bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of Cervical Vertebral Motion and Foraminal Changes During the Spurling Test Using Zero Echo Time Magnetic Resonance Imaging and Computed Tomography-Based Micromotion Analysis
Authors: Hutchins John , Lagerstrand Kerstin , Hebelka Hanna , Palmér Emilia , Brisby Helena 
Published: April 2024

Study Design.
Clinical experimental diagnostic study.

Objective.
The objective of the study was to investigate cervical spine dynamics including changes in the cervical foramina in patients experiencing intermittent arm radiculopathy.

Background.
Cervical foraminal stenosis is a frequent cause of radicular arm pain. The Spurling test, while specific, lacks the precision to identify symptomatic nerve roots. The relationship among vertebral motion, foraminal changes, and radiculopathy during a Spurling test remains underexplored.

Patients and Methods.
Ten patients with positive Spurling tests and magnetic resonance imaging (MRI) confirmed 1 or 2-level cervical foraminal stenosis were scanned using the Dynamic MRI Compression System enabling a simulated Spurling test inside the MRI gantry of a 3T MRI scanner with a dedicated neck coil. First, a relaxed image acquisition was undertaken, followed by slowly applying the Spurling test until the patient reported aggravation of radiculopathy or discomfort, where the next image series was taken. Zero echo time MRI was employed to obtain computed tomography (CT)–like images. The images were thereafter analyzed using the Sectra® CT-based Micromotion Analysis software for motion analysis.

Results.
The C4/C5 level exhibited the most significant movements both in translation and rotation, with less movements observed in C5 to C6 and C6 to C7 levels. No uniform pattern emerged that differentiated suspected stenotic levels from nonsuspected levels. Despite relatively small vertebral movements, 9/10 of patients reported arm pain during provocation, indicating extremely narrow margins of tolerance.

Conclusion.
This study demonstrates the utility of zero echo time MRI and CT-based Micromotion Analysis in detecting subtle yet clinically relevant vertebral motions influencing the foramina in the cervical spine during the Spurling maneuver. These findings could lead to a better understanding and potentially improved diagnostic strategies for cervical foraminal stenosis, although further research with a larger cohort is necessary to confirm these results.
B7-H3 in acute myeloid leukemia: From prognostic biomarker to immunotherapeutic target
Authors: Tan Xiao , Zhao Xiangyu 
Published: April 2024

Abstract
B7-H3 (CD276), an immune checkpoint protein of the B7 family, exhibits significant upregulation in solid tumors and hematologic malignancies, exerting a crucial role in their pathophysiology. The distinct differential expression of B7-H3 between tumors and normal tissues and its multifaceted involvement in tumor pathogenesis position it as a promising therapeutic target for tumors. In the context of acute myeloid leukemia (AML), B7-H3 is prominently overexpressed and closely associated with unfavorable prognoses, yet it has remained understudied. Despite various ongoing clinical trials demonstrating the potential efficacy of immunotherapies targeting B7-H3, the precise underlying mechanisms responsible for B7-H3-mediated proliferation and immune evasion in AML remain enigmatic. In view of this, we comprehensively outline the current research progress concerning B7-H3 in AML, encompassing in-depth discussions on its structural attributes, receptor interactions, expression profiles, and biological significance in normal tissues and AML. Moreover, we delve into the protumor effects of B7-H3 in AML, examine the intricate mechanisms that underlie its function, and discuss the emerging application of B7-H3-targeted therapy in AML treatment. By juxtaposing B7-H3 with other molecules within the B7 family, this review emphasizes the distinctive advantages of B7-H3, not only as a valuable prognostic biomarker but also as a highly promising immunotherapeutic target in AML.
Abstinence for sperm sample collection and ART outcome: an unsubstantiated myth
Authors: Schlegel Peter N. 
Published: April 2024

Purpose of review
Semen analysis is a basic component of male evaluation. Reproductive centers typically instruct men to provide a semen specimen based on recommendations from WHO Standard for semen examination. Evidence that these recommendations optimize sperm reproductive capacity is lacking. Existing data to optimize sperm quality with shorter abstinence were reviewed.

Recent findings
Several recent studies have reviewed the effects of shorter ejaculatory abstinence of semen quality and assisted reproductive technology (ART) outcomes. Shorter abstinence was defined as 1 h–1 day in one review, and <4 h in the other systematic meta-analysis and review.

