bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lung ultrasound and high-resolution computed tomography quantitative variations during nintedanib treatment for systemic sclerosis-associated interstitial lung disease
Authors: Di Battista Marco , Delle Sedie Andrea , Romei Chiara , Tavanti Laura , Da Rio Mattia , Morganti Riccardo , Della Rossa Alessandra , Mosca Marta 
Published: December 2023

Abstract

Objectives
Lung ultrasound (LUS) and high-resolution CT (HRCT) are commonly used for the evaluation of interstitial lung disease (ILD). Nintedanib (NIN) is an antifibrotic therapy approved for systemic sclerosis-associated ILD (SSc-ILD). We assessed LUS and quantitative HRCT changes in SSc-ILD patients treated with NIN during a 1 year follow-up, evaluating relationships between imaging variations and functional or quality-of-life outcomes.

Methods
SSc-ILD patients who started NIN were enrolled and followed for 12 months. Pulmonary function tests and patient-reported outcome measures (PROMs) were assessed half-yearly and quarterly, respectively. LUS was performed quarterly evaluating the presence of B-lines (BL) and pleural line irregularities (PLI). HRCT was repeated after 1 year and quantitatively analysed with CALIPER software.

Results
Ten patients (70% female, mean age 62 years) were enrolled. The mean total number of both BL and PLI was constantly decreased during NIN treatment, being significantly reduced after 12 months (from 175.1 [66.7] to 120.8 [70.3] for BL, P = 0.005; and from 50.6 [32.5] to 37.2 [22.4] for PLI, P = 0.05). Male gender, smoking habit and baseline forced vital capacity &lt;70% predicted were associated with worse LUS outcomes. A greater reduction in both BL and PLI was observed in those who improved in PROMs, especially modified Medical Research Council dyspnoea scale (P = 0.016 and P = 0.04, respectively) and Saint George's Respiratory Questionnaire (P = 0.006 and P = 0.026, respectively). No significant changes in the CALIPER percentages of normal parenchyma or ILD elements were observed after 12 months of NIN, thus paralleling the stabilization obtained at pulmonary function tests.

Conclusion
We present preliminary results on NIN effects on SSc-ILD as assessed by LUS, a useful method for frequently repeated monitoring, and CALIPER, a valid implementation whenever a HRCT is performed.
Estimating overdiagnosis in giant cell arteritis diagnostic pathways using genetic data: genetic association study
Authors: Chatzigeorgiou Charikleia , Barrett Jennifer H , Martin Javier , Morgan Ann W , Mackie Sarah L ,   UK GCA Consortium, Morgan Ann W , Mackie Sarah L , Sorensen Louise , Raashid Lubna Haroon , Martin Steve , Robinson James I , Mellen Sam , Hoggart Sarah , Barrett Jennifer H , Taylor John C , Pease Colin , Dasgupta Bhaskar , Watts Richard , Gough Andrew , Isaacs John D , Green Michael , McHugh Neil , Hordon Lesley , Kamath Sanjeet , Nisar Mohammed , Patel Yusuf , Yee Chee-Seng , Stevens Robert , Nandi Pradip , Nandagudi Anupama , Jarrett Stephen , Li Charles , Levy Sarah , Mollan Susan , Salih Abdel , Wordsworth Oliver , Gondo Prisca , Hollywood Jane , Peters Genessa , Routledge Christine , Gill Anne , Carr Lisa , Wood Rose , Williams Clare , Oakley Mandy , Sanders Emma , Mackenzie Felicity , Fong Rosanna , James Lynne , Spimpolo Jenny , Kempa Andy , Culfear Karen , Nugaliyadde Asanka , Roads Esme , Rowbotham Bridie , Masqood Zahira 
Published: December 2023

Abstract

Objectives
GCA can be confirmed by temporal artery biopsy (TAB) but false negatives can occur. GCA may be overdiagnosed in TAB-negative cases, or if neither TAB nor imaging is done. We used HLA genetic association of TAB-positive GCA as an ‘unbiased umpire’ test to estimate historic overdiagnosis of GCA.

Methods
Patients diagnosed with GCA between 1990 and 2014 were genotyped. During this era, vascular imaging alone was rarely used to diagnose GCA. HLA region variants were jointly imputed from genome-wide genotypic data of cases and controls. Per-allele frequencies across all HLA variants with P &lt; 1.0 × 10−5 were compared with population control data to estimate overdiagnosis rates in cases without a positive TAB.

