bluuebunny/crossref_metadata_2025_split huggingface dataset:
Simulated microgravity predisposes kidney to injury through promoting intrarenal artery remodeling
Authors: Lyu Qiang , Zhao Delong , Liu Jiaqi , Zhang Yingjie , Wang Qian , Wang Xu , Chen Jingjing , Chi Yunxia , Li Ping , Cai Guangyan , Zhang Li , Ma Jin , Chen Xiangmei 
Published: January 2025

AbstractSpaceflight‐induced multi‐organ dysfunction affects the health of astronauts and the safety of in‐orbit flight. However, the effect of microgravity on the kidney and the underlying mechanisms are unknown. In the current study, we used a hindlimb unweighting (HU) animal model to simulate microgravity and employed histological analysis, ischemia–reperfusion experiments, renal ultrasonography, bioinformatics analysis, isometric force measurement, and other molecular experimental settings to evaluate the effects of microgravity on the kidneys and the underlying mechanisms involved in this transition. Relative to controls, 31‐day hindlimb unweighting had no obvious effect on serum creatinine and urea nitrogen levels as well as on renal injury scores; however, animals in the HU group showed an impaired renal recovery to ischemia–reperfusion injury. Ultrasonography showed that renal resistive index was increased, which indicated an altered renal hemodynamics induced by simulated microgravity. The enhanced vasoconstriction mediated by the Rho‐kinase pathway and impaired vasodilation mediated by NO‐eNOS of the intrarenal artery contributed to the altered renal hemodynamics. Simulated microgravity predisposes the kidney to ischemia–reperfusion injury. The altered renal hemodynamics induced by renal arterial remodeling may account for the increased renal injury susceptibility, providing a target for early intervention in kidney dysfunction under microgravity.
Segment specific loss of NFAT5 function in the kidneys is sufficient to induce a global kidney injury like phenotype
Authors: Engel Kristina , Kulow Vera Anna , Chernyakov Dmitry , Willscher Edith , Fähling Michael , Edemir Bayram 
Published: January 2025

AbstractNuclear factor of activated T‐cells 5 (NFAT5) is a transcription factor known for its role in osmotic stress adaptation in the renal inner medulla, due to the osmotic gradient that is generated between the renal cortex and renal inner medulla. However, its broader implications in kidney injury and chronic kidney disease (CKD) are less understood. Here we used two different Cre deleter mice (Ksp1.3‐Cre and Aqp2‐Cre) to generate tubule segment and even cell type‐specific NFAT5‐deficient mice and performed extensive gene expression profiling. In both Nfat5 knockout models, we observed massive changes in gene expression pattern, with heightened inflammatory responses and renal injury, culminating in renal fibrosis. Interestingly, inflammatory responses were much more prominent in the Aqp2Cre+/−Nfat5fl/fl mice that lack NFAT5 only in the collecting duct. By analyzing gene expression in the medullary and cortical regions of the kidney separately, we confirmed that the loss of NFAT5 results in kidney injury that extends beyond hypertonic areas. Renal injury correlates with the expression level of genes involved in inflammatory response, injury severity, and cytokine signaling. Thus, NFAT5 is essential not only for adapting to osmotic stress but also for its loss of function, which induces activation of inflammatory response and cytokine signaling that might affect regions with functional NFAT5 expression.
Interprofessional Debrief on Racism, Equity, and Microaggressions (I-DREAM): Using Simulation to Change Awareness, Attitudes, and Abilities Across an Institution
Authors: Sran Simranjeet S. , Walsh Heather , Agrawal Dewesh , Dwivedi Pallavi , Ho Brandon , King Simmy , Lindgren Christina , Manuel Rosalyn , Nicholson Laura , Yurasek Gregory , Zaveri Pavan 
Published: January 2025

Abstract

Purpose
Effective diversity, equity, and inclusion (DEI) education is imperative to combat bias across health care organizations. The authors evaluated the effectiveness of interprofessional, simulation-based DEI training in improving clinicians’ awareness, attitudes, and abilities regarding bias, racism, inclusion, microaggressions, and equity in the workforce.

Method
From October 2021 to June 2022, interprofessional clinicians at Children’s National Hospital in Washington, DC, completed the Interprofessional Debrief on Racism, Equity, and Microaggressions (I-DREAM) training. Participants underwent small group training that included debriefing prerecorded simulations depicting language barriers, microaggressions, and other biased interactions. They were offered optional surveys before training, after training, and at 3-month follow-up. Participants’ awareness and attitudes of the events were assessed. Additional data were collected from monthly use of telephone interpreter services.

