bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patient Attitudes Toward Self- or Partner-, Friend-, or Family-Administered Long-acting Injectable Antiretroviral Therapy: A Mixed-Methods Study Across 3 Urban Human Immunodeficiency Virus Clinics
Authors: Collins Lauren F , Koester Kimberly A , McNulty Moira C , Montgomery Elizabeth T , Johnson Mallory O , Neilands Torsten B , Dilworth Samantha E , Sauceda John A , Dance Kaylin , Erguera Xavier , Diaz Tsuzuki Manami , Gutierrez José I , Christopoulos Katerina A , Colasanti Jonathan A 
Published: May 2024

Abstract

Background
Long-acting injectable (LAI) cabotegravir/rilpivirine (CAB/RPV) offers a novel drug delivery option for persons with human immunodeficiency virus (PWH) but requires administration every 4 or 8 weeks by a medical professional.

Methods
To facilitate LAI antiretroviral therapy (ART) scale-up, we evaluated patient interest in alternative administration approaches via a mixed-methods, serial cross-sectional study across 3 US HIV clinics. We surveyed PWH (December 2021 to May 2022) on appeal of self- or partner/friend/family-administered LAI-CAB/RPV; multivariable ordinal logistic regression explored associated characteristics. To contextualize survey results, we thematically analyzed semi-structured interview data collected from PWH (August 2020 to July 2021) on attitudes toward out-of-clinic LAI-ART administration.

Results
Among 370 surveyed PWH (median age, 46 years; 26% cisgender female, 59% Black, 56% sexual minority, 34% housing instability), self-administering LAI-CAB/RPV appealed to 67%. PWH who were White (adjusted odds ratio [aOR], 3.30 [95% confidence interval {CI}, 1.42–7.64]), stably housed (aOR, 2.16 [95% CI, 1.30–3.59]), or gay/bisexual (aOR, 1.81 [1.14–2.89]) were more likely to endorse self-administration. Fewer PWH (60%) reported partner/friend/family administration as appealing; adjusted models revealed similar sociodemographic preferences for this outcome. In 72 interviews, PWH noted that acceptability of out-of-clinic LAI-ART administration was qualified by convenience, prior injection experience, and potential fear of self-inflicted pain, dependence on others, and/or HIV disclosure.

Conclusions
In a multisite sample of PWH, self- and, to a lesser extent, partner/friend/family-administration of LAI-CAB/RPV appealed to most; however, was less appealing among populations more impacted by health disparities. Innovative LAI-ART delivery options could free up in-clinic resources to focus scale-up among marginalized populations.
Accretion of the Lower Oceanic Crust at Fast-Spreading Ridges: Insights from Hess Deep (East Pacific Rise, IODP Expedition 345)
Authors: Basch Valentin , Sanfilippo Alessio , Snow Jonathan E , Loocke Matthew , Zanetti Alberto 
Published: May 2024

Abstract
At mid-ocean ridges, melts that formed during adiabatic melting of a heterogeneous mantle migrate upwards and ultimately crystallize the oceanic crust. The lower crustal gabbros represent the first crystallization products of these melts and the processes involved in the accretion of the lowermost crust drive the chemical evolution of the magmas forming two thirds of Earth’s surface. At fast-spreading ridges, elevated melt supply leads to the formation of a ⁓6-km-thick layered oceanic crust. Here, we provide a detailed petrochemical characterization of the lower portion of the fast-spread oceanic crust drilled during IODP Expedition 345 at the East Pacific Rise (IODP Holes U1415), together with the processes involved in crustal accretion. The recovered gabbroic rocks are primitive in composition and range from troctolites to olivine gabbros, olivine gabbronorites and gabbros. Although textural evidence of dissolution-precipitation processes is widespread within this gabbroic section, only the most interstitial phases record chemical compositions driven by melt-mush interaction processes during closure of the magmatic system. Comparing mineral compositions from this lower crustal section with its slow-spreading counterparts, we propose that the impact of reactive processes on the chemical evolution of the parental melts is dampened in the lower gabbros from magmatically productive spreading centres. Oceanic accretion thereby seems driven by fractional crystallization in the lower gabbroic layers, followed by upward reactive percolation of melts towards shallower sections. Using the composition of clinopyroxene from these primitive, nearly unmodified gabbros, we estimate the parental melt trace element compositions of Hess Deep, showing that the primary melts of the East Pacific Rise are more depleted in incompatible trace elements compared to those formed at slower spreading rates, as a result of higher melting degrees of the underlying mantle.
Instructing to Impact: Exploration of Doctor of Physical Therapy Education Instruction of Social Determinants of Health and Health Equity for People With Disabilities
Authors: Herrman Deana , Pechak Celia M , Berg Kristin , Magasi Susan 
Published: May 2024

