bluuebunny/crossref_metadata_2025_split huggingface dataset:
Recombinant Deoxyribonuclease I Eye Drops for Ocular Graft Versus Host Disease: Results of a Randomized Clinical Trial
Authors: Mun Christine S. , Surenkhuu Bayasgalan , Chen Yi-Fan , Atassi Nour , Mun Jessica , Kim Christian , Sheth Tanya , Sarwar Monazzah Akbar , Pradeep Anubhav , Jain Sandeep 
Published: February 2024

Objective:
We have previously shown that neutrophil extracellular traps (NETs) are present on the ocular surface of patients with ocular graft versus host disease (oGVHD), contributing to inflammation and surface disease. Therefore, we performed a clinical trial using deoxyribonuclease I (DNAase) eye drops to test the hypothesis that reducing the abundance of NETs from the ocular surface will reduce signs and symptoms of oGVHD.

Methods:
A prospective, phase I or II, randomized, placebo-controlled, double-masked clinical trial was performed to determine the safety and preliminary efficacy of DNAase (0.1%) eye drops four times daily for 8 weeks in patients with oGVHD (n=58). Intent-to-treat analysis was performed to determine the change in safety outcome measures (drug tolerability and proportion of adverse events) and efficacy outcome measures (ocular surface disease index [OSDI] score and corneal staining) between baseline and week 8.

Results:
Tolerability and adverse events were similar in the vehicle and DNAase groups. Within the DNAase group (but not the vehicle group), corneal staining showed a statistically significant and clinically meaningful reduction at week 8 (3.50 [2.75; 5.00]) compared with baseline (5.00 [3.00; 7.00]). The OSDI score also showed a statistically significant clinically meaningful reduction of 18.4 (9.16; 33.1) (P<0.001) at week 8 compared with baseline (45.5 [31.8; 50.0]) within the DNAase group. The proportion of eyes that had improvement in subjective global assessment (SGA) and mucous discharge was significantly greater in the DNAase group (55.6% and 57.7% at weeks 4 and 8, respectively; P<0.0001 at both time points) as compared with the vehicle group (35.7% and 34.0% at weeks 4 and 8, respectively).

Conclusions:
Treatment of patients with oGVHD using DNAase eye drops is safe and demonstrates preliminary efficacy. Deoxyribonuclease I eye drops can potentially reduce the severity of signs and symptoms of ocular surface disease in patients with oGVHD.
Using an Equity in Research Framework to Develop a Community-Engaged Intervention to Improve Preexposure Uptake Among Black Women Living in the United States South
Authors: Randolph Schenita D. , Jeter Elizabeth , Johnson Ragan 
Published: February 2024

Abstract
In the U.S. South, over half of new HIV diagnoses occur among Black Americans with research lagging for women who face increased HIV rates and low PrEP uptake, among other health inequities. Community engaged research is a promising method for reversing these trends with established best practices for building infrastructure, implementing research, and translating evidence-based interventions into clinical and community settings. Using the 5Ws of Racial Equity in Research Framework (5Ws) as a racial equity lens, the following paper models a review of a salon-based intervention to improve PrEP awareness and uptake among Black women that was co-developed with beauty salons, stylists, and Black women through an established community advisory council. In this paper we demonstrate how the 5Ws framework was applied to review processes, practices, and outcomes from a community-engaged research approach. The benefits of and challenges to successful collaboration are discussed with insights for future research and community impact.
Digitized Electrocardiography Measurements Support the Biological Plausibility of the Pathological Significance of ST Segments in Athletes
Authors: Montalvo Samuel , Froelicher Victor F. , Hadley David , Wheeler Matthew T. 
Published: February 2024

Objective:
ST segment deviations around the isoelectric line are common findings in manifest cardiovascular disease. In athletes, ST elevation is common, while ST depression is considered rare. However, clinical studies in athletes have associated ST depression with myocardial fibrosis and fatty infiltration and ST elevation with pericarditis and myocarditis. This study aims to explore the association between resting ST segment deviations and resting heart rate, an indicator of training and autonomic tone and electrocardiography (ECG) markers of exercise training effect and cardiovascular health R and T wave amplitude.

Design:
Retrospective analysis of digitized ECG data.

Setting:
Institutional setting.

