bluuebunny/crossref_metadata_2025_split huggingface dataset:
Analysis of comb-gnawing behavior in Apis cerana cerana (Hymenoptera: Apidae)
Authors: Meng Qingxin , Huang Rong , Li Hui , Gong Xueyang , Yue Dan , Jiang Wutao , Tian Yakai , Dong Kun 
Published: February 2024

Abstract
Apis cerana cerana exhibits a prominent biological trait known as comb gnawing. In this study, gnawed combs from colonies during different seasons were collected, investigating the comb age and locations of gnawing. Patterns of comb gnawing were recorded, and the effects of 2 factors, namely, comb type and season, on the mass of wax residues and the gnawed surface area were measured. The results revealed that A. c. cerana predominantly gnaws combs that have been used for over 6 months, with gnawing concentrated in the brood-rearing area. In the first 3 seasons, significantly higher masses of wax residues and larger gnawed surface areas were found in greater wax moth larvae (GWML)-infested combs compared to newly built and old combs. Also, there were significantly higher masses and areas gnawed by A. c. cerana in old combs compared to newly built combs in all 4 seasons. Compared to other seasons, it exhibited significantly higher masses and areas resulting from comb-gnawing in newly built or old combs in winter. However, there were no significant differences in the masses of wax residues and surface areas gnawed in GWML-infested combs across the first 3 seasons. In conclusion, this study documented the impact of comb type and season on the comb-gnawing behavior of A. c. cerana, contributing to beekeeping management practices and the current understanding of bee biology.
Effects of comprehensive medication review on opioid overuse among medicare beneficiaries
Authors: Sim Yongbo , Hausberger Clayton F , Wang Junling 
Published: February 2024

Abstract

Objectives
This study examined the effects of the comprehensive medication review of Medicare medication therapy management programs on opioid overuse among Medicare beneficiaries.

Methods
This retrospective study analyzed Medicare data from 2016 to 2017. The intervention group included Medicare beneficiaries who newly received comprehensive medication review in 2017; the control group referred to patients who met the general eligible criteria for the medication therapy management program but did not enroll in 2016 or 2017. Propensity score matching was performed to increase characteristic compatibility between the intervention and control groups. Three measures of opioid overuse were analyzed: use of opioids at a high dosage, use of opioids from multiple providers, and concurrent use of opioids and benzodiazepines. The effects of comprehensive medication review on opioid overuse were analyzed with a multivariate logistic regression with an interaction term between the receipt of comprehensive medication review and the year 2017.

Key Findings
The proportion of concurrent use of opioids and benzodiazepines declined at a greater rate among the recipients (2.21%) than non-recipients (1.55%) of the comprehensive medication review. In the adjusted analysis, the odds ratio of no concurrent use of opioids and benzodiazepines was 5% higher (1.05; 95% confidence interval = 1.02–1.09) among recipients than non-recipients. These significant findings were not found for the other two measures of opioid overuse.

Conclusions
Comprehensive medication review is associated with reduced concurrent use of opioids and benzodiazepines among Medicare beneficiaries. Such service should be incorporated into the current approaches for addressing the opioid epidemic.
Lessons From Organic Chemistry: The Case for Considering Both High Standards and Equity in Assessment
Authors: Caretta-Weyer Holly A. , Schumacher Daniel J. , Kinnear Benjamin 
Published: February 2024

Abstract
In this commentary, the authors explore the tension of balancing high performance standards in medical education with the acceptability of those standards to stakeholders (e.g., learners and patients). The authors then offer a lens through which this tension might be considered and ways forward that focus on both patient outcomes and learner needs.
In examining this phenomenon, the authors argue that high performance standards are often necessary. Societal accountability is key to medical education, with the public demanding that training programs prepare physicians to provide high-quality care. Medical schools and residency programs, therefore, require rigorous standards to ensure graduates are ready to care for patients. At the same time, learners’ experience is important to consider. Making sure that performance standards are acceptable to stakeholders supports the validity of assessment decisions.
Equity should also be central to program evaluation and validity arguments when considering performance standards. Currently, learners across the continuum are variably prepared for the next phase in training and often face inequities in resource availability to meet high passing standards, which may lead to learner attrition. Many students who face these inequities come from underrepresented or disadvantaged backgrounds and are essential to ensuring a diverse medical workforce to meet the needs of patients and society. When these students struggle, it contributes to the leaky pipeline of more socioeconomically and racially diverse applicants.
The authors posit that 4 key factors can balance the tension between high performance standards and stakeholder acceptability: standards that are acceptable and defensible, progression that is time variable, requisite support structures that are uniquely tailored for each learner, and assessment systems that are equitably designed.
Chronic postsurgical pain
Authors: Martinez Valeria , Lehman Thomas , Lavand’homme Patricia , Harkouk Hakim , Kalso Eija , Pogatzki-Zahn Esther M. , Komann Marcus , Meissner Winfried , Weinmann Claudia , Fletcher Dominique 
Published: February 2024