Summary
Prior instructions for male patients have not been designed to optimize fertility potential for semen analyses. Optimal sperm quality is obtained by instructing men to have a short abstinence (certainly <1 day, and preferably <4 h) for semen specimens used for in vitro fertilization (assisted reproduction)
GnRH agonist trigger in poor prognosis patients undergoing a multicycle approach through DuoStim or consecutive stimulations: a SWOT analysis
Authors: Vaiarelli Alberto , Ruffa Alessandro , Cerrillo María , García-Velasco Juan Antonio 
Published: April 2024

Purpose of review
Identify the most recent and significant evidence regarding the ovulation trigger within the framework of a multicycle approach through DuoStim, providing valuable insights for improving treatment strategies in patients with a poor prognosis.

Recent findings
The trigger method plays a pivotal role in optimizing in-vitro fertilization (IVF) stimulation, influencing oocyte retrieval and maturation rates, as well as follicle recruitment in consecutive ovarian stimulations such as double stimulation. Decision-making involves multiple factors and, while guidelines exist for conventional stimulation, specific recommendations for the multicycle approach are not well established.

Summary
The different methods for inducing oocyte maturation underscore the need for personalization of IVF protocols. The GnRH agonist trigger induces rapid luteolysis and establishes favorable hormonal conditions that do not adversely affect the recruitment of consecutive follicular waves in the context of DuoStim. It serves as a valid alternative to hCG in freeze-all cycles. This strategy might enhance the safety and flexibility of ovarian stimulations with no impact on oocyte competence and IVF efficacy.
Beyond the reproductive tract: gut microbiome and its influence on gynecological health
Authors: Pérez-Prieto Inmaculada , Rodríguez-Santisteban Aida , Altmäe Signe 
Published: April 2024

Purpose of review
The analysis of microbiome in association with female health is today a “hot topic” with the main focus on microbes in the female reproductive tract. Nevertheless, recent studies are providing novel information of the possible influence of the gut microbiome on gynecological health outcomes, especially as we start to understand that the gut microbiome is an extended endocrine organ influencing female hormonal levels. This review summarizes the current knowledge of the gut microbes in association with gynecological health.

Recent findings
The gut microbiome has been associated with endometriosis, polycystic ovary syndrome, gynecological cancers, and infertility, although there is a lack of consistency and consensus among studies due to different study designs and protocols used, and the studies in general are underpowered.

Summary
The interconnection between the gut microbiome and reproductive health is complex and further research is warranted. The current knowledge in the field emphasizes the link between the microbiome and gynecological health outcomes, with high potential for novel diagnostic and treatment tools via modulation of the microenvironment.
Gender affirming care for the minimally invasive gynecologic surgeon
Authors: Simko Sarah , Popa Otilia , Stuparich Mallory 
Published: April 2024

Purpose of review
Given the current political climate and the release of an updated version of the World Professional Association for Transgender Health's guidelines, this review assesses recent updates in the care of transgender and gender diverse (TGD) patients, specifically related to care provided by gynecologists.

Recent findings
The number of people identifying as TGD and pursuing gender affirming care is increasing. Contraception for these patients is underdiscussed and high rates of pelvic pain and irregular bleeding were identified. Rates of regret are low following gender affirming surgeries, and studies have repeatedly shown their benefits for gender dysphoria. A minimally invasive approach is recommended for gender affirming hysterectomy, and the decision to proceed with bilateral salpingo-oophorectomy should be based on shared decision making. Surgical techniques include ensuring an adequate margin when taking the infundibulopelvic ligament, and consideration for two-layer vaginal cuff closure.

Summary
Gynecologists play a key role in the care of TGD patients. Recent reviews have found extensive gaps in our knowledge, including a lack of guidelines for cancer prevention, effects of testosterone on benign conditions, and the long-term effects of bilateral salpingo-oophorectomy on health outcomes for patients on testosterone.
Free Flap Reconstruction of Sternal Defects after Cardiac Surgery: An Algorithmic Approach for Dealing with Sparse Recipient Vessels
Authors: Bigdeli Amir K. , Falkner Florian , Schmidt Volker J. , Thomas Benjamin , Engel Holger , Reichenberger Matthias , Germann Günter , Gazyakan Emre , Kneser Ulrich 
Published: April 2024

Background:
Sparsity of recipient vessels poses a challenge for microsurgical free flap reconstruction of sternal defects following deep sternal wound infection after cardiac surgery.

Methods:
From January 2013, a standardized algorithm for dealing with sparse recipient vessels was strictly followed. In this retrospective study including 75 patients, we compared operative details, surgical complications, and reconstructive outcomes of patients treated according to this algorithm (group A: January 2013–May 2021; n = 46) with a historical control group (group B: January 2000–December 2012, n = 29).

