bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cardiopulmonary exercise testing, computed tomography-derived body composition, systemic inflammation and survival after elective abdominal aortic aneurysm repair
Authors: Bradley Nicholas A. , McGovern Josh , Beecroft Christina , Roxburgh Campbell S.D. , McMillan Donald C. , Guthrie Graeme J.K. 
Published: May 2024

BACKGROUND
Cardio-pulmonary exercise testing (CPEX) is selectively used before intervention for abdominal aortic aneurysm (AAA). Sarcopenia, a chronic condition defined by reduced skeletal muscle function and volume, can be assessed radiologically by computed tomography (CT)-derived body composition analysis (CT-BC), and is associated with systemic inflammation.

OBJECTIVE
The aim was to describe the association between CT-BC, CPEX, inflammation and survival in patients undergoing elective intervention for AAA.

SETTING
Patients were recruited retrospectively from a single, secondary-care centre-operative database. Cases undergoing elective endovascular aneurysm repair (EVAR) and open surgical repair (OSR) between 31 March 2015 and 25 June 2020 were included.

PATIENTS
There were 176 patients (130 EVAR, 46 OSR) available for analysis in the final study; median (interquartile range [IQR]) follow-up was 60.5 [27] months, and all completed a minimum of 2 years follow-up.

MAIN OUTCOME MEASURES
Preoperative CPEX tests were recorded. CT sarcopenia score [CT-SS, range 0 to 2, calculated based on normal/low SMI (0/1) and normal/low SMD (0/1)] assessed radiological sarcopenia. Preoperative modified Glasgow Prognostic score (mGPS) was used to assess systemic inflammation.

RESULTS
Mean [95% confidence interval (CI) survival in the CT-SS 0 vs. CT-SS 1 vs. CT-SS 2 subgroups was 80.1 (73.6 to 86.6) months vs. 70.3 (63.5 to 77.1) months vs. 63.8 (53.4 to 74.2) months] (P = 0.01). CT-SS was not associated with CPEX results (P > 0.05). Elevated CT-SS [hazard ratio (HR) 1.83, 95% CI, 1.16 to 2.89, P < 0.01] was independently associated with increased hazard of long-term mortality; however, CPEX results were not (P > 0.05).

CONCLUSION
CPEX test results were not consistently associated with body composition and did not have significant prognostic value in patients undergoing elective treatment for AAA.
Perspectives on sustainable practices in the use of nitrous oxide for labour analgesia
Authors: McGarrigle Conor , Hartigan Sean , Duffy Oscar , Tan Terry 
Published: May 2024

BACKGROUND
Climate change has emerged as the single biggest global health threat of the twenty-first century. Nitrous oxide accounts for the largest carbon footprint amongst our use of anaesthetic gas. It is a potent greenhouse gas possessing a global warming potential of approximately 265 times that of carbon dioxide. Despite recent curtailment of its use, it remains extensively employed as an analgesic for women in labour.

OBJECTIVES
Assessment of the opinions of post-natal women and staff on nitrous oxide use and to investigate whether knowledge of its environmental harm would influence their choice of labour analgesia.

DESIGN
Postnatal women and healthcare staff were invited to participate in a survey of nitrous oxide use as a labour analgesic and knowledge of its effect of the environment.

SETTING
A single-centre study in a major obstetric tertiary referral centre in Ireland in 2021.

MAIN OUTCOME MEASURES
To evaluate the awareness and perceptions of postnatal women and staff regarding the environmental impact of nitrous oxide and if it would affect their decision to use it in the future.

RESULTS
One hundred postnatal women and 50 healthcare staff completed the survey. One hundred and six post-natal women were invited to complete the survey, resulting in a response rate of 94%. Knowledge of nitrous oxide's environmental impact was low. After receiving information, 46% of patients were more inclined to seek epidural or request it earlier (54%) to limit their nitrous oxide use, while 51% would choose an alternative analgesia to avoid nitrous oxide altogether. Overwhelmingly, 99% believed they had the right to know about these harmful effects when choosing an analgesic option.

