bluuebunny/crossref_metadata_2025_split huggingface dataset:
An examination of nurse practitioner students' perceptions of knowledge, confidence, and experiences related to caring for lesbian, gay, bisexual, transgender, and queer or questioning patients: A national perspective
Authors: Smith Kathy , Cooper Stacy D. 
Published: July 2024

ABSTRACT

Background:
Lesbian, gay, bisexual, transgender, and queer or questioning (LGBTQ+) individuals are significantly less likely to have a primary health care provider, and are more likely to be uninsured, and postpone medical care. A health care provider's lack of knowledge in LGBTQ+ health needs, low confidence in discussing sexuality, and bias can result in LGBTQ+ patients choosing to delay or avoid seeking care. These are missed opportunities for health care providers to recognize their unique needs, provide education and preventive screenings and care, and manage chronic conditions.

Purpose:
The aim of this study was to examine nurse practitioner students' perceptions of knowledge, confidence, and experiences related to caring for LGBTQ+ patients.

Methodology:
Using a descriptive, cross-sectional survey research design, a 29-item online survey was distributed through email to nurse practitioner students (n = 419) across the United States.

Results:
Overall, nurse practitioners (NP) students demonstrated infrequent questioning related to gender preferences, sexual terms, and clarification of relationships. Results showed that 77.9% of NP students within two terms of graduation had not received any LGBTQ+-specific training. Almost 75% of the NP students reported not routinely asking about sexuality, and 82% reported infrequently or never asking gender identity. Furthermore, 93.1% of respondents reported providers infrequently or never ask about preferred gender or pronouns, and 86% reported providers infrequently inquire about sexual identity in primary care visits.

Conclusions:
Study findings demonstrate the uniqueness of managing care for LGBTQ+ patients and importance for more detailed LGBTQ+ health training in curricula in NP programs.

Implications:
Closing the gap in health care for LGBTQ+ patients is paramount in addressing global health disparities and population care.
Charcot–Marie–Tooth Disease and Hearing Loss: A Systematic Review With Meta-Analysis
Authors: Mills John F. , Heiland Luke D. , Nguyen Shaun A. , Close Michaela F. , Meyer Ted A. 
Published: July 2024

Objective
To characterize the pattern of hearing loss in Charcot–Marie–Tooth (CMT) disease to help guide clinical management.

Databases Reviewed
CINAHL, PubMed, and Scopus.

Methods
Two independent investigators selected studies on CMT patients with pure-tone average (PTA) and auditory brainstem response (ABR) data. Case reports, case series <5 patients, and data that overlapped with another study were excluded. Investigators performed data extraction, quality rating, and risk-of-bias assessment using the Newcastle–Ottawa Scale. Meta-analysis of mean difference using fixed/random effects models was used. Also, data were analyzed using a weighted one-way analysis of variance, with post-hoc Tukey's test for comparison.

Results
Ultimately, 6 prospective studies (N = 197) were included. The most common demyelinating subtype (CMT1A) had significantly prolonged ABR latency values across wave III (0.20 ms, 95% confidence interval [CI]: 0.05–0.35), wave V (0.20 ms, 95% CI: 0.01–0.39), waves I–III (0.20 ms, 95% CI: 0.01–0.39), and waves I–V (0.20 ms, 95% CI: 0.01–0.39) when compared to matched controls. The autosomal recessive demyelinating subtype (CMT4C) had significantly worse PTA when compared to the most common subtype (CMT1A) (Δ 28.93 dB, 95% CI 18.34–39.52) and nondemyelinating subtype (CMT2A) (Δ 28.3 dB, 95% CI: 15.98–40.62).

Conclusions
Patients with CMT can present with a variety of phenotypes depending on the causative mutation. The ABR interpeak latency values for the most common demyelinating form of CMT are delayed when compared to matched controls. Most subtypes have normal hearing thresholds, apart from CMT4C, which presents with mild hearing loss on average.
Endoscopic-Assisted Presigmoid Approach to the Internal Auditory Canal. A Feasibility Study
Authors: Irwin Lindsay A. , Lee Lawrance , Mitchell Joshua , Corwin Frank D. , Coelho Daniel H. , Manzoor Nauman F. 
Published: July 2024

Hypothesis
The retrolabyrinthine (presigmoid) approach has been utilized in various skull base surgeries but has not been fully utilized in the management of internal auditory canal (IAC) lesions, such as vestibular schwannoma (VS). Microsurgical retrolabyrinthine approach provides limited visualization of the IAC, while endoscopic-assisted techniques allow for further lateral exposure with labyrinthine preservation.

