bluuebunny/crossref_metadata_2025_split huggingface dataset:
Daily spiritual experiences and allostatic load trajectories: a longitudinal study of midlife African American women
Authors: Williams Elizabeth , Harris Latesha K. , Zhang Shuo , Cortés Yamnia I. 
Published: April 2024

Abstract

Objective
This study aimed to evaluate the association between daily spiritual experiences and allostatic load (AL) trajectories in midlife African American women.

Methods
A longitudinal analysis of public-use data from 727 African American women in the Study of Women's Health Across the Nation (SWAN) was performed. We included African American women who completed the Daily Spiritual Experiences Scale at SWAN visit 4 (2000-2001) and had AL data at three or more study visits over 7 years. AL was calculated at each visit using 10 biomarkers: systolic and diastolic blood pressure, body mass index, C-reactive protein, high-density lipoprotein cholesterol, total cholesterol, waist-to-hip ratio, fasting serum glucose, triglycerides, and dehydroepiandrosterone. Group-based trajectory modeling identified women with similar patterns of AL. We used multinomial logistic regression to estimate associations between daily spiritual experiences (some days or less, most days, daily, many times a day) and AL trajectories.

Findings
Our sample had a mean ± SD age of 49.9 ± 2.66 years, 47% were early perimenopausal, and 17% earned <$19,999 annually. The mean ± SD AL score was 2.52 ± 1.68. Three AL trajectories were identified: low (35.1%), moderate (44.7%), and high (20.2%). In age-adjusted models, women who reported daily comfort in religion and spirituality were less likely to follow a high AL trajectory (odds ratio, 0.41; 95% CI, 0.18-0.93); the association was attenuated when controlling for depressive symptoms (odds ratio, 0.48; 95% CI, 0.19-1.21).

Conclusions
Findings from this study do not support an independent association between spirituality in African American women and AL trajectories in midlife. Studies with a larger sample and additional measures of spirituality are warranted in this population.
Top-down attention does not modulate mechanical hypersensitivity consecutive to central sensitization: insights from an experimental analysis
Authors: Della Porta Delia , Scheirman Eléonore , Legrain Valéry 
Published: April 2024

Abstract
According to the neurocognitive model of attention to pain, when the attentional resources invested in a task unrelated to pain are high, limited cognitive resources can be directed toward the pain. This is supported by experimental studies showing that diverting people's attention away from acute pain leads to experiencing less pain. Theoretical work has suggested that this phenomenon may present a top-down modulatory mechanism for persistent pain as well. However, conclusive empirical evidence is lacking. To fill this gap, we used a preregistered, double-blind, between-subject study design to investigate whether performing a tailored, demanding, and engaging working memory task unrelated to pain (difficult) vs a task that requires less mental effort to be performed (easy), could lead to lower development of secondary hypersensitivity—a hallmark of central sensitization. Eighty-five healthy volunteers, randomly assigned to one of the 2 conditions, performed a visual task with a different cognitive load (difficult vs easy), while secondary hypersensitivity was induced on their nondominant forearm using high-frequency stimulation. To assess the development of secondary hypersensitivity, sensitivity to mechanical stimuli was measured 3 times: T0, for baseline and 20 (T1) and 40 (T2) minutes after the procedure. We did not observe any significant difference in the development of secondary hypersensitivity between the 2 groups, neither in terms of the intensity of mechanical sensitivity nor its spatial extent. Our results suggest that a top-down modulation through attention might not be sufficient to affect pain sensitization and the development of secondary hypersensitivity.
The Effect of the Stopping Elderly Accidents, Deaths, and Injuries Program on Falls Prevention in Neurosurgical Patients
Authors: Alsaqer Hebah , Rababah Jehad A. , Al-Hammouri Mohammed Munther , Barbarawi Mohamed M. , Suliman Mohammad 
Published: April 2024

