bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hyperbaric Oxygen Therapy (HBOT) for Management of Complex Regional Pain Syndrome (CRPS)
Authors: Cha Joon , Bosco Gerardo , Moon Richard E. , Melloni Giorgio , Camporesi Enrico M. 
Published: January 2025

Objectives:
Complex regional pain syndrome remains a challenging condition characterized by severe, persistent pain and a variety of inflammatory and trophic symptoms. This study aimed to analyze the current literature to evaluate hyperbaric oxygen therapy (HBOT)’s efficacy in treating complex regional pain syndrome (CRPS), focusing on both sympathetically-maintained pain (SMP) and sympathetically-independent pain (SIP) subtypes.

Methods:
A comprehensive literature search was conducted in PubMed Clinical Queries using the MeSH term “Complex Regional Pain Syndromes” OR the keyword “CRPS” AND “Hyperbaric Oxygen Therapy” OR the keyword “HBOT”. The selected publication types included a randomized controlled trial, a retrospective observational study, a comparative study, a retrospective case series and case reports. The search was restricted to articles published in English between January 1994 and October 2024. The results from the search were used to compile this review. Patients were categorized into SMP, SIP, or indeterminate groups based on the presence of prior sympathetic nerve block history or disease duration.

Results:
Thirteen studies involving 280 subjects were reviewed. Of the patients, 42.5% were categorized as SMP, 48.2% as SIP, and 9.3% as indeterminate. HBOT treatment ranged from 3 to 63 sessions, typically using 2.4 ATA for 90 minutes. The results indicated significant symptom relief and functional improvement across both SMP and SIP subtypes, suggesting the broad efficacy of HBOT for CRPS management.

Discussion:
This review of the current literature suggests that HBOT may offer significant symptom relief, regardless of CRPS subtype or disease duration. HBOT’s anti-inflammatory and neuroplasticity promoting properties make it a valuable non-invasive option for CRPS patients, potentially improving outcomes when combined with other therapeutic modalities. Further research is necessary to refine patient selection and optimize treatment protocols.
Transfusion Practices in Traumatic Brain Injury: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Authors: Larcipretti Anna Laura Lima , Udoma-Udofa Ofonime Chantal , Gomes Fernando Cotrim , de Oliveira Jéssica Sales , Weba Elizabet Taylor Pimenta , Cavalcante Deivyd Vieira Silva , Dharaiya Madhav Kiritbhai , Bannach Matheus de Andrade 
Published: January 2025

Objectives:
Balancing oxygen requirements, neurologic outcomes, and systemic complications from transfusions in traumatic brain injury (TBI) patients is challenging. This review compares liberal and restrictive transfusion strategies in TBI patients.

Data Sources:
Electronic databases were searched from inception to October 2024.

Study Selection:
We included randomized controlled trials comparing liberal and restrictive transfusion strategies in TBI patients.

Data Extraction:
Data were extracted by two reviewers using predefined forms.

Data Synthesis:
We included five studies with 1,533 patients: 769 (50.2%) in the liberal transfusion group and 764 (49.8%) in the restrictive group. There were no significant differences between groups favorable Glasgow Outcome Scale (risk ratio [RR], 1.16; 95% CI, 1.00–1.34), although a leave-one-out analysis demonstrated significance in this endpoint (RR, 1.24; 95% CI, 1.06–1.45). No significant difference was found regarding hospital mortality (RR, 0.98; 95% CI, 0.76–1.27), mortality at follow-up (RR, 1.03; 95% CI, 0.82–1.28), mortality in the ICU (RR, 1.00; 95% CI, 0.73–1.37), infection rates (RR, 1.08; 95% CI, 0.95–1.23), thromboembolic events (RR, 1.79; 95% CI, 0.74–4.31), hospital length of stay (LOS) (mean difference [MD], –1.45; 95% CI, –4.85 to 1.96), or ICU LOS (MD, –0.47; 95% CI, –3.84 to 2.91). The liberal transfusion strategy group had a significantly higher prevalence of acute respiratory distress syndrome (RR, 1.78; 95% CI, 1.06–2.98) and received more blood units per patient (MD, 2.62; 95% CI, 1.90–3.33).

