bluuebunny/crossref_metadata_2025_split huggingface dataset:
PRE-ECLAMPSIA AND YOUNG-ONSET DEMENTIA: TIME TO SOUND THE ALARM?
Authors: Olié Valérie , Lailler Gregory , Torres Marion , Regnault Nolwenn , Carcaillon-bentata Laure , Blacher Jacques 
Published: May 2024

Objective:
Pre-eclampsia remains a major cause of maternal and foetal morbidity and mortality worldwide, affecting 2–5% of pregnancies. Many studies have shown the cardiovascular and renal impacts of this disorder to last decades after pregnancy. Recently, an association between pre-eclampsia and neurological disorders has been described with a three-fold higher risk of late-onset vascular dementia after a mean follow-up of 20 years. The aim of our study was to estimate the impact of pre-eclampsia and gestational hypertension in the first years after pregnancy on young-onset dementia.

Design and method:
The Conception study, a nationwide prospective study including all deliveries occurring in France between 2010 and 2018, with an ongoing follow-up included 1,966,323 women aged over 29 years with no history of dementia. Dementia were identified using primary diagnosis for hospitalization during the follow-up. Hazard Ratios with maternal age as time scale were calculated using crude and adjusted Cox-proportional regression models. Models were adjusted for obesity, diabetes mellitus, tobacco smoking, drug and alcohol addiction and social deprivation.

Results:
Pre-eclampsia and gestational hypertension occurred in 2.9% and 5.9% of pregnancy respectively. Dementia occurred in 128 women during an average follow-up of 7 years. Pre-eclampsia (but not gestational hypertension) was associated with a 2.7-fold increased risk of young-onset dementia compared with pregnancy without hypertensive disorders (Table 1). The risk of young-onset dementia was even higher when pre-eclampsia occurred early (before 34 weeks of gestation) (4.15 [1.30-13.14]) or was superimposed on chronic hypertension (4.76 [1.49-15.22).

Conclusions:
While some studies have already reported cognitive function impairment and white matter lesions, our results are the first to show a short-term increase of early-onset dementia. This highlights a need for close follow-up among women who have experienced pre-eclampsia, covering neurological health as well as the metabolic, cardiovascular and renal systems. Moreover, this finding further adds to our currently limited knowledge about risk factors of young-onset dementia.
Improving coordination between obstetricians and general practitioners is relevant to enable long-term follow-up of women and to avoid delays in diagnosis due to doctors’ knowledge gaps in their obstetrical history.
A HIGH-RISK GROUP IN THE MIDDLE EAST: YOUNG WOMEN WITH HYPERTENSION AND HYPERTENSIVE DISEASE OF PREGNANCY: ANALYSIS FROM THE ANCORS YW STUDY
Authors: Hammoudeh Ayman , Abuhalimeh Raghad , Bani Baker Mohammad , Amairi Lina , Al-abdallat Tala 
Published: May 2024

Objective:
Young women, who were once thought to be immune against atherosclerotic cardiovascular disease (ASCVD), are now considered a high-risk group. This is due to higher prevalence of classical and novel risk factors (RFs) including hypertension (HTN) and hypertensive disease of pregnancy (HDP). Unfortunately, studies about clinical outcomes and prevalence of these two risk factors have not been previously studied in Middle Eastern (ME) young women with ASCVD.
Aim:To evaluate the clinical and socioeconomic profiles of ME young women with HTN and HDP, compared with women who do not have these two RFs. Comparing differences between these two groups will help develop better management and earlier diagnosis of unwanted sequelae.

Design and method:
Young women (18-50 years) with ASCVD and age-matched controls were consecutively enrolled in 12 centers (August 2021 to October 2023). Profiles of women with HTN/HDP were contrasted with those who did not have these RFs.