Results
A total of 1,811 interprofessional participants completed the I-DREAM training. Through user-generated codes, 759 presurveys and postsurveys and 276 presurveys and 3-month follow-up surveys were linked. Among these participants, 451 (60%) witnessed bias events before training and 629 (83%) after training (odds ratio [OR], 9.37; 95% CI, 5.77-15.22; P < .001), and 278 (37%) reported personally experiencing these events before training vs 496 (66%) after training (OR, 7.86; 95% CI 5.45-11.33; P < .001). Participants reporting confidence responding to bias events increased from 388 (45%) to 556 (73%) (OR, 3.28; 95% CI, 2.52-4.27; P < .001). At 3 months, 199 participants (72%) continued to express confidence in responding (OR, 3.98; 95% CI, 2.56-6.18; P < .001). Use of language interpretation increased during training (mean difference in calls per month, 261; 95% CI, 124-398; P < .001; mean difference in minutes per month, 2,249; 95% CI, 616-3,882; P = .009).

Conclusions
I-DREAM training was associated with improved clinicians’ awareness of bias events in the workplace, confidence in ability to respond to these events, and delivery of language-equitable care.
Concordance Between Trainee Self-Assessment and Expert Assessment of Cold Snare Polypectomy Competence: Results From a Randomized Clinical Study
Authors: Patel Swati G. , Muething Larissa , Kaltenbach Tonya , Nguyen-Vu Tiffany , Malvar Carmel , Keswani Rajesh N. , Hall Matthew , Aagaard Eva , Asokkumar Ravishankar , Chin Yung Ka , Hammad Hazem , Rastogi Amit , Shergill Amandeep , Simon Violet , Soetikno Alan , Soetikno Roy , Wani Sachin 
Published: January 2025

Abstract

Purpose
Many trainees lack competence in performing cold snare polypectomy (CSP), and longer observation periods using assessment tools, such as the Cold Snare Polypectomy Assessment Tool (CSPAT), may be required. However, these tools are not commonly used in busy academic endoscopy practices. This study evaluates the concordance between trainee self-assessment of CSP with expert assessment and assesses factors associated with concordance.

Method
Consecutive CSPs performed by gastroenterology trainees from 2 institutions were video recorded and rated by 8 blinded experts from 4 different academic institutions in the United States and Singapore using the CSPAT from August 2017 to February 2020. Trainees self-assessed competence for each CSP immediately after the procedure. Concordance between trainee and trainer was reported as percentage of agreement in competence (score of 3 or 4) or not yet competent (score of 1 or 2).

Results
Twenty-two trainees performed 765 colonoscopies with 2,267 CSPs. Concordance was found between expert and trainee assessment of competence for 1,380 CSPs (60.9%; 95% CI, 58.8%-62.9%; weighted κ = 0.12; 95% CI, 0.08-0.16). Trainees underassessed competence for 541 CSPs (23.9%; 95% CI, 22.1%-25.7%) and overassessed competence for 326 CSPs (15.3%; 95% CI, 13.8%-16.8%). Career plan of private practice general gastroenterology (adjusted odds ratio, 0.40; 95% CI, 0.17-0.92) and lower colonoscopy volume before study (adjusted odds ratio, 0.35; 95% CI, 0.22-0.62) were independently associated with lower likelihood of concordance between expert and trainee assessment of competence. Structured feedback was not associated with concordance, and there was no change as trainees gained experience; however, feedback decreased the proportion of overassessments.

Conclusions
There is poor concordance between trainee self-assessment and trainer assessment of CSP. Self-assessment can be used as an initial part of competency assessment, which should then be reconciled with external assessments to improve concordance in assessments.
Applications of Artificial Intelligence for Non–Psychomotor Skills Training in Health Professions Education: A Scoping Review
Authors: Costa-Dookhan Kenya A. , Adirim Zachary , Maslej Marta , Donner Kayle , Rodak Terri , Soklaridis Sophie , Sockalingam Sanjeev , Thakur Anupam 
Published: January 2025

Abstract

Purpose
This study explores uses of artificial intelligence (AI) in health professions education for non–psychomotor skills training at undergraduate, postgraduate, and continuing health professions education levels for education program development, delivery, and evaluation.

