bluuebunny/crossref_metadata_2025_split huggingface dataset:
Autoantibodies as putative biomarkers and triggers of cell dysfunctions in systemic sclerosis
Authors: Rosa Irene , Romano Eloisa , Fioretto Bianca Saveria , Manetti Mirko 
Published: July 2024

Purpose of review
Antinuclear autoantibodies represent a serological hallmark of systemic sclerosis (SSc), with anticentromere, antitopoisomerase-I, and anti-RNA polymerase III antibodies routinely assessed for diagnosis, clinical subset classification, and prognosis. In addition, an increasing number of autoantibodies have been demonstrated to play a pathogenic role by mediating different SSc manifestations. This review aims to give an overview on autoantibodies as putative biomarkers in SSc and discuss their possible pathogenic role as triggers of cell dysfunctions.

Recent findings
Over the years, different autoantibodies have been proposed as biomarkers aiding in diagnosis, disease subtype classification, disease progression prediction, organ involvement, as well as in understanding treatment response. Increasing literature also indicates functional autoantibodies as direct contributors to SSc pathogenesis by exerting agonistic or antagonistic activities on their specific cognate targets.

Summary
In SSc, search and validation of novel autoantibodies with higher diagnostic specificity and more accurate predictive values are increasingly needed for early diagnosis and specific follow-up, and to define the best therapeutic option according to different disease subsets. Moreover, since autoantibodies are also emerging as functional pathogenic players, a better unraveling of their possible pathomechanisms becomes essential to identify new targets and develop promising therapeutic agents able to neutralize their effects.
Limited Sampling Strategies Fail to Accurately Predict Mycophenolic Acid Area Under the Curve in Kidney Transplant Recipients and the Impact of Enterohepatic Recirculation
Authors: Mohamed Moataz E. , Saqr Abdelrahman , Al-Kofahi Mahmoud , Onyeaghala Guillaume , Remmel Rory P. , Staley Christopher , Dorr Casey R. , Teigen Levi , Guan Weihua , Madden Henry , Munoz Julia , Vo Duy , Sanchez Bryan , El-Rifai Rasha , Oetting William S. , Matas Arthur J. , Israni Ajay K. , Jacobson Pamala A. 
Published: July 2024

Background:
Therapeutic drug monitoring for mycophenolic acid (MPA) is challenging due to difficulties in measuring the area under the curve (AUC). Limited sampling strategies (LSSs) have been developed for MPA therapeutic drug monitoring but come with risk of unacceptable performance. The authors hypothesized that the poor predictive performance of LSSs were due to the variability in MPA enterohepatic recirculation (EHR). This study is the first to evaluate LSSs models performance in the context of EHR.

Methods:
Adult kidney transplant recipients (n = 84) receiving oral mycophenolate mofetil underwent intensive MPA pharmacokinetic sampling. MPA AUC0–12hr and EHR were determined. Published MPA LSSs in kidney transplant recipients receiving tacrolimus were evaluated for their predictive performance in estimating AUC0–12hr in our full cohort and separately in individuals with high and low EHR.

Results:
None of the evaluated LSS models (n = 12) showed good precision or accuracy in predicting MPA AUC0–12hr in the full cohort. In the high EHR group, models with late timepoints had better accuracy but low precision, except for 1 model with late timepoints at 6 and 10 hours postdose, which had marginally acceptable precision. For all models, the good guess of predicted AUC0–12hr (±15% of observed AUC0–12hr) was highly variable (range, full cohort = 19%–61.9%; high EHR = 4.5%–65.9%; low EHR = 27.5%–62.5%).

Conclusions:
The predictive performance of the LSS models varied according to EHR status. Timepoints ≥5 hours postdose in LSS models are essential to capture EHR. Models and strategies that incorporate EHR during development are required to accurately ascertain MPA exposure.
Analysis of 4725 Cases of Gluteal Augmentation with Intramuscular Fillers: A Clinical Cohort Study
Authors: Alves Danuza D. , Chacur Roberto , Menezes Honório S. , Mafaldo Rodrigo C. , Chacur Nivea Maria B.S. , Gomes Leandro D. , Vargas Vicenzo S. , Barros Manoela F. , Matzembacher Gina , Castro Gabriella Andressa M. 
Published: July 2024

Background:
In recent years, the aesthetic market has become more prominent for being not only a tool to correct unwanted features but also a social means for improving quality of life. The use of 30% polymethylmethacrylate (PMMA) as a gluteal filler has grown in popularity all over the world, being sought after by men and women for body remodeling because it provides a natural look as well as significant long-lasting results.

