bluuebunny/crossref_metadata_2025_split huggingface dataset:
A PA-led telemedicine advance care planning intervention in a life-limiting illness
Authors: Cooper Christa S. , Karl Jessica A. 
Published: February 2025

ABSTRACT

Objective:
To explore if a physician associate/assistant (PA)-led advance care planning (ACP) intervention would be successful and if patients and caregivers are comfortable having these discussions with PAs.

Methods:
We conducted a randomized controlled trial with optional open-label crossover to assess the feasibility, acceptability, and effect on ACP engagement of a PA-led telemedicine-facilitated ACP (tele-ACP) intervention in a Huntington disease (HD) clinic.

Results:
All participants felt they could effectively express themselves to the PA during the tele-ACP visit, and 95.8% felt comfortable communicating with the PA about ACP. The PA-led tele-ACP intervention significantly increased ACP engagement.

Conclusions:
Our PA-led tele-ACP intervention was feasible, acceptable, and it increased ACP engagement.
The ethics of food allergy
Authors: Buckey Timothy M. , Singh Tarandeep , Sacta Maria A. 
Published: February 2025

Purpose of review
Ethical dilemmas are a common occurrence in the provision of care to individuals with food allergies. Thus, an understanding of medical ethics is essential for allergists/immunologists.

Recent findings
Despite the importance of medical ethics in the clinical practice of food allergy, there has been little published on this topic. Some international allergy societies have published ethical guidelines. Further investigation on medical ethics in food allergy is required.

Summary
This review describes key ethical principles in relation to food allergy testing, oral food challenges, and various management strategies, including avoidance, omalizumab and oral immunotherapy. This review demonstrates the necessity for education and research on medical ethics in food allergy.
The impact of climate change in pollen food allergy syndrome
Authors: Skypala Isabel J. 
Published: February 2025

Purpose of review
To evaluate the effect of climate change on pollen allergenicity, lengthening of the pollen season, and the spread of invasive species such as ragweed. To assess evidence to determine whether these effects are impacting the prevalence of pollen food syndrome (PFS).

Recent findings
There is good evidence to demonstrate that markers of climate change, including rising temperatures and to some extent greenhouse gases, are responsible for a rise in the allergenicity of pollen and an increase in the duration of the pollen season, especially for trees. These changes are likely to be linked to the increase in the prevalence of seasonal allergic rhinitis (SAR), especially in children. Sensitization to pollen, especially tree pollen, is also a risk factor for the development of PFS. Thought to mainly affect adults, recent evidence suggests that there is a rise in the prevalence of PFS in children, linked to an increase in SAR.

Summary
Increasing SAR due to climate change could lead to a greater number of children and adults developing PFS. Although PFS is generally considered to be a mild condition, severe reactions can occur and there might be numerous plant food triggers, which can adversely affect dietary choice and nutritional intake.
Infant-Led Incubator Weaning
Authors: Rath Jennifer , Stracuzzi Lauren A. , Wawrzynski Sarah E. , Haut Catherine 
Published: February 2025

Background:
Thermoregulation is paramount in preterm infant care, traditionally addressed through nurse-led incubator weaning protocols. Recent research has introduced infant-driven incubator protocols that are demonstrating promise.

Purpose:
This study, conducted at a freestanding academic pediatric hospital in the mid-Atlantic, examined the impact of infant-led incubator weaning on a specific neonatal cohort. The primary hypothesis posited that infants in the infant-led weaning group would wean out of the incubator at earlier gestational ages and lower weights, while maintaining comparable or greater weight gain during the transition to open cribs.

Methods:
A retrospective chart review compared 40 infants weighing less than 1500 g before and after a weaning protocol change.

Results:
Infant-led weaning demonstrated lower weights at weaning to crib (M = 1836.80 g) compared with nurse-led weaning (M = 1975.9 g), with statistical significance (t [36] = 2.27, P = .02, Cohen’s d = 0.74). Infants in the infant-led group had a lower weight change 5 days prior to weaning (M = 141 g) compared with the nurse-led group (M = 185 g), which is also statistically significant (t [36] = 1.93, P = .03, Cohen’s d = 0.63). T-tests revealed no significant differences in gestational age at wean to crib, change in weight post-weaning, gestational age, or days to discharge.