Results:
The left internal mammary artery had been harvested for arterial bypass grafting in 40 of 46 cases (87%) in group A and in all cases in group B. The right internal mammary artery (RIMA) and right internal mammary vein (RIMV) were the first choice as recipient vessels. In case of unsuitability of the RIMV, a right cephalic vein (CV) turndown was used for venous outflow. If both RIMA and RIMV proved insufficient, a single-stage arterio-venous loop (AVL) between the CV and subclavian artery (CV–SA AVL), CV and thoracoacromial artery (CV–TA AVL), or subclavian artery and subclavian vein (SA–SV AVL) was established. The algorithmic approach significantly reduced partial flap necrosis [group A: n = 3 (7%) versus group b: n = 7 (24%); P = 0.04], and overall operation time [group A: 360 ± 88 min versus group B: 415 ± 80 min; P = 0.01].

Conclusions:
Standardized approaches improve clinical outcomes in microsurgical free flap sternal reconstruction after cardiac surgery.
Impact of scleral tunnel length on the position of intraocular lenses in flanged intrascleral haptic fixation
Authors: Jun Jong Hwa , Kwak Joon-Ho , Park Chang-Hyun , Lee Jiyeon , Seong Jueun , Shim Kyu Young , Afshari Natalie A. 
Published: April 2024

Purpose:
To investigate the effect of scleral tunnel length on the effective lens position and tilt of the intraocular lens (IOL) in flanged intrascleral haptic fixation (ISHF) using anterior segment optical coherence tomography (AS-OCT).

Setting:
Tertiary institution.

Design:
Retrospective case–control study.

Methods:
This study included 55 and 42 eyes that underwent ISHF with 1.0 and 2.0 mm scleral tunnels, respectively. 23 eyes that underwent sutured fixation were used as a control. The anterior chamber depth (ACD), scleral tunnel length, incident angle of haptic, and tilting of optic were analyzed using AS-OCT.

Results:
The mean postoperative ACD, vertical tilt angle, and spherical equivalent of the 1.0 mm were 5.27 ± 0.39 mm, 6.04 ± 4.87 degrees, and 0.38 ± 1.03 diopters, respectively. The ACD and vertical tilt angle of the 1.0 mm were larger than those of the others (P < .001 and P < .05, respectively), and the postoperative spherical equivalent was more hyperopic (P < .05). The 2.0 mm exhibited a lower frequency of tilting greater than 7 degrees. The intereye difference in ACD between in-the-bag fixation and ISHF of the 1.0 mm tunnel was significantly greater than that in the 2.0 mm tunnel (P < .05). The 1.0 mm tunnel had a significantly larger incident angle and a longer tunnel length (P < .001, respectively) and showed a greater difference in the tunnel length on both sides (P < .05).

Conclusions:
A shorter tunnel yielded a more unstable IOL position, greater variation in angle and tunnel length, and longer ACD during ISHF. An exact 2.0 mm tunnel must be created on both sides to achieve a stable and predictable IOL position.
Advanced practice nurse pharmacogenomics capacity and utilization
Authors: Fulton Cathy R. , Macagno Anna L.M. , Dickinson Stephanie L. , Calzone Kathleen 
Published: April 2024

ABSTRACT

Background:
Guided by Clinical Pharmacogenomic Implementation Consortium (CPIC) guidelines for >140 medications, pharmacogenomic tests inform medication selection and dosing to optimize efficacy while minimizing toxicities.

Purpose:
This study assessed pharmacogenomic self-reported curricular content, knowledge, skills, attitudes, and usage in advanced practice registered nurses (APRNs) with prescriptive privileges.

Methodology:
An online survey was administered assessing pharmacogenomic curricular content, knowledge, skills, attitudes, and usage.

Results:
Data from 266 APRNs were analyzed. Most graduated with their highest nursing degree ∼10 years ago and reported pharmacogenomic curricular content (n = 124, 48%). Pharmacogenomic curricular content was associated with pharmacogenomic familiarity (p = .045) but not with knowledge confidence (p = .615). Pharmacogenomic usage, defined as ordering a pharmacogenomic test within the past year, was low (n = 76, 29%) and most (n = 210, 84%) reported never using CPIC Guidelines. Advanced practice registered nurses (n = 162) who did not anticipate ordering a pharmacogenomic test in the next year (n = 77, 48%) indicated that they did not know what test to order.

