bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of Posthospital Brain Injury Rehabilitation Outcomes With Quasi-Experimental Controls
Authors: Parrott Devan , Salisbury David B. , Altman Irwin M. , Logan Daniel M. , McGrath Claire , Walters G. Joseph , Malec James F. 
Published: August 2024

Objective:
To further evaluate, using quasi-experimental methodologies, posthospital brain injury rehabilitation outcomes described in an accompanying report of a large observational study (n = 2120).

Setting:
Data from Intensive Rehabilitation (IR: Residential Neurobehavioral, Residential Neurorehabilitation, Home and Community Neurorehabilitation, Day Treatment, Outpatient Neurorehabilitation) and Supported Living (SL) programs serving individuals with acquired brain injury (ABI).

Participants:
Two hundred twenty-eight individuals with traumatic brain injury, stroke, or other ABI in propensity score analysis; 1344 in analysis by extent of recommended treatment completed (TC) rating.

Main Measures:
Sex, age, time since injury, Mayo-Portland Adaptability Inventory—4th edition (MPAI-4) Rasch-derived T-scores, and TC rating.

Design:
Analyses of covariance (1) of discharge MPAI-4 Total, index, and subscale T-scores on propensity score-matched samples of IR and SL participants controlling for admission scores and (2) of MPAI-4 T-scores by TC rating and diagnostic category.

Results:
Propensity score-matched groups showed superior outcomes for IR participants compared to SL participants on MPAI-4 Total T-score (F = 77.21, P < .001; partial η2 = 0.257) and all MPAI-4 index and subscale T-scores controlling for sex, age, and baseline scores. Participants with traumatic brain injury and stroke who completed the recommended course of rehabilitation had superior outcomes on all MPAI-4 T-scores compared to those who completed less than or much less than the recommended treatment. No additional benefit was apparent for those who completed more than the recommended course. The association between TC rating and outcome was not significant for the other ABI group.

Conclusions:
These analyses using quasi-experimental controls provide more scientifically rigorous evidence of the benefit of IR provided through posthospital brain injury rehabilitation programs after acute inpatient care, consistent with the results of numerous observational studies. However, improved internal validity limits external validity and generalization. The absence of a significant association between TC rating and outcomes for the other ABI group most likely reflects the difficulty prescribing rehabilitation for this highly heterogeneous group.
Aqueous-Deficient Dry Eye Increases Lipid Layer Thickness Measured by Dynamic Tear Interferometry
Authors: Ahn Hyunmin , Kim Sang Yeop , Jun Ikhyun , Kim Tae-im , Seo Kyoung Yul 
Published: August 2024

Purpose:
To investigate the impact of aqueous deficiency on lipid layer thickness (LLT) measurement in dry eye disease before and after treatment of aqueous-deficient dry eye (ADDE) using dynamic tear interferometry.

Methods:
This prospective comparative study included 230 eyes from 230 patients with ADDE. The treatment group with punctal plug insertion was compared with the control group. The average LLT (LLTave) was measured with a LipiView II tear interferometer at baseline and after 1 month. Correlation analyses were performed with the indices of the dynamics of the tear film lipid layer (TFLL).

Results:
Baseline LLTave values were 116.1 ± 26.7 and 112.3 ± 27.6 nm in the treatment group (n = 121) and the control group (n = 109), respectively. At 1 month, LLTave significantly decreased in the treatment group (difference −41.8 [95% confidence interval (CI) −47.2 to −36.3], P = 0.003). The values of tear meniscus height (TMH) at baseline and 1-month follow-up were negatively correlated with LLTave (both P < 0.001). Spreading time of TFLL to equilibrium and the deviation of TFLL were positively correlated with LLTave (all P < 0.001) and negatively correlated with TMH (P < 0.001 and 0.009). In multivariate analysis (adjusted R2 = 0.411, P < 0.001), LLTave was associated with TMH (B = −1.068; P < 0.001), adjusting for age, sex, and meibomian gland expressibility.