Abstract

Objective
The aim of this study was to explore the instruction of social determinants of health (SDOH) for people with disabilities (PWD) in doctor of physical therapy (DPT) education programs.

Methods
A sequential mixed methods study informed by a five-member disability community advisory panel was conducted. Qualitative semi-structured interviews with educators (n = 10) across 4 DPT programs in the Midwest were conducted and analyzed thematically. The qualitative findings formed the basis of the quantitative phase. An online survey was conducted with faculty of DPT programs in the United States (n = 254) with the most knowledge of instruction of SDOH and health equity for PWD (n = 74; 29% response rate). Quantitative data were analyzed with descriptive statistics and triangulated with qualitative data.

Results
SDOH for PWD is an emerging component of instruction in DPT curricula. Five themes included: emerging instruction of SDOH for PWD; conceptual frameworks informing instruction; instructional strategies; barriers to integration of SDOH for PWD; and facilitators to integration of SDOH for PWD. Quantitative analysis revealed that 71 respondents (95.9%) included disability in health equity discussions primarily focused on health care access. Limited time (n = 49; 66.2%) was the most frequently reported barrier, and educator interest in disability health equity was the most frequently reported facilitator (n = 62; 83.7%) to inclusion of the SDOH for PWD in health equity discussions.

Conclusion
Opportunities exist in DPT curricula to build on instructional strategies, integrate SDOH frameworks, and amplify facilitators to integration of SDOH for PWD.

Impact
To meet the needs of the 67 million Americans living with disabilities, students must have the knowledge and skills to address the complex needs of this historically marginalized population. Understanding the DPT education landscape around SDOH for PWD can guide DPT educators to more fully prepare their students to recognize and ameliorate health disparities faced by PWD.
Preventing postpartum insomnia: findings from a three-arm randomized-controlled trial of cognitive behavioral therapy for insomnia, a responsive bassinet, and sleep hygiene
Authors: Quin Nina , Tikotzky Liat , Astbury Laura , Spina Marie-Antoinette , Fisher Jane , Stafford Lesley , Wiley Joshua F , Bei Bei 
Published: May 2024

Abstract

Study Objectives
Insomnia symptoms are common during the perinatal period and are linked to adverse outcomes. This single-blind three-arm randomized-controlled trial examined whether two interventions targeting different mechanisms prevent postpartum insomnia.

Methods
Participants were nulliparous females 26–32 weeks gestation with Insomnia Severity Index (ISI) scores ≥ 8, recruited in Australia and randomized 1:1:1 to: (1) a responsive bassinet (RB) designed to support infant sleep and reduce maternal sleep disruption until 6 months postpartum, (2) therapist-assisted cognitive behavioral therapy for insomnia (CBT-I) delivered during pregnancy and postpartum, or (3) a sleep hygiene booklet (control; CTRL). Outcomes were assessed at baseline (T1), 35–36 weeks gestation (T2), and 2, 6, and 12 months postpartum (T3–T5). The primary outcome was ISI scores averaged T3–T5. Primary analyses were regressions controlling for baseline outcomes.

Results
One hundred and twenty-seven participants (age M ± SD = 32.62 ± 3.49) were randomized (RB = 44, CBT-I = 42, CTRL = 41). Both interventions were feasible and well-accepted, with few related adverse events reported. Compared to CTRL, the average ISI across T3–T5 was lower for CBT-I (p = .014, effect size [ES] = 0.56, medium) but not RB (p = .270, ES = 0.25, small). Exploratory findings on maternal insomnia diagnosis, sleep disturbance, sleep-related impairment, beliefs and attitudes about sleep, depression, anxiety, as well as infant sleep outcomes were also presented.

