bluuebunny/crossref_metadata_2025_split huggingface dataset:
Vancomycin Dosing and Its Association With Acute Kidney Injury in Pediatric Cardiac Intensive Care Patients Under 3 Months of Age
Authors: Ashkenazi-Hoffnung Liat , Schiller Ofer , Krubiner Mor , Dagan Ovadia , Haskin Orly , Manor-Shulman Orit , Feinstein Yael , Shochat Tzippy , Shostak Eran , Yarden-Bilavsky Havatzelet 
Published: May 2024

Background:
The standard vancomycin regimen for term neonates is 45 mg/kg/day. However, the optimal starting vancomycin dosing for achieving therapeutic levels in young infants in cardiac intensive care units remains unknown. Moreover, data on the association of supratherapeutic vancomycin levels with acute kidney injury (AKI) are limited.

Methods:
Retrospective study of infants ≤3 months old, receiving vancomycin following congenital heart surgery at postoperative intensive care unit admission. Assessed were vancomycin dosing, achievement of therapeutic trough concentration of 10–20 mg/L and development of AKI, based on the modified Kidney Disease Improving Global Outcomes criteria.

Results:
Inclusion criteria were met by 109 patients with a median age of 8 days (IQR: 6–16). The mean (SD) vancomycin dose required for achieving therapeutic concentration was 28.9 (9.1) mg/kg at the first postoperative day. Multivariate logistic regression identified higher preoperative creatinine levels and shorter cardiopulmonary bypass time as predictors of supratherapeutic vancomycin concentrations (c-index 0.788). During the treatment course, 62 (56.9%) developed AKI. Length of stay and mortality were higher in those who developed AKI as compared with those who did not. Multivariate logistic regression identified higher vancomycin concentration as a predictor for postoperative AKI, OR, 3.391 (95% CI: 1.257–9.151), P = 0.016 (c-index 0.896).

Conclusion:
Our results support a lower starting vancomycin dose of ~30 mg/kg/day followed by an early personalized therapeutic approach, to achieve therapeutic trough concentrations of 10–20 mg/L in cardiac postoperative term infants. Supratherapeutic concentrations are associated with an increased risk for AKI, which is prevalent in this population and associated with adverse outcomes.
RNA isoform expression landscape of the human dorsal root ganglion generated from long-read sequencing
Authors: Arendt-Tranholm Asta , Mwirigi Juliet M. , Price Theodore J. 
Published: May 2024

Abstract
Splicing is a posttranscriptional RNA processing mechanism that enhances genomic complexity by creating multiple isoforms from the same gene. We aimed to characterize the isoforms expressed in the human peripheral nervous system, with the goal of creating a resource to identify novel isoforms of functionally relevant genes associated with somatosensation and nociception. We used long-read sequencing to document isoform expression in the human dorsal root ganglia from 3 organ donors and validated in silico by confirming expression in short-read sequencing from 3 independent organ donors. Nineteen thousand five hundred forty-seven isoforms of protein-coding genes were detected and validated. We identified 763 isoforms with at least one previously undescribed splice junction. Previously unannotated isoforms of multiple pain-associated genes, including ASIC3, MRGPRX1, and HNRNPK, were identified. In the novel isoforms of ASIC3, a region comprising approximately 35% of the 5'UTR was excised. By contrast, a novel splice junction was used in isoforms of MRGPRX1 to include an additional exon upstream of the start codon, consequently adding a region to the 5'UTR. Novel isoforms of HNRNPK were identified, which used previously unannotated splice sites to both excise exon 14 and include a sequence in the 3' end of exon 13. This novel insertion is predicted to introduce a tyrosine phosphorylation site potentially phosphorylated by SRC. We also independently confirm a recently reported DRG-specific splicing event in WNK1 that gives insight into how painless peripheral neuropathy occurs when this gene is mutated. Our findings give a clear overview of mRNA isoform diversity in the human dorsal root ganglia obtained using long-read sequencing.
Diagnostic Capability of Intra-Articular Injections for Femoroacetabular Impingement Syndrome: A Systematic Review
Authors: Fernandes Daniel Araujo , Martins Eduardo Campos , Melo Gilberto , Locks Renato , Adam Guilherme Pradi , Neves Fabrício Souza 
Published: May 2024

Objective:
To review and critically appraise available literature concerning the diagnostic capability of intra-articular injections for femoroacetabular impingement (FAI) syndrome.

Design:
Systematic review.