Results
Genetic data from 663 GCA patients were compared with data from 2619 population controls. TAB-negative GCA (n = 147) and GCA without TAB result (n = 160) had variant frequencies intermediate between TAB-positive GCA (n = 356) and population controls. For example, the allele frequency of HLA-DRB1*04 was 32% for TAB-positive GCA, 29% for GCA without TAB result, 27% for TAB-negative GCA and 20% in population controls. Making several strong assumptions, we estimated that around two-thirds of TAB-negative cases and one-third of cases without TAB result may have been overdiagnosed. From these data, TAB sensitivity is estimated as 88%.

Conclusions
Conservatively assuming 95% specificity, TAB has a negative likelihood ratio of around 0.12. Our method for utilizing standard genotyping data as an ‘unbiased umpire’ might be used as a way of comparing the accuracy of different diagnostic pathways.
TMS disruption of the lateral prefrontal cortex increases neural activity in the default mode network when naming facial expressions
Authors: Pitcher David , Sliwinska Magdalena W , Kaiser Daniel 
Published: December 2023

Abstract
Recognizing facial expressions is dependent on multiple brain networks specialized for different cognitive functions. In the current study, participants (N = 20) were scanned using functional magnetic resonance imaging (fMRI), while they performed a covert facial expression naming task. Immediately prior to scanning thetaburst transcranial magnetic stimulation (TMS) was delivered over the right lateral prefrontal cortex (PFC), or the vertex control site. A group whole-brain analysis revealed that TMS induced opposite effects in the neural responses across different brain networks. Stimulation of the right PFC (compared to stimulation of the vertex) decreased neural activity in the left lateral PFC but increased neural activity in three nodes of the default mode network (DMN): the right superior frontal gyrus, right angular gyrus and the bilateral middle cingulate gyrus. A region of interest analysis showed that TMS delivered over the right PFC reduced neural activity across all functionally localised face areas (including in the PFC) compared to TMS delivered over the vertex. These results suggest that visually recognizing facial expressions is dependent on the dynamic interaction of the face-processing network and the DMN. Our study also demonstrates the utility of combined TMS/fMRI studies for revealing the dynamic interactions between different functional brain networks.
“O” no: a Reddit analysis of orgasmic dysfunction
Authors: Belcher Rachael , Sim Danielle , Meykler Marcella , Owens-Walton Jeunice , Hassan Naeemul , Rubin Rachel S , Malik Rena D 
Published: December 2023

Abstract

Background
Female Reddit users frequently discussed potential causes of orgasm difficulties and its implications on mental health and relationships.

Aim
This study aimed to evaluate the experiences of women discussing orgasms on the Internet site Reddit. We sought to qualitatively analyze the topics that arose in users’ discussions to better understand the potential causes of orgasm difficulties and its implications on quality of life.

Methods
Posts on the subreddit r/TwoXChromosomes containing the keywords “orgasm” and “climax” were included in the dataset. Posts and their associated comments were qualitatively analyzed using the grounded theory approach. Two independent researchers coded each thread to identify dominant themes and emergent concepts.

Outcomes
The most frequently coded primary topics included: (1) orgasm (32.2% [n = 337]), (2) psychological (17.8% [n = 186]), (3) relationships (15.4% [n = 161]), and (4) treatment (10.7% [n = 112]).

Results
Qualitative analysis of 107 threads and approximately 6300 comments resulted in 5 major categories: psychological aspect of orgasms, difficulty orgasming with partners, partners’ responses to orgasmic dysfunction, types of orgasms, and treatments for orgasmic dysfunction. Preliminary themes included (1) the presence of an emotional component or history of trauma related to orgasmic difficulty, (2) difficulty orgasming with a partner regardless of ability to orgasm during masturbation and a variety of stimulation required to orgasm, (3) mixed partner responses to orgasmic dysfunction, (4) the definition of a normal orgasm, and (5) self-motivated treatment for orgasmic dysfunction, including clitoral stimulation devices and masturbation techniques. Notably, few posters discussed their orgasmic dysfunction with healthcare providers.

Clinical Translation
The study reveals insights into the possible causes, psychosocial implications, and treatment of orgasm difficulties from a patient perspective, and can guide future research on female orgasms in a more precise, patient-oriented direction.

Strengths and Limitations
The anonymous nature of the forum allowed for insight into sensitive topics related to female orgasms and sexual trauma. Limitations include the demographic distribution of Reddit users, which was primarily younger women in their 20s and 30s, which restricts generalizability.

