bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Reciprocal Relationship Between Lumbar Intervertebral Disk Degeneration and the MRI-based Vertebral Bone Quality Score
Authors: Moser Manuel , Adl Amini Dominik , Albertini Sanchez Leonardo , Oezel Lisa , Zhu Jiaqi , Nevzati Edin , Carrino John A. , Shue Jennifer , Sama Andrew A. , Cammisa Frank P. , Girardi Federico P. , Hughes Alexander P. 
Published: January 2024

Study Design.Retrospective longitudinal study.Objective.To investigate the association between lumbar intervertebral disk degeneration (DD) and the vertebral bone quality (VBQ) score.Background.The VBQ score that is based on magnetic resonance imaging has been proposed as a measure of lumbar spine bone quality and is a significant predictor of healthy versus osteoporotic bone. However, the role of segmental contributing factors on VBQ is unknown.Methods.Nonsurgical patients who underwent repeated lumbar magnetic resonance imaging scans, at least three years apart primarily for low back pain were retrospectively included. VBQ was assessed as previously described. DD was assessed using the Pfirrmann grading (PFG) scale. PFG grades were summarized as PFGL1-4for the upper three lumbar disk levels, as PFGL4-S1for the lower two lumbar disc levels, and as PFGL1-S1for all lumbar disc levels. Multivariable linear mixed models were used with adjustments for age, sex, race, body mass index, and the clustering of repeated measurements.Results.A total of 350 patients (54.6% female, 85.4% White) were included in the final analysis, with a median age at baseline of 60.1 years and a body mass index of 25.8 kg/m2. VBQ significantly increased from 2.28 at baseline to 2.36 at follow-up (P= 0.001). In the unadjusted analysis, a significant positive correlation was found between PFGL1-4, PFGL1-S1, and VBQ at baseline (P< 0.05) that increased over time (P< 0.005). In the adjusted multivariable analysis, PFGL1-4(β= −0.0195;P= 0.021), PFGL4-S1(β= −0.0310;P= 0.007), and PFGL1-S1(β= −0.0160;P= 0.012) were independently and negatively associated with VBQ.Conclusions.More advanced and long-lasting DD is associated with lower VBQ indicating less bone marrow fat content and potentially stronger bone. VBQ score as a marker of bone quality seems affected by DD.
Immune cells in the B-cell lymphoma microenvironment: From basic research to clinical applications
Authors: Zhang Wenli , Liu Mengmeng , Li Wei , Song Yongping 
Published: January 2024

Abstract
B-cell lymphoma is a group of hematological malignancies characterized by variable genetic and biological features and clinical behaviors. The tumor microenvironment (TME) is a complex network in tumors, which consists of surrounding blood vessels, extracellular matrix, immune and non-immune cells, and signaling molecules. Increasing evidence has shown that the TME, especially immune cells within, is a double-edged sword, acting either as a tumor killer or as a promoter of tumor progression. These pro-tumor activities are driven by subpopulations of immune cells that express typical markers but have unique transcriptional characteristics, making tumor-associated immune cells good targets for human anti-cancer therapy by ablating immunosuppressive cells or enhancing immune-activated cells. Thus, exploring the role of immune cells in the TME provides distinct insights for immunotherapy in B-cell lymphoma. In this review, we elucidated the interaction between immune cells and tumor cells and their function in the initiation, progression, and prognosis of B-cell lymphoma, from preclinical experiments to clinical trials. Furthermore, we outlined potential therapeutic approaches and discussed the potential clinical value and future perspectives of targeting immune cells in patients with B-cell lymphoma.
Misuse of the P Value
Authors: Reynolds Staci S. , Waldrop Julee 
Published: January 2024

Introduction
Quantitative research and quality improvement (QI) both seek to improve care provided to patients. However, clinicians often blur the lines between how to appropriately analyze data from these methodologies. Clinicians may inappropriately use statistical analyses for QI initiatives, rather than using run and statistical process control (SPC) charts to analyze improvements in outcomes.

Objective
The purpose of this article was to address the analytic methods used for QI initiatives in the clinical setting in an effort to show clinicians how to identify meaningful improvements in clinical practice.

Methods
In this article, we provide an example comparing the same evidence-based practice/QI initiative (chlorhexidine gluconate bathing in a medical intensive care unit) using a quasi-experimental pretest/posttest research design with statistical analyses completed with t tests with analyses using run and SPC charts to show the data trended over time. Using a pretest/posttest design, chlorhexidine gluconate bathing compliance improved from 63% to 65%, a nonsignificant change, P = .075. These same data plotted on run and SPC charts, however, show a shift and a trend, indicating clinically significant improvements per QI methodologies.