Conclusions:
In ADDE, the TFLL was measured to be thicker than the normal range of 60 to 99 nm and became thinner with treatment. LLT was affected by not only meibum secretion but also aqueous status due to changes in the dynamics of TFLL.
Chronic pain is specifically associated with updating working memory: a longitudinal twin study
Authors: Rader Lydia , Wager Tor D. , Friedman Naomi P. 
Published: August 2024

Abstract
Worse executive function (EF) is associated with chronic pain and could mechanistically contribute to pain chronification. It is unclear whether there is overall impairment in EFs or whether there are impairments in specific cognitive domains. Furthermore, the possible genetic risk underlying these associations has not been tested. Participants were from the Colorado Longitudinal Twin study; 786 same-sex twins completed a battery of EF tasks at ages 23 and/or 28 and 634 of these twins self-reported chronic pain at mean age = 28.1; prevalence = 27.76% using the Brief Pain History Questionnaire. The EF tasks were used to define a Common EF factor and 2 factors specific to updating working memory and shifting mental set. We estimated the phenotypic and genetic associations of stable EF variance across ages 23 and 28, as well as EF variance unique to age 28, with pain. With respect to stable EF variance, pain phenotypically correlated with the Updating-specific factor (r = −0.21, P = 0.008) but did not significantly correlate with the Common EF factor (r = −0.06, P = 0.350) nor with the Shifting-specific factor (r = −0.03, P = 0.709). There were no significant phenotypic correlations between pain and EF variance unique to age 28. A twin model indicated that pain and Updating-specific variance share genetic risk (rA = −0.46, P = 0.005) but not environmental risk (rE = 0.05, P = 0.844). Updating working memory shares a phenotypic and genetic relationship with pain in young adults. Impairments in gating or monitoring pain signals may play a mechanistic role in pain development.
Small molecule targeting NaV1.7 via inhibition of CRMP2-Ubc9 interaction reduces pain-related outcomes in a rodent osteoarthritic model
Authors: Hestehave Sara , Allen Heather N. , Gomez Kimberly , Duran Paz , Calderon-Rivera Aida , Loya-López Santiago , Rodríguez-Palma Erick J. , Khanna Rajesh 
Published: August 2024

Abstract
Osteoarthritis (OA) is a highly prevalent and disabling joint disease, characterized by pathological progressive joint deformation and clinical symptoms of pain. Disease-modifying treatments remain unavailable, and pain-mitigation is often suboptimal, but recent studies suggest beneficial effects by inhibition of the voltage-gated sodium channel NaV1.7. We previously identified compound 194 as an indirect inhibitor of NaV1.7 by preventing SUMOylation of the NaV1.7-trafficking protein, collapsin response mediator protein 2. Compound 194 reduces the functional activity of NaV1.7 channels and produces effective analgesia in a variety of acute and neuropathic pain models. However, its effectiveness has not yet been evaluated in models of OA. Here, we explore the effects of 194 on pain-related outcomes in the OA-like monoiodoacetate model using behavioral assessment, biochemistry, novel in vivo fiber photometry, and patch clamp electrophysiology. We found that the monoiodoacetate model induced (1) increased pain-like behaviors and calcium responses of glutamatergic neurons in the parabrachial nucleus after evoked cold and mechanical stimuli, (2) conditioned place aversion to mechanical stimulation, (3) functional weight bearing asymmetry, (4) increased sodium currents in dorsal root ganglia neurons, and (5) increased calcitonin gene–related peptide-release in the spinal cord. Crucially, administration of 194 improved all these pain-related outcomes. Collectively, these findings support indirect inhibition of NaV1.7 as an effective treatment of OA-related pain through the inhibition of collapsin response mediator protein 2-SUMOylation via compound 194.
Disclosure of HIV Status to Sexual Partners Among People With HIV in Singida Regional Referral Hospital of Tanzania: A Cross-Sectional Study
Authors: Alexander Alex Gabagambi , Relf Michael , Bosworth Hayden B. , Mmbaga Blandina T. , Muiruri Charles 
Published: August 2024

Abstract
HIV status nondisclosure to sexual partners remains a major challenge in Tanzania's health system. This hospital-based, descriptive, cross-sectional study design recruited 380 people living with HIV (PLWH) to assess voluntary HIV status disclosure to sexual partners, the associated factors, and outcomes among PLWH in Tanzania. Approximately 78% (n = 297) of the study participants reported disclosing their HIV status to their sexual partners. Adjusted multivariable logistic regression analysis revealed that HIV status disclosure to sexual partners was significantly associated with living with a sexual partner (adjusted odds ratio [AOR] = 3.91, 95% CI [1.43–10.72]), knowledge of HIV disclosure (AOR = 11.71, 95% CI [2.88–47.63]), known serostatus of the sexual partner (AOR = 40.20, 95% CI [15.31–105.56]), and HIV disclosure–related stigma (AOR = 0.92, 95% CI [0.85–0.99]). Addressing these significant factors will maximize the magnitude of voluntary disclosure to sexual partners.
Telemetry discontinuation education for Nurse Practitioners decreases hospital costs—A quality-improvement project
Authors: Rodriguez Christopher , Bianco Nicole , Bucco Theresa , Collum Karen , O'Neill Sharon Patricia , David Daniel 
Published: August 2024

ABSTRACT

Background:
Despite updated American Heart Association guidelines, interventions designed to reduce telemetry misuse are uncommon.