Method
This scoping review was conducted in 5 stages: (1) planning and research, (2) search strategy, (3) screening and selection, (4) review and recording data, and (5) synthesis. Seven bibliographic databases were searched using the main search terms artificial intelligence and continuing health professional education for articles that used AI for the purposes of non–psychomotor skills training for health professions education and involved health care professionals and/or trainees. Databases were searched for articles published from January 1, 2001, to March 26, 2024. The original searches were performed on July 26, 2021, and again on March 26, 2024. Two reviewers independently screened, reviewed, and extracted data. Data extraction was performed using Kern’s 6-step curriculum development framework to guide analysis.

Results
In total, 9,914 studies related to AI in health professions education for non–psychomotor skills training were screened. Of these, 103 studies were identified that met inclusion criteria. Of these 103 studies, 52 (50%) were cohort studies. The most common learner population was health care professional students (67 studies [65%]). Most studies (76 [74%]) were set in nonclinical settings. Sixty-eight studies (66%) fit under step 6 of Kern’s criteria (evaluation and assessment), illustrating that AI is predominantly being used for the purposes of evaluation and assessment of learners and programs.

Conclusions
Most studies in the literature illustrate that AI is being applied in a non–psychomotor context to evaluate health professional education programs and assess learners. Additional opportunities to use AI in curriculum design and implementation could include identification of learning needs for training, personalizing learning with AI principles, and evaluating health care professional education programs.
Exploring the clinical, psychological, and social relevance of menopause for trans and gender diverse people: a qualitative study
Authors: Xin Michelle Qian Lin , Lane Riki 
Published: January 2025

Abstract

Objective
The aim of this study was to explore the meanings and experiences of menopause for trans and gender diverse (TGD) people and how menopause affects clinical practice.

Methods
For this qualitative study in 2021‐2022, a scoping literature review informed interview schedule development. Following email invitations, online semi-structured interviews were conducted in March‐April 2021 in Australia with three prominent TGD community leaders (trans male, trans female, nonbinary person) and three experienced medical practitioners (general practitioner, endocrinologist, psychiatrist), which were audio-recorded and transcribed. Inductive, iterative thematic analysis of transcripts was conducted. A further literature search was completed in 2024.

Results
Themes identified included the following: (1) no consensus on the definition of menopause for TGD individuals; (2) diverse menopause experiences existing in the TGD community; (3) large variations present regarding perimenopausal hormone therapy for older TGD patients: maintain dose, taper to low dose, or cease hormones; and (4) minimal support for TGD people to discuss menopause and concerns around aging. Saturation was not reached with the sample size.

Conclusions
There is a paucity of relevant research and no consensus on definitions, management, or impacts of menopause for TGD people. Therefore, current management approaches should be individually tailored and guided by clinical expertise. To formulate practical and realistic recommendations for clinical practice, future research could include the following: (1) a broader literature review into varied gender-affirming hormone treatment (GAHT) regimens among aging TGD people; (2) utilizing the Delphi technique to achieve expert consensus regarding GAHT in older TGD individuals; and (3) a prospective study design of TGD participants on different GAHT regimens over time.
Evaluation of the association between thyroid-stimulating hormone with handgrip strength and dynapenia in euthyroid postmenopausal women
Authors: García-Alfaro Pascual , Pérez-López Faustino R. , Sulé María Angela , Rodríguez Ignacio 
Published: January 2025

Abstract

Objective
To examine the association between serum thyroid-stimulating hormone (TSH) levels with handgrip strength (HGS) and dynapenia in euthyroid postmenopausal women.

Methods
This was an exploratory cross-sectional study among 385 participants from the Department of Obstetrics, Gynecology, and Reproduction of the Dexeus Women's University Hospital, Barcelona, Spain. Age, age at menopause, adiposity, alcohol consumption, body mass index (BMI), and smoking status were recorded. TSH was determined by electrochemiluminescence immunoassay. HGS was measured using a digital dynamometer, and physical activity was assessed by the International Physical Activity Questionnaire. Dynapenia was considered when HGS was <20 kg. A directed acyclic graph was designed to identify confounding variables. Multivariable linear and logistic regression models were adjusted by age, age at menopause, adiposity, BMI, glomerular filtration rate, glycated hemoglobin, physical activity, and smoking status.