Conclusion
The example in this article highlights the pitfall of relying only on statistical analyses and P values to determine the importance of a clinical project, and provides a practical example for how run or SPC charts can be used to identify improvements over time.
The Relationship Between Uncertainty and Psychological Distress Among Family Caregivers of Patients With Delirium in Intensive Care Units
Authors: Haji Assa Amal , Cao Xueyuan , Boehm Leanne M. , Umberger Reba A. , Carter Michael A. 
Published: January 2024

Background
Although family caregivers experienced negative psychological symptoms associated with witnessing intensive care unit delirium in their loved ones, there is a lack of clear understanding of how delirium is associated with family caregiver psychological distress. Uncertainty could be a factor contributed to this association.

Objectives
The aim of this study was to examine the relationship between uncertainty and psychological distress among family caregivers of patients with delirium in intensive care units.

Methods
A cross-sectional correlational design was used for this observational study of adult family caregivers of patients admitted to the intensive care unit and who reported witnessing delirium symptoms in their loved ones. Family caregivers completed an electronic survey in January 2022 that consisted of a family caregiver and patient demographic form, the Mishel Uncertainty in Illness Scale-Family Member, and the Kessler Psychological Distress Scale. Descriptive, correlational, and regression statistical analyses were applied.

Results
One hundred twenty-one adult family caregivers were enrolled. Family caregivers reported substantial uncertainty (mean, 106.15, on a scale of 31-155) and moderate to severe psychological distress (mean, 31.37, on a scale of 10-50) regarding their witnessing of delirium episodes in their loved ones. Uncertainty was significantly correlated with psychological distress among family caregivers (r
s = 0.52, P < .001). Uncertainty significantly predicted psychological distress among family caregivers (regression coefficient, 0.27; P < .001).

Discussion
Family caregiver uncertainty was positively associated with psychological distress. This distress can interfere with family caregiver involvement in patient delirium care. These findings are essential to increase critical care nurse awareness and inform the development of nursing interventions to alleviate possible uncertainty and distress.
A Validated Assay to Quantify Osimertinib and Its Metabolites, AZ5104 and AZ7550, from Microsampled Dried Blood Spots and Plasma
Authors: Venkatesh Bharat , Yuile Alex , McKay Matthew J. , Narayanan Sathya , Wheeler Helen , Itchins Malinda , Pavlakis Nick , Clarke Stephen J. , Molloy Mark P. 
Published: January 2024

Background:
Osimertinib is an oral small-molecule tyrosine kinase receptor inhibitor used to treat non–small cell lung cancer (NSCLC) with a sensitizing epidermal growth factor receptor mutation. Patients may experience drug toxicity and require dose deescalation. The study aimed to quantitate osimertinib and its 2 active metabolites, AZ5104 and AZ7550, in microsampled dried blood spots (DBS) collected from patients with NSCLC using a hemaPEN device and compare them with plasma drug levels.

Methods:
A 6-min ultrahigh-performance liquid chromatography–tandem mass spectrometry method was developed and validated using plasma and DBS. The accuracy, selectivity, matrix effect, recovery, and stability were assessed using bioanalytical validation criteria. The hematocrit effect was investigated in DBS. Drug levels were measured in 15 patients with NSCLC, and the Bland–Altman method was used to compare measurements between plasma and DBS.

Results:
The validated assay determined accurate and precise quantities, respectively, for osimertinib in both plasma (93.2%–99.3%; 0.2%–2.3%) and DBS (96.7%–99.6%; 0.5%–10.3%) over a concentration of 1–729 ng/mL. The osimertinib metabolites, AZ5104 and AZ7550, were similarly validated in accordance with bioanalytical guidelines. For 30%–60% patient hematocrit, no hematocrit bias was observed with DBS for all analytes. The Bland–Altman method showed high concordance between plasma and DBS analyte levels. Stability experiments revealed that osimertinib and its metabolites were poorly stable in plasma at room temperature, whereas all analytes were stable in DBS for 10 days at room temperature.