Local problem:
There was a systemic failure within the institution to adopt the most recent guidelines, resulting in poor use of resources and downstream costs.

Methods:
Case–control. Pre–post educational intervention, quality-improvement (QI) project in an urban academic cancer institution. Baseline telemetry usage was observed in 2,984 nonintensive inpatients in 21 hospital services over 6 months. Outcome measures were weekly telemetry usage in total minutes and cost savings based on a cost-predicted algorithm. Performance was compared between the intervention group and a control group for 3 months. Measures were compared using QI control charts and inferential statistics.

Intervention:
Three high-using telemetry services primarily staffed by certified nurse practitioners (CNPs) were provided with a telemetry education intervention. The intervention consisted of four ten-minute educational sessions over 2 weeks delivered to the highest three telemetry using services.

Results:
Forty-five providers received the educational intervention (78% CNPs and physician assistants [PAs] and 22% medical doctors [MDs]) and 272 did not (57% CNPs and PAs and 43% MDs). Only the educational intervention group showed measurable decreases shown by shifts in QI control charts. Decreased usage in the intervention group produced greater cost savings per patient when compared with the control group ($71.98 vs. $60.68), resulting in an estimated total annual cost savings of $94,740.

Conclusions:
Educational interventions for inpatient CNPs that reinforce national policies for telemetry discontinuation improve practice efficiency and potentially decrease health care costs.
Behind the Curtain
Authors: Sun Ruichen , Henderson Morgan , Goetschius Leigh , Han Fei , Stockwell Ian 
Published: August 2024

Introduction:
Predictive models have proliferated in the health system in recent years and have been used to predict both health services utilization and medical outcomes. Less is known, however, on how these models function and how they might adapt to different contexts. The purpose of the current study is to shed light on the inner workings of a large-scale predictive model deployed in 2 distinct populations, with a particular emphasis on adaptability issues.

Methods:
We compared the performance and functioning of a predictive model of avoidable hospitalization in 2 very different populations: Medicaid and Medicare enrollees in Maryland. Specifically, we assessed characteristics of the risk scores from March 2022 for the 2 populations, the predictive ability of the scores, and the driving risk factors behind the scores. In addition, we created and assessed the performance of an “unadapted” model by applying coefficients from the Medicare model to the Medicaid population.

Results:
The model adapted to, and performed well in, both populations, despite demographic differences in these 2 groups. However, the most salient risk factors and their relative weightings differed, sometimes dramatically, across the 2 populations. The unadapted Medicaid model displayed poor performance relative to the adapted model.

Conclusions:
Our findings speak to the need to “peek behind the curtain” of predictive models that may be applied to different populations, and we caution that risk prediction is not “one size fits all”: for optimal performance, models should be adapted to, and trained on, the target population.
Trajectories of Depressive Symptoms Among Patients Undergoing Chemotherapy for Breast, Gastrointestinal, Gynecological, or Lung Cancer
Authors: Suskin Johanna A. , Paul Steven M. , Stuckey Ashley R. , Conley Yvette P. , Levine Jon D. , Hammer Marilyn J. , Miaskowski Christine , Dunn Laura B. 
Published: August 2024

Background
Individuals who undergo chemotherapy for cancer are at elevated risk of developing depressive symptoms, yet substantial interindividual variation exists in trajectories of these symptoms.

Objective
To examine interindividual variations in trajectories of depressive symptoms during 2 cycles of chemotherapy and to evaluate associations between demographic and clinical characteristics, symptom severity scores, psychological adjustment characteristics (eg, stress and coping), and initial levels and trajectories of depressive symptoms.

Methods
Patients (n = 1323) diagnosed with breast, gynecologic, lung, or gastrointestinal cancer completed the Center for Epidemiological Studies—Depression Scale 6 times, over 2 cycles of chemotherapy. At enrollment, patients provided demographic information and completed a broad range of symptom, stress, and coping measures. Hierarchical linear modeling was used to identify characteristics associated with initial levels and trajectories of depressive symptoms.

