bluuebunny/crossref_metadata_2025_split huggingface dataset:
RELATIONSHIP BETWEEN OPTICAL COHERENCE TOMOGRAPHY BIOMARKERS AND NUMBER OF INTRAVITREAL RANIBIZUMAB INJECTIONS IN EYES WITH NEOVASCULAR AGE-RELATED MACULAR DEGENERATION IN THE HARBOR STUDY
Authors: Tong Nianting , Fan Wenying , Su Li , Ebraheem Adel , Uji Akihito , Marion Kenneth , Sadda Srinivas 
Published: June 2024

Purpose:
To correlate baseline spectral-domain optical coherence tomography characteristics with the number of as-needed intravitreal injections of ranibizumab over a 24-month follow-up period in eyes with neovascular age-related macular degeneration.

Methods:
Two hundred thirty-six eyes of 236 subjects with neovascular age-related macular degeneration treated with ranibizumab 0.5 mg pro re nata in the HARBOR study were enrolled. Baseline spectral-domain optical coherence tomography images were evaluated by certified reading center graders for specific morphologic features of the macular neovascularization lesion and surrounding retina. Baseline optical coherence tomography features and patient demographics correlated with the number of injections over the next 2 years.

Results:
The mean number of injections in the 0.5 mg pro re nata group was 8.07 (median 8, 3–12) after 12 months and 14.25 (median 14, 3–24) after 24 months of treatment. After multivariate, linear, regression analysis, the only baseline parameter that was independently associated with a higher injection frequency at both 12 and 24 months was a greater baseline subretinal fluid thickness.

Conclusion:
A greater subretinal fluid thickness at baseline was associated with a higher frequency of pro re nata injections over 12 and 24 months in eyes treated with ranibizumab for neovascular age-related macular degeneration. These findings may be of value in counseling patients who are about to initiate therapy for macular neovascularization.
Examining Opportunities Offered Outside of Home Country in Physical Therapy Education: Considering the Colonial History of Global Health
Authors: Dholakia Kripa , Audette Jennifer , Gamble April , Hartman Jeff 
Published: June 2024

Background and Purpose.
Increasingly, PT programs in the United States are providing educational experiences outside of the home country (OHC) where faculty and students engage in global health initiatives. It is important to consider that the field of global health has its historical roots in colonialism, which has led to inequities and injustice. Those who are engaged in this work must assist in reversing this colonial legacy. The purpose of this position paper is to present the colonial history of global health, to provide context, and to spark critical reflection among PT educators about how OHC experiences are developed and configured.

Position and Rationale.
As a profession, we must educate ourselves about the history of global health and critically reflect on OHC engagements to ensure that we support equity and justice.

Discussion and Conclusion.
We must start by grounding our OHC experiences in health equity and justice. This should be done by considering the colonial history of global health and the privileges we hold as members of academic institutions in the United States. Why we offer OHC experiences in PT education should be investigated and clear to both faculty and students. Excluding this colonial history and its impacts risks perpetuating the historical harms to the health and well-being of the populations we claim to be serving.
Retrieval Practice Improves Exam Performance as a Function of Review Question Number and Format
Authors: Pitt Jason , Huebner Bethany 
Published: June 2024

Introduction.
Although retrieval practice is a well-established method of improving learning, it is unclear whether review question format matters or how many review questions are needed to maximize the effects of retrieval practice.

Review of Literature.
Inconsistent findings are reported regarding review question format, and no studies were conducted in physical therapy education programs. A positive relationship is reported between review question number and exam performance, but no studies estimate the number of review questions needed to maximize retention of specific learning objectives.

Subjects.
Eighty-eight second-year Doctor of Physical Therapy students (baseline cohort = 42 students, intervention cohort = 46 students).

Methods.
Exam questions were randomly assigned into different review categories. Some exam questions received no review, whereas other exam questions were reviewed with open-ended review questions or varying numbers of multiple-choice review questions. Performance on 160 multiple-choice exam questions was compared between review question categories using mixed-effects logistic regression models.