Implications for Practice and Research:
Infant-led weaning emerges as a safe alternative with potential benefits for preterm neonates and their families. While initial positive outcomes are evident, further research with a larger neonatal cohort is imperative to validate the efficacy of infant-led weaning as a successful alternative to traditional methods.
Radiation Exposure in Operatively Treated Pediatric Femur Fracture Patients
Authors: Huffman Nickelas , Nair Ajay , Drees Summer M. , Bouck Trevor , Yatsonsky David , Krugh Kerry , Seegert Sara , Russell Benjamin H. , Lewis Adrian , Buerk Aaron , Georgiadis Gregory M. 
Published: February 2025

Background:
Children who sustain femur fractures are exposed to medical radiation as part of their treatment. In addition to standard radiographs and fluoroscopy, computerized tomography (CT) is a major source of ionizing radiation (IR). These patients frequently undergo CT scans during their treatment. The aim of the current study was to quantify the factors associated with greater IR exposure in children with operatively treated femur fractures and compare radiation exposure among those who received CT scans versus those who did not.

Methods:
Thirty-eight patients below 18 years old with operatively treated traumatic femur fractures were included in the study. They fell into one of 2 groups: 1 received 1 or more CT scans (CT group), and the other did not receive a CT scan (non-CT scan). The 2 groups were then compared by total quantitative radiation exposure, age, BMI, location of the femur fracture, open versus closed fracture, and the presence versus absence of fracture displacement.

Results:
The effective dose of IR exposure that occurred within the operating room (OR) made up 75.7%±27.4% of the total IR exposure among all patients. Patients in the CT group had over a 5-fold greater quantitative cumulative IR exposure compared with the non-CT group (P<0.0001). Furthermore, patients in the CT group were significantly older than (P=0.004) and had a greater BMI (P=0.045) than the non-CT group.

Conclusion:
Children with pediatric femur fractures often exceed what is considered a low level of radiation. There is a significant difference in radiation exposure between pediatric femur fracture patients who receive 1 or more CT scans compared with those who do not receive a CT scan.

Level of Evidence:
Level III—retrospective cohort study.
Functional Deficits Associated with Dark Without Pressure
Authors: Cobbs Lucy V. , Bijon Jacques , Freund K. Bailey 
Published: February 2025

Purpose:
To describe a patient with progressive visual symptoms and reduced retinal sensitivity corresponding to dark without pressure (DWP).

Methods:
Retrospective chart review of a single patient. Comprehensive ophthalmic examinations and multimodal imaging techniques, including optical coherence tomography (OCT), OCT-angiography, and microperimetry, were analyzed.

Results:
A 23-year-old male presented with progressive peripheral areas of blurred vision superiorly in his right eye and temporally in his left eye. These disturbances corresponded with dark areas of retina inferiorly in his right eye and nasally in his left eye having characteristic features of DWP on multimodal imaging. Although Humphrey visual field (HVF) 24-2 testing was normal, microperimetry showed decreased retinal sensitivity in areas of DWP relative to adjacent areas without DWP.

Conclusion:
Prior descriptions of DWP have described it as a benign retinal finding showing no functional deficits. We demonstrate that DWP can be associated with progressive visual complaints showing decreased retinal sensitivity on microperimetry and undetected with HVF 24-2 testing.
Postoperative acute pain trajectory and chronic postsurgical pain after abdominal surgery: a prospective cohort study and mediation analysis
Authors: Chen Dong Xu , Zhang Yu Yang , Liu Jing , Chen Yu 
Published: February 2025

Background:
This study aimed to investigate the trajectories of acute postoperative pain intensity during the initial 5 days after abdominal surgery, and to analyze their association with the risk of developing chronic postsurgical pain (CPSP).

Methods:
We enrolled patients with elective abdominal surgery with pain measurements taken across postoperative days 1 through 5. Since postoperative pain is often unavoidable and its initial intensity is closely related to the invasiveness of the surgery, focusing on the overall pain trajectory may be more meaningful than evaluating pain at a single time point. Therefore, the primary outcome of this study was to identify distinct pain trajectories. Secondary outcome was the incidence of CPSP between differences pain trajectories. Lastly, mediation analyses were performed to explore the mediating role of the quality of recovery and subacute pain on the studied associations.