Participants:
Seven thousand eight hundred thirty-six (male athletes = 4592, female athletes = 3244) healthy asymptomatic athletes (14-35 years).

Main Outcome Measures:
A series of correlations and regressions were conducted between ST depression (<0.0 µV) and ST elevation (>0.0 µV), on R and T wave amplitudes, and heart rate in leads V2, V5, and aVF.

Results:
Positive correlations between ST elevation and R and T wave (S wave in V2) amplitudes and leads V5, V2, and aVF in male and female athletes (range of r = 0.1-0.54). In addition, there was a negative correlation between ST elevation and HR for male and female athletes. Finally, there was a negative correlation between ST depression and R wave and HR for male and female athletes in V5 (P < 0.01).

Conclusions:
In athletes, ST segment elevation is correlated with R and T wave amplitudes and negatively correlated with HR. In addition, ST segment elevation is correlated with low heart rate, consistent with its higher prevalence in athletes. ST segment depression is not influenced by HR but is negatively associated with R and T wave amplitudes.
Parents' Experiences with Postpartum Support Groups using Videoconferencing
Authors: Price Sheri , Aston Megan , MacLeod Anna , Stone Kathryn , Jack Susan , Benoit Britney , Ollivier Rachel , Joy Phillip , Iduye Damilola 
Published: February 2024

Abstract

Purpose:
To explore new parents' experiences with web-based videoconferencing as a mechanism of offering postpartum virtual support groups.

Study Design and Methods:
Virtual support sessions and individual interviews were conducted to explore participants' experiences with virtual postpartum groups.

Results:
Thirty-seven parents participated in seven virtual support sessions and 19 participated in individual interviews. Participant narratives centered on perceptions of safety when engaging in virtual support groups. Tools within the virtual space (camera; mute) created a relational paradox which provided safeguards but also hindered the building of trust. Participants described negotiating the fear of harm and judgment within virtual spaces alongside feelings of security in connecting from the safety of their homes.

Clinical Implications:
The virtual environment provides a forum for new parents to access information and support and an avenue for engagement with maternal child nurses and care providers. Awareness of how parents perceive safety in the virtual environment is an important part of facilitating and structuring parent groups on videoconferencing platforms. Nurses should be familiar with videoconferencing technology and be able to guide parents. Experience facilitating virtual groups to ensure safety and security while providing needed support is a valuable nursing skill.
A Participatory Approach to Identifying Gaps in and Recommendations for Sexually Transmitted Infection and Preexposure Prophylaxis Clinical Services in Pierce County, Washington
Authors: Zinsli Kaitlin , Means Arianna Rubin , Barbee Lindley A. , Rodriguez Evelyn Manley , Kerani Roxanne P. 
Published: February 2024

Background
Pierce County, Washington, has a high burden of sexually transmitted infections (STIs) relative to Washington State and the United States. We used a participatory approach to identify gaps in STI and preexposure prophylaxis (PrEP) service provision in Pierce County and generate recommendations to address these gaps.

Methods
In collaboration with the Tacoma-Pierce County Health Department (TPCHD), we conducted 14 key informant interviews with local STI/PrEP providers from varied clinical settings. Using rapid qualitative analysis, we identified key gaps and strengths in service provision. Local, state, and national HIV/STI subject matter experts (SMEs) prioritized the gaps and recommendations to address them via an online survey.

Results
The primary 6 gaps ranked by SMEs (N = 32) in order of importance included the following: (1) inadequate availability of STI and PrEP services, (2) lack of awareness of STI and PrEP services, (3) need for free/low cost STI and PrEP care, (4) need for stronger relationships among providers and TPCHD, (5) reduced accessibility related to geographically distributed population and centralized services, and (6) frequent referrals pose a service barrier. Subject matter experts prioritized recommendations for each gap as follows: (1) create an STI specialty clinic, (2) implement an STI/PrEP service availability outreach campaign, (3) strengthen referral relationships between TPCHD and free/low-cost providers, (4) develop a provider support network, (5) create a mobile STI clinic, and (6) develop an STI specialty clinic.