Conclusion
Reddit provides a medium for individuals with orgasm difficulties to discuss their experiences. Posts addressed users’ inability to orgasm, their mental health and relationships, the stimulation required for orgasm, and treatments for orgasmic dysfunction. Interestingly, very few posts discussed healthcare, potentially suggesting that women do not classify their orgasmic dysfunction as a health issue.
Effect of Return Electrode Placement at Apical Cochleostomy on Current Flow With a Cochlear Implant
Authors: Landsberger David M. , Long Christopher J. , Kirk Jonathon R. , Stupak Natalia , Roland J. Thomas 
Published: December 2023

Objectives:
A method for stimulating the cochlear apex using perimodiolar electrode arrays is described. This method involves implanting an electrode (ECE1) into the helioctrema in addition to standard cochlear implant placement. One objective is to verify a suitable approach for implanting ECE1 in the helicotrema. Another is to determine how placement of ECE1 reshapes electric fields.

Design:
Two cadaveric half-heads were implanted, and electric voltage tomography was measured with ECE1 placed in many positions.

Results:
An approach for placing ECE1 was identified. Changes in electric fields were only observed when ECE1 was placed into the fluid in the helicotrema. When inside the helicotrema, electric voltage tomography modeling suggests an increased current flow toward the apex.

Conclusions:
Placement of ECE1 into the cochlear apex is clinically feasible and has the potential to reshape electric fields to stimulate regions of the cochlea more apical than those represented by the electrode array.
Praying the Psalms as a Nursing Resilience Intervention
Authors: Helms Kristin , Rajamohan Santhiny , Tedone Deborah 
Published: December 2023

ABSTRACT:
Nurses face a range of unhealthy organizational, physical, psychological, and spiritual issues that can lead to burnout, turnover, and leaving the profession. Nurses who use prayer for support may find their faith to be another source of tension when stressors endlessly continue without change despite prayer. Walter Brueggemann's states of orientation, disorientation, and reorientation in his classic work on praying the Old Testament book of Psalms offer a means for managing spiritual tension. Praying using the psalms can become a self-care tool for building resilience.
Long-term Survival Among Patients With De Novo Human Epidermal Growth Receptor 2–Positive Metastatic Breast Cancer in Manitoba
Authors: McAndrew Erin N. , Graham Jeffrey , Dufault Brenden , Desautels Danielle N. , Kim Christina A. 
Published: December 2023

Objectives:
Although metastatic breast cancer (MBC) is considered incurable, human epidermal growth receptor 2 (HER2)–directed therapy has improved outcomes significantly, with some patients experiencing durable responses to treatment. The aim of this study was to identify potential predictors of long-term survival (LTS) among patients with de novo HER2-positive MBC who received HER2-directed treatment.

Methods:
Eligible patients from 2008 to 2018 were identified using the Manitoba Cancer Registry. LTS was defined as survival ≥5 years from the time of diagnosis. Univariate logistic regression models were performed to assess variables of clinical interest and the odds of LTS. Overall survival (OS) was defined as the time from diagnosis of MBC to death of any cause. OS was estimated using the Kaplan-Meier method with log-rank comparative analyses as a univariate analysis. A Cox proportional hazards model was used for OS estimates in a univariate analysis.

Results:
A total of 62 patients were diagnosed with de novo HER2-positive MBC and received HER2-directed therapy. Eighteen (29%) achieved LTS. The median OS of the whole cohort was 50.2 months (95% CI: 28.6—not reached). Radiographic response to first-line treatment was associated with LTS; complete and partial responses were both associated with higher odds of LTS (odds ratio: 28.33 [95% CI: 2.47-4006.71, P = 0.0043] and odds ratio: 7.80 [95% CI: 0.7317-1072.00, P = 0.0972], respectively). The best radiographic response was associated with improved OS.

Conclusion:
Radiographic response to first-line HER2-directed therapy is a predictor for LTS in patients with de novo HER2-positive MBC. Larger studies are needed to identify patients who can safely discontinue HER2-targeted therapy.
CAPABLE: A Scoring System Utilizing Patient-Reported Measures to Evaluate Patient Experience After Mohs Surgery
Authors: Fox Matthew C. , Riddle Ashley O. , Cervantes Jose A. , Shelton Megan E. , Woody Meghan , Latour Emile , Hollmig S. Tyler , Bar Anna A. , Leitenberger Justin J. 
Published: December 2023

BACKGROUND
Patient experience metrics are gaining prominence in health care. We introduce the CAPABLE survey to assess postoperative experiences of Mohs surgery patients.

OBJECTIVE
We sought to determine whether CAPABLE scores aligned with overall patient satisfaction in Mohs surgery.