Setting:
N/A.

Participants:
N/A.

Interventions:
N/A.

Main Outcome Measures:
Studies assessing pain relief following intra-articular injections for the diagnosis of FAI syndrome, compared with arthroscopy as diagnostic reference standard, were considered eligible. Searches were performed across 8 databases, and the risk of bias was evaluated through the Quality Assessment of Diagnostic Accuracy Studies tool.

Results:
From 489 articles identified, 4 were included for analysis. Intra-articular injections were composed of anesthetic agents (such as lidocaine, bupivacaine, and ropivacaine), combined or not with corticosteroids (triamcinolone and betamethasone). All studies were judged as “at risk of bias”, and a substantial heterogeneity was found considering assessment methods and pain relief thresholds for a positive response to intra-articular injections. Overall, 2 studies reported that intra-articular injections presented a high accuracy in determining the presence of FAI syndrome. However, the remaining 2 studies indicated that intra-articular injections might present restricted diagnostic capability to discriminate FAI syndrome from healthy individuals or those with other hip pathologies.

Conclusions:
Based on limited evidence, the diagnostic capability of intra-articular injections for FAI syndrome cannot be supported. It remains unclear which pain relief thresholds are related to a higher diagnostic capability. The combination of anesthetics with corticosteroids should also be further explored, including multiple pain assessments for evaluation of prolonged effects.
Lateral Epicondylalgia and Thoracic Kyphosis: A Study on Young Athletes
Authors: Šarčević Zoran , Stanković Milan , Tepavčević Andreja 
Published: May 2024

Objective:
The etiology of lateral epicondylalgia (LE) remains unclear, although it has been linked to various factors. Recent theories suggest a potential connection between LE and impairments in the kinetic chain. In our study, we aimed to investigate the association between another factor influencing kinetic chain impairment, specifically an increased angle of thoracic kyphosis, and the presence of initial signs of LE in young athletes.

Design:
This study employed an observational, case–control design.

Setting:
The participants underwent examination during a routine preventive checkup conducted by a sports physician at Novi Sad Healthcare Center, Sports Medicine Center.

Participants:
One hundred young athletes aged 10 to 15 years were included in the study. Half of the participants reported pain in the lateral aspect of the elbow during maximal hand grip, while the remaining athletes served as controls and did not experience any pain.

Assessment of Independent Variables:
Thoracic kyphosis inclination angles were measured using a digital inclinometer.

Main Outcome Measures:
Pain was assessed using the pressure pain threshold at a specific point associated with lateral epicondylalgia, measured by a digital algometer.

Results:
Participants exhibiting initial signs of LE displayed significantly different angles of anteroposterior curvatures of the spine compared with the control group. Moreover, the angle of thoracic kyphosis was significantly associated with pain in the lateral aspect of the elbow.

Conclusions:
Our findings confirm an association between initial signs of lateral epicondylalgia and the grade of thoracic kyphosis in young athletes.
Popularizing Surgical Cures: Walter Dandy and the Vestibular Neurectomy for Menière's Disease at the Johns Hopkins Hospital
Authors: Perdomo Dianela , Ward Bryan K. 
Published: May 2024

Objectives
To uncover the context that allowed for the vestibular neurectomy to grow in favor and practice at the Johns Hopkins Hospital in the early 20th century, and the reasons for its broad abandonment since.

Methods
The Walter E. Dandy (1905–1946) and Samuel J. Crowe collections (1905–1920) at the Alan Mason Chesney Medical Archives were reviewed, as well as the Samuel J. Crowe and Stacy Guild Temporal Bone Collection.

Results
Speculation on the etiology of Menière's disease (MD) has been countless, as have the medical and surgical interventions aimed at treating it. At the Johns Hopkins Hospital, Walter Dandy popularized the neurectomy for MD and performed 692 procedures from 1924 to 1946, believing it to be a curative therapy for vertigo. When he later modified the procedure from a total cranial nerve section to a partial vestibular neurectomy preserving auditory function, surgical candidacy expanded to include nearly any patient with vestibular symptoms. After his passing, trainees' attention shifted to traumatic injuries, likely influenced by WWII. This left the procedure scarcely used until third parties rekindled interest decades later.