Conclusions
Sexually transmitted infection specialty clinics were prioritized by SMEs to improve access to STI and PrEP care in Pierce County, and to serve as a resource for local providers.
Association of mild traumatic brain injury, post-traumatic stress disorder, and other comorbidities on photosensitivity
Authors: Jotie Jenalyn M. , Gustafson Jennifer A. , Fonda Jennifer R. , Fortier Catherine B. , Milberg William P. , Fortenbaugh Francesca C. 
Published: February 2024

SIGNIFICANCE
Photosensitivity is common after mild traumatic brain injury. However, this study demonstrates that photosensitivity is also impacted by common comorbidities that often occur with mild traumatic brain injury. Understanding how physical and psychological traumas impact photosensitivity can help improve provider care to trauma survivors and guide novel therapeutic interventions.

PURPOSE
This study aimed to characterize the association between mild traumatic brain injury and common comorbidities on photosensitivity in post-9/11 veterans.

METHODS
Existing data from the Translational Research Center for TBI and Stress Disorders cohort study were analyzed including traumatic brain injury history and post-traumatic stress disorder clinical diagnostic interviews; sleep quality, anxiety, and depression symptoms self-report questionnaires; and photosensitivity severity self-report from the Neurobehavioral Symptom Inventory. Analysis of covariance and multiple ordinal regression models were used to assess associations between mild traumatic brain injury and common comorbidities with photosensitivity severity.

RESULTS
Six hundred forty-one post-9/11 veterans were included in this study. An initial analysis showed that both mild traumatic brain injury and current post-traumatic stress disorder diagnosis were independently associated with higher photosensitivity ratings compared with veterans without either condition, with no interaction observed between these two conditions. Results of the ordinal regression models demonstrated positive associations between degree of photosensitivity and the number of mild traumatic brain injuries during military service and current post-traumatic stress disorder symptom severity, particularly hyperarousal symptoms, even when controlling for other factors. In addition, the degree of sleep disturbances and current anxiety symptoms were both positively associated with photosensitivity ratings, whereas depression symptoms, age, and sex were not.

CONCLUSIONS
Repetitive mild traumatic brain injury, post-traumatic stress disorder, anxiety, and sleep disturbances were all found to significantly impact photosensitivity severity and are therefore important clinical factors that eye care providers should consider when managing veterans with a history of deployment-related trauma reporting photosensitivity symptoms.
Clinical report: Virtual reality enables comparable contrast sensitivity measurements to in-office testing (pilot study)
Authors: Cheng Christopher P. , Serafini Randal A. , Labkovich Margarita , Warburton Andrew J. , Navarro Vicente , Shaik Neha , Reddy Harsha , Chelnis James G. 
Published: February 2024

SIGNIFICANCE
Vision health disparities largely stem from inaccessibility to vision specialists. To improve patient access to vision tests and to expedite clinical workflows, it is important to assess the viability of virtual reality (VR) as a modality for evaluating contrast sensitivity.

PURPOSE
This study aimed to assess the validity of a VR version of the Pelli-Robson contrast sensitivity test by comparing its results with those of the corresponding in-office test.

METHODS
Twenty-eight participants (mean ± standard deviation age, 37.3 ± 20.5 years) with corrected vision were recruited for testing on a voluntary basis with randomized administration of the in-office test followed by the VR analog or vice versa. Nineteen participants took each test twice to assess test-retest consistency in each modality. Virtual reality tests were conducted on a commercial Pico Neo Eye 2 VR headset, which has a 4K screen resolution. The environment for both tests was controlled by the participant for location and lighting.

RESULTS
Similar sensitivity scores were obtained between testing modalities in both the right (n = 28 participants; Wilcoxon match-paired signed rank [SR], p=0.7) and left eyes (n = 28 participants; Wilcoxon match-paired SR, p=0.7). In addition, similar test-retest scores were found for VR (n = 19 participants; Wilcoxon match-paired SR, p=1.0) or in-office (n = 19 participants; Wilcoxon match-paired SR, p=1.0) tests. Virtual reality Pelli-Robson results correlated well with in-office test results in variably diseased participants (n = 14 eyes from 7 participants, R
2 = 0.93, p<0.0001).