BACKGROUND
Chronic postsurgical pain (CPSP) is a clinical problem, and large prospective studies are needed to determine its incidence, characteristics, and risk factors.

OBJECTIVE
To find predictive factors for CPSP in an international survey

DESIGN
Observational study

SETTING
Multicentre European prospective observational trial

PATIENTS
Patients undergoing breast cancer surgery, sternotomy, endometriosis surgery, or total knee arthroplasty (TKA).

METHOD
Standardised questionnaires were completed by the patients at 1, 3, and 7 days, and at 1, 3, and 6 months after surgery, with follow-up via E-mail, telephone, or interview.

MAIN OUTCOME MEASURE
The primary goal of NIT-1 was to propose a scoring system to predict those patient likely to have CPSP at 6 months after surgery.

RESULTS
A total of 3297 patients were included from 18 hospitals across Europe and 2494 patients were followed-up for 6 months. The mean incidence of CPSP at 6 months was 10.5%, with variations depending on the type of surgery: sternotomy 6.9%, breast surgery 7.4%, TKA 12.9%, endometriosis 16.2%. At 6 months, neuropathic characteristics were frequent for all types of surgery: sternotomy 33.3%, breast surgery 67.6%, TKA 42.4%, endometriosis 41.4%. One-third of patients experienced CPSP at both 3 and 6 months. Pre-operative pain was frequent for TKA (leg pain) and endometriosis (abdomen) and its frequency and intensity were reduced after surgery. Severe CPSP and a neuropathic pain component decreased psychological and functional wellbeing as well as quality of life. No overarching CPSP risk factors were identified.

CONCLUSION
Unfortunately, our findings do not offer a new CPSP predictive score. However, we present reliable new data on the incidence, characteristics, and consequences of CPSP from a large European survey. Interesting new data on the time course of CPSP, its neuropathic pain component, and CPSP after endometriosis surgery generate new hypotheses but need to be confirmed by further research.

TRIAL REGISTRATION
clinicaltrials.gov ID: NCT03834922
Hemoadsorption Combined with Hemodialysis and the “Inflammation Mitigation Hypothesis”
Authors: Brendolan Alessandra , Lorenzin Anna , De Cal Massimo , Virzi Grazia Maria , Cantaluppi Vincenzo , Marengo Marita , Lentini Paolo , Ronco Claudio 
Published: February 2024

ABSTRACT
Clinical outcomes are still unsatisfactory in patients undergoing chronic maintenance dialysis. Signs and symptoms of uremic intoxication are often present even in presence of an adequate dialysis delivery. These along with cardiovascular and skeletal complications, have been correlated to the accumulation of inflammatory chemical mediators, beta-2 microglobulin (β2M), parathyroid hormone (PTH) and other middle to large molecular weight toxins that are insufficiently cleared by current dialysis techniques. Such condition determines a vicious loop where a subclinical status of inflammation causes a disruption of the immunological response affecting outcomes by accelerated atherosclerosis, anemia, and frequent infections. The overall picture can be described as a systemic inflammatory syndrome with simultaneous activation of the innate and the adaptive immunity. In such condition, new options and techniques are required to achieve a more effective blood purification and to correct the altered immuno-homeostasis. New efficient and biocompatible sorbents are today available (HA 130 Cartridge, Jafron Medical, Zhuhai, China) and they can be advantageously coupled in series with the hemodialyzer to perform hemoadsorption combined with hemodialysis (HA-HD). This technique has been already studied in at least two randomized trials demonstrating an effective improvement of clinical and biochemical outcomes. We have calculated the kinetics of β2M in a single session, in a series of three consecutive sessions of a week and in a period of three months using different frequencies of application (first month: Three sessions per week; second month: Two sessions per week; third month: One session per week). In the single session the reduction ratio was superior to other techniques such as hemodialysis (HD), high-flux hemodialysis (HFD) or hemodiafiltration (HDF). In the thrice weekly regime, the time average concentration (TAC) of β2M resulted inferior to HD and HDF. In the long period, a lower concentration of β2M was maintained even with a once-a-week regime. Considering the parallel reduction of inflammatory parameters, we could hypothesize that the enhanced removal of uremic toxins and chemical mediators led to a mitigation of the systemic inflammation with a progressive reduction in the generation of β2M. This “inflammation mitigation hypothesis (IMH)” supports the prescription of HA-HD once a week, possibly after a month of thrice weekly regime.
Associations of Intimate Partner Violence and Drug Use on Viral Suppression Among Women Living With HIV in South Florida: A Secondary Analysis
Authors: Deaterly Caroline , Richards Veronica , Weaver Michael , Villalba Karina , Varma Deepthi , Payton Isaac , Cook Robert 
Published: February 2024

