bluuebunny/crossref_metadata_2025_split huggingface dataset:
Correlation between the oxygenation status of extrasynovial tissue in the wrist and disease activity in rheumatoid arthritis: a photoacoustic imaging study
Authors: Huang Zhibin , Wu Huaiyu , Hong Xiaoping , Song Di , Liang Weiyu , Huang Qin , Ye Xia , Xu Wenyi , Hu Qiu , Liu Cuilian , Li Guoqiu , Xu Jinfeng , Dong Fajin 
Published: January 2024

Abstract

Objective
RA is characterized by hypoxia in the synovial tissue. While photoacoustic (PA) imaging offers a method for evaluating tissue oxygenation in RA patients, studies exploring the link between the oxygenation status of extrasynovial tissue in the wrist and disease activity remain scarce. We aimed to assess synovial oxygenation in RA patients using a multimodal photoacoustic-US (PA/US) imaging system and establish its correlation with disease activity.

Methods
A retrospective study was conducted on 111 patients with RA and 72 healthy controls from 2022 to 2023. Dual-wavelength PA imaging quantified oxygen saturation (So2) levels in the synovial membrane and peri-wrist region. Oxygenation states were categorized as hyperoxia, intermediate oxygenation, and hypoxia based on So2 values. The association between oxygenation levels and the clinical disease activity index was evaluated using a one-way analysis of variance, complemented by the Kruskal–Wallis test with Bonferroni adjustment.

Results
Of the patients with RA, 39 exhibited hyperoxia, 24 had intermediate oxygenation, and 48 had hypoxia in the wrist extrasynovial tissue. All of the control participants exhibited the hyperoxia status. Oxygenation levels in patients with RA correlated with clinical metrics. Patients with intermediate oxygenation had a lower disease activity index compared with those with hypoxia and hyperoxia.

Conclusion
A significant correlation was found to exist between wrist extrasynovial tissue oxygenation and disease activity in patients with RA.
Postpartum Treatment for Chronic Hepatitis C Virus Among People With Opioid Use Disorder: A Prospective Pilot Clinical Trial
Authors: Chappell Catherine A. , Stewart Ellen , Laird Hollis J. , Jonassaint Naudia , Kasula Katelyn , Patterson Maya , Krans Elizabeth E. 
Published: January 2024

ObjectiveThe objective of this study was to evaluate the feasibility and acceptability of postpartum hepatitis C virus (HCV) treatment integrated within a substance use treatment program for pregnant and postpartum people with opioid use disorder (OUD).MethodsWe conducted a prospective pilot clinical trial of sofosbuvir/velpatasvir (SOF/VEL) treatment among postpartum people with OUD and HCV. Feasibility outcomes included rates of HCV treatment utilization and completion, medication adherence, and sustained virologic response 12 weeks after treatment completion (SVR12). Acceptability was measured through self-reported adverse effects and medication adherence.ResultsFrom January 2018 to August 2021, 164 pregnant people received care for OUD at the study site. Among those, 64 (39.0%) were HCV antibody positive and 45 (27.4%) had active HCV infection. Among 45 eligible patients, 32 (71.1%) enrolled and 21 (46.7%) initiated HCV treatment. Of 21 participants who initiated treatment, 16 (76.2%) completed the SOF/VEL treatment, and 11 (52.4%) completed the SVR12. All participants who completed treatment were cured. Common reasons for dropout during the HCV clinical care cascade were OUD treatment discontinuation, illicit substance use recurrence, and lost to follow-up. Participants reported high satisfaction with HCV treatment, including minimal adverse effects, and no HCV treatment concerns.ConclusionsNearly half of pregnant people with HCV initiated postpartum treatment within an integrated care model of HCV treatment within a substance use treatment program. Postpartum SOF/VEL was efficacious, tolerable, and acceptable. Despite this, postpartum HCV treatment among people with OUD remains challenging, and many barriers remain.
Exploration Into Patterns of Cannabis Use Across Pregnancy and Postpartum
Authors: Eitel Anna E. , Witcraft Sara M. , McRae-Clark Aimee L. , Brady Kathleen , King Courtney , Guille Constance 
Published: January 2024

Objectives
Peripartum cannabis use can be harmful to pregnant individual’s and children’s health, yet it is the most used illicit substance during the peripartum period. Despite the ability of some people to reduce and abstain from cannabis use during pregnancy, the first year postpartum is a high-risk time for returning to cannabis. However, characterization of cannabis use patterns in the peripartum period and risk factors for return to use postpartum are not well established. The aims of this exploratory study were to describe patterns of peripartum cannabis use and identify factors associated with increased frequency of postpartum cannabis use among individuals who reported reduced use during pregnancy.

