building trusting and respectful long-term relationships with patients and the public.

Conclusions
The guiding principles could be used by medical schools as a starting point to build relationships with their local communities to increase the authentic and sustainable engagement of patients and the public in the educational mission of the medical school.
Gastrointestinal disease in systemic sclerosis: the neglected organ system?
Authors: McMahan Zsuzsanna , Pandolfino John , Perlman Harris , Del Galdo Francesco , Hinchcliff Monique 
Published: August 2024

Purpose of review
Identifying outcomes and clinical trial endpoints enabled the discovery of new inflammatory bowel disease (IBD) treatments. Herein, we describe efforts to advance the study of gastrointestinal (GI) manifestations in systemic sclerosis (SSc).

Recent findings
Insights into the scope of the problem, as well as advancements in the measurement and treatment of SSc-GI, are underway. Proposed SSc esophageal endophenotypes are now defined, risk stratification methods are growing, and imaging and functional studies are now employed to guide therapeutic interventions. Additional progress is being made in characterizing the gut microbiome in patients with SSc. Research into the role of the immune response in the pathogenesis of SSc-GI disease is also ongoing, evolving simultaneously with the development of methods to facilitate data collection with real-time capture of diet, exercise, and medication data.

Summary
Multidisciplinary teams are working to deepen our understanding of SSc-GI disease pathogenesis, to identify biomarkers for risk stratification and the assessment of disease activity, and to develop and validate outcomes and clinical trial endpoints to pave the way toward effective therapy for SSc-GI disease.
The Price for Delayed Diagnosis of Pediatric Septic Hip: Increased Cost and Poor Outcomes
Authors: Nielsen Ena , Mortimer J. Alexandra , Bompadre Viviana , Yandow Suzanne 
Published: August 2024

Background:
Most authors agree that early diagnosis and treatment of pediatric septic hip, within 4 days of onset of symptoms, is crucially important for good outcomes. In healthcare, value is a function of outcome over cost. The purpose of this study was to determine the clinical outcome and cost, therefore value, associated with early versus delayed treatment of pediatric septic arthritis of the hip.

Methods:
A retrospective review was performed at a single pediatric hospital. Hospital records over 6 years (2011 to 2016) were examined to identify patients who had undergone treatment for primary septic arthritis of the hip. Patient demographics, clinical data at presentation, treatment information, and follow-up data were recorded. Hospital charges at account level were calculated and compared between groups.

Results:
Forty-three subjects were identified for analysis. Twelve presented more than 4 days after the onset of symptoms (delayed diagnosis). There was no difference in patient demographics, Kocher criteria, or initial imaging performed between those with early versus delayed diagnosis. The delayed group had significantly longer length of hospital stay (17 vs. 9 d, P=0.003), follow-up needed (56 vs. 19 wk P=0.001), long-term complications (50% vs. 3%, P=0.000), duration of antibiotics (8 vs. 5.5 wk, P=0.043), greater number of I&Ds (2 vs. 1, P=0.04), more tissue cultures and blood draws (6 vs. 2, P=0.002; and 3 vs. 2 P=0.009, respectively) and more radiographs taken as outpatients (4 vs. 2, P=0.001, respectively). The average total hospital charge (inpatient and outpatient) was $102,774 in the early diagnosis group and $243,411 in the delayed group (P=0.012).

Conclusions:
Delayed diagnosis of pediatric septic hip correlated with longer length of hospital stay, duration of follow-up, and more long-term complications. These factors contributed to higher total hospital costs and therefore decreased healthcare value.
Burden of non-communicable diseases in China and its provinces, 1990–2021: Results from the Global Burden of Disease Study 2021
Authors: Liu Hanxiao , Yin Peng , Qi Jinlei , Zhou Maigeng 
Published: August 2024

Abstract

Background:
Non-communicable diseases (NCDs) are the primary causes of disability and death. The aim of this study is to analyze the disease burden of NCDs in China from 1990 to 2021.

Methods:
This study used data on NCDs in China and its provinces from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021. The study analyzed the disease burden of NCDs in 2021 and its changes from 1990 to 2021 using indicators including deaths and disability-adjusted life years (DALYs).

