bluuebunny/crossref_metadata_2025_split huggingface dataset:
LGBTQIA+ Cultural Competence in Physical Therapist Education and Practice: A Qualitative Study From the Patients’ Perspective
Authors: Hofmann Melissa C , Mulligan Nancy F , Stevens Kelly , Bell Karla A , Condran Chris , Miller Tonya , Klutz Tiana , Liddell Marissa , Saul Carlo , Jensen Gail 
Published: April 2024

Abstract

Objective
The purpose of this study was to explore the experiences of cultural competence and humility among patients of the lesbian, gay, bisexual, transgender, queer, intersex, and asexual (LGBTQIA+) community in physical therapy. Researchers sought to understand the perspectives of adults over 18 years old who have received physical therapy and identify as a member of the LGBTQIA+ community.

Methods
A phenomenological qualitative approach was utilized for this study. Patients were recruited through social media and LGBTQIA+ advocacy organizations across the United States. Twenty-five patients agreed to participate in the study. Focus groups and individual interviews were conducted using a semi-structured interview guide informed by Campinha-Bacote domains of cultural competence (cultural awareness, skill, knowledge, encounter, and desire) to collect individual experiences, discussions, thoughts, perceptions, and opinions.

Results
Three central themes and subthemes emerged from the data and were categorized according to cultural acceptance (societal impact, implicit and explicit bias), power dynamics between the in-group and out-group (out-group hyperawareness of their otherness), and participant solutions (policy, training, education).

Conclusion
An LGBTQIA+ patient’s experience is influenced by the provider cultural acceptance, and the resulting power dynamics that impact LGBTQIA+ patients’ comfort, trust, and perceptions of care. Enhanced patient experiences were found more prevalent with providers that possessed elevated levels of education or experience with this community, supporting Campinha-Bacote assumption that there is a direct relationship between level of competence in care and effective and culturally responsive service.

Impact
Awareness of the underlying issues presented in these themes will assist in the development of effective solutions to improve LGBTQIA+ cultural competence among physical therapists and physical therapist assistants on a systemic level.
How Nurse Faculty in Saudi Arabia View Their Competencies in All Aspects of the Faculty Role
Authors: Alanazi Fadiyah Jadid , Rossi Rose A. 
Published: April 2024

Abstract
This study used a quantitative descriptive survey with a sample of 92 participants to assess perceived nurse faculty competency in their role at Saudi Arabian universities. Participants’ perceptions overall were highly positive in the areas of teaching, scholarship, and service competencies. Participants reported less competence in the areas of scholarship and service when they started in their role. Orientation and a mentor relationship with senior faculty were reported to aid in their transition to the faculty role. The findings of the study identify strategies to support the new nurse educator.
Activity of the Sodium Leak Channel Maintains the Excitability of Paraventricular Thalamus Glutamatergic Neurons to Resist Anesthetic Effects of Sevoflurane in Mice
Authors: Wu Yujie , Zhang Donghang , Liu Jin , Jiang Jingyao , Xie Keyu , Wu Lin , Leng Yu , Liang Peng , Zhu Tao , Zhou Cheng 
Published: April 2024

Background
Stimulation of the paraventricular thalamus has been found to enhance anesthesia recovery; however, the underlying molecular mechanism by which general anesthetics modulate paraventricular thalamus is unclear. This study aimed to test the hypothesis that the sodium leak channel (NALCN) maintains neuronal activity in the paraventricular thalamus to resist anesthetic effects of sevoflurane in mice.

Methods
Chemogenetic and optogenetic manipulations, in vivo multiple-channel recordings, and electroencephalogram recordings were used to investigate the role of paraventricular thalamus neuronal activity in sevoflurane anesthesia. Virus-mediated knockdown and/or overexpression was applied to determine how NALCN influenced excitability of paraventricular thalamus glutamatergic neurons under sevoflurane. Viral tracers and local field potentials were used to explore the downstream pathway.

Results
Single neuronal spikes in the paraventricular thalamus were suppressed by sevoflurane anesthesia and recovered during emergence. Optogenetic activation of paraventricular thalamus glutamatergic neurons shortened the emergence period from sevoflurane anesthesia, while chemogenetic inhibition had the opposite effect. Knockdown of the NALCN in the paraventricular thalamus delayed the emergence from sevoflurane anesthesia (recovery time: from 24 ± 14 to 64 ± 19 s, P < 0.001; concentration for recovery of the righting reflex: from 1.13% ± 0.10% to 0.97% ± 0.13%, P < 0.01). As expected, the overexpression of the NALCN in the paraventricular thalamus produced the opposite effects. At the circuit level, knockdown of the NALCN in the paraventricular thalamus decreased the neuronal activity of the nucleus accumbens, as indicated by the local field potential and decreased single neuronal spikes in the nucleus accumbens. Additionally, the effects of NALCN knockdown in the paraventricular thalamus on sevoflurane actions were reversed by optical stimulation of the nucleus accumbens.