Conclusions:
Our findings suggest that a liberal transfusion strategy results in better neurologic outcomes than a restrictive approach. Future research should examine the complication profile and the effects of using a 9 g/dL threshold. We advocate for revising current guidelines to establish 9 g/dL as the standard threshold for transfusions in TBI patients.
Assessing Physician Motivation to Engage in Continuing Professional Development on Artificial Intelligence
Authors: Gavarkovs Adam G. , Kueper Jacqueline , Arntfield Robert , Myslik Frank , Thompson Keith , McCauley William 
Published: January 2025

Abstract
To realize the transformative potential of artificial intelligence (AI) in health care, physicians must learn how to use AI-based tools effectively, safely, and equitably. Continuing professional development (CPD) activities are one way to learn how to do this. The purpose of this article is to describe a theory-based approach for assessing health professionals' motivation to participate in CPD on AI-based tools. An online survey, based on an AI competency framework developed from existing literature and expert consultations, was administered to practicing physicians in Ontario, Canada. Across eight subcompetencies for using AI-based tools (eg, appraise AI-based tools for their regulatory and legal status), the survey measured physicians' perception they could successfully enact the competency, the importance of the competency in meeting their practice needs, and the desirability of participating in CPD activities on the competency. Motivation scores were calculated by multiplying the three scores together. Ninety-five physicians completed the survey. The highest motivation scores were for the subcompetency of identifying AI-based tools based on clinical needs, while the lowest motivation scores were for appraising tools' regulatory and legal status. All AI subcompetencies were generally rated as important, and CPD activities were generally perceived as desirable. This survey demonstrates the utility of a theory-based approach for assessing physicians' motivation to learn. Although the survey results are context specific, the approach may be useful for other CPD providers to support decision making about future AI-related CPD activities.
Coping With Microaggressions and Gaslighting in the Surgical Learning Environment
Authors: Nguyen Daryn , Thrikutam Nikhitha , Bialowas Christie 
Published: January 2025

Summary:
Plastic surgery and plastic surgical training programs are institutions rife with rewards. However, these rewards can be tempered by general physical and psychosocial stressors inherent to a surgical specialty. Although progress has been made in addressing the physical demands of training, less attention is given to the psychosocial and interpersonal challenges faced by plastic surgeons and trainees. Two key stressors are microaggressions and gaslighting. Microaggressions are generally unintentional but highly impactful expressions of bias, whereas gaslighting involves deliberate psychological manipulation. The purpose of our article is to explain the influence of microaggressions and gaslighting on plastic surgery providers. Most importantly, we aim to provide a framework for recognizing and addressing them professionally.
Mental Health and Wellness Among Plastic Surgeons During Oral Board Certification Examination Preparation
Authors: Bergman Hannah J. , Jehle Charles C. , Khansa Ibrahim 
Published: January 2025

Background:
The field of plastic and reconstructive surgery has recently made a dramatic shift toward attention to mental health, with residency curricula expanding to include training on burnout prevention and the promotion of well-being. After graduation, however, new surgeons face a difficult year of preparation for the oral board certification examination. This group of young surgeons remains largely unstudied and undersupported throughout what may be the most challenging period of their educational journey.

Methods:
In spring of 2024, an electronic survey was sent to members of the American Society of Plastic Surgeons who had completed their oral board examination within the past 3 years. Demographics, study habits, utilization of preparatory courses, and aspects of mental and physical health during the examination year were explored, and factors impacting well-being were identified.

Results:
Thirty-two respondents were included in the analysis, 85.7% of whom reported passing the examination on their first attempt. Most began in-earnest studying 1–3 months before the examination, with the majority studying 11–15 hours/week. The majority utilized study groups and preparatory courses. Half of the respondents reported that the examination was a financial burden. Anxiety and depression related to the examination were reported by 81.5% and 25.9% of respondents, respectively. Seeking medical attention and self-medicating was reported by 18.52% of respondents.

Conclusions:
Many examinees experience mental health concerns during the preparation period for the oral board examination. Nevertheless, measures to support well-being may exist and should be offered both during and after the examination preparation period.
Familial Steep Corneas in Posterior Polymorphous Corneal Dystrophy 3 Due to a Novel ZEB1 Gene Mutation
Authors: Koval Tal , Banne Ehud , Neimark Eli , Spierer Oriel 
Published: January 2025

Purpose:
To present 4 family members with posterior polymorphous corneal dystrophy (PPCD), nonkeratoconic steep corneas, and myopia caused by a previously unknown genetic alteration in the ZEB1 gene.

Methods:
Ophthalmic examinations and corneal curvature analyses were performed for all patients. Whole-exome targeted gene panel sequencing was performed for 1 patient. Pathogenic variant confirmation and segregation of the variant were performed for all 4 patients using Sanger sequencing.