Results:
The final analysis encompassed 1170 patients (36.75% female) with a median age of 55 years. Two distinct clusters were identified: with movement (high: 533 [45.56%]; low: 637 [54.44%]) and at rest (high: 363 [31.03%]; low: 807 [68.97%]). Patients in the high pain trajectory group (during movement [odds ratio [OR] 2.04, 95% CI 1.56–2.68] or at rest [OR 1.90, 95% CI 1.44–2.53]) exhibited nearly doubled risk of CPSP. Moreover, these patients exhibited a significantly poorer recovery quality. Mediation analyses revealed that the poor recovery quality at postoperative 5 days (17.62%–18.57%) and higher subacute pain at postoperative 1 month (29.46%–32.75%) were significant mediators in the association between adverse postoperative acute pain trajectory patterns and CPSP.

Conclusion:
This study highlights the clinical significance of postoperative pain trajectory profiles in predicting the risk of CPSP, emphasizing postoperative acute pain trajectory as a critical indicator and subacute pain as a significant mediator. The findings underscore the potential for tailored pain management strategies targeting acute pain trajectories to reduce such risk.
Development of a Pediatric Age-Based and Weight-Adjusted Nomogram for Bladder Volumes Associated With Successful Completion of Transabdominal Pelvic Ultrasound (TPU)
Authors: Drayna Patrick C. , Johnson Cameron , Chinta Sri S. , Jaafar Hayder , Thomas Danny , Visotcky Alexis , Dupont Amanda S. , Kumbhar Sachin 
Published: February 2025

Objective:
To develop a nomogram for pediatric bladder volumes associated with the successful completion of transabdominal pelvic ultrasound (TPU) in female pediatric patients presenting with lower abdominal and/or pelvic pain in the emergency department. This study hypothesizes that the target bladder volumes for successful TPU vary by age and weight.

Methods:
We retrospectively calculated bladder volumes on all successful transabdominal pelvic ultrasound studies during a 2-year period for patients 8 to 18 years old by ellipsoid bladder volume formula using the largest cross-sectional areas captured on transverse and longitudinal cine clips. Measurements were collected by 2 study personnel with initial measurements validated by a pediatric radiologist. Bladder volume by age and weight percentile groups were descriptively analyzed, and a quantile regression model was used to regress bladder volume on age adjusting for patient weight.

Results:
We analyzed bladder volumes from 1030 successful transabdominal pelvic ultrasound studies. The greatest drop in median volume was seen amongst non-overweight children in younger age groups. Nomogram bladder volumes for transabdominal pelvic ultrasound increase consistently with age and weight until approximately 13 years old and 60 kg, respectively, with minimal change thereafter in patients 13 to 18 years old.

Conclusions:
We provide a pediatric age-based and weight-adjusted nomogram for bladder volumes associated with successful transabdominal pelvic ultrasound imaging. Further evaluation of its use is warranted to decrease inefficiency in bladder filling prior to TPU completion and improve timeliness in diagnosing pelvic emergencies.
Preferences for Care Among African American Women Considering Postmastectomy Breast Reconstruction
Authors: Shammas Ronnie L. , Hung Anna , Ramkalawan Janel , Mullikin Alexandria , Moore Angelo , Greenup Rachel A. , Hollenbeck Scott T. , Phillips Brett T. , Matros Evan , Reed Shelby D. , Lee Clara N. 
Published: February 2025

Background:
Approximately 20% of patients report inadequate discussions with their providers about reconstructive options, with an increased frequency reported in non-White women. Eliciting treatment preferences with adaptive choice-based conjoint (ACBC) analysis can improve our understanding of what patients’ value. We aimed to determine what African American (AA) patients value when considering breast reconstruction options.

Methods:
Cross-sectional ACBC with AA women considering breast reconstruction recruited through community partnerships and an academic medical center. Relative importance scores, part-worth utilities, and maximum-acceptable risks were calculated to assess preferences for attributes of flap versus implant reconstruction.

Results:
Overall, 181 women, 101 from an academic center and 80 from the community were included. The most important attributes were risk of complications [mean (SD) relative importance (RI), 26% (12%)], additional surgeries [RI, 24% (14%)], and abdominal morbidity [RI, 22% (11%)]. Women were least concerned with appearance [RI, 15% (12%)] and recovery time [RI, 14%, (10%)]. Fewer women preferred a profile representing flap (n=27, 15%) compared to implant reconstruction (n=154, 85%). Those who preferred flap reconstruction cared most about additional surgeries [RI, 36% (15%)]; in contrast, those who preferred implant reconstruction cared most about complications [RI, 27% (12%)]. Participants with fewer comorbidities [OR, 0.84; p=0.012], no prior surgical complication (OR, 0.32; p=0.029), and prophylactic mastectomy (OR, 6.07; p=0.19) were more likely to choose the implant profile.