Conclusions
Activity of the NALCN maintains the excitability of paraventricular thalamus glutamatergic neurons to resist the anesthetic effects of sevoflurane in mice.

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Targeted Neonatal Echocardiography Performed by Nurse Practitioners in the NICU
Authors: Larocque Jill , Pepper Dawn , Vetland Carla , Mallinson Sara , Hyderi Abbas , Hornberger Lisa K. , Kumaran Kumar 
Published: April 2024

Background:
Targeted neonatal echocardiography (TNE) and hemodynamic consultation have typically been performed by physicians. The Stollery Children’s Hospital neonatal intensive care unit (NICU) expanded their TNE training program to include neonatal nurse practitioners (NNPs), the first in North America.

Purpose:
This study examines the thoughts and perceptions of clinicians about the incorporation of NNPs providing TNE and hemodynamic consultation and investigates key facilitators and challenges for consideration when planning future training, expansion of service in Edmonton, or beyond.

Methods:
In this descriptive study using qualitative methodology, purposive sampling was used to invite NICU clinicians to participate. Using a semistructured topic guide, a focus group and 2 individual interviews were conducted.

Results:
Participants were supportive of NNPs. Advantages included increased access to service, acquisition and retention of skills, provision of patient-centered care, and leveraged interpersonal relationships in the decision-making process. Key aspects of program expansion included climate and culture of the NICU, presence of adequate patient volume, and resources to support training.

Implications for Practice and Research:
Support across disciplines and the collaborative working nature of the NICU are key factors in the success of the program’s development and implementation. Benefits of having NNPs on the TNE team were clearly expressed. Benefits to the health system included rapid access to hemodynamic information allowing for care based on specific pathophysiology and additional local capacity to perform TNE and reducing demand on other trained providers. Additional research could consider parental views of NNPs performing TNE and hemodynamic consultation as well as the accuracy of diagnosis between the NNPs and physician group.
Obstetric Complications and Birth Outcomes After Antenatal Coronavirus Disease 2019 (COVID-19) Vaccination
Authors: Vesco Kimberly K. , Denoble Anna E. , Lipkind Heather S. , Kharbanda Elyse O. , DeSilva Malini B. , Daley Matthew F. , Getahun Darios , Zerbo Ousseny , Naleway Allison L. , Jackson Lisa , Williams Joshua T.B. , Boyce Thomas G. , Fuller Candace C. , Weintraub Eric S. , Vazquez-Benitez Gabriela 
Published: April 2024

OBJECTIVE:
To evaluate the association between antenatal messenger RNA (mRNA) coronavirus disease 2019 (COVID-19) vaccination and risk of adverse pregnancy outcomes.

METHODS:
This was a retrospective cohort study of individuals with singleton pregnancies with live deliveries between June 1, 2021, and January 31, 2022, with data available from eight integrated health care systems in the Vaccine Safety Datalink. Vaccine exposure was defined as receipt of one or two mRNA COVID-19 vaccine doses (primary series) during pregnancy. Outcomes were preterm birth (PTB) before 37 weeks of gestation, small-for-gestational age (SGA) neonates, gestational diabetes mellitus (GDM), gestational hypertension, and preeclampsia–eclampsia–HELLP (hemolysis, elevated liver enzymes, and low platelet count) syndrome. Outcomes in individuals vaccinated were compared with those in propensity-matched individuals with unexposed pregnancies. Adjusted hazard ratios (aHRs) and 95% CIs were estimated for PTB and SGA using a time-dependent covariate Cox model, and adjusted relative risks (aRRs) were estimated for GDM, gestational hypertension, and preeclampsia–eclampsia–HELLP syndrome using Poisson regression with robust variance.