CONCLUSIONS
Patients should be informed of the environmental impact of nitrous oxide antenatally, empowering them to make informed decision on a climate friendly analgesic option if they wish.
Food Insecurity and Family Dynamics
Authors: Krishnamurthy Sudarshan , Chait Joshua S. , Reddy Menaka N. , Galli Lucas D. , Skelton Joseph A. 
Published: May 2024

Background:
Undernutrition is related to numerous childhood outcomes. However, little research has investigated the relationship between food insecurity and family dynamics. This systematic review seeks to validate the evidence for a relationship between these 2 factors.

Methods:
A systematic literature review was conducted in Embase, PubMed, and Scopus. Inclusion criteria include peer-reviewed research articles published during or after 1996 in English, using standardized measures of family function and food insecurity. Exclusion criteria include measurement of parent or child characteristics without assessing household or family characteristics or demographics. Two reviewers independently voted using Covidence, and Alpha agreement was determined at each phase.

Results:
A total of 15 studies were included for data extraction after the initial search being completed in April 2022. All included studies were found to be appropriate in numerous categories for quality assessment. Primary findings from these studies show a potential relationship exists between food insecurity and family dynamics.

Discussion:
The findings in this review suggest that effects of food insecurity expand to various aspects of healthy family functioning. Unhealthy family dynamics in childhood can also expose children to trauma and lead to increased physical and mental health disorders in the future.
Permanent Peripheral Nerve Stimulator for Complex Regional Pain Syndrome of the Forearm and Hand
Authors: Chappell Ava G. , Kalainov David M. , Samworth Alexander , Yuksel Selcen S. , Rangwani Sean , Nader Antoun 
Published: May 2024

Summary:
A 51-year-old woman with diabetes and depression was referred to the anesthesia pain clinic with a 15-year history of complex regional pain syndrome type I of the right forearm and hand in the radial sensory nerve distribution. There was no recognized antecedent trauma and she had failed both medical treatment and radial sensory nerve decompression surgery. An ultrasound-guided local anesthetic block of the radial nerve in the upper arm resulted in partial and temporary improvement in pain. She subsequently underwent trial of a peripheral nerve stimulator (PNS) followed by permanent PNS implant placement over the radial nerve proper proximal to the elbow. Within the first month of use, she endorsed substantially improved pain and strength in her right hand. These improvements were sustained for more than 1 year. Applications of PNS technology for treatment of extremity complex regional pain syndrome and neuropathic extremity pain in general are reviewed.
The Lymphedematous Limb as a Donor Site for Breast Fat Grafting
Authors: Ahmed Shahnur , Mohan Ganesh , Hulsman Luci , Greene Arin K. , Shaheen Muhammad , Sinha Mithun , Hassanein Aladdin H. 
Published: May 2024

Summary:
Breast cancer–related lymphedema results in chronic upper limb swelling with subcutaneous deposition of fluid and fibroadipose tissue. Morbidity includes psychosocial distress, infection, and difficulty using the extremity. Operative management includes excisional procedures such as suction-assisted lipectomy to reduce abnormal subcutaneous fibroadipose tissue to improve limb volume. Patients who have had postmastectomy breast reconstruction often benefit from fat grafting. This report introduces the concept of fat grafting the breast using the lymphedematous arm as a donor site. This technique improves the volume of the limb by removing the excess subcutaneous adipose, and at the same time reconstructs the breast without adding a donor site not related to the breast cancer–related lymphedema.
Sleep Disruption Persists and Relates to Memory Disability After Traumatic Brain Injury: A Cross-Sectional Study of Adults in the Chronic Phase of Injury
Authors: Morrow Emily L. , Duff Melissa C. 
Published: May 2024

Objective:
To examine sleep disruption in chronic traumatic brain injury (TBI) across 3 aims: (1) to examine differences in self-reported sleep disruption between adults with and without a chronic history of TBI; (2) to query reported changes in sleep after TBI; and (3) to explore the relationship between self-reported sleep disruption and memory failures in daily life.

