bluuebunny/crossref_metadata_2025_split huggingface dataset:
Identification and characteristics of patients with potential difficult-to-treat psoriatic arthritis: exploratory analyses of the Greek PsA registry
Authors: Vassilakis Konstantinos D , Papagoras Charalampos , Fytanidis Nikolaos , Gazi Sousana , Mole Evangelia , Krikelis Michael , Voulgari Paraskevi V , Kaltsonoudis Evripidis , Koletsos Nikolaos , Boumpas Dimitrios , Katsimpri Pelagia , Katsifis-Nezis Dimitrios , Dimitroulas Theodoros , Kougkas Nikolaos , Boutel Maria , Sfikakis Petros P , Tektonidou Maria G , Gialouri Chrysoula , Bogdanos Dimitrios , Simopoulou Theodora , Koutsianas Christos , Mavrea Evgenia , Katsifis Gkikas , Kottas Konstantinos , Konsta Maria , Tziafalia Matthoula , Kataxaki Evangelia , Kalavri Eleni , Klavdianou Kalliopi , Grika Eleftheria P , Sfontouris Charalampos , Daoussis Dimitrios , Iliopoulos George , Bournazos Ilias , Karokis Dimitrios , Georganas Konstantinos , Patrikos Dimos , Vassilopoulos Dimitrios , Fragoulis George E 
Published: May 2024

Abstract

Objective
To present the characteristics of patients with potential difficult-to-treat (D2T) PsA.

Methods
We used data from the Greek multicentre registry of PsA patients. D2T PsA was defined as follows: patients with at least 6 months’ disease duration, who have failed to at least one conventional synthetic DMARD and at least two biologic DMARDs/targeted synthetic DMARDs with a different mechanism of action and have either at least moderate disease activity (MODA) defined as DAPSA (Disease Activity index in PSoriatic Arthritis) &gt;14, and/or are not at minimal disease activity (MDA). Demographic and clinical characteristics were compared between D2T and non-D2T PsA patients. In two sensitivity analyses, patients classified as D2T solely according to the MODA or MDA criterion were examined separately.

Results
Among 467 patients included, 77 (16.5%) were considered D2T and 390 non-D2T PsA. Compared with non-D2T, patients with D2T PsA presented more commonly with extensive psoriasis (P &lt; 0.0001) and were more likely to have higher BMI (P = 0.023) and a history of IBD (P = 0.026). In the MODA and MDA sensitivity analyses, 7.5% and 12.5% of patients were considered D2T, respectively. In both sensitivity analyses, extensive psoriasis was again identified as an independent variable for D2T PsA (P = 0.001 and P = 0.008, respectively). Moreover, female gender (P = 0.034) in the MODA analysis and axial disease (P = 0.040) in the MDA analysis were independent variables for D2T PsA.

Conclusion
Despite the availability of therapies, D2T PsA is common in real-life cohorts of patients with PsA and extensive psoriasis. High BMI, female gender, axial disease and history of IBD were also associated with D2T PsA.
Peer-led stay interviews to connect employees and develop retention strategies
Authors: Warren Nina , Gale Lisa , Rettew Stephanie , Peterson Cynthia , Sorensen Sara , Glassman Emily L. 
Published: May 2024

Abstract:
Stay interviews can strengthen employee engagement and increase retention. This quality improvement project aimed to determine nurses' motivations for staying on their current unit by conducting peer-led stay interviews. Participants responded positively to the stay interview process.
Effect of Remimazolam on Emergence Delirium in Children Undergoing Laparoscopic Surgery: A Double-blinded Randomized Trial
Authors: Cai Yu-Hang , Zhong John Wei , Ma Hong-Yu , Szmuk Peter , Wang Cheng-Yu , Wang Zhen , Zhang Xu-Lin , Dong Le-Qi , Liu Hua-Cheng 
Published: May 2024

Background
Preventing emergence delirium is a clinical goal for pediatric anesthesia, yet there is no consensus on its prevention. This study investigated the hypothesis that a continuous infusion or a single bolus of remimazolam can reduce the incidence of emergence delirium in children.