Conclusions:
Deficits were identified in APRN pharmacogenomic knowledge and skills despite academic training. Most reported not ordering pharmacogenomic tests, did not know what test to order, and did not use CPIC guidelines.

Implications:
Pharmacogenomics is a quality and safety issue. Academic training did not result in practice integration and most reported capacity deficits. Recommendation for overcoming academic deficits include: (1) assessment of pharmacogenomics curricular content and faculty teaching capacity; (2) training addressing identified deficiencies; and (3) Commission of Collegiate Nursing Education policies that include pharmacogenomics in advanced pharmacology. Practicing APRN plans include on-the-job training and/or mandatory training at the time of relicensure.
United States-Mexico Border Disparities in Alcoholic Liver Disease Mortality
Authors: Folk Akira , Mouhaffel Rama , Grewal Harneet , Noh Sangkyu , Le Cam Elise , Liu Franklin , Ho Sabrina , Loveland Macklin , Sainbayar Enkhsogt , Pham Hoang Nhat , Ferreira João Paulo , Ibrahim Ramzi 
Published: April 2024

Background:
US-Mexico (US-MX) border regions are impacted by socioeconomic disadvantages. Alcohol use disorder remains widely prevalent in US-MX border regions, which may increase the risk of alcoholic liver disease (ALD).

Goals:
We aimed to characterize ALD mortality trends in border regions compared to non-border regions from 1999 to 2020 in the United States (US).

Methods:
We performed a cross-sectional analysis using the CDC repository. We queried death certificates to find ALD-related deaths from 1999 to 2020, which included demographic information such as gender, race/ethnicity, and area of residence. We estimated age-adjusted mortality rates (AAMR) per 100,000 population and compared the AAMRs across border and non-border regions. We also explored yearly mortality shifts using log-linear regression models and calculated the average annual percentage change (AAPC) using the Monte Carlo permutation test.

Results:
In all, 11,779 ALD-related deaths were identified in border regions (AAMR 7.29) compared with 361,523 in non-border regions (AAMR 5.03). Border male (AAMR 11.21) and female (AAMR 3.77) populations were higher compared with non-border male (AAMR 7.42) and female (2.85) populations, respectively. Border non-Hispanic populations (AAMR 7.53) had higher mortality compared with non-border non-Hispanic populations (4.79), while both populations experienced increasing mortality shifts (AAPC +1.7, P<0.001 and +3.1, P<0.001, respectively). Border metropolitan (AAMR 7.35) and non-metropolitan (AAMR 6.76) regions had higher mortality rates compared with non-border metropolitan (AAMR 4.96) and non-metropolitan (AAMR 5.44) regions.

Conclusions:
Mortality related to ALD was higher in border regions compared with non-border regions. Border regions face significant health disparities when comparing ALD-related mortality.
Evaluation of skull bone viability and effect of early surgical intervention in electrical contact burns using 18F-Sodium Fluoride PET-CT imaging
Authors: Kumar Parmod , Arora Pulkit , Kumar Rajender , Singh Harmandeep , Parashar Atul , Mittal Bhagwant R. , Bhattacharya Anish 
Published: April 2024

Objective
Electrical contact burns of the scalp cause serious morbidity and mortality. Early necrotic bone debridement and flap cover are crucial for successful wound closure. 18F Sodium Fluoride (NaF), with high bone-to-soft tissue activity ratio, is useful for bone viability assessment. This study evaluated the role of 18F NaF PET-computed tomography (CT) in objectively defining the extent and depth of nonviable calvarial bone, to guide adequate bone debridement.

Method
Of 20 patients referred to our institute with electrical contact burns of the scalp during a 2-year period, 15 were enrolled in the study. Two weeks after the initial management, tracer uptake pattern was noted on 18F NaF PET-CT of the head and exposed bone measured. Surgical bone debridement was based on scan findings, followed by wound closure. All patients underwent clinical evaluation and follow-up scan 3 months after surgery.

Results
Eight patients showed a central photopenic area in the exposed bone (maximum standardized uptake value [SUVmax] of 0.76 ± 0.14 with mean maximum dimensions 4.10 ± 1.76/2.67 ± 1.54 cm). High tracer uptake (SUVmax, 9.66 ± 6.03) was seen peripheral to the exposed bone (mean maximum dimensions, 8.14 ± 3.03/4.75 ± 1.61 cm). Postoperatively, there was no significant change in tracer uptake in the central debrided region or peri-debridement bone area under the flap. Clinically all patients showed a well-healed flap.