Conclusions
CBT-I but not RB reduced prenatal insomnia (very large effect) and prevented postpartum insomnia (medium effect). Further research is needed to examine the effects of both CBT-I and RB on other outcomes such as sleep-related well-being, postpartum depression, and maternal postpartum sleep duration.

Clinical Trial Registration
The Study for Mother-Infant Sleep (The SMILE Project): reducing postpartum insomnia using an infant sleep intervention and a maternal sleep intervention in first-time mothers. https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=377927, Australian New Zealand Clinical Trials Registry: ACTRN12619001166167.
A new sauropod species from north-western Brazil: biomechanics and the radiation of Titanosauria (Sauropoda: Somphospondyli)
Authors: Pereira Paulo V L G C , Bandeira Kamila L N , Vidal Luciano S , Ribeiro Theo B , Candeiro Carlos R dos A , Bergqvist Lilian P 
Published: May 2024

Abstract
Titanosaurs were the most diverse sauropod group during the Cretaceous period, with most of its diversity being found during the Late Cretaceous. In this work, Tiamat valdecii, gen. et sp. nov. is described, a new species of basal titanosaur prospected from the Açu Formation (Albian–Cenomanian), Potiguar Basin, Ceará state, north-east Brazil. The new taxon is composed by an associated sequence of anterior to middle caudal vertebrae, being diagnosed by four diagnostic features: a marked accessory tuberosity dorsoventrally developed, located on the prezygapophyses; deeply medioventral excavated articulation facets of prezygapophysis and post-zygapophyses articular facets; presence of developed hypantrum–hyposphene articulations; and short middle centra with a well-marked articular facet for the haemal arch. The phylogenetic analysis reveals that Tiamat valdecii was a basal member of Titanosauria. Tiamat is the first species of Early Cretaceous titanosaur known for the Açu Formation. Biomechanical analysis shows that the tuberosity and excavation of the zygapophyses of the middle caudal vertebrae of Tiamat provide greater stability against shear loads in the amphicoelous vertebrae presented; in addition, they allow greater range of lateral movements without affecting the integrity of the joints. These features may have been an evolutionary alternative for the stability of the middle of the caudal vertebral column. The discovery of T. valdecii in the Açu Formation not only increases the known dinosaur diversity for this unit, but also helps us elucidate part of the first titanosaur radiation.
Hypoxic adipose stem cell‐derived exosomes carrying high‐abundant USP22 facilitate cutaneous wound healing through stabilizing HIF‐1α and upregulating lncRNA H19
Authors: Qian Li , Li Bo , Pi Li , Fang Bairong , Meng Xianxi 
Published: May 2024

AbstractHypoxic preconditioning has been recognized as a promotive factor for accelerating cutaneous wound healing. Our previous study uncovered that exosomal lncRNA H19, derived from adipose‐derived stem cells (ADSCs), plays a crucial role in orchestrating cutaneous wound healing. Herein, we aimed to explore whether there is a connection between hypoxia and ADSC‐derived exosomes (ADSCs‐exos) in cutaneous wound healing. Exosomes extracted from ADSCs under normoxic and hypoxic conditions were identified using transmission electron microscope (TEM) and particle size analysis. The effects of ADSCs‐exos on the proliferation, migration, and angiogenesis of human umbilical vein endothelial cells (HUVECs) were evaluated by CCK‐8, EdU, wound healing, and tube formation assays. Expression patterns of H19, HIF‐1α, and USP22 were measured. Co‐immunoprecipitation, chromatin immunoprecipitation, ubiquitination, and luciferase reporter assays were conducted to confirm the USP22/HIF‐1α/H19 axis, which was further validated in a mice model of skin wound. Exosomes extracted from hypoxia‐treated ADSCs (termed as H‐ADSCs‐exos) significantly increased cell proliferation, migration, and angiogenesis in H2O2‐exposed HUVECs, and promoted cutaneous wound healing in vivo. Moreover, H‐ADSCs and H‐ADSCs‐exos, which exhibited higher levels of H19, were found to be transcriptionally activated by HIF‐1α. Mechanically, H‐ADSCs carrying USP22 accounted for deubiquitinating and stabilizing HIF‐1α. Additionally, H‐ADSCs‐exos improved cell proliferation, migration, and angiogenesis in H2O2‐triggered HUVECs by activating USP22/HIF‐1α axis and promoting H19 expression, which may provide a new clue for the clinical treatment of cutaneous wound healing.
Long-Term Results After Laparoscopic Lavage for Perforated Diverticulitis Purulent Peritonitis in Sweden: A Population-Based Observational Study
Authors: Samuelsson Andreas , Bock David , Prytz Mattias , Ehrencrona Carolina , Wedin Anette , Angenete Eva , Haglind Eva 
Published: May 2024