Background
Traditional approaches to the IAC have the disadvantage of hearing sacrifice or retraction of brain tissue. With the introduction of endoscopic techniques and enhanced visualization, access to this region of complex anatomy is possible.

Methods
Radiomorphometric and anatomical dissection was performed on two cadaveric temporal bones. High-resolution computed tomography was used to segment and delineate the volume of the IAC. Projected accessible IAC was compared to actual postdissection data with preservation of the posterior semicircular canal (PSCC) via the retrolabyrinthine corridor.

Results
While preserving the PSCC, the 0° and 30° endoscopes visualized 57.1% and 78.6% of the IAC for cadaver 1, and 64.0% and 76.0% of the IAC for cadaver 2, respectively. Sacrificing the PSCC, the 0° and 30° endoscopes provided visualization of 78.6% 85.7% of the IAC for cadaver 1, and 88.0% and 95.1% of the IAC for cadaver 2, respectively.

Conclusions
Retrolabyrinthine approach to resection of VS is a potentially viable hearing-preserving alternative to traditional approaches. This approach provides access to the majority of the IAC, while angled endoscopes or sacrifice of the PSCC can provide additional access toward the fundus. Further studies are needed to determine the clinical feasibility of this approach.
Effect of Non-ablative Medical Therapy on Progression of Hearing Loss in Menière's Disease: A Systematic Review and meta-Analysis
Authors: Thompson-Harvey Adam , Pyle Madeline , Harvey Erin , Harris Michael S. 
Published: July 2024

Objective
To systematically review how audiometric data change over time in patients with Menière's disease (MD) undergoing non-ablative medical therapy.

Databases Reviewed
Medline (via PubMed), Scopus, Web of Science, Cumulated Index to Nursing and Allied Health Literature (CINAHL), Google Scholar.

Methods
A systematic review and meta-analysis of the literature was performed. Adult patients undergoing non-ablative medical therapy and reported duration of disease or follow-up were included and pooled estimates of pure-tone average (PTA) were tabulated. Studies were excluded if they did not use established MD, did not have pure-tone average (PTA) audiometric data, underwent ear surgery or ablative therapies, and were systematic reviews or case reports.

Results
Out of 198 articles meeting full eligibility, 13 studies, involving 950 patients with MD, were included in the review and further analyzed. No effect on progression of PTA from initial diagnosis was seen between the different medical therapies within 2 years of non-ablative medical treatment. There was a significant worsening of PTA after 2 year, regardless of treatment used. High levels of heterogeneity among studies were noted up to 6 months from diagnosis (I
2 = 79%), likely reflecting differences in patient characteristics, treatment regimens, and study design. Overall, the risk of bias was low for the majority of included studies.

Conclusions
Patients diagnosed with MD who are undergoing non-ablative medical therapy should be counseled on the likelihood of worsening of hearing loss over the course of the disease despite elected treatment.
Novel and complementary treatment approaches in attention-deficit/hyperactivity disorder
Authors: Caterfino Andrew , Krishna Shruthi , Chen Victoria 
Published: July 2024

Purpose of review
To provide an updated review of novel and complementary treatment approaches for children and adolescents with attention-deficit/hyperactivity disorder.

Recent findings
The evidence for complementary attention-deficit/hyperactivity disorder treatments is often promising, but limited to small, unblinded studies. Recent evidence from larger, more rigorous studies reveals that most of these treatments have modest efficacy. Omega-3 polyunsaturated fatty acids, saffron, broad spectrum micronutrients, and physical exercise have potential benefits that seem to outweigh known risks. However, neurofeedback, cognitive training, and trigeminal nerve stimulation need further research to determine whether specific sub-groups of children/adolescents with attention-deficit/hyperactivity disorder would benefit long-term with their associated tolerable risks.