Results:
Of 618 young women enrolled (mean age 44.0±4.5 years), 305 (48.6%) had HTN and/or HDP, and 322 (51.4%) did not have HTN/HDP. Compared with women with no HTN/HDP, the HTN/HDP group had more ASCVD (44.9% vs. 22.4%), diabetes (33.1% vs. 9.6%), and obesity (52.1% vs. 35.7%), all p values<0.05. Of the novel RFs studied, in addition to the higher prevalence of HDP, there was a higher prevalence of preterm delivery in the hypertensive group. However, gestational diabetes, persistent weight gain, premature menopause, and polycystic ovary syndrome were of no significant difference. Regarding the psychosocial factors, less education and less physical activity were observed in the HTN/HDP group. On multivariate analysis, HTN was found to be an independent predictor of ASCVD (Odds ratio 2.15, 95% CI 1.41-3.30, p<0.001). Based on these findings, HTN in women can be considered an important risk factor for predicting outcomes and prognosis.

Conclusions:
ME young women with HTN/HDP are more likely to have a worse clinical and psychosocial profile compared with those who do not. These women should be targeted for early screening and management in all cardiovascular prevention programs in our region.
Parosmia Is Positively Associated With Problematic Drinking, as Is Phantosmia With Depressive Symptoms
Authors: Agarwal Khushbu , Luk Jeremy W. , Stangl Bethany L. , Schwandt Melanie L. , Momenan Reza , Goldman David , Diazgranados Nancy , Kareken David A. , Leggio Lorenzo , Ramchandani Vijay A. , Joseph Paule V. 
Published: May 2024

ObjectivesAlcohol use disorder (AUD) is a global health problem with significant negative consequences, including preventable deaths. Although olfactory dysfunction is associated with chronic alcohol drinking, the relationship among specific types of olfactory deficits, depressive symptoms, and problematic drinking remains to be explored. Here, we examined the prevalence of olfactory distortion (parosmia) and hallucination (phantosmia) and assessed their associations with problematic drinking and depressive symptoms.MethodsIn April–June 2022, 250 participants across the spectrum of AUD were recruited for assessment in the National Institute on Alcohol Abuse and Alcoholism COVID-19 Pandemic Impact on Alcohol study. Surveys covered self-reported olfactory function, depressive symptoms, and problematic drinking, with key measures assessed, including the Alcohol Use Disorders Identification Test and the Patient Health Questionnaire. Predictors in the analysis included parosmia and phantosmia, with covariates comprising age, sex, socioeconomic status, race, ethnicity, COVID-19 infection status, and smoking status.ResultsAmong 250 individuals, 5.2% experienced parosmia and 4.4% reported phantosmia. Parosmia was associated with higher Alcohol Use Disorders Identification Test scores (β = 7.14; 95% confidence interval = 3.31, 10.96;P< 0.001), whereas phantosmia was linked to higher Patient Health Questionnaire scores (β = 3.32; 95% confidence interval = 0.22, 6.42;P= 0.03). These associations persisted in both the full sample and the subset of participants without COVID-19.ConclusionsOur study highlights strong existing links among olfactory deficits, problem drinking, and depressive symptoms, underscoring the need to assess smell impairments in clinical settings. Future research should explore these connections further to develop new treatments for individuals with AUD and depression.
Anorexia nervosa and systemic lupus erythematosus: a coincidence?
Authors: Kudsi Maysoun , Tarcha Raghad , Khalayli Naram , Haidar Ghina , Btrush Sana 
Published: May 2024

Introduction and importance:
The COVID-19 pandemic has led to a post-acute syndrome that can persist for an extended period. The correlation between anorexia nervosa (AN) and some autoimmune diseases has been reported. Systemic lupus erythematosus (SLE) is a systemic autoimmune disease, presented with different clinical ions and periods, affecting all ages, especially females. The coexistence of SLE and AN has been reported in rare cases. The authors present the case of a 22-year-old male with severe AN coexisting with SLE.

Case presentation:
We present a case of a 22-year-old male diagnosed with SLE. He also completely refused to eat and drink and presented with behavioral disorders and suicidal thoughts. He was on 200 mg/day of oral hydroxychloroquine, 400 units/day of vitamin D, and 1000 mg/day of oral calcium. There was no positive other history, trauma, drug addiction, or family history. AN was diagnosed according to ICD-10 and DSM-V. Physical examination revealed decreased subcutaneous tissue and muscle atrophy. The weight of the patient was 35.3 kg. Verbal contact was maintained, and psychotic symptoms were not observed. Tenderness in all joints was noticed, while swelling in both knees and right ankle joints was found. Laboratory tests revealed elevated inflammatory markers. Treatment includes a high-calorie diet administered by a feeding tube. The patient began to gain weight after 3 months. He is on 200 mg/day hydroxychloroquine, with remission till now January 2024.

