bluuebunny/crossref_metadata_2025_split huggingface dataset:
Australian adaptation and external validation of Commissioning for Quality in Rheumatoid Arthritis-RA-Patient Reported Experience Measure (CQRA-RA-PREM)
Authors: Bryant Madeleine J , Black Rachel J , Lester Susan , Chand Vibhasha , Barrett Claire , Buchbinder Rachelle , Lassere Marissa , March Lyn , Hill Catherine L 
Published: August 2024

Abstract

Objectives
To evaluate the reliability and validity of an adapted Commissioning for Quality in Rheumatoid Arthritis-RA-Patient-Reported Experience Measure (CQRA-RA-PREM) for assessing care experience in an Australian rheumatology outpatient cohort.

Methods
Individual patient interviews were performed to check the language and completion time of the CQRA-RA-PREM before modification. Australian Rheumatology Association Database (ARAD) participants completed the CQRA-PREM-Australian version (CQRA-PREM-AU) (22 items, 5 domains), disease activity measure (RAPID-3, BASDAI) and Assessment of Quality of Life (AQOL-6D) index. Exploratory factor analysis (EFA) assessed item correlation. Cronbach’s α assessed internal consistency.

Results
Individual patient interviews (n = 8, 62% male, mean age 50 years, mean disease duration 4.5 years) informed CQRA-RA-PREM modification. The ARAD survey response rate was 707/1124 (63%); 459 (65%) RA, 134 (19%) PsA, 114 (16%) AS; 67% female, mean age 62 years, mean disease duration 22 years. The median instrument completion time was 299 s (interquartile range 284–414). Scoring of responses allowed an averaged overall score. EFA extracted five factors: all items loading similarly onto factor 1, indicating validity of the overall score. The CQRA-PREM-AU score correlated with the AQOL-6D score (ρ = 0.23, P &lt; 0.01); partial correlation with disease activity was not significant (ρ = 0.03, P = 0.45), indicating divergent validity. Reliability was comparable across disease subgroups (Cronbach’s α &gt;0.94). The mean overall score did not differ by disease subgroup [4.1 (s.d. 0.6, P = 0.73) and there was no floor/ceiling effect.

Conclusion
CQRA-PREM-AU is a valid and reliable instrument to measure self-reported care experience in Australian rheumatology patients and may be interpreted as an average overall numerical score.
Opioid alternatives in spine surgeries
Authors: Rajan Shobana , Rishi Gaiha , Ibrahim Marco 
Published: August 2024

Purpose of review
The escalating opioid crisis has intensified the need to explore alternative pain management strategies for patients undergoing spine surgery. This review is timely and relevant as it synthesizes recent research on opioid alternatives for perioperative management, assessing their efficacy, side effects, and postoperative outcomes.

Recent findings
A systematic search was conducted to capture articles from the past 18 months that examined opioid-sparing strategies. Findings indicate that multimodal analgesia, incorporating nonsteroidal anti-inflammatory drugs (NSAIDs), acetaminophen, lidocaine, gabapentinoids, N-methyl-D-aspartate (NMDA) antagonists, dexmedetomidine, and emerging regional block techniques like the erector spinae block and TLIF (thoraco lumbar interfascial block), can significantly reduce opioid consumption without compromising pain relief. Additionally, these approaches reduce opioid-related side effects such as postoperative nausea, vomiting, and prolonged hospital stays.

Summary
The use of multimodal analgesia aligns with current pain management guidelines and addresses public health concerns related to opioid misuse. While effective, these alternatives are not without side effects, and the ultimate outcome depends on balancing benefits and risks. Future research should focus on the long-term outcomes of opioid alternatives, their effectiveness across diverse populations, and further validation and optimization of these strategies.
Rising Stillbirth Rates Related to Congenital Syphilis in the United States From 2016 to 2022
Authors: Machefsky Aliza , Hufstetler Kaitlin , Bachmann Laura , Barbee Lindley , Miele Kathryn , O'Callaghan Kevin 
Published: August 2024

OBJECTIVE:
To identify trends in stillbirth rates attributed to congenital syphilis in the United States by describing congenital syphilis–related stillbirths and comparing characteristics of pregnant people who had congenital syphilis–related stillbirths with those of people who had preterm and full-term liveborn neonates with congenital syphilis.