METHODS
This was a cross-sectional, survey-based study of patients presenting for their first postoperative visit after Mohs surgery. The CAPABLE survey included questions on postoperative instructions, activity limitations, pain control, provider accessibility, and bleeding, followed by 2 overall satisfaction questions taken from the Outpatient and Ambulatory Surgery Consumer Assessment of Healthcare Providers and Systems survey. The pilot study took place at the University of Texas Dell Medical School (DMS), followed by a validation study (n = 206) at DMS and Oregon Health and Science University (OHSU). We assessed for correlations between CAPABLE scores and overall satisfaction.

RESULTS
In the pilot study (n = 137), overall CAPABLE scores and scores of individual CAPABLE components correlated positively with overall satisfaction.
In the multisite validation study (n = 206) spanning DMS and OHSU, CAPABLE scores correlated positively with overall satisfaction.

CONCLUSION
The CAPABLE survey is a concise tool for assessing specific, actionable components of the postoperative patient experience in Mohs surgery, while correlating with overall patient satisfaction.
Anatomic Location Influences Duration of Local Lidocaine Anesthesia in Dermatologic Surgery
Authors: Navrazhina Kristina , Shah Kalee , Rigo Rachel , Shochat Tzippy , Minkis Kira 
Published: December 2023

BACKGROUND
Although the onset and duration of local anesthetics are well-defined, how the anatomic site influences the duration of local anesthetics has not been well characterized in dermatology.

OBJECTIVE
To define the duration of local anesthesia by anatomic site.

MATERIALS AND METHODS
This was a prospective study. Adult healthy volunteers and patients undergoing Mohs micrographic surgery were invited to participate. The nose and the shin were chosen to represent highly and poorly vascularized anatomic sites, respectively. A total of 0.5 mL of buffered 1% lidocaine hydrochloride with 1:100,000 epinephrine was injected subcutaneously into each anatomic site of each participant. A pinprick test was used to assess adequate anesthesia until return of baseline sensation or visit completion.

RESULTS
This study enrolled 25 participants. Time to return of sensation was significantly shorter on the nose compared with the shin (p < .0001). On the nose, there was an association between male sex and shorter time to return of sensation.

CONCLUSION
Time to return of sensation is significantly shorter on the nasal ala compared with the shin, suggesting that patients may regain sensation sooner on highly vascularized sites. Defining the duration of local anesthetics based on anatomic regions is important for treatment planning in dermatologic procedures.
Skin Cancer Awareness and Knowledge About Sun Protection Practices in Solid Organ Transplant Recipients: Patient Survey Study
Authors: Farahbakhsh Navid , Potter Kathryn Anne , Nielson Colton , Longo Maria Isabel 
Published: December 2023

BACKGROUND
Adequate sun protection practices in chronically immunosuppressed patients can minimize the burden of the most common type of skin cancer in this population. In addition, early recognition of skin cancer by patients can lead to decreased morbidity, and possibly mortality from the disease. Nevertheless, there are significant gaps in the knowledge of sun protection measures and early recognition of skin cancer.

OBJECTIVE
The aim of this study is to determine the risk factors of solid organ transplant recipients (SOTRs) for developing skin cancer and their sun exposure education and behavior post-transplantation.

MATERIALS AND METHODS
This study evaluates the responses of 107 SOTRs on their outlooks and beliefs of sunscreen usage, skin cancer, and sun exposure knowledge.

RESULTS
Our study identified several significant risk factors for the development of actinic keratosis or keratinocyte carcinoma in SOTRs including history of sunburn before age 18, blue eyes, history of tanning bed use, performing monthly skin exams, ability to identify precancerous skin lesions, and history of previous skin examinations.

CONCLUSION
A patient-centered approach needs to be used to properly educate patients on effective ways to reduce excessive sun exposure. Regular skin examinations, and patients continued education are necessary components in reducing the burden of skin cancer in SOTRs.
Patient Satisfaction Following Primary Closure or Second Intention Healing After Conventional Nasal Skin Cancer Excision: A Cross-sectional Cohort Study
Authors: Theelen Frederieke F.M. , Veldhuizen Inge J. , Zhou Chao , Lee Erica H. , van Hensbergen Lusanne J. , Broekhuysen Coralien L. , van der Hulst René R.W.J. , Hoogbergen Maarten M. 
Published: December 2023

BACKGROUND
Nasal reconstruction after conventional surgical excision (CSE) of nonmelanoma skin cancer (NMSC) can be challenging. After excision and before the pathologic report, a simple reconstruction is favored. Yet, little is known about patient satisfaction after primary closure and second intention healing.

OBJECTIVE
Patient satisfaction after nasal defect reconstruction with primary closure or second intention healing, using the FACE-Q Skin Cancer.