Clinical discussion:
The novelty of our case is that it is a case of a young adult man presented with AN during mild lupus, who responded well to treatment with steroids and a high-calorie diet.

Conclusions:
Previous research has suggested the existence of a close link between food and eating disturbance and autoimmunity, and herein we provide further evidence to support this relationship by presenting a case report of an adult male with SLE and AN.
Hyaluronic Acid-based Fillers for Facial Rehabilitation in Inherited Neuropath
Authors: Bravo Bruna Souza Felix , Elias Mariana Calomeni , Bravo Leonardo Gonçalves , Jaeger Thomas Novoa Gomes , Almeida Thamires Silva Cavalcante de 
Published: May 2024

Summary:
Charcot–Marie–Tooth (CMT) disease is the most prevalent inherited neuromuscular disorder. It commonly leads to various musculoskeletal deformities, profoundly impacting the quality of life. The present case report explores the often under-recognized body image dissatisfaction in CMT, highlighting the potential benefits of a multidisciplinary approach to enhance aesthetic satisfaction. We present a case of a 54-year-old woman with CMT, who experienced chronic facial asymmetry, significantly impairing her quality of life. Seeking cosmetic enhancement, she underwent two sessions of facial treatment using hyaluronic acid-based fillers. The first session focused on correcting right mandibular hypoplasia and other facial asymmetries, whereas the second session focused on enhancing perioral aesthetics. The treatment resulted in significant aesthetic improvements, as demonstrated by high ratings in both the Physician Global Aesthetic Improvement Scale and the Subject Global Aesthetic Improvement Scale. Besides, there was a marked reduction in lip corner asymmetry, the patient’s primary concern. The role of hyaluronic acid fillers in facial aesthetic enhancement is well established, and their application in the context of CMT is a promising under-investigated field, to our knowledge. This case study highlights the importance of considering body image in CMT patients and suggests that minimally invasive aesthetic procedures can be a valuable addition to the multidisciplinary care of patients with inherited neurological disorders. Despite being a single-case study, the significant improvement in the patient’s aesthetic satisfaction requires further research in this field.
Gender Affirmation Surgery–related Hashtag Utilization on Instagram: Implications for Education and Patient Care
Authors: Gupta Nisha , Alnaseri Tahera , Slack Ginger , DeLong Michael 
Published: May 2024

Background:
Gender-affirmation surgery (GAS) allows for transgender and nonconforming patients to achieve a more congruent physical appearance and alleviate dysphoria. Social media, such as Instagram, has adopted an increasingly important role in plastic and reconstructive surgery, and understanding trends and usage related to GAS can have significant implications for patient education and outreach. As such, this cross-sectional study aims to address the following questions related to GAS-related content available on Instagram: (1) Who is posting this content? (2) What specific hashtags are they using? and (3) What are the implications behind these posts?

Methods:
This study analyzed 22 GAS-related hashtags on Instagram. Content analysis was then used to evaluate the “top” 15 posts (n = 330) associated with each hashtag.

Results:
A total of 425,607 posts were associated with the 22 hashtags queried. #topsurgery had the highest number of associated posts (n = 279,480), followed by #ftmtopsurgery (n = 41,769) and #vaginoplasty (n = 39,737). Of the “top” 330 posts, 299 were not duplicates. Plastic surgeons eligible for membership in the American Society of Plastic Surgeons accounted for only 1.7% of “top” posts (n = 5); noneligible physicians accounted for 6.0% of posts (n = 18). Patients accounted for the majority of the “top” posts sampled (n = 236; 79.9%).