Objective:
To compare long-term outcomes after laparoscopic lavage with resection surgery for perforated diverticulitis, Hinchey grade III as practiced in Sweden for 3 years.

Background:
Laparoscopic lavage has been studied in 3 randomized controlled trials. Long-term results indicate that additional surgery and a remaining stoma are less common after lavage compared with resection, but data from routine care and larger cohorts are needed to get a more complete picture.

Methods:
LapLav is a national cohort study with nearly complete coverage of all patients operated in Sweden between 2016 and 2018. The cohort was retrieved from the national patient register by a definition based on the Classification of Diseases and Related Health Problems-10 code plus the surgical procedural code. All medical records have been reviewed and data retrieved in addition to registry data. Propensity score with inverse probability weighting was used to balance the 2 groups, that is, laparoscopic lavage vs resection surgery.

Results:
Before the propensity score was applied, the cohort consisted of 499 patients. Additional surgery was more common in the resection group [odds ratio, 0.714; 95% confidence interval (CI) = 0.529–0.962; P = 0.0271]. Mortality did not differ between the groups (hazard ratio, 1.20; 95% CI = 0.69–2.07; P = 0.516). In the lavage group, 27% of patients went on to have resection surgery.

Conclusions:
In Swedish routine care, laparoscopic lavage was feasible and safe for the surgical treatment of perforated diverticulitis, Hinchey grade III. Our results indicate that laparoscopic lavage can be used as a first-choice treatment.
Minimally Invasive Robotic-assisted Perforator-to-Perforator DIEP Flap Breast Reconstruction
Authors: Kueckelhaus Maximilian 
Published: May 2024

Summary:
Reducing morbidity has been the goal of many reconstructive microsurgery efforts. Several techniques have been described for deep inferior epigastric perforator flap breast reconstruction to minimize abdominal donor-site morbidity. Although these techniques have certain tradeoffs, we designed a minimally invasive robot-assisted perforator-to-perforator approach to achieve minimal donor- and recipient-site morbidity. Simultaneous identification of the deep inferior epigastric artery (DIEA) and internal mammary artery (IMA) perforator was performed, followed by a small fascial incision around the dominant DIEA perforator. The IMA perforator was prepared for a prepectoral anastomosis. The short DIEA pedicle was dissected without further longitudinal fascial incision until an adequate diameter compared with the IMA perforator was reached, and a robot-assisted perforator-to-perforator anastomosis was performed prepectorally. All patients underwent reconstruction performed by a single surgeon. The smallest abdominal incision was 2.5 cm with a DIEP pedicle length of 6 cm. The average IMA perforator diameter was 1.14 mm (1.0 mm–1.2 mm). The average vein diameter was 2.0 mm (1.5–3.0 mm). The incision to closure lasted 330 minutes (313–348 minutes). Flap ischemia was 105 minutes (82–118 minutes), whereas the time for robot-assisted anastomosis was 25 minutes (22–30 minutes). All anastomoses were performed successfully. Our initial experience with robot-assisted perforator-to-perforator anastomosis for DIEP flap breast reconstruction demonstrates promise in achieving minimal patient morbidity. Raising only a very short pedicle can be compensated by adding the prepectoral IMA perforator length and enabling a good size match for small-caliber anastomosis. This technique combines important aspects of most minimally invasive DIEP flap harvests and insets.
Regional Transformation
Authors: McGinnis Juli , Aquino-Maneja Emma , Geloso Kristy , Zaragoza Carrie , Spicer Jerry , Kawar Lina Najib 
Published: May 2024

Background:
Synergistic opportunity exists between Magnet-aspiring environments and High Reliability Organization (HRO) cultures to elevate safety, quality, new knowledge, continuous improvement, hierarchical flattening, and frontline empowerment.

