bluuebunny/crossref_metadata_2025_split huggingface dataset:
A National Study of Expedited Partner Therapy Use in Emergency Departments: A Survey of Medical Director Knowledge, Attitudes, and Practices
Authors: Solnick Rachel E. , Cortes Rafael , Chang Ethan J. , Dudas Paul , Deng Daxuan , Jamison Cornelius D. , Mmeje Okeoma , Kocher Keith E. 
Published: October 2023

Background
Emergency departments (EDs) are the primary source of health care for many patients diagnosed with sexually transmitted infections (STIs). Expedited partner therapy (EPT), treating the partner of patients with STIs, is an evidence-based practice for patients who might not otherwise seek care. Little is known about the use of EPT in the ED. In a national survey, we describe ED medical directors' knowledge, attitudes, and practices of EPT.

Methods
A cross-sectional survey of medical directors from academic EDs was conducted from July to September 2020 using the Academy of Academic Administrators of Emergency Medicine Benchmarking Group. Primary outcomes were EPT awareness, support, and use. The survey also examined barriers and facilitators.

Results
Forty-eight of 70 medical directors (69%) responded. Seventy-three percent were aware of EPT, but fewer knew how to prescribe it (38%), and only 19% of EDs had implemented EPT. Seventy-nine percent supported EPT and were more likely to if they were aware of EPT (89% vs. 54%; P = 0.01). Of nonimplementers, 41% thought EPT was feasible, and 56% thought departmental support would be likely. Emergency department directors were most concerned about legal liability, but a large proportion (44%) viewed preventing sequelae of untreated STIs as “extremely important.”

Conclusions
Emergency department medical directors expressed strong support for EPT and reasonable levels of feasibility for implementation but low utilization. Our findings highlight the need to identify mechanisms for EPT implementation in EDs.
Modifications to Sexual Behaviors Associated With Mpox (Monkeypox) Virus Transmission Among Persons Presenting for mpox Vaccination, Washington, DC, August–October, 2022
Authors: Copen Casey E. , Delaney Kevin P. , Agnew-Brune Christine , Berry Isha , Griffin Isabel , Hassan Rashida , Oakley Lisa P. , Wondmeneh Sarah , Rhodes Trevor , Gillani Sarah , Lee Michelle , Ashley Patrick , Willut Christina , Mangla Anil T. , Waltenburg Michelle A. , Jackson David A. ,   DC Mpox Response Project Team
Published: October 2023

Background
Over 30,000 mpox cases were reported during the 2022 mpox outbreak with many cases occurring among gay, bisexual and other men who have sex with men (MSM). Decreases in U.S. mpox cases were likely accelerated by a combination of vaccination and modifications to sexual behaviors associated with mpox virus transmission. We assessed reports of sexual behavior change among participants receiving mpox vaccination in Washington, DC.

Methods
During August to October 2022, 711 adults aged ≥18 years receiving mpox vaccination at two public health clinics in Washington, DC completed a self-administered questionnaire that asked whether sexual behaviors changed since learning about mpox. We calculated the frequency and percentages of participants reporting an increase, decrease, or no change in 4 of these behaviors by demographic, clinical, and behavioral characteristics with 95% confidence intervals.

Results
Overall, between 46% and 61% of participants reported a decrease in sexual behaviors associated with mpox virus transmission, 39% to 54% reported no change in these behaviors, and <1% reported an increase. Approximately 61% reported decreases in one-time sexual encounters (95% confidence interval [CI], 56.8%–64.7%), 54.3% reduced numbers of sex partners (95% CI, 50.4%–58.0%), 53.4% decreased sex via a dating app or sex venue (95% CI, 49.7%–58.0%), and 45.6% reported less group sex (95% CI, 40.4%–50.9%). Reported decreases in these behaviors were higher for MSM than women; in non-Hispanic Black than non-Hispanic White participants; and in participants with human immunodeficiency virus than participants without human immunodeficiency virus.

Conclusions
Most participants receiving mpox vaccination reported decreasing sexual behaviors associated with mpox virus transmission, including groups disproportionately affected by the outbreak.
Clinical Report: Clinician Feedback on the Magnetic Levator Prosthesis
Authors: Houston Kevin E. , Nadeau Melanie , Paschalis Eleftherios I. 
Published: October 2023

ABSTRACT

SIGNIFICANCE
Stakeholder engagement has been identified by national health organizations as a crucial step to successful translation of new health care treatments. In this clinical report, clinician-stakeholder feedback is presented for the magnetic levator prosthesis (MLP), a promising noninvasive spectacle device that restores eyelid motility with magnetic force.