Setting:
Community-dwelling participants completed self-report sleep and memory surveys as part of their participation in a larger patient registry.

Participants:
This study included 258 participants, and half (n = 129) of them have a chronic history of moderate-severe TBI (mean time since injury is 5.1 [SD 6.5] years).

Design:
We report descriptive statistics from this matched cross-sectional study on sleep in the chronic phase of injury. We also used planned Wilcoxon ranked-sum tests and exploratory correlations to examine the relationships of sleep disruption with TBI diagnosis, injury chronicity, and memory.

Main Measures:
We used the Pittsburgh Sleep Quality Index to measure sleep disruption and the Epworth Sleepiness Scale to measure daytime sleepiness. Participants answered questions about postinjury sleep and responded to the Everyday Memory Questionnaire as a measure of memory failures in daily life.

Results:
Individuals with TBI had significantly higher rates of sleep disruption than those without TBI, as measured by the Pittsburgh Sleep Quality Index but not on the Epworth Sleepiness Scale. Sleep disruption in TBI manifested more in sleep quality than quantity. Half of the participants with TBI reported a negative change in sleep postinjury. In an exploratory analysis, sleep disruption was related to memory failure in daily life in the TBI sample.

Conclusions:
Sleep disruption persists long after TBI but may be under-recognized in people with chronic TBI. Given that sleep is critical for memory and rehabilitation outcomes well into the chronic phase of injury, steps to improve the identification and management of sleep disruption are needed. Key words:
chronic, memory, sleep, traumatic brain injury
Trauma-Informed Care Education Initiative Explores Impact on Perinatal Nurse Secondary Traumatic Stress and Workforce Challenges
Authors: Runyon Maggie C. , Irby Mandy N. , Rojas Landivar Paula 
Published: May 2024

Background:

Psychological trauma refers to long-lasting adverse effects on well-being precipitated by the experience of a distressing event or a combination of events. High rates of psychological birth trauma in patients contribute to secondary traumatic stress (STS) in perinatal nurses, creating workplace challenges and resulting in dissatisfaction, apathy, and attrition. Perinatal nurses experience high rates of STS, and researchers have called for a universal standard of trauma-informed care (TIC). However, there is a lack of published results on effectively creating TIC education in this nurse population.

Methods:
A pre/posttest design evaluated an online pilot evidence-based practice project addressing a perinatal nurse education initiative on STS and its correlation with nurse attitudes toward TIC. Participants include perinatal nurses in the United States (n = 29). Two scales measured the program’s effect on nurses: the Secondary Traumatic Stress Scale (STSS) and the Attitudes Related to Trauma-Informed Care (ARTIC) scale.

Results:
A paired t test evaluating pre- and postprogram levels of the STSS showed a decrease in STS (t
28 = −3.28, P = .003, Cohen’s d = 0.609), the ARTIC scale results showed an increased receptiveness to TIC (t
28 = 3.8, P < .001, Cohen’s d = 0.706], and a not significant correlation was found between pretest STS and ARTIC scores (Spearman’ ρ = −0.248, P = .194).

Conclusion:
This program supported a significant reduction in nurses’ identification of STS. Future perinatal nurse education can expand to build a standard of TIC that is patient-centered and reduces nurse STS.
Sepsis best practices
Authors: Seckel Maureen A. 
Published: May 2024

Abstract:
Sepsis remains a complex and costly disease with high morbidity and mortality. This article discusses Sepsis-2 and Sepsis-3 definitions, highlighting the 2021 Surviving Sepsis International guidelines as well as the regulatory requirements and reimbursement for the Severe Sepsis and Septic Shock Management Bundle (SEP-1) measure.
Can artificial intelligence help ED nurses more accurately triage patients?
Authors: Regan Melinda 
Published: May 2024