ABSTRACT

BACKGROUND: Despite the negative consequences of falls among neurosurgery patients in acute care settings, there is a lack of high-quality evidence for successful fall prevention programs. This study was conducted to evaluate the effectiveness of the Stopping Elderly Accidents, Deaths, and Injuries (STEADI) program on falling prevention compared with routine falling protocol in neurosurgical patients in Jordan. METHODS: A prospective quasi-experimental design was used in this study. The sample comprised 70 neurosurgical patients from a major university-affiliated hospital in Jordan. The study sample was assigned into a control group (35 patients) and an intervention group (35 patients). A demographics questionnaire, and different fall risk screening tools and tests were used in this study as recommended by the STEADI program. RESULTS: Multivariate analysis of variance results showed a significant effect (P = .001) of the STEADI program on the linear combination of outcome measures. Independent samples t tests further confirmed the program's effectiveness, with statistically significant mean differences in most outcome measures between the intervention and control groups post intervention. After implementing the study intervention, participants in the intervention group had a statistically significant lower risk for falls. CONCLUSION: The findings indicate potential effectiveness in improving neurosurgery patients' outcomes and reducing the risk of falls. Implementing the study recommendations can enhance patient safety and promote evidence-based fall prevention interventions in neurosurgery patients.
Feasibility of a Capacity Building Organizational Intervention for Worker Safety and Well-being in the Transportation Industry
Authors: Peters Susan E. , López Gómez María-Andrée , Hendersen Gesele , Martínez Maldonado Marta , Dennerlein Jack 
Published: April 2024

Objective
This study developed, implemented, and evaluated the feasibility of executing an organizational capacity building intervention to improve bus driver safety and well-being in a Chilean transportation company. Method: Through an implementation science lens and using a pre-experimental mixed methods study design, we assessed the feasibility of implementing a participatory organizational intervention designed to build organizational capacity. Result: We identified contextual factors that influenced the intervention mechanisms and intervention implementation and describe how the company adapted the approach for unexpected external factors during the COVID-19 pandemic and social and political unrest experienced in Chile. Conclusions: The intervention enabled the organization to create an agile organizational infrastructure that provided the organization’s leadership with new ways to be nimbler and more responsive to workers’ safety and well-being needs and was robust in responding to strong external forces that were undermining worker safety and well-being.
Leadership From a Different Lens: Shaping the Future of Healthcare Education
Authors: Jalaba Stephanie M. , Ruger Katherine M. 
Published: April 2024

Abstract
Physician assistant (PA) educators are responsible for preparing the next generation of PAs to be not only healthcare providers but also healthcare leaders. Regardless of whether advanced practice providers choose to pursue formal leadership roles in healthcare, they will undoubtedly be expected to possess and exhibit leadership skills. The PA profession indicates leadership as an important professional competency, yet leadership training is rare in current curricula. The PA community should consider the importance of leadership training for educators as they influence future PAs and the way PA students will affect their future patients and the healthcare systems for which they work. The aim of this article was to bring awareness to the need for leadership skill training in PA education, to review common leadership styles in healthcare, and to offer practical leadership tips to healthcare educators.
Rates, Predictors, and Outcomes of Ustekinumab Dose Escalation in Inflammatory Bowel Disease
Authors: Petrov Jessica C. , Al-Bawardy Badr , Alzahrani Raneem , Mohamed Gamal , Fine Sean 
Published: April 2024

Objective:
Ustekinumab (UST) is effective for the induction and maintenance of remission in inflammatory bowel disease (IBD). However, a significant proportion of patients will require UST dose escalation. We sought to determine the rates, predictors, and outcomes of UST dose escalation in patients with IBD.

Patients and Methods:
This was a multicenter, retrospective study of all patients with IBD who received UST from January 1, 2014 to March 1, 2022. Primary outcomes were the rates and predictors of UST dose escalation. Secondary outcomes included steroid-free clinical remission, endoscopic healing, and normalization of serum c-reactive protein in patients who underwent UST dose escalation.

Results:
A total of 198 patients were included (58% females and 76.7% with Crohn's disease). UST dose was escalated by 55.5% (n = 110). Mean baseline albumin was lower in the UST dose escalation group at 3.86 ± 0.47 versus 4.03 ± 0.45 g/dL (P = 0.044). The mean hemoglobin was lower in the UST dose escalation group at 12.1 ± 1.83 versus 12.7 ± 1.42 (P = 0.049). On multivariate analysis, male sex alone was associated with the need for dose escalation (odds ratio: 4.08, 95% CI: 1.20 – 13.90; P = 0.025). In the UST dose escalation group, 66.1% achieved steroid-free clinical remission, 55.8% had normalization of c-reactive protein, and 35.8% achieved endoscopic healing.