METHODS:
Cases of congenital syphilis reported to the Centers for Disease Control and Prevention during 2016–2022 were analyzed and categorized as stillbirth, preterm live birth (before 37 weeks of gestation), or term live birth (37 weeks or later). Cases with unknown vital status or gestational age were excluded. Frequencies were calculated by pregnancy outcome, including pregnant person demographics; receipt of prenatal care; syphilis stage and titer; and timing of prenatal care, testing, and treatment.

RESULTS:
Overall, 13,393 congenital syphilis cases with vital status and gestational age were reported; of these, 853 (6.4%) were stillbirths. The number of congenital syphilis–related stillbirths increased each year (from 44 to 231); the proportion of congenital syphilis cases resulting in stillbirth ranged from 5.2% to 7.5%. Median gestational age at delivery for stillborn fetuses was 30 weeks (interquartile range 26–33 weeks). People with congenital syphilis–related stillbirths were more likely to have titers at or above 1:32 (78.9% vs 45.5%; P<.001) and to have received no prenatal care (58.4% vs 33.1%; P<.001) than people with liveborn neonates with congenital syphilis. The risk of stillbirth was twice as high in persons with secondary syphilis compared with those with primary syphilis (11.5% vs 5.7%, risk ratio 2.00; 95% CI, 1.27–3.13). Across all congenital syphilis cases, 34.2% of people did not have a syphilis test at their first prenatal visit.

CONCLUSION:
Stillbirths occurred in more than 1 in 20 pregnancies complicated by congenital syphilis. Risk factors for stillbirth included high titers, secondary stage, and lack of prenatal care. If the prevalence of congenital syphilis continues to rise, there will be a corresponding increase in the overall stillbirth rate nationally.
Omega Fatty Acid-Based Therapy for Healing of Recalcitrant Wounds in Patients with Complex Comorbidities
Authors: Reinkraut Jacob , Khokhar Adeen , Abdou Sarah , Wali Sonya , Bell Desmond 
Published: August 2024

ABSTRACT
The human body possesses the unique ability to repair itself after injury through complex, sequential phases. Current development of advanced wound care therapies generally focuses on addressing a single aspect of this biological process that can result in delayed or ineffective wound healing. When patients present with further systemic and local confounding pathologies, it can result in painful, chronic wounds that are especially challenging to treat.
In this case report, the authors demonstrate how treatment with a novel multimodal wound matrix expedited healing and decreased pain in two patients who had each been unresponsive to treatment with advanced modalities for more than 7 months. The first patient had factor V Leiden, and the second patient had sickle cell disease. Use of a once-weekly treatment protocol with the multimodal wound matrix, combined with sharp debridement when deemed clinically necessary, resulted in elimination of pain and expedited wound healing to closure. The wound matrix’s omega fatty acid-based formulation is designed to target multiple factors common among hard-to-heal wounds that when not addressed can adversely inhibit the wound-healing cascade.
Role of sphingolipid metabolism signaling in a novel mouse model of renal osteodystrophy based on transcriptomic approach
Authors: Wang Yujia , Di Yan , Li Yongqi , Lu Jing , Ji Bofan , Zhang Yuxia , Chen Zhiqing , Chen Sijie , Liu Bicheng , Tang Rining 
Published: August 2024

Abstract

Background:
Renal osteodystrophy (ROD) is a skeletal pathology associated with chronic kidney disease-mineral and bone disorder (CKD-MBD) that is characterized by aberrant bone mineralization and remodeling. ROD increases the risk of fracture and mortality in CKD patients. The underlying mechanisms of ROD remain elusive, partially due to the absence of an appropriate animal model. To address this gap, we established a stable mouse model of ROD using an optimized adenine-enriched diet and conducted exploratory analyses through ribonucleic acid sequencing (RNA-seq).

Methods:
Eight-week-old male C57BL/6J mice were randomly allocated into three groups: control group (n = 5), adenine and high-phosphate (HP) diet group (n = 20), and the optimized adenine-containing diet group (n = 20) for 12 weeks. We assessed the skeletal characteristics of model mice through blood biochemistry, microcomputed tomography (micro-CT), and bone histomorphometry. RNA-seq was utilized to profile gene expression changes of ROD. We elucidated the functions of differentially expressed genes (DEGs) using gene ontology (GO) analysis, Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis, and gene set enrichment analysis (GSEA). DEGs were validated via quantitative real-time polymerase chain reaction (qRT-PCR).