CONCLUSIONS
In this pilot trial, we demonstrated that VR Pelli-Robson measurements of corrected vision align with those of in-office modalities, suggesting that this may be a reliable method of implementing this test in a more interactive and accessible manner.
Cannabis oil extracts for chronic pain: what else can be learned from another structured prospective cohort?
Authors: Pud Dorit , Aamar Suhail , Schiff-Keren Bareket , Sheinfeld Roee , Brill Silviu , Robinson Dror , Fogelman Yaakov , Habib George , Sharon Haggai , Amital Howard , Boltyansky Boris , Haroutounian Simon , Eisenberg Elon 
Published: February 2024

Abstract

Introduction:
The use of medicinal cannabis for managing pain expands, although its efficacy and safety have not been fully established through randomized controlled trials.

Objectives:
This structured, prospective questionnaire-based cohort was aimed to assess long-term effectiveness and safety of cannabis oil extracts in patients with chronic pain.

Methods:
Adult Israeli patients licensed to use cannabis oil extracts for chronic pain were followed prospectively for 6 months. The primary outcome measure was change from baseline in average weekly pain intensity, and secondary outcomes were changes in related symptoms and quality of life, recorded before treatment initiation and 1, 3, and 6 months thereafter. Generalized linear mixed model was used to analyze changes over time. In addition, “responders” (≥30% reduction in weekly pain at any time point) were identified.

Results:
The study included 218 patients at baseline, and 188, 154, and 131 at 1, 3, and 6 months, respectively. At 6 months, the mean daily doses of cannabidiol and Δ9-tetrahydrocannabinol were 22.4 ± 24.0 mg and 20.8 ± 30.1 mg, respectively. Pain decreased from 7.9 ± 1.7 at baseline to 6.6 ± 2.2 at 6 months (F(3,450) = 26.22, P < 0.0001). Most secondary parameters also significantly improved. Of the 218 participants, 24% were “responders” but could not be identified by baseline parameters. “Responders” exhibited higher improvement in secondary outcomes. Adverse events were common but mostly nonserious.

Conclusion:
This prospective cohort demonstrated a modest overall long-term improvement in chronic pain and related symptoms and a reasonable safety profile with the use of relatively low doses of individually titrated Δ9-tetrahydrocannabinol and cannabidiol.
Mortality Among HIV-Infected Adults on Antiretroviral Therapy in Southern Uganda
Authors: Nabukalu Dorean , Yiannoutsos Constantin T. , Semeere Aggrey , Musick Beverly S. , Murungi Teddy , Namulindwa Jane Viola , Waswa Francis , Nakigozi Gertrude , Sewankambo Nelson K. , Reynolds Steven J. , Lutalo Tom , Makumbi Fredrick , Kigozi Godfrey , Nalugoda Fred , Wools-Kaloustian Kara 
Published: February 2024

Background:
Monitoring and evaluation of clinical programs requires assessing patient outcomes. Numerous challenges complicate these efforts, the most insidious of which is loss to follow-up (LTFU). LTFU is a composite outcome, including individuals out of care, undocumented transfers, and unreported deaths. Incorporation of vital status information from routine patient outreach may improve the mortality estimates for those LTFU.

Settings:
We analyzed routinely collected clinical and patient tracing data for individuals (15 years or older) initiating antiretroviral treatment between January 2014 and December 2018 at 2 public HIV care clinics in greater Rakai, Uganda.

Methods:
We derived unadjusted mortality estimates using Kaplan–Meier methods. Estimates, adjusted for unreported deaths, applied weighting through the Frangakis and Rubin method to represent outcomes among LTFU patients who were successfully traced and for whom vital status was ascertained. Confidence intervals were determined through bootstrap methods.

Results:
Of 1969 patients with median age at antiretroviral treatment initiation of 31 years (interquartile range: 25–38), 1126 (57.2%) were female patients and 808 (41%) were lost. Of the lost patients, 640 patient files (79.2%) were found and reviewed, of which 204 (31.8%) had a tracing attempt. Within the electronic health records of the program, 28 deaths were identified with an estimated unadjusted mortality 1 year after antiretroviral treatment initiation of 2.5% (95% CI: 1.8% to 3.3%). Using chart review and patient tracing data, an additional 24 deaths (total 52) were discovered with an adjusted 1-year mortality of 3.8% (95% CI: 2.6% to 5.0%).