Conclusions:
UST dose escalation was needed in more than half of patients with IBD in this real-world cohort. UST dose escalation resulted in clinical remission in more than half of the cohort and endoscopic healing in one-third of patients.
“Nobody Wants to Have Conversation About HIV.” A Thematic Analysis of in-Depth Interviews With Black Adolescent Women and Providers About Strategies for Discussing Sexual Health and HIV Prevention
Authors: Hill Samantha V. , Pratt Madeline C. , Elopre Latesha , Simpson Tina , Gaines Lanzi Robin , Matthews Lynn T. 
Published: April 2024

Background
Black adolescent girls and young women (AGYW) in the US Southeast are disproportionately burdened by HIV. Infrequent assessment of sexual health in clinical encounters may contribute to low preexposure prophylaxis uptake for this population. This study explores Black AGYW and providers' perspectives on engaging in discussions about sexual health, including preexposure prophylaxis.

Methods
In-depth interviews (IDIs) were conducted with Black AGYW aged 14 to 24 years and health care providers (MD, DO, NP, PA) who self-reported caring for Black AGYWs in Alabama. In-depth interviews were grounded in Andersen's Behavioral Model of Health Service Utilization to explore barriers and facilitators to sexual health discussions. After separate analyses, AGYW and provider IDIs were aggregated and reanalyzed using thematic analysis to identify themes related to their views on ways to improve Black AGYW engagement in sexual health discussions while in clinical settings.

Results
Twelve Black AGYW and 11 providers completed IDIs. Client median age was 21 years, representing 9 Alabama counties. Providers were predominately non-Hispanic White (82%), female (73%), and physicians (64%). Themes about ways to improve sexual health discussions included the following: (1) improve sexual health education for providers and adolescents, (2) normalize conversations in clinical settings, and (3) engage communities to continue these conversations outside of clinical settings.

Conclusions
Sexual health and HIV prevention discussions with Black AGYW are not occurring. This study is one of the first to identify and highlight Black AGYW and provider-identified shared strategies for improving these discussions. Operationalizing these strategies is crucial to facilitating these discussions.
The effect of weight gain and metabolic dysfunction-associated steatotic liver disease on liver fibrosis progression and regression in people with HIV
Authors: Guaraldi Giovanni , Milic Jovana , Renzetti Stefano , Motta Federico , Cinque Felice , Bischoff Jenny , Desilani Andrea , Conti Jacopo , Medioli Filippo , del Monte Martina , Kablawi Dana , Elgretli Wesal , Calza Stefano , Mussini Cristina , Rockstroh Juergen K. , Sebastiani Giada 
Published: April 2024

Objective:
People with HIV (PWH) have high risk of liver fibrosis. We investigated the effect of weight gain and metabolic dysfunction-associated steatotic liver disease (MASLD) on liver fibrosis dynamics.

Design:
Multicenter cohort study.

Methods:
Fibrosis progression was defined as development of significant fibrosis [liver stiffness measurement (LSM) ≥8 kPa], or transition to cirrhosis (LSM ≥13 kPa), for those with significant fibrosis at baseline. Fibrosis regression was defined as transition to LSM less than 8 kPa, or to LSM less than 13 kPa for those with cirrhosis at baseline. MASLD was defined as hepatic steatosis (controlled attenuation parameter >248 dB/m) with at least one metabolic abnormality. A continuous-time multistate Markov model was used to describe transitions across fibrosis states.

Results:
Among 1183 PWH included from three centers (25.2% with viral hepatitis coinfection), baseline prevalence of significant fibrosis and MASLD was 14.4 and 46.8%, respectively. During a median follow-up of 2.5 years (interquartile range 1.9–3.5), the incidence rate of fibrosis progression and regression was 2.8 [95% confidence interval (CI) 2.3–3.4] and 2.2 (95% CI 1.9–2.6) per 100 person-years, respectively. In Markov model, weight gain increased the odds of fibrosis progression [odds ratio (OR) 3.11, 95% CI 1.59–6.08], whereas weight gain (OR 0.30, 95% CI 0.10–0.84) and male sex (OR 0.32, 95% CI 0.14–0.75) decreased the odds of fibrosis regression. On multivariable Cox regression analysis, predictors of fibrosis progression were weight gain [adjusted hazard ratio (aHR) 3.12, 95% CI 1.41–6.90] and MASLD (aHR 2.72, 95% CI 1.05–7.02).