Methods:
A retrospective, multicenter study analyzed the medical records of 2801 patients who underwent a total of 4725 gluteal filler procedures between January 2009 and December 2021 at the different locations of Clínica Leger. The study protocol was approved by the Brazilian National Research Ethics Commission.

Results:
The medical records of 2801 patients (2666 women and 135 men) who underwent 4725 gluteal filler injections were retrospectively analyzed. A total of 922,776 mL of PMMA was used (average = 329 mL/patient). The occurrence of 101 adverse events (2.1%) was observed, and no statistically significant relationship between the mean injected volume and the incidence of complications could be found.

Conclusions:
According to the data presented in this study, the use of PMMA injections with the appropriate volumes for aesthetic treatments and corrections is safe and effective.
Reimagining Faculty Development: A 5-Year Journey of Outcomes and Lessons Learned of a Physician Assistant Faculty Fellowship
Authors: Gordes Karen L. , Cawley James F. , Kulo Violet , Fleming Shani , Kayingo Gerald 
Published: July 2024

Introduction
Faculty sufficiency remains one of the major bottlenecks in health workforce development. There is a need for effective models for practicing clinicians to successfully transition to academic teaching roles. This article describes outcomes and lessons learned at the 5-year mark for a statewide faculty development workforce initiative for the physician assistant (PA) profession at the PA Leadership and Learning Academy (PALLA) in Maryland.

Methods
The PALLA PA faculty fellowship is a state-funded workforce initiative that consists of a 10-month training program that includes synchronous workshops, asynchronous learning modules, experiential teaching opportunities, and completion of an individual project in the realm of scholarship/service under longitudinal mentorship. Programmatic outcomes were longitudinally tracked using the Kirkpatrick model of training evaluation to evaluate the faculty training program at 4 levels of criteria: reaction (level 1), learning (level 2), behavior (level 3), and results (level 4). Key performance indicators for the fellowship include the ability for fellow graduates to provide educational support to Maryland PA programs, engage in, and promote scholarship in the PA profession and build an academic portfolio.

Results
To date, 4 cohorts of PAs (23 individuals) have completed the fellowship. Learner reaction (level 1) evaluated through surveys, and interviews reveal a positive fellowship experience, with fellows noting benefits of the longitudinal nature of the experience and individualized mentorship and fellows self-report high level of achievement of fellowship learning goals (level 2). Local and national PA review of fellow curricular and scholarly products has been positive (level 3). After graduation, 9 fellows are engaged in faculty roles, providing academic support to local PA programs; 11 fellows have had scholarly products accepted; all fellow graduates have generated an academic portfolio; and 2 fellows have provided new service to PA organizations (level 4).

Discussion
Four years of fellowship data demonstrate positive impact across Kirkpatrick 4 levels of training evaluation. Nearly, all participants have new contributions in teaching, scholarship, or service roles because of the fellowship. Key lessons learned were the benefits of the longitudinal nature of the experience for scaffolding of learning and ongoing, individualized mentorship.
Mock Board Exam Writing Groups in Physician Assistant Education: A Method to Enhance Curriculum and Mentor Junior Faculty
Authors: Loyd India , Moon Mary B. , Braun Tim , Boyett Jennifer , Foster Kenneth , Duniphin Darlla , Douglas Chad , Miller Frederick C. 
Published: July 2024