Conclusion:
AA patients place greatest value on minimizing complication risk and additional surgeries when considering post-mastectomy reconstruction. Future studies should assess how eliciting individual-level preferences can improve shared decision-making in surgery.
Trait Impulsivity Predicts Treatment Response in Gambling Disorder
Authors: Chamberlain Samuel R. , Ioannidis Konstantinos , Grant Jon E. 
Published: February 2025

Objectives
Impulsivity is thought to be a core feature of gambling disorder, yet little is known as to whether trait impulsivity predicts treatment response.

Methods
Data were pooled from 2 previous randomized controlled pharmacological trials using naltrexone and N-acetyl cysteine.

Results
Trait impulsivity statistically explained variation in medication treatment response (P = 0.0260, R
2 = 0.26). Higher baseline motor impulsiveness was associated with greater treatment response (P = 0.009).

Conclusions
Measures of impulsivity may thus be important to include in future large-scale datasets, in trial settings but also routine clinical gambling clinic practice, toward building predictive algorithms that may ultimately help to inform optimal treatment choices and improve outcomes.
DNA sequencing of whole human cytomegalovirus genomes from formalin-fixed, paraffin-embedded tissues from congenital cytomegalovirus disease cases
Authors: Li Kathy K. , Suárez Nicolás M. , Camiolo Salvatore , Orton Richard J. , Davison Andrew J. 
Published: February 2025

AbstractBackgroundCongenital cytomegalovirus disease (cCMV) can be severe but is uncommon. Investigations of the role of genome sequence variation in the causative virus (human cytomegalovirus, HCMV) in clinical outcome have to date depended on small sample numbers derived from fresh tissues. Extensive formalin-fixed, paraffin-embedded (FFPE) cCMV biorepositories established worldwide potentially provide much larger sample numbers for future investigations. However, there are no published reports of sequencing whole HCMV genomes from such material.ObjectiveTo sequence whole HCMV genomes from cCMV FFPE material.Study designSixteen FFPE samples of foetal kidney or placental tissue were processed from ten cCMV cases in foetuses or neonates. Two commercial kits for extracting DNA from FFPE material were evaluated, HCMV DNA was enriched in the extracts, and the samples were sequenced on the Illumina platform. The sequence read datasets were analysed by genotyping, genome assembly and variant calling using a published software pipeline.ResultsWhole HCMV genomes were sequenced for five cases using either DNA extraction kit.ConclusionsSequencing whole HCMV genomes from cCMV FFPE material is feasible. This potentially facilitates future studies of the effects of HCMV variation on the clinical outcome of cCMV.HighlightsHuman cytomegalovirus (HCMV) causes congenital cytomegalovirus disease (cCMV).cCMV samples exist in formalin-fixed, paraffin-embedded (FFPE) biorepositories.Sequencing whole HCMV genomes from such material is feasible.This may aid future studies on the effect of HCMV diversity on cCMV outcomes.
Understanding motivations of older women to continue or discontinue breast cancer screening
Authors: Weller Susan C. , Pappadis Monique R. , Krishnan Shilpa , Stearnes Marsja R. , Sheffield Kristin M. , Tan Alai , Qi Jeffrey Z. , Goodwin James S. 
Published: February 2025

ABSTRACTBackgroundBreast cancer screening guidelines indicate screening in women over 75 years of age is optional, depending upon patient health and preferences.ObjectivesTo link experiences and perceptions of older women concerning screening to their intention to continue or discontinue screening.DesignQualitative comparative study, comparing continuers and discontinuers.SettingCommunity-residing adults.ParticipantsA purposive sample (n=59) with equal representation of White, Black, and Hispanic women by age (70-74 years and 75 and older) and educational level (≤12 grade and >12 grade).MeasurementsIn-depth qualitative interviews explored women’s perceptions of mammograms, the benefits and risks of screening, and personal screening experiences. Interviews were coded and quality-checked by two or more coders. A qualitative comparative analysis (QCA) was used to identify combinations of personal characteristics and themes linked to the intention to continue (n=32) or discontinue (n=27) screening.ResultsPersonal experience themes were strongly linked to the intention to continue or discontinue. Women who mentioned recent screening (within three years) and either a spontaneously mentioned cancer story concerning a friend or family member or a doctor’s screening recommendation intended to continue screening (91% true positive rate, model sensitivity). Women who did not schedule screening and who did not mention a cancer story or a doctor’s recommendation (or neither) intended to discontinue screening (81% true negative rate, model specificity). These themes transcended differences in race/ethnicity, age, and educational level.ConclusionContinuation of breast cancer screening in older women is motivated by their personal screening history combined with cancer experiences and/or a doctor’s screening recommendation.
Characterization of RNA cargo from extracellular vesicles obtained from cerebrospinal fluid and plasma samples in schizophrenia participants and healthy volunteers
Authors: Gallego Juan A. , Palade Joanna , Alsop Eric , Hutchins Elizabeth , Hsieh Michael , Logerman Amber , Bilagody Cherae , Reiman Rebecca , Meechoovet Bessie , Terraf Panieh , Beecroft Blake , Janss Alex , Gallaso Francesca , Whitsett Timothy G. , Blanco Emily A. , Lencz Todd , Keuren-Jensen Kendall Van , Malhotra Anil K. 
Published: February 2025