Methods
An online survey identified 47 individuals who used cannabis during the peripartum period. Descriptive statistics characterized the sample and among those who reduced use during pregnancy, χ2 determined the frequency of postpartum cannabis use per preconception reasons for use.

Results
During preconception, 95.7% of individuals used cannabis, and of those who were presently postpartum, 65% resumed use after delivery. Anxiety and stress were the most common motivations for cannabis use throughout the peripartum period, but social motivations (ie, fun, relaxation) were the only preconception factors that increased frequency of return to cannabis use postpartum.

Conclusions
Our exploratory study describes the characteristics of individuals using cannabis in the peripartum period and provides insight into correlates of resumption of cannabis use postpartum. These findings may inform future work to further determine temporal associations, confounding risk factors, and intervention techniques to prevent the return to cannabis use postpartum.
The Goutallier Classification System
Authors: Corazzelli Giuseppe , Meglio Vincenzo , Corvino Sergio , Leonetti Settimio , Ricciardi Francesco , D’Elia Alessandro , Pizzuti Valentina , Santilli Marco , Innocenzi Gualtiero 
Published: January 2024

Study Design.
Retrospective, observational study.

Objective.
To determine the relationship between the Goutallier classification system (GS) and anthropometric, clinical, and radiologic features in 168 patients with lumbar spinal stenosis (LSS).

Background.
There is no agreement on a classification system that is both reliable and easy to use for describing the severity of fatty degeneration in the paravertebral muscles of the lower back in patients with symptomatic LSS. This study aimed to determine the statistical relationship between the GS and anthropometric, clinical, and radiologic factors in 168 patients with LSS.

Materials and Methods.
This study was conducted on 168 patients with LSS scheduled for elective decompressive surgery. A control group of 110 healthy individuals was enrolled. The study assessed paralumbar musculature fatty infiltration using GS on preoperative magnetic resonance imaging. The authors evaluated the statistical association between patient age, body mass index (BMI), preoperative Oswestry disability index (ODI) questionnaire, and cross-sectional areas (CSAs) of the dural sac and lumbar paraspinal muscles. Multivariate analysis was performed to adjust for confounding.

Results.
This study enrolled 168 patients with symptomatic LSS (95 men, 73 women); mean±SD age: 67.81±9.38 (range: 32.78–92.34) years; BMI: 28.29±3.36 (19.95–38.10) kg/m2. The control group was comprised of 110 healthy patients (61 men and 49 women). Age, sex, BMI, and erector spinae (ES)-CSA were not significantly different between the two groups. The authors found a direct relationship between GS grade and age and an inverse relationship between GS grade and dural sac-, multifidus lumbaris (LM)-, ES-, and psoas muscle (PM)-CSAs. Univariate analyses showed the variables statistically related to a higher GS grade included patient age (P<0.001), ODI (P=0.136), dural sac-CSA (P=0.011), LM-CSA (P< 0.001), ES-CSA (P<0.001), and PM-CSA (P<0.001). Multivariate least squares analysis showed the GS grade to be influenced by patient age (P=0.01), LM-CSA (P=0.002), ES-CSA (P=0.002), and PM-CSA (P=0.003).

Conclusions.
GS shows great potential as a tool for evaluating fat infiltration in the paralumbar muscles. This measure does not correlate with the ODI and BMI but is related to all radiologic parameters and patient age. Further prospective studies are required to establish a link between preoperative and postoperative outcomes in the setting of paraspinal fat infiltration.
Removal of Incidental Skin Cancer During Mohs Micrographic Surgery Indicated for a Different Primary Tumor
Authors: Darsha Adrija K. , Pousti Bobak T. , Loh Tiffany Y. , Hau Jennifer T. , Brian Jiang Shang I. 
Published: January 2024

BACKGROUND
Mohs surgery is a tissue-sparing, microscopically controlled procedure used to treat biopsy-proven skin cancers. Because Mohs surgery allows for examination of the complete margin of each tissue layer removed, separate cancers can be treated concomitantly when identified. As early detection of skin cancer is beneficial for reducing morbidity, incidental tumors discovered during Mohs surgery are of significant interest.

OBJECTIVE
Our objective was to determine the prevalence and characteristics of incidental skin cancers found during Mohs surgery.

METHODS
A retrospective chart review of cases seen at University of California, San Diego, from 2014 to 2021 was performed.