Abstract:
The Emergency Severity Index (ESI) is the most popular tool used to triage patients in the US and abroad. Evidence has shown that ESI has its limitations in correctly assigning acuity. To address this, AI can be incorporated into the triage process, decreasing the likelihood of assigning an incorrect ESI level.
Radiation-Induced Cellular Plasticity: A Strategy for Combatting Glioblastoma
Authors: He Ling , Azizad Daria , Bhat Kruttika , Ioannidis Angeliki , Hoffmann Carter J. , Arambula Evelyn , Bhaduri Aparna , Kornblum Harley I. , Pajonk Frank 
Published: May 2024

SummaryGlioblastoma is the deadliest brain cancer in adults and almost all patients succumb to the tumor. While surgery followed by chemo-radiotherapy significantly delays disease progression, these treatments do not lead to long-term tumor control and targeted therapies or biologics have so far failed to further improve survival.Utilizing a transient radiation-induced state of multipotency we used the adenylcyclase activator forskolin to alter the cellular fate of glioma cells in response to radiation. The combined treatment induced the expression of neuronal markers in glioma cells, reduced proliferation and led to a distinct gene expression profile. scRNAseq revealed that the combined treatment forced glioma cells into a microglia- and neuron-like phenotypes.In vivothis treatment led to a loss of glioma stem cells and prolonged median survival in mouse models of glioblastoma. Collectively, our data suggest that revisiting a differentiation therapy with forskolin in combination with radiation could lead to clinical benefit.
ninjaCap: A fully customizable and 3D printable headgear for fNIRS and EEG brain imaging
Authors: von Lühmann Alexander , Kura Sreekanth , O’Brien W. Joseph , Zimmermann Bernhard B. , Duwadi Sudan , Rogers De’Ja , Anderson Jessica E. , Farzam Parya , Snow Cameron , Chen Anderson , Yücel Meryem A. , Perkins Nathan , Boas David A. 
Published: May 2024

AbstractSignificanceAccurate sensor placement is vital for non-invasive brain imaging, particularly for functional near infrared spectroscopy (fNIRS) and diffuse optical tomography (DOT), which lack standardized layouts like EEG. Custom, manually prepared probe layouts on textile caps are often imprecise and labor-intensive.AimWe introduce a method for creating personalized, 3D-printed headgear, enabling accurate translation of 3D brain coordinates to 2D printable panels for custom fNIRS and EEG sensor layouts, reducing costs and manual labor.ApproachOur approach uses atlas-based or subject-specific head models and a spring-relaxation algorithm for flattening 3D coordinates onto 2D panels, using 10-5 EEG coordinates for reference. This process ensures geometrical fidelity, crucial for accurate probe placement. Probe geometries and holder types are customizable and printed directly on the cap, making the approach agnostic to instrument manufacturers and probe types.ResultsOur ninjaCap method offers 2.2±1.5 mm probe placement accuracy. Over the last five years, we have developed and validated this approach with over 50 cap models and 500 participants. A cloud-based ninjaCap generation pipeline along with detailed instructions is now available at openfnirs.org.ConclusionsThe ninjaCap marks a significant advancement in creating individualized neuroimaging caps, reducing costs and labor while improving probe placement accuracy, thereby reducing variability in research.
Needs Assessment for the Development of a Sustainability Curriculum for Surgical Residents
Authors: Matthys Madeline , Wang Jane , Sathe Tejas S. , Wang Kaiyi , Gandhi Seema , Lee Hanmin , Alseidi Adnan ,   the Sustainability Curriculum Working Group
Published: May 2024