Results
Interindividual differences in initial levels of depressive symptoms were associated with marital status, functional status, level of comorbidity, chemotherapy toxicity, sleep disturbance, morning fatigue, cognitive function, global and cancer-related stress, and coping characteristics (ie, sense of coherence, venting, behavioral disengagement, and self-blame). Interindividual differences in depression trajectories were associated with education, cancer type, chemotherapy toxicity, sleep disturbance, evening energy, evening fatigue, cognitive function, global and cancer-related stress, and self-blame.

Conclusions
We present new findings concerning the trajectories and predictors of depressive symptoms during chemotherapy.

Implications for Practice
Modifiable risk factors (eg, stress and coping) are important targets for intervening to address depressive symptoms in oncology patients.
Navigating Improper Care Settings: Nurses’ Experiences Assisting Oncological Patients at the End of Life in Surgical Departments
Authors: Bearzot Sara , Ortez Giulia , Cadorin Lucia , Ghirotto Luca , Bressan Valentina 
Published: August 2024

Background
Despite the growing preference for end-of-life care at home, numerous oncological patients continue to spend their final moments in surgical wards. This incongruity in settings may contribute to “dysthanasia,” unnecessarily prolonging futile treatments and resulting in undue suffering. As frontline caregivers, nurses frequently bear the brunt of these challenging situations for patients and their families.

Objective
To investigate the experiences of nurses providing care to terminally ill oncological patients inappropriately admitted to surgical departments.

Methods
We adopted a phenomenological descriptive study. Nurses purposefully selected from 7 distinct surgical units at a University Hospital in Northeast Italy were recruited. Data collection took place through open-ended semistructured interviews. The interview content was analyzed using Colaizzi’s framework.

Results
The study with 26 participants revealed emotional challenges, especially for less-experienced nurses. Diverse perspectives among nurses emphasized the need for better palliative care knowledge. Despite the commitment to quality care, collaboration challenges and discordant goals with physicians impacted comprehensive care delivery.

Conclusions
Dysthanasia relates to participants’ challenges in caring for oncological patients in inappropriate settings, hindering transparent communication and exacerbating discordance with doctors.

Implications for Practice
Communication and collaboration among healthcare professionals, particularly nurses, and surgeons are crucial. Ongoing education in end-of-life care, coupled with advance care planning, empowers patients, aligns treatment choices, and prevents dysthanasia across diverse healthcare settings.
Experiences of Exercise-Related Worry Among Chinese Childhood Cancer Survivors and Their Carers
Authors: Gu Yujing , Xu Xiaomin , Fan Juhong , Wu Feifei , Fan Shujun , Xie Jun 
Published: August 2024

Background
The low levels of physical activity in childhood cancer survivors have increasingly garnered attention from nursing scholars. Exercise-related worry is a prominent barrier, yet the understanding of such experiences among childhood cancer survivors and their primary caregivers remains scarce.

Objective
The aim of this study was to further understand the factors contributing to exercise-related worry from the perspective of childhood cancer survivors and their primary caregivers.

Methods
In this qualitative study, we conducted face-to-face semistructured interviews with childhood cancer survivors (n = 20) and carers (n = 20) in 2 hospitals in China. The interviews were analyzed according to thematic analysis.

Results
Two main themes and 8 subthemes emerged: (1) internal factors: changes in the perception of physical activity (threat perception from the disease, active avoidance of stressful events, lack of safety due to past experiences), and (2) external factors: weak support system (limited peer support, family strength, feeling abandoned by the tumor team, reintegration into school, external environmental constraints). In summary, exercise-related worry is from internal factors and can be influenced by external factors.

Conclusion
There are various factors contributing to the concerns of exercise in childhood cancer survivors, which may be a key factor for their significantly lower levels of physical activity compared to guideline recommendations.