PURPOSE
This study aimed to evaluate MLP clinical need and translational barriers.

METHODS
Ten vision rehabilitation optometrists who attended an educational presentation on the MLP and participated in a hands-on workshop in the fitting of a patient were invited to complete an anonymous online survey. Ten multiple-choice items gathered data on estimated patient need, current approaches, main barriers to MLP, temporary versus chronic use, cost barriers, and need for insurance coverage. Open fields allowed for additional comments.

RESULTS
Nine of 10 specialists completed the survey. Of those, seven answered that they could potentially see at least 1 to 5 patients for ptosis management within a year. The most common ptosis management options reported were the ptosis crutch, taping the eyelid open, and oxymetazoline drops, all with six responses each. Seven clinicians indicated that cost was a main concern. If cost to patient was not a barrier, all indicated they would be at least somewhat likely to try the MLP (1) for temporary management of ptosis, (2) as a pre-surgical trial, and (3) for long-term management of ptosis, with more selecting extremely likely and very likely than somewhat likely. Main comments were expressing enthusiasm for the technology and that it would be more appealing for patients if covered by insurance.

CONCLUSIONS
This clinical report suggests that the main barriers to clinical success of the MLP may be cost and insurance coverage, appearance of the device, and self-application. Possible solutions are cost-benefit analysis research, engineering efforts to reduce spectacle magnet size and improve the ease of eyelid magnet application.
Repeated Low-level Red-light Therapy: The Next Wave in Myopia Management?
Authors: Salzano Aaron D. , Khanal Safal , Cheung Nathan L. , Weise Katherine K. , Jenewein Erin C. , Horn Darryl M. , Mutti Donald O. , Gawne Timothy J. 
Published: October 2023

ABSTRACT

SIGNIFICANCE
Exposure to long-wavelength light has been proposed as a potential intervention to slow myopia progression in children. This article provides an evidence-based review of the safety and myopia control efficacy of red light and discusses the potential mechanisms by which red light may work to slow childhood myopia progression.
The spectral composition of the ambient light in the visual environment has powerful effects on eye growth and refractive development. Studies in mammalian and primate animal models (macaque monkeys and tree shrews) have shown that daily exposure to long-wavelength (red or amber) light promotes slower eye growth and hyperopia development and inhibits myopia induced by form deprivation or minus lens wear. Consistent with these results, several recent randomized controlled clinical trials in Chinese children have demonstrated that exposure to red light for 3 minutes twice a day significantly reduces myopia progression and axial elongation. These findings have collectively provided strong evidence for the potential of using red light as a myopia control intervention in clinical practice. However, several questions remain unanswered. In this article, we review the current evidence on the safety and efficacy of red light as a myopia control intervention, describe potential mechanisms, and discuss some key unresolved issues that require consideration before red light can be broadly translated into myopia control in children.
Challenges of Families of Patients Hospitalized in the PICU: A Preplanned Secondary Analysis From the Navigate Dataset*
Authors: Tager Julia B. , Hinojosa Jessica T. , LiaBraaten Brynn M. , Balistreri Kathryn A. , Aniciete Danica , Charleston Elizabeth , Frader Joel E. , White Douglas B. , Clayman Marla L. , Sorce Lauren R. , Davies W. Hobart , Rothschild Charles B. , Michelson Kelly N. ,   on behalf of the Navigate Study Investigators
Published: October 2023