Results
Multivariable linear regression model showed that age (β = −0.22; 95% CI, −0.28 to −0.16), adiposity (β = −0.15; 95% CI, −0.22 to −0.07), BMI (β = 0.15; 95% CI, 0.04-0.25), glomerular filtration rate (β = −0.04; 95% CI, −0.07 to −0.01), and physical activity (β = 0.79; 95% CI, 0.07-1.5) were significantly associated with HGS. Instead, serum TSH levels were not significantly associated (β = 0.21; 95% CI, −0.10 to 0.51). Multivariable logistic regression model showed that dynapenia was associated with age (OR, 1.20; 95% CI, 1.12-1.31) and glomerular filtration rate (OR, 1.03; 95% CI, 1.00-1.05). No significant association between TSH and dynapenia was observed (OR, 0.98; 95% CI, 0.78-1.23).

Conclusions
In this study of postmenopausal women, normal TSH levels were not associated with low HGS or dynapenia.
Health-related quality of life across menopausal stages among middle-aged Korean women
Authors: Choi Hye Rin , Chang Yoosoo , Kang Danbee , Lee Jiseon , Jang Yoonyoung , Kim Hoon , Ryu Seungho , Park Hyun-Young , Cho Juhee 
Published: January 2025

Abstract

Objectives
We examined the health-related quality of life (HRQoL) during menopause transition (MT) among middle-aged Korean women.

Methods
This cross-sectional study comprised 2,290 middle-aged women who completed web-based questionnaires between 2020 and 2022. Based on self-reported menstrual cycle patterns, menopause status was classified as premenopausal, early or late transition, or postmenopausal. HRQoL was assessed using the Patient-Reported Outcomes Measurement Information system, with all 29 items scored using a T-score metric. Multiple linear regression analyses were performed to investigate whether HRQoL varied based on MT stages. Antimüllerian hormone levels were used as an objective measure instead of self-reported menstrual status in the sensitivity analysis. Logistic regression models were used to estimate the prevalence ratios for moderate or severe HRQoL symptoms across menopausal stages.

Results
The mean T-scores for anxiety, depression, and pain interference and intensity were significantly higher with advancing menopausal stage. Anxiety, depression, sleep disturbances, pain interference, and intensity were significantly and linearly positively correlated with MT stages after adjusting for potential confounders. Physical function significantly worsened in the late transition stage compared with premenopausal status (β = −1.51 [95% CI, −2.72 to −0.31] in late MT and β = −1.92 [95% CI, −3.46 to −0.37] in postmenopause, P for trend = 0.007). However, no significant trends were observed in the sensitivity analysis using antimüllerian hormone levels. Women with moderate or severe symptoms in all domains except physical function had significantly higher prevalence ratios according to MT.

Conclusions
Overall HRQoL was lower with advancing menopausal stages. All symptoms should be monitored to control early transition symptoms. Thus, women undergoing MT should consistently assess and manage not only menopausal symptoms but also the overall quality of their health to prevent both menopause-specific and nonspecific conditions and their consequences.
Vascular Effects of Botulinum Toxin in Human Skin
Authors: Moreno Rozo Natalia K. , Gómez Díaz Oswaldo J. , Beltran Pachon Paloma , Restrepo Daniel , Gómez Santiago 
Published: January 2025

Summary:
Botulinum toxin-A (BTX-A) is widely used for aesthetic purposes and is recognized for its vasomotor actions. However, new medical applications have emerged. This study aims to describe the effect of BTX-A on human skin perfusion, particularly vessel diameter, blood flow, and blood vessel density in regions with known low vessel density. This case series involved 40 patients who were treated with subcutaneous injections of BTX-A and sodium chloride 0.9% into marked skin areas on their backs. Skin blood flow, vessel diameter, and density were measured using infrared thermography and Doppler ultrasound before the injection and on days 1, 7, and 21 posttreatment. BTX-A-treated areas exhibited higher blood flow, larger blood vessel diameter, increased blood vessel density, and the emergence of new detectable perforators. In contrast, areas receiving sodium chloride 0.9% showed no significant changes. Data analysis was conducted using an independent t test and Jeffreys interval. BTX-A injection appears to boost human skin blood circulation, potentially prompting the emergence of new detectable perforators, gradual widening of vessel diameter, and increased blood flow and temperature. These observations suggest potential benefits of BTX-A in areas with compromised blood supply to stimulate the emergence of new detectable perforators.
Autologous Fat Grafting in Hand Surgery: A Systematic Review
Authors: Henderson Brennon , Cushman Caroline J. , Price Ashley D. , Hoffpauir Lauren A. , Jain Neil , Hernandez Evan J. , Idicula Anceslo , MacKay Brendan J. 
Published: January 2025

Background:
Autologous fat grafting (AFG) has gained popularity in both cosmetic and reconstructive surgery, including hand surgery, due to its regenerative potential and dual benefits of enhancing aesthetics and function. This systematic review aims to evaluate the efficacy of AFG in treating various hand pathologies.