RESULTS
Of 13,464 Mohs surgery cases, 4.53% (n = 610) had incidental skin cancers found during removal of the initially identified tumor. Of the 610 cases, 88.4% (n = 539) had basal cell carcinoma as the primary tumor and either squamous cell carcinoma (SCC) or SCC in situ as the incidental tumor. About 7.87% (n = 48) had SCC as the primary tumor and basal cell carcinoma as the incidental tumor. All tumors were removed with clear margins and without significant complications.

CONCLUSION
Diagnosis of incidental tumors during Mohs surgery enables early detection of skin cancer and circumvents the need for additional surgery, likely resulting in decreased morbidity and improved cost-effectiveness.
Comparison of Treatment Efficacy of Different Number of Botulinum Toxin Type A Injection Sites for Crow’s Feet Lines: A Single-Center Retrospective Clinical Study in Vietnam
Authors: Nguyen Quang Minh , Le Thi Mai , Duong Phuc Hieu , Vu Thai Ha , Le Huu Doanh 
Published: January 2024

Objective:
Botulinum toxin type A is frequently used to treat crow’s feet lines. However, the optimal dose and injection sites are still controversial. The objective of this study was to compare the efficacy of different botulinum toxin type A injection patterns for the treatment of crow’s feet.

Methods:
This single-center, retrospective, clinical study was conducted at the National Hospital of Dermatology and Venereology from July 2020 to December 2020. Data on 60 patients with crow’s feet were collected and divided into 2 groups (3- or 4-point intramuscular injection) according to the intramuscular injection technique the patients received. The treatment efficacy was assessed based on the changes in the Crow’s Feet Grading Scale score at 1, 4, and 16 weeks after treatment. Repeated measures analysis of variance was used for the assessment of changes in scores over time between the two groups.

Results:
After treatment, the average Crow’s Feet Grading Scale score was significantly decreased compared with the pretreatment score at all timepoints (1, 4, and 16 weeks) in both states (dynamic: For 3-point intramuscular injection technique, 1 week: 1.90 ± 0.71 vs. 2.97 ± 0.56; 4 weeks: 1.87 ± 0.68 vs. 2.97 ± 0.56; 16 weeks: 2.60 ± 0.67 vs. 2.97 ± 0.56. For 4-point intramuscular injection technique, 1 week: 1.73 ± 0.83 vs. 3.03 ± 0.49; 4 weeks: 1.73 ± 0.74 vs. 3.03 ± 0.49; 16 weeks: 2.57 ± 0.68 vs. 3.03 ± 0.49, all P < 0.001. and static: For 3-point intramuscular injection technique, 1 week: 1.20 ± 0.89 vs. 2.20 ± 0.85; 4 weeks:1.20 ± 0.89 vs. 2.20 ± 0.85; 16 weeks: 1.87 ± 0.97 vs. 2.20 ± 0.85; For 4-point intramuscular injection technique, 1 week: 1.50 ± 0.86 vs. 2.30 ± 0.84; 4 weeks: 1.33 ± 0.84 vs. 2.30 ± 0.84; 16 weeks: 1.87 ± 0.97 vs. 2.30 ± 0.84. All P < 0.001). The average subjective patient-rated satisfaction scores after treatment were significantly higher in the 4-point injection group than in the 3-point injection group (P = 0.028). The adverse events were post-injection bruising in 3 patients and a feeling of eyelid tightness in 3 patients.

Conclusion:
Botulinum toxin type A injection is an effective treatment for crow’s feet. Adding a fourth injection maintains the same therapeutic effect and does not increase adverse effects. Patients with lower-fan crow’s feet patterns may benefit more from 4-point injection therapy. However, the present findings require confirmation in studies with larger sample sizes, longer follow-up times, and different botulinum toxin type A doses.
A Conversation with a Key Architect of Modern TCM in the West- Professor Ted Kaptchuk
Authors: Solos Ioannis , Buck Charles , Kaptchuk Ted 
Published: January 2024