Summary
There is not sufficient evidence for complementary treatments to be recommended as substitutes for first-line pharmacological and psychosocial treatment options. Nonetheless, some adjuvant therapies to currently recommended attention-deficit/hyperactivity disorder treatments can be safe. Physicians should be familiar with existing and emerging complementary treatments to help guide families.
The Influence of the Extracorporeal Membrane Oxygenation Circuit and Components on Anticoagulation Management: The Pediatric Extracorporeal Membrane Oxygenation Anticoagulation CollaborativE Consensus Conference
Authors: Himebauch Adam S. , Priest John R. , Annich Gail M. , McMullan D. Michael , Turner David A. , Muszynski Jennifer A. , Alexander Peta M.A. , Paden Matthew L. , Gehred Alison , Lyman Elizabeth , Said Ahmed S. ,   for the Pediatric Extracorporeal Membrane Oxygenation (ECMO) Anticoagulation CollaborativE (PEACE), in collaboration with the Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network, the Pediatric Critical Care Blood Research Network (BloodNet), and the Pediatric ECMO subgroup of PALISI and the Extracorporeal Life Support Organization (PediECMO)
Published: July 2024

OBJECTIVES:
To derive systematic-review informed, modified Delphi consensus regarding the influence of extracorporeal membrane oxygenation (ECMO) circuit components on anticoagulation practices for pediatric ECMO for the Pediatric ECMO Anticoagulation CollaborativE.

DATA SOURCES:
A structured literature search was performed using PubMed, EMBASE, and Cochrane Library (CENTRAL) databases from January 1988 to May 2021.

STUDY SELECTION:
Management of ECMO anticoagulation in the setting of different ECMO circuit components.

DATA EXTRACTION:
Two authors reviewed all citations independently, with a third independent reviewer resolving conflicts. Twenty-nine references were used for data extraction and informed recommendations, evidence-based consensus statements, and good practice statements. Evidence tables were constructed using a standardized data extraction form.

DATA SYNTHESIS:
Risk of bias was assessed using the Quality in Prognosis Studies tool. The evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation system. Forty-eight experts met over 2 years to develop evidence-based recommendations and, when evidence was lacking, expert-based consensus statements or good practice statements for the influence of ECMO circuit and components on anticoagulation management. A web-based modified Delphi process was used to build consensus via the Research And Development/University of California Appropriateness Method. Consensus was defined as greater than 80% agreement. One good practice statement, 2 weak recommendations, and 2 consensus statements are presented.

CONCLUSIONS:
The incorporation of new component technologies into clinical practice has outpaced clinical investigations of anticoagulation strategies for pediatric ECMO. Future investigations should leverage academic and industrial collaborations, translational platforms, and modern biostatistical methods to improve patient outcomes.
Assessing the impact of a 2-day online workshop on spasticity
Authors: Antoniadou Eleftheria , Lakoumentas John , Dy Roselle , Tyllianakis Minos , Esquenazi Alberto 
Published: July 2024

Background:
Οnline education has become widespread, but there has been little evaluation of its impact in terms of knowledge gain and acceptance. This article presents an assessment of a webinar on spasticity and botulinum toxin injection. The seminar aimed at health professionals working with patients with spasticity

Methods/Results:
It was conducted for 2 days; on the first day, a thorough analysis of spasticity was performed, whereas the second day focused on treatment, particularly botulinum toxin injections. The evaluation was performed using 2 questionnaires: the first rated the knowledge gain (questions prepared from the expert panel; evaluation was performed before the beginning and after the completion, plus a clinical case to justify the treatment), and the second rated acceptance (with a 5-point Likert scale. The results showed significant improvement (P < 0.001) in knowledge gain and positive acceptance by the participants (from max 100% to a min 69.81% agreement).

Conclusions:
An online workshop on spasticity management is not only acceptable but also has a positive impact on knowledge.
Effect of the Athletes’ Origin and Type of Impairment on Participation and the Likelihood of Winning a Medal in the Paralympic Games
Authors: Severin Anna Cecilia , Kinderen Annemarie , Baumgart Julia Kathrin 
Published: July 2024

Objective
This study investigated whether the origin (acquired or congenital) and type of impairment affect the participation and likelihood of winning a medal in different sports at the Paralympic Games.