Results.
Both open-ended and multiple-choice review questions significantly improved exam question performance. Performance on exam questions improved most when more than one multiple-choice review question was provided. After controlling for exam question difficulty, multiple-choice review questions were superior to open-ended review questions.

Discussion and Conclusion.
On multiple-choice exams, multiple-choice review questions are at least as effective as open-ended review questions. Given their ease of implementation, multiple-choice review questions are an efficient means to improve multiple-choice exam question performance.
The impact of slowly digestible and resistant starch on glucose homeostasis and insulin resistance
Authors: Chisbert Maëliss , Castell Anne-Laure , Vinoy Sophie , Nazare Julie-Anne 
Published: June 2024

Purpose of reviewThis review will summarize recent studies assessing the effect of slowly digestible starch (SDS) and resistant starch (RS) on glucose metabolism in healthy, prediabetic or type 2 diabetic adults.Recent findingsCurrently, a particular interest in starch and its digestibility has arisen, with data showing a positive effect of SDS and RS on the glucose homeostasis of healthy, at-risk, prediabetic and type 2 diabetic patients but research is ongoing.SummaryCarbohydrates (CHO) and especially starch play a major role in the prevention and management of metabolic diseases such as type 2 diabetes (T2D). This largely depends on the quality and the digestibility (rate and extent) of the ingested starchy products, beyond their quantity. SDS have been poorly studied but display a beneficial effect on reducing glucose excursions in healthy and insulin-resistant subjects and a relevant potential to improve glucose control in type 2 diabetic individuals. As for RS, the results appear to be encouraging but remain heterogeneous, depending the nature of the RS and its role on microbiota modulation. Further studies are needed to confirm the present results and investigate the potential complementary beneficial effects of SDS and RS on long-term glucose homeostasis to prevent cardiometabolic diseases.
Micronutrient (iron, selenium, vitamin D) supplementation and the gut microbiome
Authors: Faradina Amelia , Tinkov Alexey A. , Skalny Anatoly V. , Chang Jung-Su 
Published: June 2024

Purpose of review
Deficiencies in micronutrients persist as widespread global challenges, where supplementation remains a crucial therapeutic approach. This review aims to elucidate the intricate relationships between micronutrient supplementation – specifically iron, selenium (Se), and vitamin D (Vit D) – and gut microbiota composition, investigating their collective impact on host health and disease susceptibility.

Recent findings
Maintaining balanced iron levels is essential for gut microbiota equilibrium and host health, as both iron deficiency and excess disrupt gut bacterial balance, affecting colon health. Se supplementation can restore and improve the gut microbial balance, influencing health outcomes not only in the gut but also in areas such as neuroprotection in the brain, testicular health, and metabolic syndrome. Clinical and experimental models demonstrate that Vit D modulates the gut microbiome, enhancing anti-inflammatory effects, supporting metabolic health, and potentially reducing the risk of gut-related behavioral changes and diseases.

Summary
Findings of this review emphasize that balanced iron levels are essential for maintaining a healthy gut microbiota composition and underscore the beneficial effects of Se and Vit D in modulating the gut microbiome. The interactions between micronutrients and the gut microbiome are complex but may have a broad spectrum of health outcomes.
Role of dietary fibres in cardiometabolic diseases
Authors: Dahm Christina C. , Langmann Fie , Nannsen Anne Østergaard , Ibsen Daniel B. 
Published: June 2024

Purpose of review
This review highlights recent developments in understanding the role of dietary fibre and specific fibre types on risk and management of cardiometabolic disease with a focus on the causal pathways leading to cardiometabolic diseases, namely weight management, glycaemic control, and lipid levels, as well as the latest findings for cardiovascular disease outcomes such as coronary heart disease, stroke, and mortality. Evidence for mechanisms through gut microbiota are also briefly reviewed.

Recent findings
Dietary fibre intake is associated with improved weight management, the extent of which may depend on the subtype of dietary fibre. Overall dietary fibre intake reduces blood glucose and HbA1c, however soluble fibres may be particularly effective in reducing HbA1c, fasting blood glucose and blood lipids. Individual meta-analyses and umbrella reviews of observational studies on dietary fibre, as well as major fibre types, observed inverse associations with incident coronary heart disease, stroke, and mortality due to cardiovascular disease. As different types of fibres exerted different health benefits, fibre diversity (i.e. combinations of fibres) should be further investigated.