OBJECTIVES:To describe challenges experienced by parents of children hospitalized in the PICU during PICU admission as reported by family navigators.DESIGN:A preplanned secondary analysis of open-response data coded via inductive qualitative approach from the Navigate randomized controlled trial (RCT) dataset (ID NCT02333396).SETTING:Two university-affiliated PICUs in the Midwestern United States as part of an RCT.PATIENTS:Two hundred twenty-four parents of 190 PICU patients.INTERVENTIONS:In 2015–2017, trained family navigators assessed and addressed parent needs, offered weekly family meetings, and provided post-PICU discharge parent check-ins as part of a study investigating the effectiveness of a communication support intervention (“PICU Supports”).MEASUREMENTS AND MAIN RESULTS:We analyzed qualitative data recorded by family navigators weekly across 338 encounters. Navigators described families’ “biggest challenge,” “communication challenges,” and ways the team could better support the family. We used an inductive qualitative coding approach and a modified member-checking exercise. The most common difficulties includedhome life,hospitalization, anddiagnosis distress(45.2%, 29.0%, and 17.2% of families, respectively). Navigators often identified that parents had co-occurring challenges. Communication was identified as a “biggest challenge” for 8% of families. Communication challenges includedlack of information, team communication, andcommunication quality(7.0%, 4.8%, and 4.8% of families, respectively). Suggestions for improving care included better medical communication, listening, rapport, and resources.CONCLUSIONS:This study describes families’ experiences and challenges assessed throughout the PICU stay. Family navigators reported families frequently experience stressors both internal and external to the hospital environment, and communication challenges between families and providers may be additional sources of distress. Further research should develop and assess interventions aimed at improving provider-family communication and reducing stressors outside the hospitalization itself, such as home life difficulties.
Deep Learning–Based Automated Labeling of Coronary Segments for Structured Reporting of Coronary Computed Tomography Angiography in Accordance With Society of Cardiovascular Computed Tomography Guidelines
Authors: Brandt Verena , Fischer Andreas , Schoepf Uwe Joseph , Bekeredjian Raffi , Tesche Christian , Aquino Gilberto J. , O’Doherty Jim , Sharma Puneet , Gülsün Mehmet A. , Klein Paul , Ali Asik , Few William Evans , Emrich Tilman , Varga-Szemes Akos , Decker Josua A. 
Published: October 2023

Purpose:
To evaluate a novel deep learning (DL)–based automated coronary labeling approach for structured reporting of coronary artery disease according to the guidelines of the Society of Cardiovascular Computed Tomography (CT) on coronary CT angiography (CCTA).

Patients and Methods:
A retrospective cohort of 104 patients (60.3 ± 10.7 y, 61% males) who had undergone prospectively electrocardiogram-synchronized CCTA were included. Coronary centerlines were automatically extracted, labeled, and validated by 2 expert readers according to Society of Cardiovascular CT guidelines. The DL algorithm was trained on 706 radiologist-annotated cases for the task of automatically labeling coronary artery centerlines. The architecture leverages tree-structured long short-term memory recurrent neural networks to capture the full topological information of the coronary trees by using a two-step approach: a bottom-up encoding step, followed by a top-down decoding step. The first module encodes each sub-tree into fixed-sized vector representations. The decoding module then selectively attends to the aggregated global context to perform the local assignation of labels. To assess the performance of the software, percentage overlap was calculated between the labels of the algorithm and the expert readers.

Results:
A total number of 1491 segments were identified. The artificial intelligence–based software approach yielded an average overlap of 94.4% compared with the expert readers’ labels ranging from 87.1% for the posterior descending artery of the right coronary artery to 100% for the proximal segment of the right coronary artery. The average computational time was 0.5 seconds per case. The interreader overlap was 96.6%.

Conclusions:
The presented fully automated DL-based coronary artery labeling algorithm provides fast and precise labeling of the coronary artery segments bearing the potential to improve automated structured reporting for CCTA.
Lung–Reporting and Data System 2.0
Authors: Chelala Lydia , Hossain Rydhwana , Jeudy Jean , Nader Ziad , Kastner Julia , White Charles 
Published: October 2023

Purpose:
To determine the frequency of malignancy of nonperifissural juxtapleural nodules (JPNs) measuring 6 to < 10 mm in a subset of low-dose chest computed tomographies from the National Lung Cancer Screening Trial and the rate of down-classification of such nodules in Lung-Reporting and Data System (RADS) 2.0 compared with Lung-RADS 1.1.

Materials and Methods:
A secondary analysis of a subset of the National Lung Screening Trial was performed. An exemption was granted by the Institutional Review Board. The dominant noncalcified nodule measuring 6 to <10 mm was identified on all available prevalence computed tomographies. Nodules were categorized as pleural or nonpleural. Benign or malignant morphology was recorded. Initial and updated categories based on Lung-RADS 1.1 and Lung-RADS 2.0 were assigned, respectively. The impact of the down-classification of JPN was assessed. Both classification schemes were compared using the McNemar test (P < 0.01).