Results:
A mother and her 3 children presented with bilateral diffuse corneal opacities, vesicular aggregates at the Descemet membrane level, and endothelial stippling, compatible with the diagnosis of PPCD. All patients had steeper than average keratometry readings with normal globe axial lengths and refractive moderate to extremely high myopia, ranging from −2 to −16.5 diopters (spherical equivalent). The younger patients had more severe findings, with the youngest, an 11-month-old girl, presenting with keratometry readings of 66.72 × 69.48 @ 132 degrees and 66.10 × 67.32 @ 34 degrees in the right and left eyes, respectively. The ZEB1:c.794-1G>A; chr10-31809053G>A; NM_001174096.2 mutation was detected in all patients.

Conclusions:
We describe a novel ZEB1 mutation associated with PPCD, nonkeratoconic steep corneas, and myopia. PPCD3 should be considered not only as an endothelial pathology but also as an ectatic disorder and should be ruled out in young children presenting with high myopia.
Intermediate-Term Outcomes and Complications of Ahmed Glaucoma Valve in Type 1 Keratoprostheses
Authors: Kolipaka Gowri Pratinya , Sastry Ramyashri , Nukala Naveen , Shanbhag Swapna S. , Senthil Sirisha 
Published: January 2025

Purpose:
To evaluate intermediate-term outcomes and complications associated with Ahmed glaucoma valve (AGV) implantation in eyes with type 1 keratoprosthesis (KPro).

Methods:
We retrospectively reviewed records of 43 eyes of 43 Indian patients with type 1 KPro and AGV from 2009 to 2021 with a minimum of 6-months of follow-up. Five eyes that had AGV before KPro were excluded, leaving 38 eyes for analysis. Primary outcome measure was postoperative complications. Secondary outcome measure was stability of glaucoma, assessed by Humphrey visual fields, intraocular pressure, and best-corrected visual acuity (BCVA). Sight-threatening complications, implant removal, or repeat glaucoma surgery was considered failure.

Results:
Median age (interquartile range) at AGV implantation was 36.5 (23–49) years, with median post-AGV follow-up of 30.5 (6.5–53) months. Preoperative logarithm of minimal angle of resolution median BCVA was 0.6 (0.4–1). Post-AGV, median intraocular pressure as measured by scleral Schiotz reduced significantly from 30.4 (20.6–30.4) to 13.5(12.2–14.8) mm Hg (P < 0.0001), and the mean number of antiglaucoma medications significantly decreased from 3.4 to 1.7 (P < 0.0001). Mean BCVA (P = 0.24) remained stable. Humphrey visual fields mean deviation progressed from −13.5 dB (−25, −9) to −26 dB (−30, −13) at final follow-up (P = 0.05) and progression occurred in 10 eyes. Seven eyes (18.4%) had postoperative complications needing surgical intervention, including tube block [5 eyes (13.1%)] and tube exposure [2 eyes (5%)]. One failed AGV needed additional glaucoma surgery after 8 years. None had implant extrusion/explanation or endophthalmitis.

Conclusions:
Ahmed glaucoma valve implantation offered promising results in managing glaucoma in eyes with type 1 KPro, particularly in relatively young Indian population. However, close monitoring for tube-related complications and glaucoma progression is warranted.
Diagnostic Efficiency of Tongue-Coating Microbiome in Patients With SARS-CoV-2 Omicron Variant Infection and Recovery
Authors: Sun Junyi , Sun Ying , Zou Yawen , Wang Haiyu , Rao Benchen , Zhang Xinyue , Liu Liwen , Zhang Guizhen , Cui Guangying , Liu Qi , Xing Jiyuan , Xu Ning , Zheng Chunfu , Yu Zujiang , Ren Zhigang 
Published: January 2025