Methods:
A systematic review was conducted following PRISMA guidelines. PubMed, Cochrane Library, and Embase databases were searched for studies published between January 2001 and October 2022 using the terms “(autologous fat grafting) AND (hand).” Of 224 studies identified, 14 met the inclusion criteria. These studies were analyzed based on study design, pathology treated, type of AFG used, and primary outcomes.

Results:
The review included 14 studies: 9 prospective/retrospective studies, 3 case reports, and 2 randomized control trials. Digital ulcers related to systemic sclerosis and hand osteoarthritis were the most frequently treated pathologies. AFG was predominantly used to address symptoms/pain (71.4%), with aesthetics as a secondary benefit in 21.4% of cases. The studies reported improvements in pain, functionality, and patient satisfaction. However, the variability in techniques and outcomes limited the ability to perform a meta-analysis.

Conclusions:
AFG shows promise as a minimally invasive treatment option for various hand pathologies, offering both symptomatic relief and aesthetic enhancement. Although initial findings are favorable, further high-quality studies are needed to standardize techniques and confirm long-term efficacy. The versatility and safety profile of AFG suggest it has the potential to become a widely adopted technique in hand surgery.
Graded Anterior Partial-thickness Blepharotomy for the Correction of Idiopathic Unilateral Upper Eyelid Retraction: A Case Report and Literature Review
Authors: Liu Wentao , Lu Menglin , Lin Wentao , Shen Xiao 
Published: January 2025

Summary:
Idiopathic upper eyelid retraction is a rare ocular symptom characterized by abnormal upward displacement of the upper eyelid, often without any identifiable systemic disease. This condition not only affects the patient’s appearance but may also have a certain impact on their daily life and mental health. We report a case of adult idiopathic unilateral upper eyelid retraction, and based on the patient’s specific condition, we used graded anterior plate blepharoplasty for treatment. This surgical method aims to restore the normal position and facial symmetry of the eyelids by finely adjusting the eyelid tissue, especially correcting abnormalities in the levator and Miller muscles. After undergoing graded anterior plate blepharoplasty, the patient’s eyelid position and facial symmetry were significantly improved. Postoperative observation showed that the patient’s upper eyelid retraction symptoms were effectively corrected, and the correction effect was stable without recurrence. This study confirmed the effectiveness and safety of graded anterior lamellar blepharoplasty in the treatment of idiopathic unilateral upper eyelid retraction in an adult. This surgical method not only significantly improves the eyelid position and facial symmetry of patients but also has fast postoperative recovery and fewer complications, providing valuable insights for the management of idiopathic upper eyelid retraction.
Preoperative and early postoperative factors associated with visual outcome after macular-off retinal detachment surgery
Authors: Zhao Yuan , Sheng Yan 
Published: January 2025

Purpose:
To evaluate preoperative and early postoperative factors associated with changes in visual acuity in macula-off rhegmatogenous retinal detachment (RRD) patients.

Methods:
A retrospective review of 59 eyes from 59 patients who underwent pars plana vitrectomy (PPV) and silicone oil (SiO) tamponade for macula-off RRD. Preoperative and early postoperative characteristics were analyzed using the classification and regression tree (CART) analysis.

Results:
The baseline preoperative BCVA improved from 1.67 ± 0.97 logMAR to 0.21 ± 0.22 logMAR at final visit. Central foveal thickness (CFT) and BCVA showed significant increases from 1 week post-surgery onward. Mean CFT significantly increased from 136.97 ± 40.17 μm to 192.54 ± 34.09 μm (p < 0.001). The percentage of eyes with integrated external limiting membrane (ELM) and ellipsoid zone (EZ) was progressively increased from 45.76% and 10.17% to 98.31% and 71.19%, respectively (p < 0.001). BCVA at 1week after surgery, ELM integrity, preoperative intraretinal cysts, and macula-off duration were significantly associated with final visual recovery after surgery.

Conclusion:
The first week postoperative BCVA is the most powerful predictor for final BCVA. ELM integrity, intraretinal cysts, and macula-off duration are also significantly associated with final visual recovery.