Results:
A total of 2813 patients (62 ± 5 y, 1717 men) with 4408 noncalcified nodules were studied. One thousand seventy-three dominant nodules measuring 6 to <10 mm were identified. Three hundred forty-eight (32.4%) were JPN. The updated scheme allowed down-classification of 310 JPN from categories 3 (n = 198) and 4A (n = 112) to category 2. We, therefore, estimate a 4.8% rate of down-classification to category 2 in the entire National Lung Screening Trial screening group. Two/348 (0.57%) JPN were malignant, both nonbenign in morphology. The false-positive rate decreased in the updated classification (P < 0.01).

Conclusion:
This study demonstrates the low malignant potential of benign morphology JPN measuring 6 mm to <10 mm. The Lung-RADS 2.0 approach to JPN is estimated to reduce short-term follow-ups and false-positive results.
Identifying Coronary Artery Calcification Using Chest X-ray Radiographs and Machine Learning
Authors: Jeong Hyunseok , Park Hyung-Bok , Hong Jongsoo , Lee Jina , Ha Seongmin , Heo Ran , Jung Juyeong , Hong Youngtaek , Chang Hyuk-Jae 
Published: October 2023

Purpose:
To evaluate the ability of radiomics score (RS)–based machine learning to identify moderate to severe coronary artery calcium (CAC) on chest x-ray radiographs (CXR).

Materials and Methods:
We included 559 patients who underwent a CAC scan with CXR obtained within 6 months and divided them into training (n = 391) and validation (n = 168) cohorts. We extracted radiomic features from annotated cardiac contours in the CXR images and developed an RS through feature selection with the least absolute shrinkage and selection operator regression in the training cohort. We evaluated the incremental value of the RS in predicting CAC scores when combined with basic clinical factor in the validation cohort. To predict a CAC score ≥100, we built an RS-based machine learning model using random forest; the input variables were age, sex, body mass index, and RS.

Results:
The RS was the most prominent factor for the CAC score ≥100 predictions (odds ratio = 2.33; 95% confidence interval: 1.62-3.44; P < 0.001) compared with basic clinical factor. The machine learning model was tested in the validation cohort and showed an area under the receiver operating characteristic curve of 0.808 (95% confidence interval: 0.75-0.87) for a CAC score ≥100 predictions.

Conclusions:
The use of an RS-based machine learning model may have the potential as an imaging marker to screen patients with moderate to severe CAC scores before diagnostic imaging tests, and it may improve the pretest probability of detecting coronary artery disease in clinical practice.
Microbiological Culture Versus 16S/18S Ribosomal RNA PCR-Sanger Sequencing for Infectious Keratitis: A Three-Arm, Diagnostic Cross-Sectional Study
Authors: Hammoudeh Yasmeen , Suresh Lakshmi , Ong Zun Zheng , Lister Michelle M. , Mohammed Imran , Thomas D. John I. , Cottell Jennifer L. , Holden Jennifer M. , Said Dalia G. , Dua Harminder S. , Jeng Ting Darren Shu 
Published: October 2023

ABSTRACTPurposeTo compare the diagnostic performance of microbiological culture and 16S/18S polymerase chain reaction (PCR)-Sanger sequencing for infectious keratitis (IK) and to analyse the effect of clinical disease severity on test performance and inter-test concordance.DesignA three-arm, diagnostic cross-sectional study.SubjectsWe included patients who presented with presumed bacterial/fungal keratitis to the Queen’s Medical Centre, Nottingham, UK, between June 2021 and September 2022.Methods/interventionsAll patients underwent simultaneous culture (either direct or indirect culture, or both) and 16S (pan-bacterial) / 18S (pan-fungal) ribosomal RNA (rRNA) PCR-Sanger sequencing. The bacterial/fungal genus and species identified on culture were confirmed using matrix-assisted laser desorption/ionization-time-of-flight mass spectrometry. Relevant clinical data were also collected to analyze for any potential clinico-microbiological correlation.Main outcome measuresDiagnostic yield, test accuracy (including sensitivity and specificity), and inter-test agreement [including percent agreement and Cohen’s kappa (k)].ResultsA total of 81 patients (86 episodes of IK) were included in this study. All organisms identified were of bacterial origin. Diagnostic yields were similar among direct culture (52.3%), indirect culture (50.8%), and PCR (43.1%; p=0.13). The addition of PCR enabled a positive diagnostic yield in 3 (9.7%) direct culture-negative cases. Based on composite reference standard, direct culture had the highest sensitivity (87.5%; 95% CI, 72.4-95.3%), followed by indirect culture (85.4%; 95% CI, 71.6-93.5%) and PCR (73.5%; 95% CI, 59.0- 84.6%), with 100% specificity noted in all tests. Pairwise comparisons showed substantial agreement among the three tests (percent agreement=81.8-86.2%, Cohen’sk=0.67-0.72). Clinico-microbiological correlation demonstrated higher culture-PCR concordance in cases with greater infection severity.ConclusionsThis study highlights a similar diagnostic performance of direct culture, indirect culture and 16S rRNA PCR for bacterial keratitis, with substantial inter-test concordance. PCR serves as a useful diagnostic adjuvant to culture, particularly in culture- negative cases or those with lesser disease severity (where culture-PCR concordance is lower).
Multi-session transcutaneous spinal cord stimulation prevents chloride homeostasis imbalance and the development of spasticity after spinal cord injury in rat
Authors: Malloy Dillon C. , Côté Marie-Pascale 
Published: October 2023