Conclusions:
When used appropriately, social media can be a powerful tool for spreading awareness on procedures and educating patients. Although there is a paucity of plastic surgeons posting GAS-related content on Instagram, patients are playing an important role in disseminating information.
Lessons for tomorrow: The role of relationships and mindfulness in sustaining services during a crisis
Authors: Hajjar Lauren , Sullivan Erin , Maurer Marsha , Yang Julius 
Published: May 2024

Background
The COVID-19 pandemic placed unprecedented demands on hospitals around the globe, making timely crisis response critical for organizational success. One mechanism that has played an effective role in health care service management during large-scale crises is the Hospital Incident Command System.

Purpose
The aim of this article was to understand the role of HICS in the management of a large academic medical center and its impact on relationships and communication among providers in the delivery of services during a crisis.

Methodology
This mixed methods study was based on meeting observations, document reviews, semistructured interviews, and two measures of team performance within an academic medical center in the Northeast during the COVID-19 pandemic. Descriptive and bivariate analyses were applied, and qualitative data were coded and analyzed for themes.

Results
HICS provided a systematic information-sharing and decision-making process that increased communication and coordination among team members. Analyses indicate a correlation between dimensions of relational coordination and organizational mindfulness. Qualitative data revealed the importance of shared meetings and huddles and the evolution of HICS across multiple waves of the crisis.

Conclusion
HICS facilitated organizational improvements during the crisis response and generated opportunities to maintain specific coordination practices beyond the crisis. The prolonged implementation of HICS during the COVID-19 pandemic created challenges, including the disruption of the routine leadership structure.

Practical Implications
Applying relational coordination and organizational mindfulness frameworks may allow hospitals to leverage communications and relationships within a high-stakes environment to improve service delivery.
Nurse practitioners, physician assistants, and trust: A systematic review
Authors: Porter Tracy H. , Peck Jessica A. , Thoebes Gina 
Published: May 2024

Background
The use of physician extenders (e.g., nurse practitioners [NPs] and physician assistants [PAs]) has risen in recent years in the U.S. health care domain, yet some scholars have questioned if physician extenders are being fully utilized in the health care field.

Purposes
The purpose of this research was to conduct a systematic review to determine if trust in the NP/PA might be influential in the ways these professionals are utilized. We view trust through the lens of Mayer et al. and their model of organizational trust, and we seek to examine how patients, physicians, and NPs/PAs themselves view one another.

Methods
This systematic review spanned from 1996 to 2022 and applied the Preferred Reporting Items for Systematic Reviews and Meta-Analyses strategy. The final sample consisted of 29 articles.

Results
The findings point to how the antecedents of trust according to Mayer et al.; i.e., trustee's ability, benevolence, and integrity) influence the trusting relationships between patients and NPs/PAs and between physicians and NPs/PAs. Consequences and outcomes of trust are also discussed. Importantly, a trustor's propensity to trust and repeat interactions over time (e.g., feedback loop) is influential to trusting relationships.

Practice Implications
These findings offer health care organizations insight into the mechanisms for building trust as physician extenders become more prominent in the health care field.
Service mix and financial performance in rural hospitals: A contingency theory perspective
Authors: Cendoma Phil , Hearld Kristine Ria , Upadhye Devdutt , Landry Robert J. , Landry Amy 
Published: May 2024

Background
Rural hospitals are increasingly at risk of closure. Closure reduces the availability of hospital care in rural areas, resulting in a disparity in health between rural and urban citizens, and it has broader economic impacts on rural communities as rural hospitals are often large employers and are vital to recruiting new businesses to a community. To combat the risk of closure, rural hospitals have sought partnerships to bolster financial performance, which often results in a closure of services valuable to the community, such as obstetrics and certain diagnostic services, which are viewed as unprofitable. This can lead to poor health outcomes as community members are unable to access care in these areas.

Purpose
In this article, we explore rural hospital service offerings and financial performance, with an aim to illuminate if specific service offerings are associated with positive financial performance in a rural setting.

Methods
Our study used hospital organization data, as well as county-level demographics with periods of analysis from 2015 and 2019. We employed a pooled cross-sectional regression analysis with robust standard errors examining the association between total margin and service lines among rural hospitals in the United States.