RESULTS:
Among 55,591 individuals eligible for inclusion, 23,517 (42.3%) received one or two mRNA COVID-19 vaccine doses during pregnancy. Receipt of mRNA COVID-19 vaccination varied by maternal age, race, Hispanic ethnicity, and history of COVID-19. Compared with no vaccination, mRNA COVID-19 vaccination was associated with a decreased risk of PTB (rate: 6.4 [vaccinated] vs 7.7 [unvaccinated] per 100, aHR 0.89; 95% CI, 0.83–0.94). Messenger RNA COVID-19 vaccination was not associated with SGA (8.3 vs 7.4 per 100; aHR 1.06, 95% CI, 0.99–1.13), GDM (11.9 vs 10.6 per 100; aRR 1.00, 95% CI, 0.90–1.10), gestational hypertension (10.8 vs 9.9 per 100; aRR 1.08, 95% CI, 0.96–1.22), or preeclampsia–eclampsia–HELLP syndrome (8.9 vs 8.4 per 100; aRR 1.10, 95% CI, 0.97–1.24).

CONCLUSION:
Receipt of an mRNA COVID-19 vaccine during pregnancy was not associated with an increased risk of adverse pregnancy outcomes; this information will be helpful for patients and clinicians when considering COVID-19 vaccination in pregnancy.
Role of mechanical stimulus in mast cell activation
Authors: Li Hantao , Guo Ziwei , Xiangdong Qi 
Published: April 2024

ABSTRACT
Mast cells play a critical role in allergic reactions and other types of inflammatory diseases. There is circumstantial evidence from preclinical approaches that suggest the involvement of mast cells in the development of various diseases. However, the mediator of mast cell accumulation and proliferation in these diseases remains unknown. Studies of mast cell activation have primarily focused on IgE-mediated mast cell-dependent anaphylaxis. Recently, several studies implied the link between mast cell activation and mechanical stimulus. On the surface, mast cells express several mechanoreceptors, such as TRPV2 and ADGRE2, to access external mechanical force. Mechanosensitive cells, including neurons and epithelial cells, secrete inflammatory cytokines to activate mast cells when countering scratching or trauma. Integrin-mediated pathways that sense mechanical properties will migrate mast cells to areas with stiffness variations. In this review, we discuss the evidence linking mechanical stimulus to mast cell activation.
Large PET/CT dataset statistics for the correlation between torso organ standardized uptake value and personal physiological features
Authors: Zhang Nan , Huo Li , Zhang Yanjun , Yu Lijuan , Wang Hongkai 
Published: April 2024

ABSTRACT

Background:
The knowledge of [18F] fluoro-deoxy-glucose (18F-FDG) uptake range in normal torso organ is useful for metabolic disease diagnosis and treatment planning. This study aims to reveal the relationship between torso organ uptakes and personal physiological features, so as to quickly calculate the normal uptake value for patients according to his/her own physiological parameter.

Materials and Methods:
This study collected 767 18F-FDG positron emission tomography/computed tomography (PET/CT) images of normal people. The regions of torso organs were segmented and the mean values of classical body weight-normalized standard uptake value (W-SUV) and lean-body-mass-normalized standard uptake value (L-SUV) were calculated for each organ. The Pearson correlation coefficients and multiple regression formulas were calculated to reveal the influence of physiological features on W-SUV and L-SUV. Comparison between W-SUV and L-SUV were also conducted in terms of the correlation strength, regression confidence and inter-hospital consistency.

Results:
This study obtains the regression formulas for normal organ uptake calculation according to personal physiological parameters. The analysis reveals that lean body mass is the major factor affecting the uptakes of most organs (R > 0.5). It is also worthy to find that the L-SUV formulas have better prediction confidence and inter-hospital consistency than the W-SUV, indicating the advantage of L-SUV for organ uptake evaluation.

Conclusion:
Compared to the previously similar studies, this study clarifies the influential factors of torso organ 18F-FDG uptake. We derived detailed formulas for computing individually adapted normal organ SUVs. The comparison between L-SUV and W-SUV also highlights the stability and reliability of L-SUV for cross-center organ uptake analysis.
ADVANCES IN PHOTORECEPTOR AND RETINAL PIGMENT EPITHELIUM QUANTIFICATIONS IN INTERMEDIATE AGE-RELATED MACULAR DEGENERATION
Authors: Frank Sophie , Reiter Gregor Sebastian , Leingang Oliver , Fuchs Philipp , Coulibaly Leonard Mana , Mares Virginia , Bogunovic Hrvoje , Schmidt-Erfurth Ursula 
Published: April 2024

Purpose:
In this study, differences in retinal feature visualization of high-resolution optical coherence tomography (OCT) devices were investigated with different axial resolutions in quantifications of retinal pigment epithelium and photoreceptors (PRs) in intermediate age-related macular degeneration.