Implications for Practice
The findings of this study call for healthcare professionals to provide additional assistance for childhood cancer survivors with exercise-related worry and establish personalized mechanisms for supporting physical activity in pediatric cancer survivors within the Chinese healthcare system.
99mTc-PYP and 68Ga-FAPI PET/CT Images of Hereditary Transthyretin Amyloidosis With Cardiac Involvement
Authors: Kibar Ali , Sahin Kubra , Ikitimur Baris , Sager Sait , Sayman Haluk Burcak 
Published: August 2024

Abstract
Amyloidosis is a protein misfolding disorder characterized by the extracellular deposition of insoluble amyloid fibrils, derived from abnormally folded proteins. These fibrils disrupt tissue structure and function, leading to organ dysfunction. The condition encompasses various subtypes, each associated with distinct precursor proteins and clinical manifestations. 99mTc-PYP scintigraphy is used widely and holds significant importance for diagnosis. 68Ga-FAPI is also a promising radiotracer for various diseases. To our knowledge, this is the first case of a patient with hereditary transthyretin amyloidosis with cardiac involvement, which FAPI PET showed diffuse increased myocardial uptake.
The Application Value of Using Semiquantitative and Quantitative Parameters in Multimodal Ultrasound to Distinguish Between Benign and Malignant BI-RADS 4 Lesions
Authors: Dai Xi , Zhou Xiao-Yu , Chen Piao-Fei , Gong Zhe-Li , Wang Zhi-Ping , Wang Di 
Published: August 2024

Abstract
This study aims to explore the value of real-time strain elastography (RTE) and contrast-enhanced ultrasonography (CEUS) in the diagnosis of breast BI-RADS 4 lesions. It collected 85 cases (totaling 85 lesions) diagnosed with breast BI-RADS 4 through routine ultrasound from October 2020 to December 2022 in Huangshan City People's Hospital. All lesions underwent RTE and CEUS examination before surgery, and the ImageJ software was used to measure the periphery of lesion images in the enhancement peak mode and grayscale mode to calculate the contrast-enhanced ultrasound area ratio. The diagnostic capabilities of single-modal and multimodal ultrasound examination for the malignancy of breast BI-RADS 4 lesions were compared using the receiver operating characteristic curve; the Spearman correlation analysis was adopted to evaluate the correlation between multimodal ultrasound and CEUS area ratio. As a result, among the 85 lesions, 51 were benign, and 34 were malignant. The areas under the curve (AUCs) of routine ultrasound (US), US + RTE, US + CEUS, and US + RTE + CEUS were 0.816, 0.928, 0.953, and 0.967, respectively, with the combined method showing a higher AUC than the single application. The AUC of the CEUS area ratio diagnosing breast lesions was 0.888. There was a strong positive correlation (r = 0.819, P < 0.001) between the diagnostic performance of US + RTE + CEUS and the CEUS area ratio. In conclusion, based on routine ultrasound, the combination of RTE and CEUS can further improve the differential diagnosis of benign and malignant lesions in breast BI-RADS 4.
Liver Retransplantation Using Living Donor Grafts: A Feasible Approach for Chronic Allograft Failure
Authors: Tanaka Kosuke , Ito Takashi , Uchida Yoichiro , Masano Yuki , Okumura Shinya , Hirata Masaaki , Kageyama Shoichi , Anazawa Takayuki , Koyama Yukinori , Ogiso Satoshi , Ishii Takamichi , Nagai Kazuyuki , Hatano Etsuro 
Published: August 2024

Background.
The indication of living donor liver retransplantation (re-LDLT) for retransplant candidates with chronic allograft failure (CAF) is increasing because of the high mortality rate of patients on the waiting list. However, evidence supporting re-LDLT for CAF remains scarce because of technical difficulties. We aimed to examine the feasibility based on our significant case experience.

Methods.
A total of 95 retransplant cases (adult: 53, pediatric: 42) between 2000 and 2020 were retrospectively reviewed. Graft survival after re-LDLT and deceased donor liver retransplantation (re-DDLT) was compared among recipients with CAF and acute allograft failure (AAF).

Results.
Re-LDLTs for CAF were performed in 58 (61.1%) cases, re-DDLTs for CAF in 16 (16.8%) cases, re-LDLTs for AAF in 13 (13.7%) cases, and re-DDLTs for AAF in 8 (8.4%) cases. Re-DDLTs have become increasingly prevalent over time. Retransplantation for AAF results in lower graft survival than that for CAF in both adult and pediatric cases. All adult recipients who underwent re-LDLT for AAF died within 1 y after retransplantation. The 5-y graft survival between re-LDLT and re-DDLT for CAF was not significantly different (73.8% versus 75.0%, P = 0.84). Operation time and blood loss were not significantly different.

Conclusions.
The survival rate of re-LDLT for recipients with CAF is permissible. Re-LDLT may be another treatment option for recipients with CAF.