Abstract
Suboptimal viral suppression is associated with worse outcomes and increased HIV transmission among women with HIV (WWH). Based on syndemic theory, we hypothesized that women exposed to recent intimate partner violence (IPV) and current drug use would be most likely to have suboptimal HIV viral suppression. We analyzed baseline data from a longitudinal clinical trial (WHAT-IF? Will Having Alcohol Treatment Improve My Functioning?) that enrolled WWH from Miami, FL, who reported heavy drinking. Bivariate logistic regression was done, mean age was 48 years (n = 194; SD: 8.7), 40% had current drug use (other than alcohol), and 14% reported recent IPV. WWH who reported both IPV and drug use had the highest rate of suboptimal viral suppression (45%), but these differences were not statistically significant. The high rates of suboptimal viral suppression, drug use, and IPV suggest a need to include screening for IPV in clinical guidelines related to HIV care in women.
Essential Components of a Neuroscience Nursing Orientation: A Delphi Study
Authors: Bautista Cynthia , Vyas Marianne Beare , Daniels Lorin , Guanci Mary , Rhudy Lori 
Published: February 2024

ABSTRACT

BACKGROUND: The essential components of an effective neuroscience nurse orientation program for those caring for the adult general care population have not been well defined or standardized. METHODS: Using a 2-round, modified Delphi methodology, electronic surveys were distributed to 53 experts in neuroscience nursing orientation to gain consensus on the essential components of orientation for the neuroscience nurse. Survey data included demographics of the expert, literature-based components of neuroscience nurse orientation, and an opportunity to agree/disagree or write in additional components. RESULTS: Round 1 of the consensus survey elicited a response rate of 55% (29/53), and round 2 had a 51% (27/53) response rate. On the basis of round 1 expert responses, 4 new orientation components were added, and 36 components of a neuroscience nursing orientation were revised to include only the elements with ≥75% agreement. Twenty-two elements in round 2 met the criteria of ≥75% very important and important to include as components of a neuroscience nursing orientation. CONCLUSION: An expert consensus was reached on the necessary components of a neuroscience nursing orientation. The identified neuroscience nursing orientation components concentrated on improving nursing practice and provision of care to adult neuroscience patients. This study demonstrates priority components within a standardized orientation program for neuroscience nurses based on literature and expert consensus. A comprehensive neuroscience nursing orientation is a vital step in sustaining high-quality care for patients and improving neurological outcomes.
Second-look upper endoscopy as the initial approach to subepithelial lesions: a reassuring and reliable strategy
Authors: Capela Tiago Lima , Macedo Silva Vítor , Freitas Marta , Cúrdia Gonçalves Tiago , Dias de Castro Francisca , Magalhães Joana , Leite Sílvia , Cotter José 
Published: February 2024

Background
Although endoscopic ultrasound (EUS) plays a critical role in the management of subepithelial lesions (SEL) of upper gastrointestinal tract many can be classified solely by a thorough upper gastrointestinal endoscopy (UGE) which can reduce the burden of additional studies.

Aims
Analyze the impact of a stepwise approach starting with a second-look UGE before the decision of EUS in patients referred to our center with suspected SEL.