Abstract:
The interview was conducted on November 20, 2022 by Ioannis Solos and Charles Buck. Ted Kaptchuk (泰开阳) is a Professor of Medicine and a Professor of Global Health & Social Medicine at Harvard Medical School. In 1975, he graduated from the Macau Institute of Chinese Medicine, Macau, China. After returning to the West, Ted taught Chinese medicine throughout the States, Europe, Latin America, and Australia. Ted's book, The Web That Has No Weaver: Understanding Chinese Medicine is a groundbreaking explanation of East Asian medicine that continues to shape the discourse of the Chinese medicine profession in the West and has been translated into 13 languages. In 1990, Ted was recruited in Harvard Medical School to help research Chinese medicine. After encountering high placebo responses in multiple acupuncture clinical trials, Ted decided to switch his career to primarily studying placebo. He has published over 300 peer-reviewed articles. He has been awarded the Lifetime Achievement Award from the Society of Acupuncture Research (2015), the Lifetime Achievement Award from the Society for Interdisciplinary Placebo Studies (2021), and the William Silen Lifetime Achievement Award in Mentoring from Harvard Medical School (2022).
William Morris, Establishing the Foundation for the Advancement of TCM in the US
Authors: Solos Ioannis , Buck Charles , Morris William 
Published: January 2024

Abstract:
Charles Buck and Ioannis Solos conducted this interview on the 2nd of March 2023. William Morris has sustained practice since 1980. He has served on the California, Texas and Massachusetts Professional Associations, as well as the National Association. He has tendered 20 years of service to the field through academic medicine, earning a master's degree in medical education to assist in developing Chinese medical doctoral programs and institutional review boards. He earned an OM.D. in 1988, a DAOM in 2002, and a Ph.D. focused on pulse diagnosis as clinical epistemology in 2009. He has published five books, including TCM Case Studies Dermatology, Li Shi-zhen Pulse Studies: An Illustrated Guide, Neoclassical Pulse Diagnosis, Cycles in Medical Astrology, and Transformation: Treating Trauma with Acupuncture and Herbs. (Fig. 1)
A clinical study on gastric cancer patients administered EN and PN versus PN alone in enhanced recovery after surgery
Authors: Fan Xin , Xu Yachen , Wan Rong , Zhang LiWen , Han He , Chen Jixiang 
Published: January 2024

Background and objectives:Enhanced recovery after surgery (ERAS) recommends avoiding enteral nutrition (EN) due to undesirable sequelae such as pulmonary aspiration and infections. Not using of EN in nongastric resections under ERAS pathways is often successful. However, parenteral nutrition (PN) alone followed by early postoperative oral feeding in gastric cancer patients, recommended by the ERAS guidelines, has unclear benefit and is only adopted after gastric resection. This study aimed to compute the postoperative outcomes of EN and PN compared to those of the ERAS-recommended nutritional pathway. Our secondary objective was to compare postoperative complications between the two groups.Materials and methods:Of 173 gastrectomy patients, 116 patients were in the combined group (EN and PN), whereas 57 patients were in the PN alone group. Statistical analysis was performed with the Statistical Package for the Social Sciences (SPSS) version 26.0.0 software. The data were analyzed by one-way ANOVA, the independent samplet-test, or, in the case of several independent samples, by the Kruskal–Wallis test. Categorical data were analyzed by Pearson’s χ2test or Fisher’s exact test.Results:The observed indices included C-reactive protein (CRP), platelet (PLT), white blood cells (WBC), hemoglobin (Hb), albumin, and PRE-albumin. The secondary outcomes included length of hospital stay (LOS), cost, incidence of pulmonary infection, and total incidence of infection.Conclusion:The combined mode of nutrition is feasible and is not associated with postoperative complications in gastric cancer patients under ERAS.
Worse Depression Profiles Are Associated With Higher Symptom Burden and Poorer Quality of Life in Patients With Gynecologic Cancer
Authors: Calvo-Schimmel Alejandra , Hammer Marilyn J. , Wright Alexi A. , Blank Stephanie V. , Cohen Bevin , Harris Carolyn , Shin Joosun , Conley Yvette , Paul Steven , Cooper Bruce , Levine Jon D. , Miaskowski Christine 
Published: January 2024

Background
Depression is a pervasive symptom in patients with gynecological cancer undergoing chemotherapy.

Objectives
Purposes were to identify subgroups of patients with distinct depression profiles and evaluate for differences in demographic and clinical characteristics, severity of common symptoms, and quality of life (QOL) outcomes among these subgroups.

Methods
Patients with gynecological cancer (n = 231) completed the Center for Epidemiologic Studies–Depression Scale 6 times over 2 cycles of chemotherapy. All of the other measures were completed prior to the second or third cycle of chemotherapy. Latent profile analysis was done to identify the distinct depression profiles. Differences were evaluated using parametric and nonparametric tests.