Design
We analyzed competition data and athlete biographies web scraped from the International Paralympic Committee’s website (www.Paralympic.org)

Results
In some sports, athletes with one origin or type of impairment were overrepresented. For example, 76% of Para-snowboarders had an acquired impairment. Furthermore, mixed effects logistic regression analyses showed that the origin of impairment had no effect on the likelihood of winning a medal in most sports. However, athletes with a congenital impairment had a significantly higher likelihood of winning a medal compared to those with an acquired impairment in Para-athletics, Para-alpine skiing, and Para-biathlon (odds ratio: 1.71, P < 0.01, odds ratio: 3.69, P = 0.002, and odds ratio: 3.70, P = 0.016, respectively). Athletes with a given origin-type of impairment combination also may have an advantage or disadvantage in some sports. For example, athletes with an acquired spinal cord injury win proportionally fewer medals in Para-powerlifting.

Conclusions
Understanding potential effects of the origin and type of impairment on participation and medaling chances in Paralympic sports can help shape the development of Para-sports and support talent identification.
Comparative Effectiveness of Exercise on Cardiorespiratory Function or Exercise Efficiency After Stroke
Authors: Zha Fubing , Wen Qiong , Zhou Mingchao , Shan Linlin , Wang Yulong 
Published: July 2024

Objective
The network meta-analysis was to compare and rank the effectiveness of different exercises on cardiorespiratory function or exercise efficiency in poststroke patients.

Design
A network meta-analysis of randomized controlled trials was conducted. PubMed, Embase, Cochrane Library, and Web of Science were searched. The impact of exercises including individual and combination of aerobic exercise, resistance exercise, task-oriented training, gait training, breathing exercise, and regular rehabilitation training on 6-min walk test, peak oxygen consumption, maximum oxygen consumption, resting heart rate, resting systolic blood pressure, and resting diastolic blood pressure were assessed.

Results
In total, 36 studies were included in the meta-analysis. Aerobic exercise + GT (63.06%) had the highest likelihood of improving 6-min walk test performance in poststroke patients. Regular rehabilitation training + resistance exercise was the most favorable exercise in terms of 6-min walk test performance assessing by minimum clinically significant difference. Aerobic exercise + resistance exercise had the highest likelihood of improving peak oxygen consumption and reducing resting heart rate in poststroke patients.

Conclusion
Different types of exercise demonstrated the benefits of improving cardiorespiratory function in stroke patients. Further research is needed to determine the best exercise regimen to maximize the benefits of rehabilitation interventions for poststroke patients.
Prevalence of Self-reported COVID-19 Infection in Persons With Complicated Mild to Severe Traumatic Brain Injury
Authors: Pinto Shanti M. , Adams Leah M. , Chavez Audrie , Perrin Paul B. , Watanabe Thomas K. , Golden Katherine , Sterling Ally , Hoffman Jeanne M. , Daneshvar Daniel H. , Rabinowitz Amanda , Callender Librada , Hammond Flora M. 
Published: July 2024

Objectives
The aims of the study are to describe the incidence of self-reported COVID-19 history in a longitudinal cohort of individuals with complicated mild to severe traumatic brain injury and describe demographic, injury, and functional differences based on history of COVID-19 infection.

Design
Individuals with complicated mild to severe traumatic brain injury aged 16 or older at time of injury who were enrolled in the Traumatic Brain Injury Model Systems longitudinal cohort study, completed a baseline or follow-up interview between October 1, 2021–March 31, 2023, and provided information about COVID-19 history and timing of COVID-19 infection was collected.

Results
Of the 3627 individuals included in the analysis, 29.5% reported a history of COVID-19 infection. Those with reported COVID-19 history tended to be younger, not of a racial/ethnic minority background, and greater functional status at follow-up based on the Glasgow Outcome Scale-Extended Scale compared with those with no reported COVID-19 history (P < 0.05). Among those with COVID-19 history, 61.8% did not receive medical care, 27.6% received medical care but no hospitalization, and 10.5% were hospitalized. Of those hospitalized, 21.4% required ventilator use.