Abstract
Ensuring students are prepared for the Physician Assistant National Certification Exam (PANCE) is an institutional priority for all physician assistant programs. While many factors predicting PANCE performance have been investigated, exploration and discussions of interventions to improve PANCE performance are limited. Repeated exposure to board-style questions has been shown to improve board scores in similar populations. Currently, existing question banks cannot be used to generate secure summative examinations, and commercial question banks may perpetuate inequitable access among physician assistant (PA) students. To address this issue, the University of Oklahoma Physician Assistant program used a community of practice model to create a mock board exam writing group. The group was created to facilitate the development of 9 PANCE-style exams to bolster students' clinical preparedness and PANCE performance. These writing groups also provided a platform for junior faculty to receive feedback and guidance from senior colleagues, thus facilitating and promoting mentorship. This article highlights the potential benefits of mock board exam writing groups in PA education and provides insight into their development and implementation.
Comparison of Pain With Ultrasound-Guided Intra-Articular Hip Injections With and Without Prior Subcutaneous Local Anesthesia
Authors: Lazaro Rondy Michael , Smith Joshua M. , Bender Nicholas , Punreddy Ankit , Barford Nathan , Paul Jennifer H. 
Published: July 2024

Objective:
To compare pain levels of intra-articular hip steroid injections performed with and without prior subcutaneous local anesthesia (LA) injection.

Design:
Randomized prospective study.

Setting:
University-based musculoskeletal clinic.

Participants:
Forty-one adult patients undergoing a first-time ultrasound-guided unilateral intra-articular hip steroid injection.

Interventions:
Subjects were randomized into 1 of 2 groups: intra-articular hip injection with prior subcutaneous LA with 2 mL of lidocaine 1% (With LA) or hip injection without prior subcutaneous LA (Without LA). Visual analog scale (VAS) pain scores (0–100) were collected before and after each injection.

Main Outcome Measures:
Visual analog scale pain score for the intra-articular hip injection.

Results:
Of the 41 total subjects, 18 were randomized to the Without LA group and 23 to the With LA group. There was no significant difference in baseline (preprocedure) VAS scores between the Without LA (mean ± SD = 39.2 ± 27.2) and With LA (41.2 ± 24.0) groups (P = 0.864). The mean ± SD VAS score for the subcutaneous LA injection in the With LA group was 20.4 ± 16.1. There was no significant difference in VAS scores for the intra-articular hip injection between the Without LA (48.5 ± 27.7) and With LA (39.5 ± 25.7) groups (P = 0.232).

Conclusions:
Subcutaneous injection of lidocaine before an intra-articular hip injection did not significantly decrease pain from the intra-articular hip injection. Providers may perform intra-articular hip injections with a 22-gauge 3.5-inch spinal needle without the need for an extra subcutaneous LA injection.
Impact of Gender and Marital Status on Door-to-Treatment (DTT) Time and Acute Stroke Outcome
Authors: Karim Nurose , Tumin Dmitry , Karim Sehrish 
Published: July 2024

Objectives:
Delays in acute stroke treatment lead to poor outcomes. Women can present with atypical stroke symptoms, are older at the time of stroke, and tend to be living alone, causing delays in pre-hospital diagnosis and seeking care. It is unclear if gender disparities in ED arrival and stroke assessment are compounded by gender differences after ED arrival. Therefore, we sought to identify if gender and marital status were associated with faster door-to-treatment (DTT) time.

Methods:
Our single-center stroke database was queried for adults presenting to ED with acute stroke between January 1, 2018 and January 30, 2023 treated with IV thrombolytics (IVT)+/− endovascular thrombectomy (EVT) and a known DTT time. The primary outcome was DTT (door-to-needle+door-to-puncture) time. Data collected includes the National Institutes of Health Stroke Scale (NIHSS) at presentation and discharge, gender, marital status, age, and intervention (IVT alone or IVT+/− EVT).

Results:
Among 674 patients identified, 35 patients were excluded due to missing data. Of 639 patients (median age 66 y), 25%/18% of patients were married men/women, respectively, and 22%/35% were single men/women. Median DTN time, DTP time, and discharge NIHSS score were 36, 79, and 4 mins, respectively. On multivariable analysis, neither DTT time nor NIHSS score at discharge improved among married men relative to any other combination of gender and marital status.