Methods:
Patients were imaged with standard SPECTRALIS HRA + OCT and the investigational High-Res OCT device (both by Heidelberg Engineering, Heidelberg, Germany). Drusen, retinal pigment epithelium, and PR layers were segmented using validated artificial intelligence–based algorithms followed by manual corrections. Thickness and drusen maps were computed for all patients. Loss and thickness measurements were compared between devices, drusen versus nondrusen areas, and early treatment diabetic retinopathy study subfields using mixed-effects models.

Results:
Thirty-three eyes from 28 patients with intermediate age-related macular degeneration were included. Normalized PR integrity loss was significantly higher with 4.6% for standard OCT compared with 2.5% for High-Res OCT. The central and parafoveal PR integrity loss was larger than the perifoveal loss (P < 0.05). Photoreceptor thickness was increased on High-Res OCT and in nondrusen regions (P < 0.001). Retinal pigment epithelium appeared thicker on standard OCT and above drusen (P < 0.01).

Conclusion:
Our study shows that High-Res OCT is able to identify the condition of investigated layers in intermediate age-related macular degeneration with higher precision. This improved in vivo imaging technology might promote our understanding of the pathophysiology and progression of age-related macular degeneration.
Urinastatin combined with octreotide versus sole octreotide in severe acute pancreatitis: a meta-analysis
Authors: Zeng Siyao , Li Yue , Wen Lianghe , Li Yunlong , Yao Zhipeng , Cao Yang , Li Ming , Wang Hongliang , Zheng Junbo 
Published: April 2024

Background:
For severe acute pancreatitis (SAP), the combination of urinastatin and octreotide (OCT) is increasingly used. This meta-analysis assesses whether the combination therapy of urinastatin and OCT is more effective than using sole OCT in treating SAP.

Methods:
After searching 12 databases in English and Chinese as well as two clinical trial centers up to October 7, 2023, we compared the combination of urinastatin and OCT with sole OCT in treating SAP. Statistical measures utilized include risk ratios (RR), weighted mean difference (WMD), and 95% confidence intervals (95% CI).

Results:
We summarized 145 studies from 145 hospitals in 26 provinces, municipalities, and autonomous regions of China, including 13,605 patients. It was found that for SAP, using urinastatin combined with OCT compared to using sole OCT can improve the total effective rate (I

2
= 0%; RR: 1.22; 95% CI: 1.19-1.24; P < 0.01), reduce mortality rate (I

2
= 0%; RR: 0.21; 95% CI: 0.09-0.46; P < 0.01), and reduce the overall incidence rate of complications (I

2
= 0%; RR: 0.28; 95% CI: 0.23-0.34; P < 0.01). In addition, combination therapy reduced in-hospital length of stay, abdominal pain relief time, time for blood and urine amylase to return to normal, inflammatory markers, and improved oxidative stress indicators, immune function indicators, and hemorheology indicators.

Conclusions:
Low-quality evidence suggests that for SAP, the combined use of urinastatin and OCT may be associated with better improvement in patients' symptoms, signs, CT imaging manifestations, and laboratory indicators such as inflammatory markers, oxidative stress markers, immune function indicators, and hemorheological indicators compared to using OCT alone. Additionally, the combination therapy compared to monotherapy may also be associated with lower mortality, a reduced incidence rate of complications, and a shorter in-hospital length of stay. Future research calls for multicenter, high-quality, well-designed studies to validate our findings.
The association between cataract surgery and mental health in older adults: a review
Authors: Wang Shan , Du Zijing , Lai Chunran , Seth Ishith , Wang Yaxin , Huang Yu , Fang Ying , Liao Huiyi , Hu Yijun , Yu Honghua , Zhang Xiayin 
Published: April 2024