Conclusions
Neurectomy as the preferential treatment for MD at the Johns Hopkins Hospital was not driven by pure scientific reasoning but was rather contingent on historical context and sponsorship by a prominent figure like Walter Dandy. Appreciation of MD's natural history has since curtailed the favorability of destructive procedures in preference for conservative management.
Impact of Cochlear Implantation on Quality of Life in Chinese Americans
Authors: Fan Caleb J. , Mavrommatis Maria A. , Wanna George B. , Cosetti Maura K. 
Published: May 2024

Objectives
To investigate the quality of life (QOL) of adult Mandarin-speaking Chinese Americans after cochlear implantation (CI) using the cross-culturally adapted Chinese Cochlear Implant Quality of Life-10 (CIQOL-10) Global.

Study Design
Cross-sectional.

Setting
Tertiary care neurotology practice in New York City.

Patients
Thirty adult Mandarin-speaking Chinese Americans (22.8–89.4 yr, mean 48.9 yr) with prelingual (12) or postlingual (18) deafness who underwent CI between 1995 and 2020. All patients were at least 1 year from CI activation.

Intervention
CI.

Main Outcomes Measures
Chinese CIQOL-10 Global score.

Results
There were no detectable differences in mean Chinese CIQOL-10 Global scores between the prelingual (mean 51.9, SD 11.0) and postlingual (mean 44.0, SD 16.4) cohorts (p = 0.1; 95% CI, −2.3 to 18.1; Hedges' g = 0.5). Comparison of the overall cohort (mean 47.1, SD 14.8) with previously published CIQOL-10 Global scores of English-speaking American CI users (mean 51.5, SD 10.4) demonstrated a significant difference (p = 0.02; 95% CI, 0.4–8.4; Hedges' g = 0.4). For the overall cohort, multivariable analysis demonstrated that combined household income (p = 0.007, β = 7.4; 95% CI, 0.7–14.0) was positively associated with Chinese CIQOL-10 Global scores.

Conclusions
This study is the first to evaluate QOL after CI in Mandarin-speaking Chinese American adults. The CIQOL-10 Global scores of Mandarin-speaking Chinese Americans CI users are significantly worse than those of English-speaking American CI users. Combined household income may be positively associated with QOL in the Mandarin-speaking Chinese American CI population. More resources are needed to assess outcomes and support rehabilitation in this population.
Sarcopenia is an independent risk factor for short-term mortality in patients undergoing transjugular intrahepatic portosystemic shunt
Authors: Stoffel Elina , Hwang Soo Young , Qian Xia , Geller Brian , Morelli Giuseppe , Zhang Wei 
Published: May 2024

Background
Sarcopenia is common in patients with cirrhosis and is a risk factor for increased mortality. Transjugular intrahepatic portosystemic shunt (TIPS) placement has been utilized in cirrhosis patients with decompensation . We investigated the role of sarcopenia in predicting mortality in patients undergoing TIPS.

Methods
We conducted a single-center retrospective study of 232 patients with cirrhosis who underwent TIPS between January 2010 and December 2015. Sarcopenia was defined by the psoas muscle index (PMI) cutoff value, calculated based on dynamic time-dependent outcomes using X-tile software. Kaplan–Meier analysis demonstrated the difference in survival in the sarcopenia group versus the non-sarcopenia group. . Univariate and multivariate analyses were used to identify the relationship between sarcopenia and post-TIPS mortality during a follow-up period of 1 year.

Results
For TIPS indications, 111 (47.84%) patients had refractory ascites, 69 (29.74%) patients had variceal bleeding, 12 (5.17%) patients had ascites, and 40 (17.24%) for other indications. The mean PMI was 4.40 ± 1.55. Sarcopenia was defined as a PMI value of <4.36 in males, and <3.23 in females. Sarcopenia was present in 96 (41.38%) of patients. . Kaplan–Meier analysis showed thatsarcopenia is associated with worse survival (log-rank P < 0.01). Multivariate Cox regression analysis showed that sarcopenia is independently associated with worse survival during the 1-year follow-up period with an hazard ratio of 2.435 (95% CI 1.346–4.403) (P < 0.01), after adjusting for age, BMI, indications for TIPS, etiology for cirrhosis, and MELD score and stratified by sex.

Conclusion
Sarcopenia is an independent risk factor for 1-year mortality in patients undergoing TIPS and should be considered when patients are evaluated as a candidate for TIPS.
Mediating effect of diabetes on the relationship between nonalcoholic fatty liver disease and atherosclerotic cardiovascular disease: a prospective cohort study
Authors: Yuan Wei , Ran Ying , Wang Jierui , Pei Fei , Cui Liufu , Chen Shuohua , Wu Shouling , Zhou Lu 
Published: May 2024

Objective
This study explored the mediating effect of diabetes on the relationship between nonalcoholic fatty liver disease (NAFLD) and atherosclerotic cardiovascular disease (ASCVD).