Abstract
SARS-CoV-2 variants still pose threats to human public health. However, there has been little research regarding alterations in the tongue-coating microbiome in patients infected with the Omicron variant (PIOVs). Herein, we collected 963 tongue-coating samples prospectively, including 349 samples from PIOVs, 242 samples from recovered PIOVs (RPs), 300 samples from healthy controls (HCs) and 72 samples from patients infected with the original strain (PIOSs). We randomly selected tongue-coating samples from PIOVs and HCs as the discovery cohort and validation cohort. Tongue-coating microbiota was analyzed using Miseq sequencing. Our results showed that the tongue-coating microbial diversity of PIOVs was increased. We found that in PIOVs, the abundance was increased in 20 genera, including Prevonella and Atopobium, while the abundance was decreased in 23 genera, including Neisseria and Haemophilus. The classifier based on six optimal microbial markers had high diagnostic efficiency in the discovery cohort (area under the curve of 97.73%) and the validation cohort (area under the curve of 93.06%) between the PIOV and HC groups. Importantly, compared with PIOSs, PIOVs showed an increase in Fusobacterium. Recovery of patients was associated with the restoration of the tongue-coating microbiota. In conclusion, this study is the first to characterize the tongue-coating microbiota in PIOVs, and to construct non-invasive diagnostic models, providing new strategies for the prevention and control of coronavirus variants.
The comparative effectiveness of medicinal cannabis for chronic pain versus prescription medication treatment
Authors: Wasan Ajay D. , O'Connell Brian , DeSensi Rebecca , Bernstein Cheryl , Pickle Elizabeth , Zemaitis Michael , Levy Oren , Jeong Jong-Hyeon , Cooper Gregory F. , Douaihy Antoine 
Published: January 2025

Abstract
Reviews of the effectiveness of medicinal cannabis for chronic pain vary in their conclusions. IASP has identified that a key missing evidence in this debate is data from observational cohort studies, analyzed with comparative effectiveness methods. In a medically supervised context to the use of marijuana for chronic pain, we identified 440 patients certified for medical marijuana by pain specialists in a single healthcare system. They were characterized by a battery of patient-reported outcomes stored electronically in the University of Pittsburgh Patient Outcomes Repository for Treatment (PORT). At 3 months, 38.6% were responders, based on clinically meaningful improvements in pain, function, or global impression of change, and maintained this response at 6 months. In the 157 patients who were coprescribed opioids, at 6 months there was a mean 39.3% decrease in morphine milligram equivalents (P < 0.05 for the difference vs baseline). In addition, 8114 patients treated in the same pain clinics with prescription pain medications instead (nonopioid or opioid) during the same timeframe were selected from PORT as a control group for comparison. They had a 34.9% rate of response at 3 months. Using the causal inference method of stratified modeling, logistic regression revealed an odds ratio of 2.6 in favor of medical marijuana vs medication treatment (P < 0.01). Potential harms data were not available in the PORT registry. Medical marijuana was comparatively more effective than prescription medications for the treatment of chronic pain at 3 months, although the populations compared were slightly different.
Persistent changes in the dorsal root ganglion nociceptor translatome governs hyperalgesic priming in mice: roles of GPR88 and Meteorin
Authors: Sankaranarayanan Ishwarya , Kume Moeno , Mohammed Ayaan , Mwirigi Juliet M. , Inturi Nikhil Nageswar , Munro Gordon , Petersen Kenneth A. , Tavares-Ferreira Diana , Price Theodore J. 
Published: January 2025

Abstract
Hyperalgesic priming is a model system that has been widely used to understand plasticity in painful stimulus–detecting sensory neurons, called nociceptors. A key feature of this model system is that following priming, stimuli that do not normally cause hyperalgesia now readily provoke this state. We hypothesized that hyperalgesic priming occurs because of reorganization of translation of mRNA in nociceptors. To test this hypothesis, we used paclitaxel treatment as the priming stimulus and translating ribosome affinity purification to measure persistent changes in mRNA translation in Nav1.8+ nociceptors. Translating ribosome affinity purification sequencing revealed 161 genes with persistently altered mRNA translation in the primed state. Among these genes, we identified Gpr88 as upregulated and Metrn as downregulated. To provide functional evidence for these changes in hyperalgesic priming in a related priming model, we used the interleukin-6 priming model. A GPR88 agonist injection into the paw had no effect in naive mice but caused mechanical hypersensitivity and grimacing responses in female primed mice. Systemic Meteorin treatment in primed mice completely reversed established hyperalgesic priming mechanical hypersensitivity and grimacing responses to prostaglandin E2 in female mice. Our work demonstrates that altered nociceptor translatomes are causative in producing hyperalgesic priming in multiple models in female mice.
Optimizing Workplace Violence Reporting in a Multisite Hospital Setting: A Quality Improvement Initiative
Authors: Skippon Johanna , Pullan Caroline , Ballarino Emilie , Farrukh Maaha , Topolovec-Vranic Jane 
Published: January 2025

ABSTRACT

Introduction:
Workplace violence (WPV) is a significant concern in healthcare settings and indicates the need for accurate reporting to plan and implement effective interventions. This article presents the results of a quality improvement (QI) initiative implemented at a large academic health sciences center to improve the reporting of WPV events.