Methods
A total of 120 children aged 1 to 6 yr were randomly and equally allocated into three groups: group RC, which received a continuous infusion of remimazolam at 1 mg · kg−1 · h−1; group RB, which received a single bolus of remimazolam at 0.2 mg · kg−1 at the beginning of wound closure; and group C, which received a continuous infusion of saline at 1 ml · kg−1 · h−1 and a single bolus of saline at 0.2 ml · kg−1 at the beginning of sutures. The primary outcome was the incidence of emergence delirium assessed by the Pediatric Anesthesia Emergence Delirium scale. Secondary outcomes included the number of rescue propofol administrations in the postanesthesia care unit, recovery time, and adverse events.

Results
Emergence delirium was observed in 14 of 40 (35%) patients in group C, 2 of 40 (5%) patients in group RC (vs. group C, P = 0.001; risk ratio, 95% CI: 0.14, 0.04 to 0.59), and 3 of 39 (7.7%) patients in group RB (vs. group C, P = 0.003; risk ratio, 95% CI: 0.22, 0.07 to 0.71). Ten of 40 patients in group C, 2 of 40 patients in group RC (vs. group C, P = 0.012; risk ratio, 95% CI: 0.20, 0.05 to 0.86), and 2 of 39 patients in group RB (vs. group C, P = 0.014; risk ratio, 95% CI: 0.21, 0.05 to 0.88) needed rescue propofol. No differences in the recovery time and adverse effects were detected.

Conclusions
Both continuous infusion and single bolus administration of remimazolam can effectively reduce the occurrence of emergence delirium in children.

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Determinants and Practice Variability of Oxygen Administration during Surgery in the United States: A Retrospective Cohort Study
Authors: Billings Frederic T. , McIlroy David R. , Shotwell Matthew S. , Lopez Marcos G. , Vaughn Michelle T. , Morse Jennifer L. , Hennessey Cassandra J. , Wanderer Jonathan P. , Semler Matthew W. , Rice Todd W. , Wunsch Hannah , Kheterpal Sachin 
Published: May 2024

Background
The best approaches to supplemental oxygen administration during surgery remain unclear, which may contribute to variation in practice. This study aimed to assess determinants of oxygen administration and its variability during surgery.

Methods
Using multivariable linear mixed-effects regression, the study measured the associations between intraoperative fraction of inspired oxygen and patient, procedure, medical center, anesthesiologist, and in-room anesthesia provider factors in surgical cases of 120 min or longer in adult patients who received general anesthesia with tracheal intubation and were admitted to the hospital after surgery between January 2016 and January 2019 at 42 medical centers across the United States participating in the Multicenter Perioperative Outcomes Group data registry.

Results
The sample included 367,841 cases (median [25th, 75th] age, 59 [47, 69] yr; 51.1% women; 26.1% treated with nitrous oxide) managed by 3,836 anesthesiologists and 15,381 in-room anesthesia providers. Median (25th, 75th) fraction of inspired oxygen was 0.55 (0.48, 0.61), with 6.9% of cases less than 0.40 and 8.7% greater than 0.90. Numerous patient and procedure factors were statistically associated with increased inspired oxygen, notably advanced American Society of Anesthesiologists classification, heart disease, emergency surgery, and cardiac surgery, but most factors had little clinical significance (less than 1% inspired oxygen change). Overall, patient factors only explained 3.5% (95% CI, 3.5 to 3.5%) of the variability in oxygen administration, and procedure factors 4.4% (95% CI, 4.2 to 4.6%). Anesthesiologist explained 7.7% (95% CI, 7.2 to 8.2%) of the variability in oxygen administration, in-room anesthesia provider 8.1% (95% CI, 7.8 to 8.4%), medical center 23.3% (95% CI, 22.4 to 24.2%), and 53.0% (95% CI, 52.4 to 53.6%) was unexplained.

Conclusions
Among adults undergoing surgery with anesthesia and tracheal intubation, supplemental oxygen administration was variable and appeared arbitrary. Most patient and procedure factors had statistical but minor clinical associations with oxygen administration. Medical center and anesthesia provider explained significantly more variability in oxygen administration than patient or procedure factors.