Conclusions:
Gender differences in the knowledge of stroke warning signs and gender disparities in ED assessment did not translate into faster DTT time. More work is needed to find ways to accelerate stroke care after ED arrival.
Knowledge on Sexually Transmitted Infections and Dedicated Health Care Centers Among Italian Adults: Insights From a Nationwide Cross-Sectional Study
Authors: Lo Moro Giuseppina , Scaioli Giacomo , Paladini Giovanni , Martinelli Alessia , Zanaga Giulia , Bert Fabrizio , Siliquini Roberta 
Published: July 2024

Background
Sexually transmitted infections (STI) are a global concern. In Italy, despite the presence of publicly funded STI diagnostic centers, limited attention has been given to the knowledge of these services among the adult population. This study primarily aimed to evaluate Italian adults' knowledge about STI and dedicated health care centers. Secondarily, it explored condom usage behaviors.

Methods
Conducted nationwide, this cross-sectional study used an online questionnaire. The primary outcomes included knowledge of dedicated STI centers and scores on the Sexually Transmitted Disease Knowledge Questionnaire (STD-KQ); secondary outcomes included inconsistent condom usage rates during various forms of intercourse.

Results
With a participant count of 1036, results indicated that only 36% were aware of dedicated STI centers. The median STD-KQ score was 11 (interquartile range, 6–15). Multivariable regression models unveiled factors significantly associated with knowledge. Lesbian, gay, bisexual, transsexual, and queer (LGBTQ) individuals, health care workers, and those with higher STD-KQ scores exhibited greater STI centers' awareness. Better STD-KQ scores correlated with higher education levels, substance use, past STI diagnosis, and health care employment. Around 80% of the sample reported inconsistent condom use during different forms of intercourse. Although enhanced knowledge correlated with increased condom use, certain groups exhibited discrepancies between knowledge of STI and actual condom use.

Conclusions
These findings emphasize the need for targeted awareness campaigns to enhance accessibility to STI centers, underscoring the necessity for multifaceted interventions beyond information dissemination to address suboptimal condom usage. In providing insights into STI knowledge and behaviors among Italian adults, this research informs interventions and policy adjustments to combat STI.
Subcutaneous and Visceral Adipose Tissue Reference Values From the Framingham Heart Study Thoracic and Abdominal CT
Authors: Marquardt J. Peter , Tonnesen P. Erik , Mercaldo Nathaniel D. , Graur Alexander , Allaire Brett , Bouxsein Mary L. , Samelson Elizabeth J. , Kiel Douglas P. , Fintelmann Florian J. 
Published: July 2024

Background
Computed tomography (CT) captures the quantity, density, and distribution of subcutaneous and visceral (SAT and VAT) adipose tissue compartments. These metrics may change with age and sex.

Objective
The study aims to provide age-, sex-, and vertebral level–specific reference values for SAT on chest CT and for SAT and VAT on abdomen CT.

Materials and Methods
This secondary analysis of an observational study describes SAT and VAT measurements in participants of the Framingham Heart Study without known cancer diagnosis who underwent at least 1 of 2 CT examinations between 2002 and 2011. We used a previously validated machine learning–assisted pipeline and rigorous quality assurance to segment SAT at the fifth, eighth, and tenth thoracic vertebra (T5, T8, T10) and SAT and VAT at the third lumbar vertebra (L3). For each metric, we measured cross-sectional area (cm2) and mean attenuation (Hounsfield units [HU]) and calculated index (area/height2) (cm2/m2) and gauge (attenuation × index) (HU × cm2/m2). We summarized body composition metrics by age and sex and modeled sex-, age-, and vertebral level–specific reference curves.

Results
We included 14,898 single-level measurements from up to 4 vertebral levels of 3797 scans of 3730 Framingham Heart Study participants (1889 [51%] male with a mean [standard deviation] age of 55.6 ± 10.6 years; range, 38–81 years). The mean VAT index increased with age from 65 (cm2/m2) in males and 29 (cm2/m2) in females in the <45-year-old age group to 99 (cm2/m2) in males and 60 (cm2/m2) in females in >75-year-old age group. The increase of SAT with age was less pronounced, resulting in the VAT/SAT ratio increasing with age. A free R package and online interactive visual web interface allow access to reference values.