Conclusion:
Fibrosis transitions are driven by metabolic health variables in PWH, independently of viral hepatitis coinfection and antiretroviral class therapy.
Association between obesity and cancer risk in adults with HIV in Korea
Authors: Jang Yoonyoung , Kim Taehwa , Choi Yunsu , Ahn Kyoung Hwan , Kim Jung Ho , Seong Hye , Kim Youn Jeong , Kim Shin-Woo , Choi Jun Yong , Kim Hyo Youl , Song Joon Young , Choi Hee Jung , Kim Sang Il. , Sohn Jang Wook , Chin BumSik , Choi Bo-Youl , Park Boyoung 
Published: April 2024

Introduction:
This study aimed to investigate the association between obesity and cancer risk as well as site-specific cancer risks in adults with HIV using a nationwide health screening database in Korea.

Methods:
Of the 16,671 adults with a new diagnosis of HIV from 2004 to 2020, 456 incident cancer cases and 1814 individually matched controls by sex, year of birth, year of HIV diagnosis, and follow-up duration (1 : 4 ratio) were included in this nested case–control study. The association between obesity (BMI ≥25 kg/m2) and cancer risks was estimated and presented as odds ratios (ORs) and 95% confidence intervals (95% CIs).

Results:
Of the 456 cancer incident cases, there were 146 AIDS-defining cancer cases and 310 non-AIDS-defining cancer cases. Compared with nonobese adults with HIV, obese adults with HIV were at higher risk of non-AIDS-defining cancer (OR = 1.478, 95% CI = 1.118–1.955). Otherwise, the overall risk of AIDS-defining cancer (OR = 0.816, 95% CI = 0.520–1.279) and each type of AIDS-defining cancer (Kaposi sarcoma and non-Hodgkin's lymphoma) were not high in obese adults with HIV. Of the specific types of non-AIDS-defining cancers, obesity was associated with an increased risk of colorectal cancer (OR = 3.090, 95% CI = 1.110–8.604) and liver, bile duct, and pancreatic cancers (OR = 2.532, 95% CI = 1.141–5.617).

Conclusion:
Obesity, which is one of the important health concerns in HIV management, was associated with an increased risk of non-AIDS-defining cancer but not AIDS-defining cancer.
Can Automated 3-Dimensional Dixon-Based Methods Be Used in Patients With Liver Iron Overload?
Authors: Venkatakrishna Shyam Sunder B. , Otero Hansel J. , Khrichenko Dmitry , Serai Suraj D. 
Published: April 2024

Purpose
Accurate quantification of liver iron concentration (LIC) can be achieved via magnetic resonance imaging (MRI). Maps of liver T2*/R2* are provided by commercially available, vendor-provided, 3-dimensional (3D) multiecho Dixon sequences and allow automated, inline postprocessing, which removes the need for manual curve fitting associated with conventional 2-dimensional (2D) gradient echo (GRE)–based postprocessing. The main goal of our study was to investigate the relationship among LIC estimates generated by 3D multiecho Dixon sequence to values generated by 2D GRE–based R2* relaxometry as the reference standard.

Methods
A retrospective review of patients who had undergone MRI scans for estimation of LIC with conventional T2* relaxometry and 3D multiecho Dixon sequences was performed. A 1.5 T scanner was used to acquire the magnetic resonance studies. Acquisition of standard multislice multiecho T2*-based sequences was performed, and R2* values with corresponding LIC were estimated. The comparison between R2* and corresponding LIC estimates obtained by the 2 methods was analyzed via the correlation coefficients and Bland-Altman difference plots.

Results
This study included 104 patients (51 male and 53 female patients) with 158 MRI scans. The mean age of the patients at the time of scan was 15.2 (SD, 8.8) years. There was a very strong correlation between the 2 LIC estimation methods for LIC values up to 3.2 mg/g (LIC quantitative multiecho Dixon [qDixon; from region of interest R2*] vs LIC GRE [in-house]: r = 0.83, P < 0.01; LIC qDixon [from segmentation volume R2*] vs LIC GRE [in-house]: r = 0.92, P < 0.01); and very weak correlation between the 2 methods at liver iron levels >7 mg/g.