Conclusions:
The measurement of osimertinib, AZ5104, and AZ7550 from hemaPEN microsampled DBS is a convenient and reliable approach for therapeutic drug monitoring that produces measurements consistent with plasma drug levels.
Study on Correction Method of Counting Loss below the Threshold for Low Energy Radionuclides Based on Monte Carlo Simulation
Authors: Kong Shuying , Tuo Fei , Lu Tianxiang 
Published: January 2024

Abstract
In the absolute measurement method of nuclide radioactivity by the internal gas proportional counter, the reasonable correction of the small pulse counting loss is the key to obtaining the measurement results accurately. Considering the decay type and energy of radioactive gas nuclides, the influence of the low-energy beta particles and the wall effect counting loss on the activity measurement results is different also. To this end, two typical radioactive gas nuclides (37Ar and 3H) are used to study the cause of counting loss based on the Monte Carlo simulation. The results show that the counting loss of small pulse in the activity measurement of 37Ar comes mainly from the wall effect generated by x rays. Within the given gas pressure of 60-300 kPa, the simulated wall effect correction factors are 1.063-1.021. The decay energy of β particles generated by 3H is very low, and there is no obvious wall effect. The small pulse counting loss mainly comes from the low-energy beta particles’ contribution with the energy below the counting threshold, which can be corrected by extrapolating the beta energy spectrum at a lower counting threshold (below 1 keV).
Making Sense of Schizoposting
Authors: Johansson Jim A. , Holmes Dave 
Published: January 2024

ABSTRACT
Online radicalization has gained considerable attention in the media and in academia. Much attention has shifted to so-called “homegrown terrorists.” Mental health concerns of those who display signs of online radicalization are identified as a potential contributing factor to this process. Although it seems both tempting to attribute mental health concerns, attempts to “make sense” of schizoposting (a bizarre and often violent form of online engagement) via conventional “clinical” analysis prove insufficient. This article offers a critical analysis of an extremely disturbing (online) phenomenon through the radical poststructuralist scholarship of late French philosophers, Deleuze and Guattari. Given that schizoposting and those individuals who engage in this behavior have yet to receive any attention in the nursing and health-related literature, it is critical that future research aims to better understand this population, such that appropriate interventions may be proposed.
Comparison of Quality of Life Outcomes for Percutaneous Versus Transcutaneous Implantable Hearing Devices: A Systematic Review and Meta-analysis
Authors: Gutierrez Jorge A. , Shannon Christian M. , Nguyen Shaun A. , Meyer Ted A. , Lambert Paul R. 
Published: January 2024

ObjectiveTo compare quality of life (QOL) outcomes of percutaneous and transcutaneous bone conduction devices (pBCD and tBCD, respectively).Databases ReviewedPubmed, Scopus, CINAHL.MethodsA systematic review was performed searching for English language articles from inception to March 15, 2023. Studies reporting QOL outcomes measured using a validated tool following implantation of either pBCDs or tBCDs were considered for inclusion. QOL outcomes included scores for Glasgow Benefit Inventory, Glasgow Children's Benefit Inventory, Abbreviated Profile of Hearing Aid Benefit, and the Speech, Spatial, and Qualities of Hearing Scale. A meta-analysis of continuous measures was performed.ResultsA total of 52 articles with 1,469 patients were included. Six hundred eighty-nine patients were implanted with pBCDs, and the remaining 780 were implanted with tBCDs. Average Glasgow Benefit Inventory scores for the tBCD group (33.0, 95% confidence interval [22.7–43.3]) were significantly higher than the pBCD group (30.9 [25.2–36.6]) (Δ2.1 [1.4–2.8],p< 0.0001). Mean Glasgow Children's Benefit Inventory scores (Δ3.9 [2.0–5.8],p= 0.0001) and mean gain in Abbreviated Profile of Hearing Aid Benefit scores (Δ5.6 [4.8–6.4],p< 0.0001) were significantly higher among patients implanted with tBCDs than those implanted with pBCDs. Patients implanted with tBCDs also had significantly higher gains on the Speech (Δ1.1 [0.9–1.3],p< 0.0001), Spatial (Δ0.8 [0.7–0.9],p< 0.0001), and Qualities of Hearing (Δ1.2 [1.1–1.3],p< 0.0001) portions of the Speech, Spatial, and Qualities of Hearing Scale than those implanted with pBCDs.ConclusionsPatients implanted with transcutaneous devices had better QOL outcomes than those implanted with percutaneous devices.
A Clinical Prediction Model to Assess Risk for Pancreatic Cancer Among Patients With Acute Pancreatitis
Authors: Wang Louise , Rahimi Larki Navid , Dobkin Jane , Salgado Sanjay , Ahmad Nuzhat , Kaplan David E. , Yang Wei , Yang Yu-Xiao 
Published: January 2024

Objectives
We aimed to develop and validate a prediction model as the first step in a sequential screening strategy to identify acute pancreatitis (AP) individuals at risk for pancreatic cancer (PC).