Results:
Between 1990 and 2021, the NCD burden in China exhibited an upward trend. In 2021, China had 10.6 (95% uncertainty interval [UI]: 9.0–12.2) million deaths and 349.3 (95% UI: 301.5–401.2) million DALYs due to NCDs, accounting for 91.0% (95% UI: 90.4–91.7%) of all deaths and 86.7% (95% UI: 86.0–87.4%) of all DALYs. NCDs caused a lower disease burden in females than in males. Cardiovascular diseases and neoplasms were the main NCD level 2 causes of deaths and DALYs, resulting in 5.1 (95% UI: 4.3–5.9) and 2.8 (95% UI: 2.3–3.4) million deaths and 100.2 (95% UI: 84.6–116.6) million and 71.2 (95% UI: 59.3–85.2) million DALYs in 2021, respectively. Chronic respiratory diseases were the third leading cause of NCD deaths, while musculoskeletal disorders were the third leading cause of NCD DALYs. Qinghai, Xizang, and Heilongjiang had the highest age-standardized mortality rates and age-standardized DALY rates (per 100,000) for NCDs, while Hong Kong Special Administration Region (SAR), Macao SAR, and Shanghai recorded the lowest age-standardized mortality rates and age-standardized DALY rates.

Conclusions:
NCDs caused a high disease burden in China and exhibited heterogeneity across sexes and provinces. China needs to focus on addressing key NCDs and implement intervention measures tailored to the disease distribution characteristics to reduce the NCD burden.
The Effect of Laughter Yoga on Vasomotor Symptoms and Sleep Quality in Menopausal Women
Authors: Aksoy-Can Ahu , Güner-Emül Tuba , Değirmenci Filiz , Buldum Aysu , Aksu Aslıhan , Vefikuluçay-Yılmaz Duygu 
Published: August 2024

This experimental study aimed to determine the effects of online laughter yoga on the sleep quality and vasomotor symptoms (VMS) of menopausal women through a prospective, randomized controlled trial. About 36 women who attend the Menopause School were randomized into either the laughter yoga (n = 18) or the control group (n = 18). The laughter yoga group participated in eight online laughter yoga sessions, with two sessions per week for four weeks, whereas the control group did not receive any intervention. Data were collected using the Descriptive Characteristics Form, Visual Analog Scale (VAS), and Pittsburgh Sleep Quality Index (PSQI). The laughter yoga group had significantly lower posttest VAS scores compared with the control group in all VMS (P < .05). Furthermore, the posttest PSQI score of the laughter yoga group was significantly lower than that of the control group (P < .05). Although there was no significant difference in the pretest and posttest scores obtained by the control group from the VAS and PSQI (P > .05), the intervention group exhibited a statistically significant difference in their pretest and posttest VAS and PSQI scores (P < .05; P < .001, respectively). The results indicate that laughter yoga is an effective method for reducing VMS and improving sleep quality.
Effectiveness of Auricular Acupressure on Improving Pain and Heart Rate Variability in Patients After Cervical Spine Surgery
Authors: Liu Ying-Yin , Chien Tsui-Wei , Li Chin-Ching 
Published: August 2024

Cervical spine surgery is a common neurosurgical procedure; however, postoperative pain remains a problem. This study aimed to examine the effectiveness of auricular acupressure, which is considered a noninvasive, convenient, and safe method for pain reduction and heart rate variability in patients after surgery. A total of 62 patients who underwent cervical spine surgery were randomly divided into experimental (32 patients) and control (30 patients) groups. Both groups received routine care, whereas the experimental group received auricular acupressure three times a day for four days. The Short-Form McGill Pain Questionnaire was administered, and heart rate variability measurements were obtained on the first, second, third, and fourth postoperative days. The results indicated that auricular acupressure was effective in reducing pain (P < .05) and improving heart rate variability (P < .05) in patients. Based on the findings, this study suggests that auricular acupressure can be used as a complementary treatment to reduce pain in patients after cervical spine surgery.
Findings Associated With Prolonged COVID-19 Recovery Among Boston Healthcare Workers
Authors: Zalaquett Nader , Lutchman Kevan , Iliaki Eirini , Buley Jane , Nathan Neetha , Sotos Prieto Mercedes , Kales Stefanos N. , Lan Fan-Yun 
Published: August 2024

Objective
This study aimed to evaluate the long-term, symptomatic recovery of healthcare workers from acute COVID-19 infections up to 3 years after the initial COVID-19 outbreak.