AbstractBiomarkers that are clinically useful for the diagnosis and treatment of schizophrenia are lacking. Biomarkers are critical tools that reduce the incidence of misdiagnosis, identify subgroups of patients, assist in the proper characterization of patient phenotypes, predict response to treatment or the development of side effects, and can serve as targets for novel therapeutic interventions. In this study, we evaluated small (< 200 nucleotide) and long (> 200 nucleotide) RNAs found in extracellular vesicles (EVs) isolated from the cerebrospinal fluid (CSF) and plasma of individuals with schizophrenia spectrum disorders (SSD) and healthy volunteers (HV). As EVs carry cargo from all tissues in the body, they act as a potential proxy for the tissue of origin, including cells from the brain. We compared the transcriptomic features of EVs from these two biofluids and examined their ability to discriminate between SSD and HV participants, identifying a total of 141 differentially expressed genes, some of which have been previously associated with SSD. Next, we evaluated the potential cell-types that give rise to the SSD-associated CSF RNA cargo, and found the majority were predominantly expressed in excitatory neurons. Our results highlight the potential of EVs as both a source of schizophrenia relevant biomarkers, and molecular insight into disease mechanisms.
Language Model Applications for Early Diagnosis of Childhood Epilepsy
Authors: Loyens Jitse , Slinger Geertruida , Doornebal Nynke , Braun Kees P.J. , Otte Willem M. , van Diessen Eric 
Published: February 2025

ABSTRACTObjectiveAccurate and timely epilepsy diagnosis is crucial to reduce delayed or unnecessary treatment. While language serves as an indispensable source of information for diagnosing epilepsy, its computational analysis remains relatively unexplored. This study assessed – and compared – the diagnostic value of different language model applications in extracting information and identifying overlooked language patterns from first-visit documentation to improve the early diagnosis of childhood epilepsy.MethodsWe analyzed 1,561 patient letters from two independent first seizure clinics. The dataset was divided into training and test sets to evaluate performance and generalizability. We employed two approaches: an established Naïve Bayes model as a natural language processing technique, and a sentence-embedding model based on the Bidirectional Encoder Representations from Transformers (BERT)-architecture. Both models analyzed anamnesis data only. Within the training sets we identified predictive features, consisting of keywords indicative of ‘epilepsy’ or ‘no epilepsy’. Model outputs were compared to the clinician’s final diagnosis (gold standard) after follow-up. We computed accuracy, sensitivity, and specificity for both models.ResultsThe Naïve Bayes model achieved an accuracy of 0.73 (95% CI: 0.68-0.78), with a sensitivity of 0.79 (95% CI: 0.74-0.85) and a specificity of 0.62 (95% CI: 0.52-0.72). The sentence-embedding model demonstrated comparable performance with an accuracy of 0.74 (95% CI: 0.68-0.79), sensitivity of 0.74 (95% CI: 0.68-0.80), and specificity of 0.73 (95% CI: 0.61-0.84).ConclusionBoth models demonstrated relatively good performance in diagnosing childhood epilepsy solely based on first-visit patient anamnesis text. Notably, the more advanced sentence-embedding model showed no significant improvement over the computationally simpler Naïve Bayes model. This suggests that modeling of anamnesis data does depend on word order for this particular classification task. Further refinement and exploration of language models and computational linguistic approaches are necessary to enhance diagnostic accuracy in clinical practice.