Summary
Dietary fibres improve both short-term and long-term cardiometabolic disease risk factors and outcomes, and thus should be on every menu.
Performance of the Elixhauser Comorbidity Index in Predicting Mortality Among a National US Sample of Hospitalized Homeless Adults
Authors: Tsai Jack , Kim Youngran 
Published: June 2024

Background:
The Elixhauser Comorbidity Index (ECI) is widely used, but its performance in homeless populations has not been evaluated.

Objectives:
Using a national sample of inpatients, this study compared homeless and nonhomeless inpatients on common clinical diagnoses and evaluated ECI performance in predicting mortality among homeless inpatients.

Research Design:
A retrospective study was conducted using 2019 National Inpatient Sample (NIS) data, the largest publicly available all-payer inpatient health care database in the United States.

Subjects:
Among 4,347,959 hospitalizations, 78,819 (weighted 1.8%) were identified as homeless.

Measures:
The ECI consists of 38 medical conditions; homelessness was defined using the International Classification of Diseases Tenth Revision Clinical Modification (ICD-10-CM) diagnostic code, and clinical conditions were based on the Clinical Classifications Software Refined (CCSR) for ICD-10-CM.

Results:
Leading clinical diagnoses for homeless inpatients included schizophrenia and other psychotic disorders (13.3%), depressive disorders (9.4%), and alcohol-related disorders (7.2%); leading diagnoses for nonhomeless inpatients were septicemia (10.2%), heart failure (5.2%), and acute myocardial infarction (3.0%). Metastatic cancer and liver disease were the most common ECI diagnoses for both homeless and nonhomeless inpatients. ECI indicators and summary scores were predictive of in-hospital mortality for homeless and nonhomeless inpatients, with all models yielding concordance statistics above 0.80, with better performance found among homeless inpatients.

Conclusions:
These findings underlie the high rates of behavioral health conditions among homeless inpatients and the strong performance of the ECI in predicting in-hospital mortality among homeless inpatients, supporting its continued use as a case-mix control method and predictor of hospital readmissions.
Prevention and treatment of osteomyelitis after open tibia fractures
Authors: Mehta Devan D. , Leucht Philipp 
Published: June 2024

Abstract
Infection and chronic post-traumatic osteomyelitis of the tibia after open fracture are complex problems that cause significant morbidity and threaten the viability of a limb. Therefore, it is of utmost importance for the orthopaedic surgeon to understand both patient and treatment factors that modify the risk of developing these disastrous complications. Infection risk is largely based on severity of open injury in addition to inherent patient factors. Orthopaedic surgeons can work to mitigate this risk with prompt antibiotic administration, thorough and complete debridement, expedient fracture stabilization, and early wound closure. In the case osteomyelitis does occur, the surgeon should use a systematic multidisciplinary approach for eradication.
Visual midline gauge validity and repeatability: Comparison to a current clinical method
Authors: Stalin Amritha , Ding Ran , Leat Susan J. , Binhilabi Ohwod , Labreche Tammy 
Published: June 2024

Significance
Visual midline shifts are thought to occur post-stroke and be a risk factor for falls. This study investigates a new method for quantifying visual midline shifts, a first step toward developing greater understanding of visual midline shift.

Purpose
This study standardized the parameters of a novel visual midline gauge, compared the results with the current clinical method, and presents normative data and repeatability of both methods.

Methods
Ninety-three participants without neurological or ocular problems were recruited in Canada and Hong Kong. In experiment 1, horizontal and vertical visual midlines were measured using the gauge for two speeds and two repositioning methods. In experiment 2, visual midline was measured for three distances using a target speed and repositioning method chosen based on the first experiment. Visual midlines were also measured using the current clinical method during both visits.

Results
There were no significant effects of age, speed, study location, or repositioning method on visual midline positions (all p>0.05). For the horizontal direction, measurements at 25 cm were different from those at 50 (p=0.03) and 100 cm (p=0.001). For the vertical direction, there was no such effect. The measurements were found to be repeatable to within approximately 3°. In both visits, there were significant correlations between measurements using the visual midline gauge and the clinical method for the vertical direction (all p<.001) but not for the horizontal direction (all p>0.05).