Results:
By the fifth week, adenine followed by an HP diet induced rapid weight loss and high mortality rates in the mouse group, precluding further model development. Mice with optimized adenine diet-induced ROD displayed significant abnormalities in serum creatinine and blood urea nitrogen levels, accompanied by pronounced hyperparathyroidism and hyperphosphatemia. The femur bone mineral density (BMD) of the model mice was lower than that of control mice, with substantial bone loss and cortical porosity. ROD mice exhibited substantial bone turnover with an increase in osteoblast and osteoclast markers. Transcriptomic profiling revealed 1907 genes with upregulated expression and 723 genes with downregulated expression in the femurs of ROD mice relative to those of control mice. Pathway analyses indicated significant enrichment of upregulated genes in the sphingolipid metabolism pathway. The significant upregulation of alkaline ceramidase 1 (Acer1), alkaline ceramidase 2 (Acer2), prosaposin-like 1 (Psapl1), adenosine A1 receptor (Adora1), and sphingosine-1-phosphate receptor 5 (S1pr5) were successfully validated in mouse femurs by qRT-PCR.

Conclusions:
Optimized adenine diet mouse model may be a valuable proxy for studying ROD. RNA-seq analysis revealed that the sphingolipid metabolism pathway is likely a key player in ROD pathogenesis, thereby providing new avenues for therapeutic intervention.
Contemporary Management of the Upper Limb in Apert Syndrome: A Review
Authors: Khabyeh-Hasbani Nathan , Lu Yi-Hseuh , Baumgartner William , Mendenhall Shaun D. , Koehler Steven M. 
Published: August 2024

Background:
Apert syndrome is a relatively rare genetic disorder with a constellation of distinct craniofacial deformities and bilateral syndactyly of the hands and feet. Although the literature contains ample evidence for the need to treat cranial, midfacial, and hand abnormalities, there are severe shortcomings in the literature when attempting to describe the pathology and management of the entire upper limb in patients with Apert syndrome.

Methods:
A thorough literature search was performed using PubMed, Scopus, Web of Science, and Google Scholar, on the management of the upper extremity in Apert syndrome, including the shoulder, elbow, and hand.

Results:
Our findings of the literature discuss the clinical presentation and management trends of the upper extremity in patients with Apert syndrome. Through multicenter collaboration, discussion among experts in the field, and evidence gathered from the literature, we propose treatment algorithms to treat deformities of the hand, shoulder, and elbow in patients with Apert syndrome.

Conclusions:
This review identifies that even if hand pathologies have been correctly treated, shoulder and elbow abnormalities in patients with Apert syndrome are largely ignored. To optimize outcomes, added cognizance of additional upper limb congenital differences and their management should be highly advocated in this patient population.
Artificial intelligence applications in ophthalmic surgery
Authors: Leiderman Yannek I. , Gerber Matthew J. , Hubschman Jean-Pierre , Yi Darvin 
Published: August 2024

Purpose of review
Technologies in healthcare incorporating artificial intelligence tools are experiencing rapid growth in static-image-based applications such as diagnostic imaging. Given the proliferation of artificial intelligence (AI)-technologies created for video-based imaging, ophthalmic microsurgery is likely to experience significant benefits from the application of emerging technologies to multiple facets of the care of the surgical patient.

Recent findings
Proof-of-concept research and early phase clinical trials are in progress for AI-based surgical technologies that aim to provide preoperative planning and decision support, intraoperative image enhancement, surgical guidance, surgical decision-making support, tactical assistive technologies, enhanced surgical training and assessment of trainee progress, and semi-autonomous tool control or autonomous elements of surgical procedures.