Conclusions
This study establishes age-, sex-, and vertebral level–specific reference values for CT-assessed SAT at vertebral levels T5, T8, T10, and L3 and VAT at vertebral level L3.
Diagnosis of Extraosseous Lesions Overlapping the Bones on Bone Scintigraphy
Authors: Bi Bing , Zhu Jing , Li Na , Hu Hangzhi , Shao Fuqiang 
Published: July 2024

Abstract
Extraosseous MDP uptake was not uncommon on the bone scintigraphy. When the extraosseous activity is overlapping the bones, it might cause difficulty in interpreting the result when only static images were acquired. Here we report 2 cases that abnormal MDP activity overlapping the bones on planar images, which were confirmed as soft tissue lesions by SPECT/CT or CT imaging.
Surgeon Gender and Early Complications in Elective Surgery
Authors: Caturegli Ilaria , Pachano Bravo Ana Maria , Abdellah Israa , Fatima Moomtahina , Bafford Andrea Chao , Widyaningsih Suci Ardini , Kaabia Ons 
Published: July 2024

Objective:
To examine the association between surgeon gender and early postoperative complications, including 30-day death and readmission, in elective surgery.

Background:
Variations between male and female surgeon practice patterns may be a source of bias and gender inequality in the surgical field, perhaps impacting the quality of care. However, there are limited and conflicting studies regarding the association between surgeon gender and postoperative outcomes.

Methods:
MEDLINE and Embase were searched in October 2023 for observational studies, including patients who underwent elective surgery requiring general or regional anesthesia across multiple surgical specialties. Multiple independent blinded reviewers oversaw the data selection, extraction, and quality assessment according to the PRISMA, MOOSE, and Newcastle Ottawa Scale guidelines. Data were pooled as odds ratios, using a generic inverse-variance random-effects model.

Results:
Of 944 abstracts screened, 11 studies were included in this systematic review and meta-analysis. A total of 4,440,740 postoperative patients were assessed for a composite primary outcome of mortality, readmission, and other complications within 30 days of elective surgery, with a total of 325,712 (7.3%) surgeries performed by 7072 (10.9%) female surgeons. There was no association between surgeon gender and the composite of mortality, readmission, and/or complications (odds ratio=0.97, 95% CI 0.95–1.00; I
2=64.9%; P=0.001).

Conclusions:
These results support that surgeon gender is not associated with early postoperative outcomes, including mortality, readmission, or other complications in elective surgery. These findings encourage patients, health care providers, and stakeholders not to consider surgeon gender as a risk factor for postoperative complications.
Screening and early detection of post-extubation oropharyngeal dysphagia: a best practice implementation project
Authors: Garcia Paulo Carlos , Sichieri Karina , Martins de Matos Tatiane , Malissani Martins Daniel , Peres Emília Cristina , Vaz Bonini Milena , Cardoso Franco Ortiz Diley , Alves de Araújo Püschel Vilanice , Cruz Diná de Almeida Lopes Monteiro da 
Published: July 2024

ABSTRACTIntroduction:Patients undergoing intubation and mechanical ventilation in an intensive care unit risk developing post-extubation oropharyngeal dysphagia (PED). PED can lead to aspiration complications, aspiration pneumonia, and prolonged hospitalization, as well as increased repeat intubation and in-hospital morbidity and mortality.Objective:This evidence implementation project aimed to promote evidence-based screening and early detection of PED in an adult intensive care unit in a secondary public hospital in Brazil.Method:The project followed the seven-phase JBI Evidence Implementation Framework to promote changes at the study site. The JBI Practical Application of Clinical Evidence System (PACES) and Getting Research into Practice (GRiP) approach were also used. The project was developed considering the main barriers to best practices, which were identified through a baseline audit. An educational program was designed to address the identified barriers. Two follow-up audits were then conducted to assess the changes in compliance with the evidence-based practices.Results:The baseline audit showed deficits in current practices. The first follow-up audit indicated improved compliance with best practices, with five of the seven audit criteria showing 100% compliance. The second follow-up audit indicated that compliance remained at 100% for those five criteria and increased for the other two after an additional intervention to address poor results in nursing care documentation.Conclusion:The first follow-up audit showed good adherence to the educational program for the screening and detection of PED by nurses. The second follow-up audit, in line with the new strategies, showed improvement in nursing documentation.Spanish abstract:http://links.lww.com/IJEBH/A241