Methods
A cross-sectional study was performed among employees of a community-based healthcare system in Massachusetts who had a recorded positive COVID-19 test. Survey responses were collected between September 2022 and January 2023. The survey included validated questionnaires: WHOQOL-BREF, EQ-5D-5 L, DASS-21, FCV-19S, K6+, and the Insomnia Severity Index. We compared the long-COVID (ie, symptoms lasting >28 days) and non–long-COVID groups.

Results
Among the 280 respondents (15.2% response rate), those with long COVID (73.4%) reported significantly worse quality of life and greater levels of depression, anxiety, and stress metrics. However, no significant difference was found between the two groups' fear of COVID-19.

Conclusions
Targeted support for healthcare workers with prolonged symptoms after COVID-19 is warranted.
‘Personalized medicine’: phenotyping pediatric obstructive sleep apnea
Authors: Duong-Quy Sy , Nguyen-Ngoc-Quynh Le , Nguyen-Huu Hoang 
Published: August 2024

Purpose of review
Obstructive sleep apnea (OSA) is common in children. Phenotyping pediatric OSA has a crucial role in personalized diagnosis and treatment to improve outcomes for this population. This review sets forth a clinical approach that allows for phenotyping pediatric OSA.

Recent findings
The emerging concept of phenotyping pediatric OSA is based on identifying a primary cause, which leads to a more precise understanding of the pathogenesis in any individual patient. Phenotyping enables treatment focusing on the primary cause, but does not exclude the need for supplemental management strategies based on other recognizable traits. The identification of pediatric OSA phenotypes (POP) relies on observable characteristics with significant prevalence. This review will concentrate on the most important phenotypes seen in clinical practice: pediatric OSA with craniofacial abnormalities (POPCA); OSA with upper airway disease (POPUAD); OSA with obesity (POPO), and OSA associated with neuromuscular disease (POPNED).

Summary
Phenotyping pediatric OSA is a form of personalized medicine. By identifying clinical subtypes, individualized treatment plans can be devised in order to choose therapies that are associated with predictable responses. Moreover, it is rare that a therapeutic modality is devoid of possible complications; knowledge of the phenotype being treated can enable early intervention should those occur. Finally, all of the aforementioned phenotypes require personalized support incorporating individualized care plans so as to optimize the quality of life and overall sleep health of children with OSA.
Audiovestibular Involvement in Patients With Systemic Sclerosis
Authors: Mazeda Carolina , Silva Susana P. , Romão José , Matias Daniela , Azevedo Luísa , Barcelos Anabela 
Published: August 2024

Introduction
Audiovestibular dysfunction has been reported in many autoimmune connective tissue diseases, including systemic sclerosis (SSc).

Objective
To assess the prevalence and features of audiological and vestibular disturbances in SSc patients and evaluate their relationship with disease duration, clinical features, nailfold videocapillaroscopy pattern, and immunologic profiles.

Method
A matched case-control study was conducted in a rheumatology clinic of a second-level hospital over 24 months. All patients underwent a detailed ear, nose, and throat examination, as well as audiometric and vestibular assessments, including pure tone audiometry, speech audiometry, immittance tests, and the Video Head Impulse Test.

Results
Thirty-five SSc patients and 24 healthy controls were included in the study. In the SSc group, subjective hearing loss was reported by 17.1% of patients, vertigo by 14.3%, tinnitus by 11.4%, and dizziness by 5.7%. Sensorineural hearing loss was identified in 42.9% of SSc patients, significantly higher than in the control group (p = 0.013). There was no correlation between audiological manifestations and clinical symptoms, organ involvement, immunologic characteristics, and treatment. Vestibular dysfunction was detected in 60% of SSc patients, significantly higher than the control group (p = 0.05). A significant correlation was found between abnormal Video Head Impulse Test and the presence of anti-RNA polymerase III and anti-Th/To antibodies (p = 0.05 and p = 0.034, respectively).