Summary
The proliferation of AI-based technologies in static imaging in clinical ophthalmology, continued refinement of AI tools designed for video-based applications, and development of AI-based digital tools in allied surgical fields suggest that ophthalmic surgery is poised for the integration of AI into our microsurgical paradigm.
Implementing Advance Care Planning and Care Coordination in the Care for People With Parkinson Disease: A Feasibility Study
Authors: Lennaerts-Kats Herma , Daeter Laura , Forkink Anoek , Hukema Renate K. , Bloem Bastiaan R. , Vissers Kris C.P. , Meinders Marjan J. , Groot Marieke M. 
Published: August 2024

ABSTRACT

BACKGROUND: For people with a moderate stage of Parkinson disease (PD), dedicated care coordination combined with advance care planning (ACP) is highly needed. However, evidence is lacking. The objective of this study was to assess the feasibility and acceptability of the study processes to inform a larger randomized controlled trial, aiming the effectiveness of a combined intervention on ACP and care coordination for people with PD. METHODS: Two nurse practitioners with expertise in PD followed training on a combined intervention on ACP and care coordination. Patients were invited to participate in several sessions for a period of 12 months. Feasibility of the study was surveyed covering sample recruitment, attrition rate, eligibility, intervention delivery, number of ACP sessions, type of intervention administration, and satisfaction with the intervention. RESULTS: In total, 27 patients were invited to participate, and 20 (74%) enrolled into the study, together with 11 family caregivers; 7 patients (35%) dropped out. Most patients were men (n = 20), with a mean age of 73.4 (SD 8.2) years. In total, 71 ACP sessions were held (3.6 sessions per patient on average), of which 41% of the sessions were conducted face-to-face at home, 44% at the hospital, 11% over telephone, and 4% via a videoconference call. Patients perceived the intervention not only as supportive but also as confronting. CONCLUSION: The ACP aspect of the intervention was useful and feasible to stimulate patients to think about their current care situation as well as about future care. Care coordination was less profoundly provided and discussed.
Inclusive Excellence: A Roadmap to Cultivating Belonging for Faculty of Color in Physical Therapy Education
Authors: Brown Dawn S. , Magee Julian , Woods LaDarius , Portee Charlene 
Published: August 2024

Abstract
Cultivating a sense of belonging among faculty of color decreases feelings of isolation and marginalization, translating to increased job satisfaction and retention. This roadmap for cultivating a sense of belonging for faculty of color highlights the following critical strategies: (1) adopting inclusive leadership practices, (2) understanding professional and personal identities, (3) mitigating cultural taxation, (4) minimizing microaggressions and racism, (5) providing mentorship, and (6) prioritizing acculturation over assimilation. By following this roadmap, physical therapy programs can work toward cultivating a greater sense of belonging for faculty of color, enabling them to thrive in their roles and feel valued and respected as integral members of the academic community.
Efficacy and Safety of Cold Versus Hot Snare Endoscopic Mucosal Resection in Colorectal Polyp Removal
Authors: Niu Chengu , Zhang Jing , Joshi Utsav , Elkhapery Ahmed , Boppana Hemanth Krishna , Okolo Patrick I. 
Published: August 2024

Background:
Cold snare endoscopic mucosal resection (C-EMR) is hypothesized to offer a safety advantage over hot snare endoscopic mucosal resection (H-EMR). The primary objective of this meta-analysis is to evaluate the effectiveness and safety of C-EMR versus H-EMR for the management of colorectal lesions.

Methods:
A meta-analysis was performed to determine pooled odds ratios (ORs) for comparing outcomes between the C-EMR and H-EMR groups.

Results:
The pooled OR for complete resection rates were estimated at 0.70 (95% CI: 0.36-1.36, P =0.29) and en bloc rates were 0.24 (95% CI: 0.05-1.08, P=0.06) between C-EMR group and H-EMR group. The overall complete resection rate for C-EMR was 84%, and the en bloc resection rate was 57. Notably, C-EMR was associated with a significantly lower incidence of delayed bleeding. The recurrence rate of polyps was very low (2%) when treating sessile serrated polyp (SSP) lesions, but higher (23%) for non-SSP lesions. Subgroup analysis revealed minimal recurrence of polyps after using C-EMR for lesions between 10 to 20 mm and ≥20 mm.

Conclusions:
This meta-analysis suggests that C-EMR could be a safer and equally effective alternative to H-EMR for resecting colorectal lesions. We recommend C-EMR as the preferred method for excising large colorectal lesions.
Energy balance and obesity: the emerging role of glucagon like peptide-1 receptor agonists
Authors: Beauregard Noémie , McInnis Kurt , Goldfield Gary S. , Doucet Éric 
Published: August 2024

Purpose of review
With obesity affecting over one billion people globally, understanding and managing this complex condition is more crucial than ever. This review explores the emerging role of GLP-1 receptor agonists (GLP-1RA) in weight management, focusing on their impact on energy balance. It highlights the necessity of this investigation due to the limited knowledge on both the short-term and long-term implications of GLP-1RA on energy expenditure (EE) and energy intake (EI).