Methods
Retrospective cohort study which included all adult patients referred to our center between 2015 and 2020 with suspected SEL.Second-look UGE evaluated the location, size, color, surface characteristics, movability and consistency of the SEL and bite-on-bite biopsies were performed. Decisions on SEL management and follow-up were collected.

Results
A total of 193 SEL (190 patients) were included. At the index-UGE, stomach was the most frequent location (n = 115;59.6%). Most patients performed a second-look UGE (n = 180; 94.7%). A minority was oriented directly to EUS (n = 8;4.2%) or endoscopic resection (n = 2; 1.1%). In patients who underwent a second-look UGE, SEL were excluded in 25 (13.9%) and 21 (11.7%) did not need further work-up. The remaining patients were submitted to EUS (n = 88;48.9%), surveillance by UGE (n = 44; 24.4%) or endoscopic resection (n = 2; 1.1%).

Conclusion
Systematically performing a second-look UGE, in patients referred with suspected SEL, safely preclude the need for subsequent investigation in approximately one-fourth of the patients. As UGE is less invasive and more readily available, we suggest that a second-look UGE should be the initial approach in SEL management.
Neither hepatic steatosis nor fibrosis is associated with clinical outcomes in patients with intestinal Behçet’s disease
Authors: Hyun Hye Kyung , Park Jihye , Park Soo Jung , Park Jae Jun , Kim Tae Il , Lee Jae Seung , Lee Hye Won , Kim Beom Kyung , Park Jun Yong , Kim Do Young , Ahn Sang Hoon , Kim Seung Up , Cheon Jae Hee 
Published: February 2024

Background
Behçet’s disease (BD) and nonalcoholic fatty liver disease (NAFLD) are chronic inflammatory diseases that share pathogenetic mechanisms. In this study, we investigated whether NAFLD influences the clinical outcomes in patients with intestinal BD.

Methods
Patients with intestinal BD and available hepatic steatosis index (HSI) and fibrosis-4 (FIB-4) scores were recruited between 2005 and 2022. An HSI of ≥30 and FIB-4 of ≥1.45 were used to diagnose hepatic steatosis and significant liver fibrosis, respectively. The primary outcomes were intestinal BD-related hospitalization, surgery, emergency room visits, or the first use of corticosteroids, immunomodulators, or biologic agents for intestinal BD.

Results
A total of 780 patients with BD were selected. The prevalence of hepatic steatosis and significant liver fibrosis were 72.3% and 8.8%, respectively. Multivariate analysis showed that younger age, prior smoking history, concomitant skin lesions, higher white blood cell count, and lower serum albumin levels were independently associated with an increased risk of clinical relapse (all P < 0.05), whereas hepatic steatosis and significant liver fibrosis were not (hazard ratio [HR] = 1.164, 95% confidence interval [CI] 0.923–1.468; P = 0.199 for hepatic steatosis; HR = 0.982, 95% CI 0.672–1.436; P = 0.927 for significant liver fibrosis).

Conclusion
Hepatic steatosis and liver fibrotic burden were not independently associated with clinical outcomes in patients with intestinal BD.
Efficacy of vedolizumab during intravenous induction therapy in ulcerative colitis and Crohn’s disease: post hoc analysis of patient-reported outcomes from the VISIBLE 1 and 2 studies
Authors: D’Haens Geert , Baert Filip , Danese Silvio , Kobayashi Taku , Loftus Edward V. , Sandborn William J. , Dornic Quentin , Lindner Dirk , Kisfalvi Krisztina , Marins Ed G. , Vermeire Séverine 
Published: February 2024

Background
Vedolizumab is an anti-α4β7 integrin antibody used to treat moderate to severe ulcerative colitis (UC) and Crohn’s disease (CD). This post hoc analysis of patient-reported outcomes (PROs) from the VISIBLE 1 (NCT02611830) and 2 (NCT02611817) phase 3 studies evaluated onset of treatment effect on patient-reported symptoms during 6-week vedolizumab induction.

Methods
Patient-reported stool frequency (SF) and rectal bleeding (RB) (UC Mayo score), and SF and abdominal pain (AP) in CD were collected via electronic diary from VISIBLE patients receiving one or more open-label intravenous (IV) vedolizumab induction doses (weeks 0 and 2). PRO data were analyzed using descriptive statistics.