ABSTRACTIntroductionThe healthcare sector accounts for 8.5% of United States (U.S.) greenhouse gas emissions, of which one-third comes from operating rooms (ORs). As a result, there is great interest in decarbonizing the OR and surgical care. However, surgical residents are not routinely educated on the negative environmental impact of surgery or how to reduce it. In this paper, we present a formal needs assessment for a sustainability curriculum geared towards surgical residents.MethodsUsing Kern’s Six-Step Framework for curriculum development, we conducted focus groups with surgical residents to perform a targeted needs assessment on three main topics: 1) the current state of surgical sustainability curricula; 2) resident knowledge regarding the environmental impact of surgery and barriers to sustainable practice; and 3) preferred educational methods and topics within sustainability education. We recorded all focus groups and performed thematic analysis using anonymized transcripts.ResultsFourteen residents participated in three focus groups, from which a qualitative analysis revealed four themes. First, surgery residents receive limited formal teaching on the negative environmental impact of surgical care or how to reduce this impact. Second, surgery residents have variable levels of prior education about and interest in sustainability in surgery. Third, several barriers prevent the implementation of sustainable changes in surgical practice, including a lack of institutional initiative, cultural inertia, concerns about workflow efficiency, and limited formal education. Finally, residents prefer to learn about practical ways to reduce waste, specifically through interactive approaches such as quality improvement initiatives.ConclusionsGiven the increasing importance of sustainability in surgery, there is an urgent need for formal resident education on this topic. This needs assessment provides a valuable foundation for future sustainability curriculum development.
The effects of white matter hyperintensities on MEG power spectra in cognitively healthy aging
Authors: Torres-Simón Lucia , Cuesta Pablo , del Cerro Alberto , Doval Sandra , Chino Brenda , Hernández Lucía , Marsh Elizabeth B. , Maestú Fernando 
Published: May 2024

AbstractObjectiveThis study sought to identify magnetoencephalography (MEG) power spectra patterns associated with cerebrovascular damage (white matter hyperintensities - WMH) and their relationship with cognitive performance and brain structure integrity in aging individuals without cognitive impairment.MethodsWe hypothesized a “slowness” pattern characterized by increased power in δ and θ bands and decreased power in the β band associated with the severity of vascular damage. MEG signals were analyzed in cognitively healthy older adults to investigate these associations.ResultsContrary to expectations, we did not observe an increase in δ and θ power. However, we found a significant negative correlation between β band power and WMH volume. This β power reduction was linked to structural brain changes, such as larger lateral ventricles, reduced white matter volume, and decreased fractional anisotropy in critical white matter tracts, but not to cognitive performance. This suggests that β band power reduction may serve as an early marker of vascular damage before the onset of cognitive symptoms.ConclusionOur findings partially confirm our initial hypothesis by demonstrating a decrease in β band power with increased vascular damage but not the anticipated increase in slow band power. The lack of correlation between the βpow marker and cognitive performance suggests its potential utility in early identification of at-risk individuals for future cognitive impairment due to vascular origins. These results contribute to understanding the electrophysiological signatures of preclinical vascular damage and highlight the importance of MEG in detecting subtle brain changes associated with aging.
Cell-free RNA Liquid Biopsy to Monitor Hematopoietic Stem Cell Transplantation
Authors: Loy Conor , Cheng Matthew P. , Gonzalez-Bocco Isabel H. , Lenz Joan , Belcher Emma , Bliss Andrew , Eweis-LaBolle Daniel , Chu Tinyi , Ritz Jerome , De Vlaminck Iwijn 
Published: May 2024

AbstractHematopoietic Stem Cell Transplantation (HSCT) is one of the oldest and most successful immunotherapies. Yet, despite long-standing success in the use of HSCT for the treatment of blood cancers and severe immune disorders, monitoring post-transplant complications remains a challenge due to a lack of informative diagnostic tests. Here, we investigate the utility of cell-free RNA (cfRNA) in plasma as a liquid biopsy to monitor allogeneic HSCT recipients during and after treatment. We assayed longitudinal samples from 92 HSCT recipients by cfRNA sequencing and show that cfRNA provides insight into treatment and recovery trajectories, immune dynamics in response to transplantation, infection, and solid-tissue injury associated with Graft-Versus-Host Disease. Collectively, our results provide support for the use of plasma cfRNA profiling to monitor complications of HSCT.