Results
Three distinct profiles were identified: low (60.1%), high (35.1%), and very high (4.8%). Compared with low class, the other 2 classes had lower functional status and were more likely to self-report a diagnosis of depression. Patients in the 2 worse profiles reported a higher comorbidity burden, higher levels of trait and state anxiety, sleep disturbance, and fatigue, as well as lower levels of cognitive function and poorer QOL. State and trait anxiety, evening fatigue, and sleep disturbance scores exhibit a “dose-response effect” (ie, as the depression profile worsened, the severity of these symptoms increased).

Conclusions
Almost 40% of our sample experienced high or very high levels of depression across 2 cycles of chemotherapy.

Implications for Practice
Clinicians can use the identified risk factors to identify high patients risk and provide tailored psychological interventions aimed to decrease symptom burden and prevent decrements in QOL.
Magnet Recognition® and Pathway to Excellence®, Complementary Programs
Authors: Lal M. Maureen 
Published: January 2024

The American Nurses Credentialing Center® (ANCC) provides healthcare organizations with 2 complementary programs: Magnet Recognition Program® and Pathway to Excellence®. Both programs support nurses in providing the best care. Understanding each program's framework and focus allows organizations to choose which program is the best fit.
Nursing is searching for solutions, the ANCC's Magnet Recognition®, and the Pathway to Excellence® programs offer evidence-based frameworks to support professional nursing practice. The frameworks result in improved nurse engagement, retention, interprofessional collaboration, nurse and patient safety, and patient outcomes.
Moral Distress and Intention to Leave During COVID
Authors: Karakachian Angela , Hebb Abigail , Peters Joy , Vogelstein Eric , Schreiber James B. , Colbert Alison 
Published: January 2024

OBJECTIVE
The aim of this study was to investigate how the experience of caring for COVID-19 patients, nurses' moral distress, and the current practice environment impact nurses' intention to leave.

BACKGROUND
Caring for COVID-19 patients has been associated with an increase in nurses' moral distress and an increase in nurses' turnover. To date, research has focused on nurses' moral distress, the practice environment, and intentions to leave during the pandemic's peak. The current workplace climate, including those who stayed in their positions, has not been adequately assessed.

METHODS
This cross-sectional correlational study was conducted in a Magnet® hospital.

RESULTS
Moral distress related to team/system (B = 0.64, t = 3.86, P < 0.001), nurses' participation in hospital affairs (B = −2.21, t = −3.52, P < 0.001), and staffing (B = −1.91, t = −5.48, P < 0.001) are strongest predictors for nurses' intention to leave postpandemic.

CONCLUSIONS
Nurses in practice still report experiencing COVID-related moral distress; however; issues related to resources and staffing have the most substantial impact on intention to leave among the current nursing workforce.
Dissemination, Utilization, and Satisfaction With Emergency Medicine Resident Simulation Curriculum for Pediatrics (EM ReSCu Peds) by North American Residency Programs
Authors: Yee Jennifer , Auerbach Marc A. , Wong Kei U. , Kaur Snimarjot , Burns Rebekah A. 
Published: January 2024

Objectives
Our research team's primary objective was to investigate how a custom standard simulation curriculum for teaching emergency medicine residents about pediatrics was being used by programs across North America. We also wanted to know if program directors were satisfied with the curriculum and whether they had challenges with implementing it. Our long-term goal is to promote the Emergency Medicine Resident Simulation Curriculum for Pediatrics for use by all programs in the United States.

Methods
We distributed an electronic questionnaire to individuals who have downloaded the Emergency Medicine Resident Simulation Curriculum for Pediatrics in the form of an e-book from the Academic Life in Emergency Medicine Web site. The curriculum was marketed through national emergency medicine (EM) and pediatric emergency medicine (PEM) groups, PEM listserv, and through the International Network for Simulation-Based Pediatric Innovation, Research, and Education. We asked survey recipients how they used the curriculum, plans for future maintenance, satisfaction with curriculum use, and whether they had any challenges with implementation. Finally, we asked demographic questions.

Results
Most survey respondents were EM or PEM health care physicians in the United States or Canada. Respondents' primary goal of using the curriculum was resident education. Through assessment with the Net Promoter Score, satisfaction with the curriculum was net positive with users largely scoring as curriculum promoters. We found COVID-19 and overall time limitations to be implementation barriers, whereas learner interest in topics was the largest cited facilitator. Most responders plan to continue to implement either selected cases or the entire curriculum in the future.

Conclusions
Of those who responded, our target audience of EM physicians used our curriculum the most. Further investigation on implementation needs, specifically for lower resource emergency programs, is needed.