METHODS
All patients who underwent CSE of nasal NMSC with immediate primary closure or second intention healing between March 2018 and March 2020 at Máxima Medisch Centrum Veldhoven were identified and asked to complete the FACE-Q Skin Cancer.

RESULTS
Of 183 patients, 140 patients completed the questionnaire. Fifty-five defects were closed by primary closure (38.5%) and 88 by second intention healing (61.5%). Thirty-one complications were reported (16.7%), of which 87.1% (n = 27) after second intention healing (p = .004). Both groups experienced high facial and scar satisfaction, low appearance-related distress, and no to minimal adverse effects. Second intention healing had 2.7 higher odds of achieving the maximum scar satisfaction score (p = .02).

CONCLUSION
This study shows high satisfaction on facial and scar appraisal, low appearance-related distress, and no to minimal adverse effects for second intention healing and primary closure after CSE of nasal NMSC.
Assessment of Donor Site Scar Outcomes, Healing Time, and Postoperative Complications Associated With Split Thickness Skin Grafts Harvested From the Hair Bearing Scalp
Authors: Bovenberg Maria Sarah , Williams Paige E. , Goldberg Leonard H. 
Published: December 2023

BACKGROUND
The hair-bearing scalp is an underused donor site for split-thickness skin grafts (STSG).

OBJECTIVE
Evaluating the donor site scar outcomes, healing times, and complications associated with STSG harvested from the hair-bearing scalp.

MATERIALS AND METHODS
During this prospective observational study, donor site healing was assessed on postoperative Days 8 and 30. Donor site scar outcomes were quantified at 1 month using the Vancouver Scar Scale. All postoperative complications were collected during the 30-day follow-up window.

RESULTS
80% of donor sites was fully healed at 1-week follow-up. Vancouver Scar Scale score at the donor site was 0.26 at 1-month follow-up. All patients experienced full hair regrowth. Maximum pain scores were reported on the night of surgery (Vancouver Scar Scale 1.8), with quick resolution in days to follow. No major complications were reported. All STSG obtained from the scalp had full take and good texture and color match with the recipient site.

CONCLUSION
The hair-bearing scalp is an excellent donor site for split-thickness skin graft harvesting.
Bloodstream Infections in Children Hospitalized for Influenza, the Canadian Immunization Monitoring Program Active
Authors: Modler Jacqueline , Morris Shaun K. , Bettinger Julie A. , Bancej Christina , Burton Catherine , Foo Cheryl , Halperin Scott A. , Jadavji Taj , Kazmi Kescha , Sadarangani Manish , Schober Tilmann , Papenburg Jesse ,   for the Canadian Immunization Monitoring Program Active (IMPACT) Investigators
Published: December 2023

Background:
We aimed to estimate the proportion of children hospitalized for influenza whose illness was complicated by bloodstream infection, describe their clinical course, and identify the factors associated with bloodstream infection.

Methods:
We performed active surveillance for laboratory-confirmed influenza hospitalizations among children ≤16 years old at the 12 Canadian Immunization Monitoring Program Active hospitals, from the 2010–2011 to 2020–2021 influenza seasons. Factors associated with bloodstream infection were identified using multivariable logistic regression analyses.

Results:
Among 9179 laboratory-confirmed influenza hospital admissions, bloodstream infection occurred in 87 children (0.9%). Streptococcus pyogenes (22%), Staphylococcus aureus (18%) and Streptococcus pneumoniae (17%) were the most common bloodstream infection pathogens identified. Children with cancer [adjusted odds ratio (aOR): 2.78; 95% confidence interval (CI): 1.23–5.63], a laboratory-confirmed nonbloodstream bacterial infection (aOR: 14.1; 95% CI: 8.04–24.3) or radiographically-confirmed pneumonia (aOR: 1.87; 95% CI: 1.17–2.97) were more likely to experience a bloodstream infection, whereas children with chronic lung disorders were less likely (aOR: 0.41; 95% CI: 0.19–0.80). Disease severity markers such as intensive care unit admission (aOR: 2.11; 95% CI: 1.27–3.46), mechanical ventilation (aOR: 2.84; 95% CI: 1.63–4.80) and longer hospital length of stay (aOR: 1.02; 95% CI: 1.01–1.03) were associated with bloodstream infection. Bloodstream infection also increased the odds of death (aOR: 13.0; 95% CI: 4.84–29.1) after adjustment for age, influenza virus type and the presence of any at-risk chronic condition.

Conclusions:
Bloodstream infections, although infrequent, are associated with intensive care unit admission, mechanical ventilation, increased hospital length of stay and in-hospital mortality, thus requiring increased levels of care among pediatric influenza hospitalizations.