Conclusion

18F NaF PET-CT appears useful for objective evaluation of skull bone viability and planning necrotic bone debridement in patients with electrical contact burns. However, additional studies with longer patient follow-up are required to validate these results.
The Potential Mediating Effect of Symptom Burden on Demoralization Through Locus of Control and Coping Strategies in Chinese Patients With Cancer
Authors: Liu Xiaoxin , Li Yanhua , Li Lezhi , Li Juan , Yang Jiao , Huang Lirong , Yao Min , Yang Linlin , Yang Qun 
Published: April 2024

BackgroundDemoralization is a psychological syndrome that is highly prevalent in patients with cancer and detrimental to individuals’ physical and mental health. To explore effective intervention, we first determined the relationships between locus of control, coping strategies, symptom burden, and demoralization.ObjectiveThe aim of this study was to determine the relationship between symptom burden, locus of control, coping strategies, and demoralization in patients with cancer.MethodsIn this descriptive-correlational study, 273 valid patients were selected with convenience sampling method from a hospital in China. Data were collected using the Chinese version of the M.D. Anderson Symptom Inventory, the Chinese version of the Multidimensional Health Locus of Control Scale, the Chinese version of the Medical Coping Modes Questionnaire, and the Mandarin version of the Demoralization Scale. Data were analyzed using descriptive and inferential statistics using SPSS and AMOS.ResultsA total of 115 patients (42.12%) experienced clinical demoralization (Mandarin version of the Demoralization Scale > 30). Symptom burden (β = 0.295,P< .001), confrontation (β = −0.117,P= .028), and resignation (β = 0.456,P< .001) had direct effects on demoralization. Symptom burden also had an indirect effect on demoralization through the mediating role of resignation (β = 0.026,P= .002). Meanwhile, locus of control can affect demoralization entirely through the indirect mediating role of coping strategies (chance locus of control via resignation [β = 0.138,P< .01], powerful locus of control via confrontation [β = −0.017,P< .05]).ConclusionsSymptom burden affects demoralization not only directly but also indirectly. Coping strategies play an important mediating role between symptom burden, locus of control, and demoralization in patients with cancer.Implications for PracticeIt is urgent to screen demoralization and identify patients with high symptom burden, maladaptive locus of control, or coping strategies. For the patients targeted, a more comprehensive and systematic approach to symptom management and more appropriate guidance related to adaptive coping strategies are needed.
Cross-Sectional Imaging Characteristics of Pancreatic Intraductal Oncocytic Papillary Neoplasms
Authors: Iranpour Negaur , Singhi Aatur , Salimian Kevan Jonathan , Azadi Javad R. , Slivka Adam , Ngan Ka-Kei , McGrath Kevin , Fasanella Kenneth , Zureikat Amer , Paniccia Alessandro , Zaheer Atif , Dasyam Anil K. 
Published: April 2024

Purpose
Pancreatic intraductal oncocytic papillary neoplasms (IOPN) are rare precursors to pancreatic ductal adenocarcinoma. We report cross-sectional computed tomography and magnetic resonance imaging (where available) findings of pancreatic IOPNs.

Materials and Methods
Consecutive cases of pancreatic IOPNs identified on pathology between 2008 and 2020 at University of Pittsburgh and Johns Hopkins University were included in the study. Cross-sectional imaging of all patients was reviewed by two subspecialty trained abdominal radiologists. Patient demographics, cross-sectional imaging appearances and growth characteristics were evaluated.

Results
In this dual-center study, 14 patients with IOPNs were included. Median age was 64 years, and 64% were male. The median size of the lesions was 5.4 cm (range, 1.4–12.3 cm). All patients had either an enhancing mural nodule (93% of patients) and/or thick internal septations (29%). Thin/imperceptible outer wall was seen in 93%. Main duct was involved in 64% of the cases. Only 14% of the cases did not demonstrate abutment of the main duct. Histologic evaluation of surgical specimen showed high-grade dysplasia without invasive carcinoma in 57% and invasive carcinoma in 43% of cases. Lesions with invasive carcinoma were larger (7.1 cm vs 4.3 cm, P = 0.05) and tended to have larger mural nodule (3.7 cm vs 1.8 cm) compared with those without invasive carcinoma.

Conclusion
Pancreatic IOPNs are rare cystic premalignant lesions, which among resected cases, are predominantly seen in middle aged men, are often large, have enhancing mural nodules and frequently harbor invasive carcinoma.