Conclusions
Incidence of COVID-19 diagnosis and related hospitalization characteristics in persons with complicated mild to severe traumatic brain injury was similar to national incidence between March 2020–2023. Secondary effects of the COVID-19 pandemic on persons with traumatic brain injury require investigation.
Feasibility of a Neurorehabilitation Pipeline and an Automated Algorithm to Select Appropriate Treatments for Upper Extremity Motor Paralysis in Individuals With Chronic Stroke
Authors: Kuwahara Wataru , Kawakami Michiyuki , Okawada Megumi , Tanamachi Kenya , Sasaki Shun , Kamimoto Takayuki , Yamada Yuka , Tsuji Tetsuya , Kaneko Fuminari 
Published: July 2024

Objective
This study aimed to investigate the feasibility of a neurorehabilitation pipeline and develop an algorithm to automatically select the appropriate treatment for individuals with upper extremity motor paralysis after stroke in the chronic phase.

Design
In experiment 1, eight post-stroke participants in the chronic phase who underwent treatment sustaining two to three phases were assessed before and after treatment. In experiment 2, a decision tree analysis was performed in which the dependent variable was set as the treatment option determined by a board-certified physiatrist for 95 poststroke participants; the independent variables were only motor function scores or both motor function scores and electromyogram variables.

Results
In experiment 1, the clinical assessment scores were improved significantly after treatment. Experiment 2 showed that the agreements of the model with only motor function scores as the independent variable and with motor function scores and electromyogram variables as the independent variables were 75.8% and 82.1%, respectively.

Conclusions
This novel treatment package is feasible for improvement of motor function in poststroke individuals with severe motor paralysis. The study also established an automated algorithm for selecting appropriate treatments for upper extremity motor paralysis after stroke, identifying standard values of key variables, including electromyography variables.
Trends in Operative Case Logs of Chief Residents in Surgery by Sex and Race
Authors: Zmijewski Polina , Park Yoon Soo , Hogan Sean , Holmboe Eric , Klingensmith Mary , Cortez Alexander , Lindeman Brenessa , Chen Herbert , Smith Brigitte , Fazendin Jessica 
Published: July 2024

Objective:
To examine case logs reported by general surgery residents and identify potential disparities in operative experience.

Background:
A recent study of 21 institutions noted significant differences between the number of cases reported during general surgery residency by trainees who are underrepresented in medicine (URiM) versus trainees who are not URiM (non-URiM). This study also identified differences between female residents and male residents. We partnered with the Accreditation Council for Graduate Medical Education to examine case logs reported from all accredited general surgery programs in the United States. This is the first time these data have been examined nationally.

Methods:
We examined total case logs submitted by graduating residents between 2017 and 2022. Group differences in mean reported case logs were examined using paired t tests for female versus male and URiM versus non-URiM overall case numbers.

Results:
A total of 6458 residents submitted case logs from 319 accredited programs. Eight-hundred fifty-four (13%) were URiM and 5604 (87%) were non-URiM. Over the 5-year study period, URM residents submitted 1096.95 (SD ± 160.57) major cases versus 1115.96 (±160.53) for non-URiM residents (difference = 19 cases, P = 0.001). Case logs were submitted by 3833 (60.1%) male residents and 2625 (39.9%) female residents over the 5-year study period. Male residents reported 1128.56 (SD ± 168.32) cases versus 1091.38 (±145.98) cases reported by females (difference = 37.18, P < 0.001). When looking at surgeon chief and teaching assistant cases, there was no significant difference noted between cases submitted by URiM versus non- URiM residents. However, male residents reported significantly more in both categories than their female peers (P < 0.001).

Conclusions:
Overall, URiM residents submitted fewer cases in the 5-year study period than their non-URiM peers. The gap in submitted cases between male and female residents was more pronounced, with male residents submitting significantly more cases than their female counterparts. This finding was consistent and statistically significant throughout the entire study period, in most case categories, and without narrowing of difference over time. A difference of 30 to 40 cases can amount to 1 to 3 months of surgical training and is a concerning national trend deserving the attention of every training program and our governing institutions.