Recent findings
GLP-1RA, such as liraglutide and semaglutide, have shown significant efficacy in promoting weight loss by reducing appetite, cravings and consequently, EI. Newer medications such as tirzepatide have demonstrated even greater weight loss success. Emerging evidence also suggests potential effects on EE, which could explain the greater weight loss success achieved with GLP-1 RA rather than typical lifestyle changes. However, comprehensive data on the total impact of these drugs on energy balance remain limited.

Summary
The findings underscore the promising role of GLP-1RA in obesity management, particularly through mechanisms influencing both EI and EE. Future research should focus on systematically measuring all components of energy balance to fully elucidate the mechanisms of GLP-1RA and optimize their therapeutic use for personalized medicine.
The case for balloon eustachian tuboplasty in children
Authors: Toivonen Joonas , Poe Dennis 
Published: August 2024

Purpose of review
Balloon dilation of the cartilaginous portion of the Eustachian tube has increasingly gained acceptance among otolaryngologists in the treatment of obstructive Eustachian tube dysfunction. There is however little data on the procedure performed in children. The purpose of this study is to review the recent developments regarding balloon dilation in pediatric patients.

Recent findings
Balloon dilation of the Eustachian tube is safe in pediatric patients. The effects of the procedure are durable during long term follow-up. Diagnosing obstructive dysfunction remains challenging. There is no single test or questionnaire for diagnosing the condition; instead a series of appropriate tests should be used. The pediatric Eustachian tube is very responsive to the effects of balloon dilation. While the treatment is effective, overtreatment can have unwanted results such as patulous symptoms. Reducing the time of dilation should therefore be considered.

Summary
Otolaryngologists performing the procedure should be familiar with the effects of balloon dilation on the pediatric Eustachian tube and consider altering the duration of dilation accordingly. Further studies are needed especially regarding patient selection, optimal age for dilation and balloon parameters for pediatrics (e.g. dimensions, inflation duration, inflation pressure).
Invasive fungal rhinosinusitis: current evidence and research opportunities
Authors: Ji Jenny , Roland Lauren T. 
Published: August 2024

Purpose of review
To summarize the evidence surrounding diagnosis, treatment, prognosis, and surveillance of patients with acute invasive fungal sinusitis (AIFS) and discuss future research needs.

Recent findings
New risk factors for AIFS such as COVID have been identified, and a new prognostic staging system has been developed.

Summary
Most patients who develop AIFS are immunocompromised, with the majority having a history of diabetes or a hematologic malignancy. Unfortunately, there are not any highly sensitive and specific diagnostic tools. Therefore, a combination of signs and symptoms, imaging, endoscopy, biopsy, and labs should be used to diagnosis AIFS. Although surgery and systemic antifungals are known to improve outcomes, there is limited data on time to intervention, duration of antifungals, and surveillance patterns. There is also limited information on factors that can predict outcomes in AIFS patients. However, sensory/perceptual changes, prolonged neutropenia duration, and comorbidity burden may be associated with a poor prognosis.
Evaluation and diagnosis of pediatric patients with dizziness
Authors: Doerfer Karl W. , Harvey Erin , LaPrade Samantha 
Published: August 2024

Purpose of review
Children experiencing dizziness frequently go unevaluated or experience delays in correct diagnosis due to systemic and inherent barriers. While most causes of pediatric dizziness do not involve the peripheral vestibular system, otolaryngologists are frequently consulted for expert opinion. This study offers a broad overview of the leading causes of pediatric dizziness and imbalance to assist otolaryngologists with evaluating and managing this challenging population.

Recent findings
Evaluation of children with dizziness should exclude serious central nervous system conditions. Approximately 70% of nonhazardous cases of pediatric dizziness are caused by migraine-related conditions, concussion, or functional disorders. Etiologies for peripheral vestibular dysfunction include inner ear malformations and vestibular disorders more commonly seen in adults. Audiometric and vestibular testing can provide helpful information, although correct diagnosis depends on a detailed history.

Summary
Otolaryngologists should be familiar with the conditions that cause dizziness in children. While most underlying causes are outside their scope of practice, understanding possible etiologies can facilitate correct diagnosis and appropriate management.