Local Problem:
Variation existed across a region’s 15 hospitals regarding Magnet-readiness, leadership engagement, journey strategies, and resource capacity.

Methods:
Quality improvement (QI) methodology and a hybrid-hub-spoke-model (HHSM) were used to support region-wide Magnet designation, improve patient outcomes, and advance nursing research.

Interventions:
HRO strategies were used region-wide to strengthen implementation and enculturation of Magnet excellence infrastructure.

Results:
Nine facilities achieved Magnet recognition. Magnet sites demonstrated significantly lower falls with injury (P = .012), lower health care-associated infections and hospital-acquired pressure injuries than non-Magnet sites. Nursing research studies increased 223%.

Conclusions:
Utilizing a HHSM and HRO strategies represent effective methods for supporting region-wide Magnet designation and continuous QI.
A Narrative Review on the Clinical Relevance of Imaging the Circumventricular Brain Organs and Performing Their Anatomical and Histopathological Examination in Acute and Postacute COVID-19
Authors: Castañeyra-Perdomo Agustin , Gonzalez-Mora Jose Luis , Carmona-Calero Emilia Maria , Makris Nikos , Carrasco-Juan Jose Luis 
Published: May 2024

Abstract
Autopsy followed by histopathological examination is foundational in clinical and forensic medicine for discovering and understanding pathological changes in disease, their underlying processes, and cause of death. Imaging technology has become increasingly important for advancing clinical research and practice, given its noninvasive, in vivo and ex vivo applicability. Medical and forensic autopsy can benefit greatly from advances in imaging technology that lead toward minimally invasive, whole-brain virtual autopsy. Brain autopsy followed by histopathological examination is still the hallmark for understanding disease and a fundamental modus operandi in forensic pathology and forensic medicine, despite the fact that its practice has become progressively less frequent in medical settings. This situation is especially relevant with respect to new diseases such as COVID-19 caused by the SARS-CoV-2 virus, for which our neuroanatomical knowledge is sparse. In this narrative review, we show that ad hoc clinical autopsies and histopathological analyses combined with neuroimaging of the principal circumventricular organs are critical to gaining insight into the reconstruction of the pathophysiological mechanisms and the explanation of cause of death (ie, atrium mortis) related to the cardiovascular effects of SARS-CoV-2 infection in forensic and clinical medicine.
Genital Self-Image and Body Dysmorphic Symptoms in Patients Undergoing Central Wedge or Linear Labiaplasty: A Clinical Trial
Authors: Minikowski Guilherme Campanha , Veiga Daniela Francescato , Felix Gabriel de Almeida Arruda , Pedroso Juan Carlos Montano , Ferreira Lydia Masako , Neto Miguel Sabino 
Published: May 2024

Background:
Labiaplasty, a surgical procedure designed to address labia minora hypertrophy, has been closely linked to the improvement of genital self-image and the alleviation of symptoms related to body dysmorphic disorder (BDD). Brazil stands as the global leader in the prevalence of labiaplasty procedures. This study aimed to assess alterations in genital self-image and symptoms of BDD in individuals with labia minora hypertrophy who underwent either wedge or trim labiaplasty.

Methods:
A total of 48 adult women undergoing labiaplasty were enrolled in this randomized clinical trial with 2 parallel groups. The allocation ratio was 1:1. The study group underwent wedge labiaplasty, and the control group underwent trim labiaplasty. Genital self-image and symptoms of BDD were assessed both preoperatively and 6 months postoperatively, using validated tools.

Results:
After a 6-month intervention period, a statistically significant improvement in genital self-image was observed (P < 0.001), alongside a marked decrease in the score of symptoms related to BDD (P < 0.001). There were no significant differences in outcomes between the groups. Furthermore, no statistically significant associations were noted between complications and the specific technique used.

Conclusions:
The study findings underscore the noteworthy improvement in genital self-image and a concurrent reduction in symptoms of BDD, evident in both the wedge and linear labiaplasty groups at the 6-month postoperative assessments. These results suggest that the choice of surgical technique does not significantly impact these outcomes.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, I.