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Infantile Hemangiomas Lose Vascular Endothelial Cadherin During Involution: Potential Role in Cell Death?
Authors: Clapp Averill , Modiri Omeed , Schonning Michael , Wu June K. 
Published: May 2024

Background:
Infantile hemangiomas (IHs) are benign endothelial cell (EC) tumors that undergo a predictable natural history, with rapid proliferation, stabilization, and involution. However, mechanisms regulating these transitions are not well understood. We have observed loss of vascular endothelial cadherin (VECAD) in involuting/involuted IHs. VECAD plays a critical role in angiogenesis, cell cycle progression, and EC survival. We hypothesize that loss of VECAD is associated with apoptosis occurring during IH involution.

Methods:
Resected IH samples were clinically categorized as proliferating (n = 4), stable (n = 4), or involuting/involuted (n = 5). Neonatal dermal tissues were used as controls (n = 5). Immunohistochemistry was conducted on sectioned specimens using antibodies against EC markers VECAD and CD31. Apoptosis was assessed with terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling assay.

Results:
CD31 signal intensity in proliferating, stable, and involuting/involuted IH ECs was unchanged relative to each other and to control ECs. VECAD signal significantly and progressively diminished as IHs progressed from proliferation to involution. Involuting/involuted IHs had significantly reduced VECAD expression compared with control ECs (P < 0.0001), proliferating IHs (P < 0.0001), and stable IHs (P < 0.001). As expected, the number of terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling-positive ECs was significantly higher in involuting/involuted IHs (P < 0.05) relative to control ECs and proliferating IHs.

Conclusions:
Loss of VECAD expression in IH endothelium corresponded to IH involution and increased apoptosis. It is unclear whether loss of VECAD is causative of IH involution; further studies are needed to elucidate the role of VECAD function in EC survival.
Effects of Optical Zone Variation of High-Addition Multifocal Contact Lenses on the Global Flash Multifocal Electroretinography
Authors: Boily Laurence , Michaud Langis , Garon Marie-Lou , Marcotte Rémy 
Published: May 2024

Objectives:
To evaluate the retinal response to myopic defocus after the wear of soft multifocal contact lenses with high addition through electroretinography.

Methods:
Twenty-seven participants meeting inclusion criteria were enrolled. Tropicamide 1% drops (2) were instilled. Participants were then fitted with three different contact lenses: a single-vision spherical lens (SE +3.00 D), L1, serving as a control, and two soft multifocal lens designs (SE +3.00 D/add +10 D), one with a central distance zone of 4.0 mm (L2) and one with a central distance zone of 7.0 mm (L3). A global flash multifocal electroretinography was performed. Direct component (DC) amplitude, DC peak time, induced component (IC) amplitude, and IC peak time were recorded. Waveforms were grouped into five concentric areas, covering from 0° to 24° of retinal eccentricity. Differences of L2/L3 versus L1 were analyzed with t tests. Finally, correlations were calculated between the percentage of defocus in the pupil area versus the electroretinography results.

Results:
Results show that the DC amplitude, caused mainly by photoreceptors and bipolar cells, is not influenced by the design of the lenses. The IC amplitude, however, is significantly decreased when the lens with a smaller optical zone (L2) is worn. This significant difference only concerns the ring 5, which corresponds to a retinal eccentricity of 15.7° to 24.0°.

Conclusion:
Soft multifocal lens designs influence the peripheral retinal reaction to defocus. A larger treatment zone seems to significantly impact the retinal response to defocus between 15.7° and 24.0° of eccentricity from the macula.
Preparing porcine lens to mimic human lens capsule
Authors: Pei Yajing , Han Shaofeng , Lu Mingfeng , Yang Yang , Ma Ke 
Published: May 2024

Purpose:
To develop a chemical method that makes porcine lens anterior capsule resemble human lens anterior capsule in tear force and perforating force.

Setting:
Beijing Tongren Hospital, Beijing, China.

Design:
Experimental study.

Methods:
Porcine eyes were divided into groups, and reagents (0.9% physiological saline, 0.1% sodium hypochlorite, 0.3% sodium hypochlorite, and 0.5% sodium hypochlorite) were injected into the anterior chamber, respectively, recorded as Groups A, B, C, and D, respectively. A senior physician collected each group of anterior capsules after performing continuous circular capsulorhexis and assessing the anterior capsule's tearing and perforation forces. An additional group, which consisted of human lens anterior capsules taken in the operating room from patients with cataract, recorded as Group E. A tensile system was used to measure each sample's tensile force.