Conclusion
Three-dimensional–based multiecho Dixon technique can accurately measure LIC up to 7 mg/g and has the potential to replace 2D GRE–based relaxometry methods.
Utility of Combined Use of Imaging Features From Abdominopelvic CT and CA 125 to Identify Presence of CT Occult Peritoneal Metastases in Advanced Gastric Cancer
Authors: Zhu Zhen-Ning , Feng Qiu-Xia , Li Qiong , Xu Wei-Yue , Liu Xi-Sheng 
Published: April 2024

Objective
The purpose of this study is to identify the presence of occult peritoneal metastasis (OPM) in patients with advanced gastric cancer (AGC) by using clinical characteristics and abdominopelvic computed tomography (CT) features.

Methods
This retrospective study included 66 patients with OPM and 111 patients without peritoneal metastasis (non-PM [NPM]) who underwent preoperative contrast-enhanced CT between January 2020 and December 2021. Occult PMs means PMs that are missed by CT but later diagnosed by laparoscopy or laparotomy. Patients with NPM means patients have neither PM nor other distant metastases, indicating there is no evidence of distant metastases in patients with AGC. Patients' clinical characteristics and CT features such as tumor marker, Borrmann IV, enhancement patterns, and pelvic ascites were observed by 2 experienced radiologists. Computed tomography features and clinical characteristics were combined to construct an indicator for identifying the presence of OPM in patients with AGC based on a logistic regression model. Receiver operating characteristic curves and the area under the receiver operating characteristic curve (AUC) were generated to assess the diagnostic performance of the combined indicator.

Results
Four independent predictors (Borrmann IV, pelvic ascites, carbohydrate antigen 125, and normalized arterial CT value) differed significantly between OPM and NPM and performed outstandingly in distinguishing patients with OPM from those without PM (AUC = 0.643–0.696). The combined indicator showed a higher AUC value than the independent risk factors (0.820 vs 0.643–0.696).

Conclusions
The combined indicator based on abdominopelvic CT features and carbohydrate antigen 125 may assist clinicians in identifying the presence of CT OPMs in patients with AGC.
Using Patient-Specific Contrast Enhancement Optimizer Simulation Software During the Transcatheter Aortic Valve Implantation—Computed Tomography Angiography in Patients With Aortic Stenosis
Authors: Masuda Takanori , Nakaura Takeshi , Higaki Toru , Funama Yoshinori , Matsumoto Yoriaki , Sato Tomoyasu , Okimoto Tomokazu , Arao Keiko , Imaizumi Hiromasa , Arao Shinichi , Ono Atsushi , Hiratsuka Junichi , Awai Kazuo 
Published: April 2024

Objectives
This study assessed whether patient-specific contrast enhancement optimizer simulation software (p-COP) can reduce the contrast material (CM) dose compared with the conventional body weight (BW)-tailored scan protocol during transcatheter aortic valve implantation-computed tomography angiography (TAVI-CTA) in patients with aortic stenosis.

Methods
We used the CM injection protocol selected by the p-COP in group A (n = 30). p-COP uses an algorithm that concerns data on an individual patient's cardiac output. Group B (n = 30) was assigned to the conventional BW-tailored CM injection protocol group. We compared the CM dose, CM amount, injection rate, and computed tomography (CT) values in the abdominal aorta between the 2 groups and classified them as acceptable (>280 Hounsfield units (HU)) or unacceptable (<279 HU) based on the optimal CT value and visualization scores for TAVI-CTA. We used the Mann–Whitney U test to compare patient characteristics and assess the interpatient variability of subjects in both groups.

Results
Group A received 56.2 mL CM and 2.6 mL/s of injection, whereas group B received 76.9 mL CM and 3.4 mL/s of injection (P < 0.01). The CT value for the abdominal aorta at the celiac level was 287.0 HU in group A and 301.7HU in group B (P = 0.46). The acceptable (>280 HU) and unacceptable (<280 HU) CT value rates were 22 and 8 patients in group A and 24 and 6 patients in group B, respectively (P = 0.76). We observed no significant differences in the visualization scores between groups A and B (visualization score = 3, P = 0.71).

Conclusion
The utilization of p-COP may decrease the CM dosage and injection rate by approximately 30% in individuals with aortic stenosis compared with the body-weight-tailored scan protocol during TAVI-CTA.