Conclusions
The measurement of visual midline is tolerant of differences in target speed, testing method, and age of the participants, and the visual midline gauge measurements are repeatable.
A National Survey of Pediatric Post-Acute Care Facilities*
Authors: Straka Nadine , França Urbano L. , Franks Jennifer D. , McManus Michael L. 
Published: June 2024

OBJECTIVES:
To identify and geolocate pediatric post-acute care (PAC) facilities in the United States.

DESIGN:
Cross-sectional survey using both online resources and telephone inquiry.

SETTING:
All 50 U.S. states surveyed from June 2022 to May 2023. Care sites identified via state regulatory agencies and the Centers for Medicare & Medicaid Services.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
Number, size, and type of facility, scope of practice, and type of care provided. One thousand three hundred fifty-five facilities were surveyed; of these, 18.6% (252/1355) were pediatric-specific units or adult facilities accepting some pediatric patients. There were 109 pediatric-specific facilities identified within 39 U.S. states. Of these, 38 were freestanding with all accepting children with tracheostomies, 97.4% (37/38) accepting those requiring mechanical ventilation via tracheostomy, and 81.6% (31/38) accepting those requiring parenteral nutrition. The remaining 71 facilities were adult facilities with embedded pediatric units or children’s hospitals with 88.7% (63/71), 54.9% (39/71), and 54.9% (39/71), accepting tracheostomies, mechanical ventilation via tracheostomy, and parenteral nutrition, respectively. Eleven states lacked any pediatric-specific PAC units or facilities.

CONCLUSIONS:
The distribution of pediatric PAC is sparse and uneven across the United States. We present an interactive map and database describing these facilities. These data offer a starting point for exploring the consequences of pediatric PAC supply.
A Qualitative Study of Strategies to Improve Occupational Well-being in Physical Medicine and Rehabilitation Physicians
Authors: Amano Alexis , Makowski Maryam S. , Trockel Mickey T. , Menon Nikitha K. , Wang Hanhan , Sliwa James , Weinstein Stuart , Kinney Carolyn , Paganoni Sabrina , Verduzco–Gutierrez Monica , Kennedy David J. , Knowlton Tiffany , Stautzenbach Thomas , Shanafelt Tait D. 
Published: June 2024

Background
Physiatry is a specialty with high rates of burnout. Although organizational strategies to combat burnout are key, it is also important to understand strategies that individual physiatrists can use to address burnout.

Objective
The aim of the study is to identify changes that resulted in improvement of occupational well-being of physiatrists over a 6- to 9-mo period.

Design
We employed two quantitative surveys spaced 6-9 mos apart to identify physiatrists who experienced meaningful improvement in occupational burnout and/or professional fulfillment between the two survey time points. These physiatrists were subsequently recruited to participate in a qualitative study using semistructured interviews to identify changes that respondents felt contributed to improvements in burnout and professional fulfillment.

Setting
Online surveys and interviews.

Participants
Physiatrists in the American Academy of Physical Medicine and Rehabilitation (AAPM&R) Membership Masterfile.

Main Outcome Measure
Burnout and professional fulfillment were assessed using the Stanford Professional Fulfillment Index.

Results
One hundred twelve physiatrists responded to the baseline and follow-up surveys. Of these, 35 were eligible for interviews based on improvements in the Stanford Professional Fulfillment Index, and 23 (64%) agreed to participate. Themes from the qualitative interviews highlighted the importance of personal lifestyle choices, approaches to improve professional satisfaction, and strategies to foster work-life harmony. Personal lifestyle strategies included investing in wellness and mental health. Efforts to improve professional satisfaction included decreasing work intensity, prioritizing meaningful aspects of work, and building relationships with colleagues. Fostering work-life harmony also included making trade-offs in both domains, setting boundaries at work, setting expectations at home, and overcoming personal challenges.