Background:Although cataract surgery has been proposed as a potentially modifiable protective factor for enhancing emotional well-being in cataract patients, studies examining the relationship between anxiety or depression and cataract surgery have yielded inconsistent findings. This review summarizes existing evidence to establish whether cataract surgery is associated with depression and anxiety in older adults.Methods:A literature search was conducted across PubMed, Medline, Web of Science, and Embase databases. An initial screening by abstracts and titles was performed, followed by a review and assessment of the methodological quality of the relevant full papers, and final inclusion of 44 studies were deemed eligible for inclusion in this review.Results:Among 44 included studies, 36 studies (81.8%) were observational studies concerning the association of cataract surgery or cataracts with anxiety or depression, four studies (9.1%) were interventional studies, and four studies (9.1%) were reviews. Cataract surgery notably enhances the mental health of individuals with impaired vision. However, the multifaceted nature of psychological well-being, influenced by various factors, suggests that cataract surgery may not address all aspects comprehensively. Additionally, preoperative anxiety and depression significantly impact cataract surgery outcomes.Conclusion:Vision impairment in older adults is closely associated with increased symptoms of depression and anxiety. While surgical intervention for cataracts improves these symptoms, it might be less effective for mental disorders with multifactorial causes. Notably, anxiety or depression poses challenges to successful preoperative and intraoperative cataract surgeries.
Association of hemorrhage-to-treatment time with outcomes in patients with brainstem cavernous malformations: a nationwide cohort study
Authors: Li Zongze , Lu Junlin , Liu Mingjian , Ma Li , Quan Kai , Zhang Hongfei , Liu Peixi , Shi Yuan , Dong Xuchen , You Chao , Tian Rui , Zhu Wei 
Published: April 2024

Background:Brainstem cavernous malformations (BSCMs) often present with haemorrhage, but the optimal timing for microsurgical intervention remains unclear. This study aims to explore how intervention timing relates to neurological outcomes in haemorrhagic BSCM patients undergoing microsurgery, offering insights for clinical decisions.Methods:A total of 293 consecutive patients diagnosed with BSCMs, who underwent microsurgery were identified between March 2011 and January 2023 at two comprehensive centres in China, with a postoperative follow-up duration exceeding 6 months. Utilizing logistic regression models with restricted cubic splines, distinct time groups were identified. Subsequently, matching weight analysis compared these groups in terms of outcomes, new haemorrhage rates, cranial nerve deficits, and perioperative complications. The primary outcome was an unfavourable outcome, which was defined as a mRS score greater than 2 at the latest follow-up.Results:Among the 293 patients, 48.5% were female, median age was (39.9±14.3) years, and median haemorrhage-to-treatment time was 42 days. Patients were categorized into acute (≤21 days), subacute (22–42 days), and delay (>42 days) intervention groups. After matching, 186 patients were analyzed. Adjusted analysis showed lower unfavourable outcome rates for acute [adjusted odds ratio (OR), 0.73; 95% CI, 0.65–0.82;P<0.001] and subacute (adjusted OR, 0.83; 95% CI, 0.72–0.95;P=0.007) groups compared to the delay group. Subacute intervention led to fewer cranial nerve deficits (adjusted OR, 0.76; 95% CI, 0.66–0.88,P<0.001). New haemorrhage incidence didn’t significantly differ among groups.Conclusions:For haemorrhagic BSCMs patients, delayed microsurgical intervention that exceeded 42 days after a prior haemorrhage were associated with an increased risk of unfavourable neurological outcomes.
A novel self-inflatable balloon for treating refractory benign esophageal strictures: a prospective, single-arm, multicenter study
Authors: Li Longsong , Xu Ning , Wang Pengju , Liu Li , Gong Wei , Bi Yawei , Ru Nan , Su Song , Wang Nanjun , Xiang Jingyuan , Han Ke , Chai Ningli , Linghu Enqiang 
Published: April 2024

Background and Aim:
Current treatments for refractory benign esophageal strictures (BESs) often take several years and have poor effects. The authors propose a novel method of self-help inflatable balloon (SHIB) and evaluate its efficacy and safety.

Methods:
A prospective, multicenter study was conducted from January 2019 to March 2022. All enrolled patients were diagnosed with refractory BESs and received SHIB. The primary endpoint was the clinical success rate at 12 months after removing SHIB. The secondary endpoints were the number of days of placing SHIB, and changes from baseline in BMI and health-related quality of life at 1, 3, 6, and 12 months.

Results:
The clinical success rate was 51.2% (21/41) with the median days of placing SHIB being 104.0 days (range: 62.0–134.5 days), which was higher in the endoscopic group compared to the caustic and surgery groups (63.3 vs. 28.6% vs. 0, P=0.025). All patients (100%) showed significant improvement in dysphagia scores during placing SHIB. Although 20 patients (48.8%) experienced recurrent stricture, the median stricture length was decreased (P<0.001) and the median intervention-free interval was prolonged (P<0.001). In all patients, the mean BMI at and health-related quality of life at 1, 3, 6, and 12 months were significantly increased compared with baseline (P<0.05). On multivariate analysis, stricture etiology and wearing time were independent predictors of recurrent stricture.

Conclusions:
The SHIB has high efficacy and safety in treating refractory BESs of different origins, especially for endoscopic resection. Stricture etiology and wearing time were independent predictors of recurrent stricture.