Methods
In this prospective community cohort study, 82 975 participants were enrolled, with the primary outcome being the incidence of new-onset ASCVD. Using the Cox proportional hazards model, the hazard ratio (HR) and 95% confidence interval (CI) for ASCVD occurrence were computed between NAFLD and non-NAFLD groups. The correlation between NAFLD and diabetes was assessed using a binary logistic regression model, and that between NAFLD, diabetes and ASCVD using a mediation model.

Results
During follow-up, 9471 ASCVD cases were observed. Compared with individuals without NAFLD, those with NAFLD showed an increased ASCVD risk (HR: 1.424; 95% CI: 1.363–1.488; P < 0.001). Stratifying NAFLD based on metabolic subphenotypes revealed a higher ASCVD risk in the NAFLD combined with diabetes subgroup than in the non-NAFLD subgroup (HR: 1.960; 95% CI: 1.817–2.115; P < 0.001). NAFLD was positively associated with baseline diabetes (odds ratio: 2.983; 95% CI: 2.813–3.163; P < 0.001). Furthermore, NAFLD severity was positively correlated with diabetes risk. Mediation analysis indicated that diabetes partially mediated the effect of NAFLD on ASCVD incidence, accounting for 20.33% of the total effect.

Conclusion
NAFLD is an independent predictor of increased ASCVD risk, which may be slightly mediated by diabetes in patients with NAFLD. Evaluating NAFLD and diabetes may be crucial in the early screening and prevention of ASCVD.
Frailty recommendations and guidelines. An evaluation of implementability and critical appraisal of clinical applicability by the ISPRM Frailty Focus Group
Authors: Antoniadou Eleftheria , Giusti Emanuele Maria , Capodaglio Paolo , HAN Dersheng , Gimigliano Francesca , Guzman Juan Manuel , OhPARK Mooyeon , Frontera Walter 
Published: May 2024

Objective:
Aging is associated with an increased burden of multimorbidity and disease-related functional loss and disability, widely impacting patients and health care systems. Frailty is a major factor in age-related disability and is an important target for rehabilitation interventions, considering that is a reversible condition.

Methods:
A working group of members of the International Society of Physical Medicine and Rehabilitation, responding to the World Health Organization (WHO) 2030 call for action to strengthen rehabilitation, was established to assess the quality and implementability of the existing guidelines for the rehabilitation of frailty. Guidelines were retrieved using a systematic search on Pubmed, Scopus, and Web of Science and from the reference lists of screened articles. The included guidelines were evaluated using the AGREE II to assess their quality and using the AGREE-REX to assess their clinical credibility and implementability. Guidelines with a score >4 in the AGREE II item evaluating the overall quality of the guideline were considered for endorsement. Finally, 9 external reviewers evaluated the applicability of each recommendation from the endorsed guidelines, providing comments about the barriers and facilitators for their implementation in their country.

Results:
Ten guidelines were retrieved and evaluated by the working group, of which 4 guidelines, that is, the WHO Guidelines on Integrated Care for Older People, the FOCUS guidelines, the Asia-Pacific Clinical Practice Guidelines for the Management of Frailty, and the ICFSR International Clinical Practice Guidelines for Identification and Management of Frailty, were considered for endorsement. All these guidelines were rated as of adequate quality and implementability.

Conclusion:
The WHO Guidelines on Integrated Care for Older People (24), the ICFSR International Clinical Practice Guidelines for Identification and Management of Frailty (15), the FOCUS guidelines (25), and the Asia-Pacific Clinical Practice Guidelines (14) for the Management of Frailty have the best quality and applicability of the existing guidelines on the management of frailty, we suggest that should be employed to define the standards of care for patients with frailty. There are barriers to their implementation, as stated by our experts, to take into account, and some of them are country or region-specific. Screening for frailty, exercise, nutrition, pharmacological management, social and psychological support, management of incontinence, and overall comprehensive clinical management are the best tools to face frailty.
Comparison of standard goal attainment scaling (GAS) and the GAS-light method for evaluation of goal attainment during neurorehabilitation of the upper limb
Authors: Pike Shannon , Cusick Anne , Turner-Stokes Lynne , Giummarra Melita J. , Chen Zhibin , Buckley David , Li Teng Han Michael , Lannin Natasha A. 
Published: May 2024

Background:
Goal attainment scaling (GAS) is now widely used as a person-centered measure of outcome from rehabilitation and has demonstrated validity in diverse populations with sensitivity to change. However, as originally described, it is time-consuming for use in busy clinical settings. The “GAS-light” is a simplified version designed for application in routine clinical practice. Although increasingly taken up by clinicians, published evidence of the validity of GAS-light method is currently lacking.