Results:
A significant difference was found between Group A and any other group in maximum tensile force and average tensile force in both transverse and longitudinal directions. No significant difference was found between any 2 groups from Group B to Group E. According to the surgeon's assessment, the tear force characteristic of the porcine lens anterior capsule treated with 0.1%, 0.3%, and 0.5% sodium hypochlorite solution was similar to that of the human lens anterior capsule.

Conclusions:
Porcine lens capsule treated using this method can be used for training of new surgeons. The porcine lens anterior capsule treated with 0.5% sodium hypochlorite, which results showed most resembled human lens anterior capsule, can be used for robotic training.
Small Patients but a Heavy Lift
Authors: Dye M. Eva , Runyan Patti , Scott Theresa A. , Dietrich Mary S. , Hatch L. Dupree , France Daniel , Alrifai Mhd Wael 
Published: May 2024

Objective:
This study explored the association between workload and the level of burnout reported by clinicians in our neonatal intensive care unit (NICU). A qualitative analysis was used to identify specific factors that contributed to workload and modulated clinician workload in the NICU.

Study Design:
We conducted a study utilizing postshift surveys to explore workload of 42 NICU advanced practice providers and physicians over a 6-month period. We used multinomial logistic regression models to determine associations between workload and burnout. We used a descriptive qualitative design with an inductive thematic analysis to analyze qualitative data.

Results:
Clinicians reported feelings of burnout on nearly half of their shifts (44%), and higher levels of workload during a shift were associated with report of a burnout symptom. Our study identified 7 themes related to workload in the NICU. Two themes focused on contributors to workload, 3 themes focused on modulators of workload, and the final 2 themes represented mixed experiences of clinicians’ workload.

Conclusion:
We found an association between burnout and increased workload. Clinicians in our study described common contributors to workload and actions to reduce workload. Decreasing workload and burnout along with improving clinician well-being requires a multifaceted approach on unit and systems levels.
The Relationship Between Restrictive Regulation of Midwives, Practice Environment, and Professional Burnout
Authors: Thumm E. Brie , Schaeffer Ann , Michel Alexandra , McFarland A. Kristienne , Long Maryann H. , Giano Zachary 
Published: May 2024

Purpose:
The purpose of the study was to investigate the relationship between state regulation of the midwifery workforce, practice environment, and burnout.

Background:
Burnout threatens the US midwifery workforce, with over 40% of certified nurse-midwives meeting criteria. Burnout can lead to poorer physical and mental health and withdrawal from the workforce. Burnout in midwives has been associated with lack of control and autonomy. In the United States, midwives' autonomy is restricted through state-level regulation that limits scope of practice and professional independence.

Methods:
A mixed-methods study was conducted using an explanatory sequential approach. Quantitative and qualitative data were collected by online surveys and analyzed in a 2-stage process, followed by data integration.

Results:
State regulation was not found to be independently associated with burnout (n = 248; P = .250); however, mediation analysis showed a significant association between state regulation, practice environment, and burnout. Qualitative analysis mirrored the importance of practice environment and expanded on its features.

Conclusion:
For midwives, unrestrictive practice regulation may not translate to burnout prevention without supportive practice environments.

Implications for practice and research:
Interventions should focus on promoting job flexibility, realistic demands, and professional values. While midwives' commitment to patients and the profession can help bolster the workforce, it can also amplify negative experiences of the practice environment.
Nurses’ Job Burnout and Resilience in Neonatal Intensive Care Units
Authors: Al-Harrasi Samhaa , Sabei Sulaiman Al , Omari Omar Al , Abrawi Umaima Al 
Published: May 2024

Purpose:
To assess the relationship between job burnout and resilience among nurses working in neonatal intensive care units (NICUs) in Oman.

Background:
NICUs induce a significant amount of stress that predisposes nurses to a substantial degree of burnout. Resilience can play a role in reducing the effects of job burnout. A limited number of studies have examined job burnout and resilience among NICU nurses.

Methods:
A cross-sectional survey design was utilized. The Maslach Burnout Inventory was used to assess burnout, and the Brief Resilience Scale was used to assess perceptions of resilience. Pearson correlation was used to assess the relationship between job burnout and resilience.

Results:
A total of 173 staff nurses participated. Participants reported low levels of emotional exhaustion and depersonalization but moderate levels on the personal accomplishment subscale. Nurses reported moderate levels of resilience. Emotional exhaustion and depersonalization were negatively correlated with resilience, while personal accomplishment was positively correlated with resilience.