Materials and Methods
We performed a population-based retrospective cohort study among individuals 40 years or older with a hospitalization for AP in the US Veterans Health Administration. For variable selection, we used least absolute shrinkage and selection operator regression with 10-fold cross-validation to identify a parsimonious logistic regression model for predicting the outcome, PC diagnosed within 2 years after AP. We evaluated model discrimination and calibration.

Results
Among 51,613 eligible study patients with AP, 801 individuals were diagnosed with PC within 2 years. The final model (area under the receiver operating curve, 0.70; 95% confidence interval, 0.67–0.73) included histories of gallstones, pancreatic cyst, alcohol use, smoking, and levels of bilirubin, triglycerides, alkaline phosphatase, aspartate aminotransferase, alanine aminotransferase, and albumin. If the predicted risk threshold was set at 2% over 2 years, 20.3% of the AP population would undergo definitive screening, identifying nearly 50% of PC associated with AP.

Conclusions
We developed a prediction model using widely available clinical factors to identify high-risk patients with PC-associated AP, the first step in a sequential screening strategy.
Proximity of Percutaneous Tibial Nerve Stimulation Needle Insertion to Surrounding Anatomic Structures: A Cadaveric Study
Authors: Warehime Jenna M. , Gaskins Jeremy T. , Gupta Ankita S. , Hattab Eyas M. , Feroz Rehan T. , Rothenberger Rodger W. , Lenger Stacy M. , Francis Sean L. , Herring Nicole R. 
Published: January 2024

(Abstracted from Am J Obstet Gynecol 2023;229:430.e1–430.e6)
Each year, spending on treatment of overactive bladder and urinary urgency sans incontinence uses at least $65.9 billion. Although many treatments for such conditions exist, the third line of medication is percutaneous tibial nerve stimulation (PTNS) for patients who wish to avoid onabotulinum toxin treatment and decline implanted devices.
Mesothelioma of Uncertain Malignant Potential (MUMP) of the Tunica Vaginalis
Authors: Ding Chien-Kuang C. , Van Roo Jason , Kryvenko Oleksandr N. , Ye Huihui , McKenney Jesse K. , Epstein Jonathan I. 
Published: January 2024

A well-differentiated papillary mesothelial tumor (WDPMT) and malignant mesothelioma are 2 well-recognized entities arising from the testis tunica vaginalis. Another mesothelial lesion exclusively seen at this site is mesothelioma of uncertain malignant potential (MUMP)—a lesion reminiscent of WDPMT yet demonstrating variable proportions of more complex architectural patterns that could be confused with invasion. MUMP was first described in 2010 with a total of 11 cases reported to date. Herein, we describe 19 additional patients who underwent hydrocelectomy, excision, and/or orchiectomy. Novel morphologic patterns found in addition to the 2010 series include spindle cells, keloidal-type collagen, and multicystic architecture lined by bland mesothelial cells. Clinical follow-up in 9 patients for more than 1 year (1.5 to 22.5 y, median 4.5 y) revealed no evidence of disease recurrence or metastases. Despite greater architectural complexity, MUMP has (1) bland cytology; (2) merging in with WDPMT areas; (3) low mitotic rate and Ki-67 nuclear labeling index; (4) retention of MTAP and BAP1 expression; and (5) benign clinical follow-up. If these cases were malignant mesotheliomas, one would have expected at least some of the patients to demonstrate disease recurrence/progression without adjuvant therapy within the available follow-up time, particularly with limited resection in most patients. Thus, we propose that “mesothelioma of uncertain malignant potential” be renamed as “complex mesothelial tumor of the tunica vaginalis.” Using the term “complex” draws a contrast with the simple cuboidal lining and simple papillary architecture seen in WDPMT. Also, labeling the lesion as “tumor” removes the stigmata of “uncertain malignant potential” and “mesothelioma” that are alarming to patients and clinicians, and potentially could unduly lead to more extensive surgery in an attempt at “complete” resection. At the same time, not definitively labeling the lesion as benign allows recommendations for follow-up.
Telehealth and Outcomes in Patients With Cancer
Authors: Grant Michael J. , Chiang Ann C. 
Published: January 2024