Conclusions
Our findings illustrate that in addition to organizational strategies demonstrated to be effective, there are actions that individual physiatrists can take to recover from burnout and foster professional fulfillment.
Nothing About Us Without Us
Authors: Waters John , Siegel Charles , O’Connell David , Sacris Joel , Mallow Michael , Ziring Deborah , Ankam Nethra 
Published: June 2024

Abstract
Medical school curricula across the United States fail to adequately prepare students to provide high-quality care to and advocate for patients with disabilities. To address this shortcoming at one large, urban medical school, the Curriculum Committee at Sidney Kimmel Medical College formed a taskforce of students and faculty to evaluate the degree and quality of disability representation in its undergraduate medical education curriculum. Taskforce members solicited input from five community members in various fields of disability advocacy to craft recommendations that reflected this community’s vision for disability education in undergraduate medical education. Community partners suggested areas of focus including clinical skills, accessibility of healthcare facilities, awareness of intersectionality with other identities, acknowledgment of bias, and respect for the patient’s autonomy via their “right to risk.” The taskforce report to the curriculum committee included nine recommendations for curricular revision based on community partner suggestions, six of which were accepted and are being implemented into the curricular content for the class of 2026 and beyond. This novel approach to implementing curricular change could encourage other medical schools to evaluate their own curricula through the lens of disability and prompt curricular revision with the input of community partners with disabilities, students, and, faculty.
Lower Neutrophil Count Without Clinical Consequence Among Children of African Ancestry Living With HIV in Canada
Authors: Bernard Isabelle , Ransy Doris G. , Brophy Jason , Kakkar Fatima , Bitnun Ari , Sauvé Laura , Samson Lindy , Read Stanley , Soudeyns Hugo , Hawkes Michael T. ,   EPIC4 Study Group
Published: June 2024

Objective:
To investigate the association between African ancestry and neutrophil counts among children living with HIV (CLWH). We also examined whether medications, clinical conditions, hospitalization, or HIV virologic control were associated with low neutrophil counts or African ancestry.

Design:
We conducted a secondary analysis of the Early Pediatric Initiation Canada Child Cure Cohort (EPIC4) Study, a multicenter prospective cohort study of CLWH across 8 Canadian pediatric HIV care centers.

Methods:
We classified CLWH according to African ancestry, defined as “African,” “Caribbean,” or “Black” maternal race. Longitudinal laboratory data (white blood cells, neutrophils, lymphocytes, viral load, and CD4 count) and clinical data (hospitalizations, AIDS-defining conditions, and treatments) were abstracted from medical records.

Results:
Among 217 CLWH (median age 14, 55% female), 145 were of African ancestry and 72 were of non-African ancestry. African ancestry was associated with lower neutrophil counts, white blood cell counts, and neutrophil–lymphocyte ratios. Neutrophil count <1.5 × 109/L was detected in 60% of CLWH of African ancestry, compared with 31% of CLWH of non-African ancestry (P < 0.0001), representing a 2.0-fold higher relative frequency (95% CI: 1.4–2.9). Neutrophil count was on average 0.74 × 109/L (95% CI: 0.45 to 1.0) lower in CLWH of African ancestry (P < 0.0001). Neither neutrophil count<1.5 × 109/L nor African ancestry was associated with medications, hospitalizations, AIDS-defining conditions, or markers of virologic control (viral load, sustained viral suppression, and lifetime nadir CD4).

Conclusions:
In CLWH, African ancestry is associated with lower neutrophil counts, without clinical consequences. A flexible evaluation of neutrophil counts in CLWH of African ancestry may avoid unnecessary interventions.
Imaging Review of Different Subchondral Insufficiency Fractures
Authors: Alidina Sameer , Luxenburg Dylan , Castro Athena , Subhawong Ty K. , Ferreira de Souza Felipe 
Published: June 2024

Abstract
Subchondral fractures are a common cause of joint pain that may ultimately lead to articular collapse and the need for arthroplasty. This type of fracture has been reported at multiple joints throughout the body. While clinical and radiographic resolution can be achieved, progressive bone collapse can occur and lead to a variety of complications. Understanding the pertinent imaging findings can aid in the early evaluation of subchondral fractures and in the prevention of their associated complications.