Methods:
The Plan-Do-Study-Act (PDSA) model was adopted to optimize the electronic reporting process, reduce inaccuracies of WPV reporting, and ensure appropriate follow-up from leadership and the Workplace Health, Safety, and Wellness (WHSW) team. Over two PDSA cycles, modifications of an electronic incident reporting form were made.

Results:
The proportion of inaccurate reporting was significantly lower (χ2 (1, N = 1,219) = 111.86, p = .001), after the QI initiative. In addition, the revisions increased staff follow-up and support from WHSW.

Conclusions:
Our QI initiative demonstrated that simple adjustments to our WPV reporting, with the revision of an electronic reporting form, had a significant improvement on incident data accuracy and staff follow-up. These findings will contribute to our organization's staff and patient safety.
Introducing Medical Educators to Interpersonal Theory: Its Application to Emotional Intelligence
Authors: Jordan Kevin D. , Thimling Emily , Lampkins Andrew J. 
Published: January 2025

Introduction
Interpersonal theory can be used to better understand the personal and social manifestations of individual difference variables in physician assistant (PA) students. Emotional intelligence (EI) is characterized by self and social awareness that facilitates effective communication. While EI has been examined in PA students, a theoretical framework for describing why and how EI has beneficial effects has not been articulated. Interpersonal theory can be used to generate hypotheses about EI and expected correlates.

Methods
One hundred nine PA students completed questionnaires assessing EI, social behavior (ie, dominance and affiliation), interpersonal efficacy, social support, loneliness, and negative social experiences. Regression analysis was used to determine interpersonal style and efficacy associated with EI. Correlation analyses were used to determine bivariate associations.

Results
Emotional intelligence was associated with a friendly interpersonal style and confidence in one’s ability to establish relationships. As expected, EI was positively correlated with social support and negatively correlated with loneliness. While in the expected direction, EI was not associated with fewer negative social experiences.

Discussion
Emotional intelligence is a potentially valuable personal resource in the lives of PA students, and there may be implications related to EI and its impact on the medical encounter. Results are discussed in terms of curriculum in PA programs and how cultivating EI could be of benefit for students. Additional research is proposed to determine which aspects of EI facilitate an effective medical encounter.
Effect of virtual reality intervention on hospitalized patients with acute pain after thoracoscopic surgery: a pilot randomized clinical trial
Authors: Cao Weibo , Ren Fan , Li Tong , Ma Fei , Shi Yuan , Li Xuanguang , Cao Cancan , Zhou Ning , Li Hanyi , Yu Haochuan , Mao Fuling , Chen Gang , Zu Lingling , Wei Li , Li Qing , Zhang Yuanyuan , Su Lin , Cui Wei , Wu Li , Zheng Yuxin , Li Jing , Wang Chunyan , Ju Renhua , Fang Chongliang , Yin Ling , Lu Yi , Zhang Qiang , Xu Song 
Published: January 2025

The study investigates the effectiveness of immersive virtual reality (VR) as a nonpharmaceutical approach to manage postoperative pain in patients following thoracoscopic surgery. In this single-center, triple-arm pilot randomized controlled trial (RCT), 61 postsurgical patients with a postoperative pain numerical rating scale (NRS) score ≥4 after receiving standard analgesia were included and assigned to either a quantum clinics-VR (QTC-VR) group, a Placebo-VR group, or a control group. The QTC-VR group engaged in a daily 10-minute interactive pain relief 3D-VR program, while the Placebo-VR group watched a daily 10-minute relaxation-based 2D film through VR headsets for three days following surgery. 61 postsurgical patients were randomized and allocated (21 in the QTC-VR group, 20 in the Placebo-VR group, and 20 in the control group) in the final intention-to-treat (ITT) analyses. Compared with patients receiving Placebo-VR intervention, patients reported significantly lower pain scores following the daily QTC-VR intervention on postoperative days 1 (mean difference, −0.889; 95% CI, −1.464 to −0.314; P < 0.001), 2 (mean difference, −0.631; 95% CI, −1.211 to −0.051; P = 0.014), and 3 (mean difference, −0.798; 95% CI, −1.345 to −0.251; P < 0.001), respectively. Additionally, patients receiving QTC-VR intervention also reported high satisfaction and tolerable adverse events with their treatment. In conclusion, this pilot RCT demonstrates that QTC-VR might be a promising intervention for pain management post-thoracoscopic surgery, warranting further validation in ongoing phase III trials.