Objective:
To evaluate the validity and sensitivity of the GAS-light rating method as a measure of goal attainment in clinical neurorehabilitation practice. To examine its agreement with the standard GAS rating (as originally described by the developers) as the gold standard and to assess its clinical utility and acceptability.

Methods design:
A direct, head-to-head comparison of the 2 GAS rating methods in a cohort of adults undergoing upper limb motor rehabilitation programs across a range of rehabilitation settings, including hospital, community outpatient, and spasticity clinic services. Study population: 60 patients (n=54 poststroke) set a total of 136 goals (range 1–4 per patient). In this comparative study, patients acted as their own controls.

Measures:
The 2 rating methods were applied independently and in parallel from a single goal-setting discussion. Goal attainment was measured on the original 5-point GAS using a predetermined follow-up guide and the GAS-light with its 6-point verbal rating scale. The evaluation included concurrent validity (intraclass correlation coefficients and agreement between the 2 ratings) and sensitivity to change using the standardized response mean (SRM). Thirteen clinicians and 52 participants completed surveys of clinical utility and patient acceptance, respectively.

Results:
Individual absolute agreement of 2-way mixed-effects intraclass correlation between the tools indicated good agreement (ICC(A,1)=0.88, 95% CI: 0.80, 0.93), and small systematic bias (–1.72 (95% CI: −3.04, −0.41). Both tools measured similar levels of change over time (GAS SRM=1.79; GAS-light SRM=1.62). Clinicians perceived GAS-light had stronger clinical utility, being quicker and easier to administer, score, and understand. Patients perceived GAS-light as acceptable, comfortable, worthwhile, and helpful.

Conclusions:
GAS-light is reliable and sensitive to change, with better clinical utility than the standard GAS. Either tool may be used to assess goal attainment in clinical upper limb neurorehabilitation.
Changes in HIV Internalized and Experienced Stigmas and Social Support After an Urban Gardens and Peer Nutritional Counseling Intervention Among People With HIV and Food Insecurity in the Dominican Republic
Authors: Derose Kathryn P. , Palar Kartika , Then-Paulino Amarilis , Han Bing , Armenta Gabriela , Celeste-Villalvir Alane , Sheira Lila A. , Jimenez-Paulino Gipsy , Acevedo Ramón , Donastorg Yeycy , Farías Hugo , Wagner Glenn J. 
Published: May 2024

Background:
Food insecurity and HIV-related stigma negatively affect HIV outcomes. Few studies have examined how food security interventions affect HIV-related stigma and social support.

Setting:
Two HIV clinics in the Dominican Republic.

Methods:
A pilot cluster randomized controlled trial of an urban gardens and peer nutritional counseling intervention was conducted to examine outcomes of HIV-related stigmas and social support. Adult patients (≥18 years of age) with moderate or severe household food insecurity and evidence of suboptimal ART adherence and/or a detectable viral load were enrolled; standard measures of internalized and experienced stigmas and social support were collected at baseline and at 6 and 12 months. Intervention clinic participants received training and materials from agronomists for a home garden, 3–4 sessions of nutritional counseling from the clinic's peer counselor, and a garden produce cooking workshop facilitated by professional nutritionists.

Results:
Of 109 study participants (46 intervention and 63 control), 103 (94%) completed 12-month follow-up. Difference-in-differences multivariate longitudinal linear regressions adjusting for sociodemographic factors found that intervention participants had reduced internalized stigma by 3.04 points (scale 0–32) at 12 months (P = 0.002); reduced probability of experiencing HIV-related stigma or discrimination in the past 6 months (20 percentage points at 6 months, P = 0.05 and 25 percentage points at 12 months, P = 0.02); and modestly improved social support at 12 months (1.85 points on 30-pt scale, P = 0.093).

Conclusion:
A fully powered, larger trial is needed to establish the efficacy of the intervention and assess pathways by which the intervention may improve HIV stigma and social support.