Conclusion:
This study demonstrated that enhancing resilience can reduce the effect of burnout among NICU nurses.

Implications for Practice and Research:
Enhancing levels of resilience among NICU nurses, in addition to providing adequate managerial support and good collegial relations, is essential to reduce their perceived job burnout.
Advances in preclinical approaches for intravesical therapy of bladder cancer
Authors: Obireddy Sreekanth Reddy , Lai Wing-Fu 
Published: May 2024

Purpose of review
The purpose of this review is to explore new strategies to treat bladder cancer. This article addresses challenges and opportunities in intravesical therapy of bladder cancer.

Recent findings
The review examines the latest advances in the development of preclinical approaches for intravesical therapy of bladder cancer. It discusses strategies to improve drug delivery efficiency by using synthesized diverse carriers. Immunotherapy with protein aggregate magnesium-ammonium phospholinoleate-palmitoleate anhydride has been shown to be more effective than intravesical Bacillus Calmette-Guerin. Novel drug delivery systems such the urinary drug-disposing strategy and intravesical nanoparticle formulations improve the drug delivery efficiency while minimizing adverse reactions. Innovative imaging techniques using near-infrared fluorescence probes and multifunctional nano-transformers enable real-time detection and targeted therapy in bladder cancer treatment.

Summary
Treatment of bladder cancer is clinically challenging. However, recent progress in drug delivery technologies shows promise. Optimizing these technologies helps improve patient outcomes, and facilitates clinical translation of different treatment modalities.
Melorheostosis With Uniform Rib Thickening
Authors: Ariga Akane , Funauchi Yuki , Sato Shingo , Kunieda Junko , Yoshii Toshitaka 
Published: May 2024

Abstract
A 16-year-old girl presented with left chest pain. Radiography and CT revealed localized abnormal calcification in the left sixth rib and sixth thoracic vertebra. Bone scintigraphy confirmed abnormal uptake of 99mTc in the same area. An open biopsy of the sixth rib was performed, leading to the diagnosis of melorheostosis. This case showed uniformly thickened calcification throughout the rib, unlike the typical “dripping candle wax” radiography finding associated with melorheostosis. This case implies the importance of open biopsy for diagnostic confirmation in cases with atypical imaging features.
Early Experience with EndoRobotic Submucosal Dissection (ERSD)
Authors: Alipouriani Ali , Ozgur Ilker , Bhatt Amit , Steele Scott R. , Sommovilla Joshua , Gorgun Emre 
Published: May 2024

Objective:
To evaluate the safety and feasibility of single-port endorobotic submucosal dissection (ERSD) using the Da Vinci SP platform for the management of rectal neoplasms.

Summary Background Data:
Endoscopic submucosal dissection (ESD) offers a potential organ-sparing treatment for advanced colorectal neoplasms but demands high technical skill and a steep learning curve. Advances in semiflexible robotic platforms, such as the Da Vinci SP, promise to simplify this procedure, potentially offering improved outcomes for patients with benign rectal neoplasms.

Methods:
A retrospective analysis of 28 patients who underwent ERSD using the Da Vinci SP platform between 2020 and 2023 was performed. Patient demographics, lesion characteristics, procedure details, outcomes, and complications were reviewed. The primary endpoint was successful en-bloc resection.

Results:
The cohort had a median age of 60.5 years and a median BMI of 28.2 kg/m², predominantly male(67.8%) with ASA categories 2 or 3(82%). Lesions had a median size of 38 mm and were located a median of 9 cm from the anal verge. The median procedure time was 87.5 minutes. En-bloc resection was achieved in all cases(100%), with no intraoperative complications or mortality. One patient experienced urinary retention, and one had late bleeding requiring blood transfusion. Pathology outcomes included 46.4% tubulovillous adenomas, 21.4% adenocarcinomas, and high-grade dysplasia in 53.6% of patients.

Conclusion:
Single-port ERSD using the Da Vinci SP platform is safe and feasible for the management of colorectal neoplasia, ensuring a high rate of en-bloc resection. It potentially offers advantages over conventional ESD, including shorter dissection times, although further studies are necessary for a definitive comparison.