Conclusions:
Data from routine outreach efforts by HIV care and treatment programs can be used to support plausible adjustments to estimates of client mortality. Mortality estimates without active ascertainment of vital status of LTFU patients may significantly underestimate program mortality.
Interpretable machine learning for predicting risk of invasive fungal infection in critically ill patients in the intensive care unit: A retrospective cohort study based on MIMIC-IV database
Authors: Cao Yuan , Li Yun , Wang Min , Wang Lu , Fang Yuan , Wu Yiqi , Liu Yuyan , Liu Yixuan , Hao Ziqian , Gao Hengbo , Kang Hongjun 
Published: February 2024

Abstract
The delayed diagnosis of invasive fungal infection (IFI) is highly correlated with poor prognosis in patients. Early identification of high-risk patients with invasive fungal infections and timely implementation of targeted measures is beneficial for patients. The objective of this study was to develop a machine learning-based predictive model for invasive fungal infection in patients during their Intensive Care Unit (ICU) stay. Retrospective data was extracted from adult patients in the MIMIC-IV database who spent a minimum of 48 hours in the ICU. Feature selection was performed using LASSO regression, and the dataset was balanced using the BL-SMOTE approach. Predictive models were built using six machine learning algorithms. The Shapley additive explanation (SHAP) algorithm was employed to assess the impact of various clinical features in the optimal model, enhancing interpretability. The study included 26,346 ICU patients, of whom 379 (1.44%) were diagnosed with invasive fungal infection. The predictive model was developed using 20 risk factors, and the dataset was balanced using the borderline-SMOTE (BL-SMOTE) algorithm. The BL-SMOTE random forest model demonstrated the highest predictive performance (AUC 0.88, 95% CI: 0.84-0.91). SHAP analysis revealed that the three most influential clinical features in the BL-SMOTE random forest model were dialysis treatment, APSIII scores, and liver disease. The machine learning model provides a reliable tool for predicting the occurrence of IFI in ICU patients. The BL-SMOTE random forest model, based on 20 risk factors, exhibited superior predictive performance and can assist clinicians in early assessment of IFI occurrence in ICU patients.

Importance
Invasive fungal infections are characterized by high incidence and high mortality rates characteristics. In this study, we developed a clinical prediction model for invasive fungal infections in critically ill patients based on machine learning algorithms. The results show that the machine learning model based on 20 clinical features has good predictive value.
A Core Outcome Set for Acute Necrotizing Pancreatitis: an Eastern Association for the Surgery of Trauma Modified Delphi Method Consensus Study
Authors: Farrell Michael , Alseidi Adanan , Byerly Saskya , Fockens Paul , Giberson Frederick A. , Glaser Jeffrey , Horvath Karen , Jones David , Luckhurst Casey , Mowery Nathan , Robinson Bryce R.H. , Rodriguez Allie , Singh Vikesh K. , Siriwardena Ajith K. , Vege Santhi Swaroop , Trikudanathan Guru , Visser Brendan C. , Voermans Rogier P. , Yeh Daniel Dante , Gelbard Rondi B. 
Published: February 2024

Abstract

Background
The management of acute necrotizing pancreatitis (ANP) has changed dramatically over the past 20 years including the use of less invasive techniques, the timing of interventions, nutritional management, and anti-microbial management. This study sought to create a core outcome set (COS) to help shape future research by establishing a minimal set of essential outcomes that will facilitate future comparisons and pooling of data, while minimizing reporting bias.

Methods
A modified Delphi process was performed though involvement of ANP content experts. Each expert proposed a list of outcomes for consideration and the panel anonymously scored the outcomes on a 9-point Likert scale. Core outcome consensus defined a priori as >70% of scores receiving 7-9 points and < 15% of scores receiving 1-3 points. Feedback and aggregate data were shared between rounds with inter-class correlation trends used to determine the end of the study.

Results
A total of 19 experts agreed to participate in the study with 16 (84%) participating through study completion. Forty-three outcomes were initially considered with 16 reaching consensuses after four rounds of the modified Delphi process. The final COS included outcomes related to mortality, organ failure, complications, interventions/management, and social factors.

Conclusion
Through an iterative consensus process, content experts agreed on a COS for the management of ANP. This will help shape future research to generate data suitable for pooling and other statistical analyses that may guide clinical practice.

Study Type
Diagnostic Tests or Criteria

Level of Evidence
Diagnostic test or criteria, V