Results
Data from 994 patients (UC 383, CD 611) showed mean ratings for all PROs declined consistently week-on-week from baseline through week 6, with early onset of improvement. By week 2, 22% of patients with UC reported RB improvement (≥1-point reduction in RB subscore, 7-day mean), rising to 45% by week 6. By week 6, 18% of patients with UC achieved SF improvement (SF subscore 0; 21% antitumor necrosis factor alpha [anti-TNFα] naive, 13% anti-TNFα experienced). SF improvement in patients with CD (reduction of ≥3 stools, 7-day mean) was achieved by 32% at week 6 (34% anti-TNFα naive, 30% anti-TNFα experienced). Fewer patients with CD reported severe/moderate AP at week 6 (5.1%/28.5%) than baseline (14.6%/61.5%). SF decline appeared greater and faster for anti-TNFα-naive vs. anti-TNFα-experienced patients (UC and CD).

Conclusion
Results indicate early onset of patient-reported UC and CD symptom improvement during vedolizumab IV induction in VISIBLE 1 and 2.
High Prevalence of Cardiometabolic Risks and Health Needs Among Patients With Hepatocellular Carcinoma After Treatment
Authors: Chen Yi-Lin , Su Chang-Chao , Chang Chia-Hao , James Kathy , Chen Mei-Yen 
Published: February 2024

Background
Many studies have indicated that inadequate health-related behavior is associated with the progression of cancer and cardiometabolic disorders. Because patients with hepatocellular carcinoma may adopt inadequate health behaviors, they are at risk for cancer recurrence, mortality, cardiometabolic disease progression, and worse quality of life.

Objective
To explore the prevalence of cardiometabolic risks and health-promoting behaviors associated with quality of life among patients with hepatocellular carcinoma after treatment.

Methods
A cross-sectional study was conducted from October 2021 to August 2022. Data were collected through face-to-face interviews using a structured questionnaire, and cardiometabolic information was recorded from medical charts.

Results
In total, 115 patients with liver cancer after treatment were enrolled; 73% were male. The mean age was 67.7 years, and high prevalence rates of central obesity (72.2%) and metabolic syndrome (47%) were noted. Inadequate exercise, oral hygiene, and cigarette smoking were common. The health-promoting score was significantly associated with exercise, the number of remaining teeth, and metabolic syndrome, which correlated with quality of life, including positive functional and negative symptoms dimensions.

Conclusions
The findings demonstrated a high prevalence of cardiometabolic risks and inadequate health-related behaviors among patients with liver cancer after treatment. This study highlights the need for healthcare providers to help patients increase health literacy for preventing cardiometabolic risks at outpatient clinics.

Implications for Practice
Findings from this study can be used to advise healthcare providers to educate patients with liver cancer during and after treatment on improving their health-promoting behaviors.
Risk Factors for Postoperative Delirium in Patients Undergoing Major Head and Neck Cancer Surgery
Authors: Sun Jiaqi , Ji Ying , Huang Jingsi , Zhao Hong 
Published: February 2024

Background
Postoperative delirium (POD) is a common and serious complication after extensive surgery. Understanding the independent and potential modifiable risk factors leading to POD in patients with head and neck cancer (HNC) can provide information for future intervention trials aimed at reducing this risk.

Objective
To systematically analyze influencing factors of POD in patients with HNC and identify high-risk individuals for delirium.

Methods
PubMed, EMBASE, Scopus, OVID, and Cochrane Library were searched for publications prior to June 2023. Comparative studies in which POD risk factors were investigated were identified following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The Newcastle-Ottawa Scale was used to evaluate the study quality. Pooled odds ratios or mean differences for individual risk factors were estimated using the Mantel-Haenszel and inverse-variance methods.

Results
This review included 17 studies with a total of 4188 patients undergoing HNC surgery. The pooled prevalence of POD was 15.44%. Based on pooled analysis, 8 significant risk factors were identified including age older than 70 years, male sex, history of smoking, history of psychiatric disorder, American Society of Anesthesiologists score, albumin level, postoperative insomnia, and fluid intake.

Conclusion
In the present study, 8 factors that correlated with POD were identified: 6 preoperative, 1 intraoperative, and 1 postoperative.

Implications for Practice
The influencing factors for POD in patients with HNC were identified that can provide a reference for improving the psychological state of the patient population and further development of effective treatment interventions.