Results
The findings suggest that some services deemed unprofitable in urban and suburban hospital settings—such as obstetrics and drug/alcohol rehabilitation—are associated with higher margins in rural hospitals. Other unprofitable service lines—such as psychiatry and long-term care—are associated with lower margins in rural hospitals.

Conclusion
Our results suggest the need of rural hospitals to choose services that align with environmental circumstances to maximize financial performance.

Practice Implication
Hospital administrators in rural settings need to take a nuanced look at their environmental and organizational specifics when deciding upon the service mix. Generalizations regarding profitability should be avoided to maximize financial performance.
New insights about community benefit evaluation
Authors: Burns Ashlyn , Yeager Valerie A. , Vest Joshua R. , Harle Christopher A. , Madsen Emilie R. , Cronin Cory E. , Singh Simone , Franz Berkeley 
Published: May 2024

Background
Nonprofit hospitals are required to conduct community health needs assessments (CHNA) every 3 years and develop corresponding implementation plans. Implemented strategies must address the identified community needs and be evaluated for impact.

Purpose
Using the Community Health Implementation Evaluation Framework (CHIEF), we assessed whether and how nonprofit hospitals are evaluating the impact of their CHNA-informed community benefit initiatives.

Methodology
We conducted a content analysis of 83 hospital CHNAs that reported evaluation outcomes drawn from a previously identified 20% random sample (n = 613) of nonprofit hospitals in the United States. Through qualitative review guided by the CHIEF, we identified and categorized the most common evaluation outcomes reported.

Results
A total of 485 strategies were identified from the 83 hospitals’ CHNAs. Evaluated strategies most frequently targeted behavioral health (n = 124, 26%), access (n = 83, 17%), and obesity/nutrition/inactivity (n = 68, 14%). The most common type of evaluation outcomes reported by CHIEF category included system utilization (n = 342, 71%), system implementation (n = 170, 35%), project management (n = 164, 34%), and social outcomes (n = 163, 34%).

Practice Implications
CHNA evaluation strategies focus on utilization (the number of individuals served), with few focusing on social or health outcomes. This represents a missed opportunity to (a) assess the social and health impacts across individual strategies and (b) provide insight that can be used to inform the allocation of limited resources to maximize the impact of community benefit strategies.
Primary Squamous Cell Carcinoma of the Thyroid Has a Molecular Genetic Profile Distinct From That of Anaplastic Thyroid Carcinoma
Authors: Ye Meihua , Guo Zhenying , Xu Jingjing , Jin Yanling , He Xianglei , Ge Minghua 
Published: May 2024

Background:
Primary squamous cell carcinoma (SCC) of the thyroid and anaplastic thyroid carcinoma (ATC) show significant clinical and histologic overlap. Their biological behaviors are so similar that the fifth WHO updates SCC as a morphologic pattern of ATC rather than a separate entity. However, molecular genomic evidence that determines them as the same histologic type is limited. We aimed to explore whether they belong to the same classification from a molecular-typing perspective.

Methods:
A cohort enrolled 15 SCCs and 15 ATCs was collected. Whole exome sequencing (WES) and RNA-sequencing were performed to analyze molecular genetic and gene-expression profiles.

Results:
Significantly differential-mutant genes were BRAF, DPCR1, PCYOX1L, BRSK2, NRG1, PRR14L, TET1, VAMP4 suggesting differences in mutation level, as well as differences in high-frequency mutated genes, and SCC had a much lower tumor mutation burden than ATC. Mutational co-occurrence and mutual exclusion were less frequent in SCC than in ATC. 2047 differential-express genes were screened, indicating differences in gene expression were extremely strong. In principal component analysis, ATC and SCC could be notably clustered together, respectively, meanwhile they could be explicitly distinguished. Unsupervised clustering analysis validated they can indeed be clearly separated from each other which demonstrated that they may be two distinctive entities.

Conclusions:
It is controversial yet SCC is classified as a morphologic pattern of ATC. We revealed that SCC exhibited molecular genetic characteristics distinct from ATC. Although the fifth WHO categorizes them together, this study may provide strong molecular genetic evidence for the next edition of WHO classification that may allow for the separation of thyroid SCC from ATC.