Abstract
Despite that telehealth has been crucial to the delivery of oncology care during the COVID-19 pandemic, the impact of this care delivery mechanism on outcomes in cancer care has not been rigorously studied relative standard in-person care for patients with cancer. Patient-centered outcomes such as quality of life, patient satisfaction, and symptoms are important outcomes that have been the primary focus of many of the existing studies in this space, yet only a select few have evaluated overall survival and other objective efficacy endpoints. Studies have alluded to positive effects of telehealth on mitigating financial toxicity and enhancing cost-effective care delivery in oncology. Telehealth carries much potential for advancing care for patients with cancer, but future study should focus on additional efficacy endpoints, implementation, and ways to reduce disparities.
Evidence-Based Practices in Cleft Palate Surgery
Authors: Applebaum Sarah A. , Aronson Sofia , Termanini Kareem M. , Gosain Arun K. 
Published: January 2024

Learning Objectives:
After studying this article, the participant should be able to: (1) Understand the embryologic origins, cause, and incidence of cleft palate. (2) Review the anatomy and common classifications of cleft palate and associated defects. (3) Describe surgical techniques for palatoplasty and understand their respective indications. (4) Gain an awareness of general perioperative care considerations, timing of repair, and risk factors for and operative mitigation of complications.

Summary:
Cleft palate affects 0.1 to 1.1 per 1000 births, with a higher incidence in certain ethnic groups but affecting both sexes equally. Cleft palate may occur in isolation or in combination with cleft lip or in association with other congenital anomalies including various syndromes. The goals of cleft palate repair are to anatomically separate the oral and nasal cavities for normal feeding and improved speech and minimize the risk of oronasal fistulas, velopharyngeal dysfunction, and disruption of facial growth. This review discusses the incidence, causes, and classification of cleft palate; surgical techniques for palatoplasty and perioperative patient management; and complications of palatoplasty.
Comparison of Recombinant Human Thyroid-Stimulating Hormone and Thyroid Hormone Withdrawal for 131I Therapy in Patients With Intermediate- to High-Risk Thyroid Cancer
Authors: Park Sohyun , Bang Ji-In , Kim Keunyoung , Seo Youngduk , Chong Ari , Hong Chae Moon , Lee Dong-Eun , Choi Miyoung , Lee Sang-Woo , Oh So Won 
Published: January 2024

Background
This meta-analysis and systematic review aimed to evaluate the therapeutic efficacy and advantages associated with the use of recombinant human thyroid-stimulating hormone (rhTSH) for radioactive iodine (RAI) therapy in patients with intermediate- to high-risk differentiated thyroid cancer.

Patients and Methods
MEDLINE, EMBASE, and Cochrane databases were searched to identify relevant articles reporting clinical outcomes of rhTSH compared with thyroid hormone withdrawal (THW) in patients with intermediate- to high-risk differentiated thyroid cancer published between January 2012 and June 2023. Meta-analyses were performed (PROSPERO registration number: CRD42022340915) to assess the success rate of radioiodine remnant ablation (RRA) in patients with intermediate to high risk and determine the disease control rate among patients with distant metastases, evaluated using the RECIST criteria.

Results
Thirteen studies involving 1858 patients were included in the meta-analysis. Pooled analyses revealed significantly higher overall RRA success rate in the rhTSH group compared with the THW group, with a risk ratio (RR) of 1.12 (95% confidence interval [CI], 1.01–1.25). However, in the subgroup analysis of high-risk patients, pooled analyses showed no significant differences in RRA success rate between the rhTSH group compared with the THW group with a pooled RR of 1.05 (95% CI, 0.88–1.24). In patients with distant metastases, there were no significant differences in the disease control rate between groups, with a pooled RR of 1.06 (95% CI, 0.78–1.44).

Conclusions
rhTSH for RAI therapy is a practical option for RAI therapy in patients with intermediate- to high-risk thyroid cancer, including those with distant metastases.
Pulmonary Amyloidoma Imitating Lung Cancer on 18F-FDG PET/CT
Authors: Leike Tatjana , Svantesson Teodor , Minervini Fabrizio , Bhure Ujwal , Grünig Hannes 
Published: January 2024

Abstract
Localized pulmonary amyloidosis forming a solitary mass known as “amyloidoma of the lung” is rare. Differentiation from lung cancer can be difficult due to suspicious features on CT and high 18F-FDG uptake. We present a case of a 77-year-old woman with an incidental lung lesion on abdominal CT. Further evaluation with chest CT and 18F-FDG PET/CT maintained the suspicion of lung cancer. However, histology revealed amyloidoma without signs of malignancy. Knowledge of imaging similarities between pulmonary amyloidomas and malignancies is important for interpreting 18F-FDG PET/CT of lung tumors; however, only biopsy can confirm the rare differential diagnosis such as pulmonary amyloidoma.