Conclusion
Our study revealed an increased prevalence of sensorineural hearing loss and vestibulopathy in SSc patients.
Nivolumab and Cabozantinib Immunotherapy Induced Thyroid Dysfunction Detected on 18F-FDG PET/CT in Renal Cell Carcinoma
Authors: Reddy Moulish , Ravina Mudalsha , Goyal Harish , Kumar Amit , Kote Rutuja 
Published: August 2024

Abstract
Targeted immunotherapy became the most advanced approach for cancer treatment. Programmed death-1 (PD-1) expressed on activated T cells can reverse immune suppression and cause T-cell activation. Nivolumab, a PD-1 immune checkpoint inhibitor antibody that is a fully human immunoglobulin G4, blocks PD-1 and promotes antitumor immunity. Cabozantinib (tyrosine kinase inhibitor) inhibits the tyrosine kinase activity of vascular endothelial growth factor receptors 1, 2, and 3. As a result of enhancing immune response in normal tissues, immune-related adverse events can occur. Thyroid dysfunction is a common form of immune-related adverse event and seen on 18F-FDG PET/CT scans post therapy.
Hot Hearts on Bone Scintigraphy Are Not All Amyloidosis
Authors: Wang Ya-Wen , Xie Yan-Ting , Sun Xiao-Xin 
Published: August 2024

Abstract
A 54-year-old woman with a history of end-stage renal disease was found to have infiltrative cardiomyopathy by echocardiography. 99mTc-pyrophosphate (99mTc-PYP) scintigraphy was positive with a remarkable myocardial uptake. Gene test found a mutation of AGXT, confirming a final diagnosis of primary hyperoxaluria. Radiotracer uptake was due to high myocardial oxalate deposition. This case illustrates false positivity of the 99mTc-PYP scan caused by hyperoxaluria-associated cardiomyopathy, which raises awareness for other conditions apart from amyloid cardiomyopathy.
Incidental Uptake of 68Ga-DOTA-IBA in Prostate Adenocarcinoma
Authors: Liu Huipan , Liu Yuhong , Xiang Feifan , Zhang Jianwen , Chen Yue 
Published: August 2024

Abstract

68Ga-labeled DOTA-ibandronic acid (68Ga-DOTA-IBA) is a novel PET agent developed for bone tumors. In addition, 68Ga-DOTA-IBA uptake in nonosseous findings has also been reported. Herein, we present a case of 68Ga-DOTA-IBA uptake in primary prostate adenocarcinoma.
CRITICAL NOREPINEPHRINE DOSE TO PREDICT EARLY MORTALITY DURING CIRCULATORY SHOCK IN INTENSIVE CARE: A RETROSPECTIVE STUDY IN 3423 ICU PATIENTS OVER 4-YEAR PERIOD
Authors: Ceausu Dimitri , Boulet Nicolas , Roger Claire , Alonso Sandrine , Lefrant Jean-Yves , Boisson Christophe , Mura Thibault , Muller Laurent 
Published: August 2024

ABSTRACT

Introduction: The maximal norepinephrine (NE) dose >1 μg/kg/min during circulatory shock apparently is associated with higher mortality, but this threshold needs confirmation. This study aimed at investigating whether NE infusion at a dose >1 μg/kg/min could predict early intensive care unit (ICU) mortality (first 5 days). The secondary objective was to assess the day-by-day relationship between NE dose during the first 4 days of ICU stay and subsequent mortality. Methods: We conducted a retrospective analysis of data from ICU patients receiving NE for circulatory shock at the Nimes University Hospital (France) from January 2016 to December 2019. Results: A total of 5,735 patients were admitted, 3,693 were screened, and 3,423 were analyzed. NE infusion at a dose >1 μg/kg/min was associated with day-5 mortality (hazards ratio: 7.40, P < 0.0001). The area under the receiver operating characteristic was 0.79 to predict day-5 mortality in ICU for maximal NE >1 μg/kg/min. The calculated threshold of 1.13 μg/kg/min for maximal NE was the best prognostic value (sensitivity: 67%, specificity: 80%, positive predictive value: 45%). When the 1.2 μg/kg/min threshold was crossed either on the first, second, third, or fourth day of ICU stay, the probability of subsequent death was 47%, 49%, 60%, and 40%, respectively. Along the first 4 days of ICU stay, the risk of death increased with increasing NE infusion dose. Conclusions: An NE infusion rate >1.13 μg/kg/min predicts day-5 mortality in ICU patients with circulatory shock. The time to reach maximal NE infusion rate was shorter in survivors than in nonsurvivors.