ABSTRACTSpasticity is a complex and multidimensional disorder that impacts nearly 75% of individuals with spinal cord injury (SCI) and currently lacks adequate treatment options. This sensorimotor condition is burdensome as hyperexcitability of reflex pathways result in exacerbated reflex responses, co-contractions of antagonistic muscles, and involuntary movements. Transcutaneous spinal cord stimulation (tSCS) has become a popular tool in the human SCI research field. The likeliness for this intervention to be successful as a noninvasive anti-spastic therapy after SCI is suggested by a mild and transitory improvement in spastic symptoms following a single stimulation session, but it remains to be determined if repeated tSCS over the course of weeks can produce more profound effects. Despite its popularity, the neuroplasticity induced by tSCS also remains widely unexplored, particularly due to the lack of suitable animal models to investigate this intervention. Thus, the basis of this work was to use tSCS over multiple sessions (multi-session tSCS) in a rat model to target spasticity after SCI and identify the long-term physiological improvements and anatomical neuroplasticity occurring in the spinal cord. Here, we show that multi-session tSCS in rats with an incomplete (severe T9 contusion) SCI (1) decreases hyperreflexia, (2) increases the low frequency-dependent modulation of the H-reflex, (3) prevents potassium-chloride cotransporter isoform 2 (KCC2) membrane downregulation in lumbar motoneurons, and (4) generally augments motor output, i.e., EMG amplitude in response to single pulses of tSCS, particularly in extensor muscles. Together, this work displays that multi-session tSCS can target and diminish spasticity after SCI as an alternative to pharmacological interventions and begins to highlight the underlying neuroplasticity contributing to its success in improving functional recovery.
Reassessment of the risks of climate change for terrestrial ecosystems
Authors: Conradi Timo , Eggli Urs , Kreft Holger , Schweiger Andreas H. , Weigelt Patrick , Higgins Steven I. 
Published: October 2023

SUMMARYForecasting the risks of climate change for species and ecosystems is necessary for developing targeted conservation strategies. Previous risk assessments mapped the exposure of the global land surface to changes in climate1–4However, this procedure is unlikely to robustly identify priority areas for conservation actions because non-linear physiological responses and co-limitation processes ensure that ecological changes will not map perfectly to the forecast climatic changes. Here, we combine ecophysio­logical growth models of 135,153 vascular plant species and plant growth form information to transform ambient and future climatologies into phytoclimates, which describe the ability of climates to support the plant growth forms that characterise terrestrial ecosystems. We forecast that 33% to 68% of the global land surface will experience a significant change in phytoclimate by 2070 under RCP 2.6 and RCP 8.5, respectively. Novel phytoclimates without present-day analogue are forecast to emerge on 0.3-2.2% of the land surface, and 0.1-1.3% of currently realised phytoclimates are forecast to disappear. Notably, the geographic pattern of change, disappearance and novelty of phytoclimates differs markedly from the pattern of analogous trends in climates detected by previous studies1,3,4, thereby defining new priorities for conservation actions and highlighting the limits of using untransformed climate change exposure indices in ecologicaI risk assessments. Our findings suggest that a profound transformation of the biosphere is underway and emphasise the need for a timely adaptation of biodiversity management practices.