bluuebunny/crossref_metadata_2025_split huggingface dataset:
Influence of short-lived radioiodines other than 131I on screening direct thyroid measurements with TCS-172 NAI(TL) survey meters
Authors: Tani Kotaro , Kim Eunjoo , Yajima Kazuaki , Naito Masayuki , Ishigure Nobuhito , Beaumont Tiffany , Broggio David , Kurihara Osamu 
Published: December 2023

Abstract
In a nuclear emergency, one of the actions taken for the sake of public is to monitor thyroid exposure to radioiodines. Japan’s Nuclear Regulation Authority recently published a report on such monitoring and proposed direct thyroid measurements with conventional NaI(Tl) survey meters (e.g. Hitachi model TCS-172) as a primary screening method. A previous study proposed screening levels (SLs) used in these simplified measurements as the net reading values of the TCS-172 device. Age-specific SLs were derived from a thyroid equivalent dose of 100 mSv due to the inhalation intake of 131I. This study addressed the possible influence of short-lived iodine isotopes other than 131I on the simplified measurements. In preparation for such measurements, the responses of the device for 132I as an ingrowth component from 132Te, 133I, 134I and 135I in the thyroid were evaluated by numerical simulations using age-specific stylized phantoms in addition to those obtained for 131I in the previous study. The radioactivity ratios of the relevant isotopes were taken from the inventory data of the Fukushima Daiichi Nuclear Power Plant. The results were used to predict the net readings of the device when 132Te-132I and 133I as well as 131I were inhaled at 24 or 72 h after the shutdown of a nuclear power plant. In these cases, the signals from 132Te-132I and 133I become undetectable a couple of days after intake, which could lead to underestimations of the thyroid dose. To estimate the thyroid dose accurately from the simplified measurements, it is necessary to identify the exact time of intake after the shutdown and the actual physiochemical property of 132Te that affects the thyroid uptake of 132I.
Patella and Trochlea Osteochondritis Dissecans: Demographics and Treatment Paradigms
Authors: Kiani Sara N. , Yellin Joseph L. , Huffman William H. , Guzek Ryan H. , Shea Kevin G. , Nguyen Jie C. , Ganley Theodore J. 
Published: December 2023

Objective:
Previous research on patellar and trochlear groove osteochondritis dissecans (OCD) is limited by small sample sizes. This study aims to describe the presentation of patients with OCD lesions of the patella and trochlea and characterize the outcomes of operative and nonoperative treatments.

Methods:
This retrospective cohort study identified all patients from a single institution from 2008 to 2021 with patellar and/or trochlear OCD lesions. Patients were excluded from the study if surgical records were unavailable or if the patient had knee surgery for a different injury at index surgery or in the 12 months postoperative. Minimum follow-up was 12 months. Outcomes included a return to sports (RTS), pain resolution, radiographic healing, and treatment “success” (defined as full RTS, complete pain resolution, and full healing on imaging).

Results:
A total of 68 patients (75 knees) were included—45 (60%) with patellar OCD and 30 (40%) with trochlear. Of the patients, 69% were males. The median age at knee OCD diagnosis was 14 years. At the final follow-up, 62% of knees (n = 44) recovered sufficiently to allow a full RTS and 54% of knees (n = 39) had full pain resolution. Of the 46 knees with radiographic imaging at least 1 year apart, 63% had full healing of the lesion. There was no significant difference in RTS, pain resolution, radiographic healing, or overall success when comparing treatments.

Conclusions:
This study provides valuable epidemiologic demographic and outcome data regarding the scarcely reported patellar and trochlear OCD. While over half of patients fully returned to sports and reported full pain resolution, a large proportion continued to experience symptoms over a year after presentation. Future research should aim to better define the treatment algorithms for these OCD subtypes.

Level of Evidence:
Level III.
Think Twice: De-Implementation of Laboratory Testing After Colorectal Surgery
Authors: Dave Yatee A. , Temple Larissa , Juviler Peter , Nabozny Michael J , Cvetanovska Marija , Wakeman Derek , Cannon Lisa M. 
Published: December 2023

BACKGROUND:
Clinically unindicated laboratory testing contributes to low-value care. Most postoperative day one labs after colorectal surgery are normal. However, no published interventions have shown reducing overall postoperative laboratory testing is safe.

OBJECTIVE:
The aim of this study was to investigate the impact of reducing postoperative laboratory testing after colorectal surgery.

DESIGN:
This is a quality improvement study.

SETTINGS:
The study was conducted at an academic center with an enhanced recovery after surgery program including 5 daily labs until discharge.

PATIENTS:
All adults undergoing colorectal or small bowel surgery formed intervention and non-intervention cohorts based on surgeons who chose to opt-into the study. Pre-implementation (November 2019 – October 2021) there were 545 intervention and 577 non-intervention patients. post-implementation (November 2021 – March 2023) there were 448 intervention and 437 non-intervention patients.

INTERVENTIONS:
The intervention included 3 postoperative day one labs and subsequent clinically indicated labs.

MAIN OUTCOME MEASURES:
Outcome measures included laboratory tests and lab-free days.

RESULTS:
Post-intervention, the intervention group had a 33% reduction in labs per hospital stay, 26% reduction in labs per day, and 49% increase in lab-free days. There was no difference in length of stay (4 v 4; p = 0.79) or readmissions (14.9% v 12.9%; p = 0.39). The non-intervention group had no significant changes in lab work or lab-free days, with no differences in length of stay (4 v 4; p = 0.49) or readmissions (11.1% v 11.0%; p = 0.96).

LIMITATIONS:
Demographics and complication rate were not reported.

CONCLUSIONS:
An intervention targeting reflexive laboratory testing after colorectal surgery resulted in safe, significant, sustained reductions in postoperative lab work, with substantial cost savings. These findings prompted a change in the laboratory order set to an opt-out system, and lab work reduction approaches have been implemented within other surgical divisions. Continuation and spread of these efforts are instrumental for prioritization of high-value surgical care. See Video Abstract at http://links.lww.com/DCR/Bxxx.
Clinical Observation or Further Excision: A Retrospective Review of Margin-positive Squamous and Basal Cell Carcinomas
Authors: Alkhatib Bailey , Waler Alexandria , Welch Madelyn , McCarthy Jack , Nam Arthur , Friedman Harold I. 
Published: December 2023

Background:
Patients determined to have margin-positive nonmelanoma skin cancer (NMSC) after initial shave or punch biopsy performed by a primary care physician or dermatologist are commonly referred to extirpative surgeons for definitive removal. Not infrequently, the residual tumor is not appreciable, and the exact location of the lesion is indiscernible. The consulting surgeon must decide to excise the presumed lesion or clinically monitor for recurrence.

Methods:
This single-center, retrospective review examined patients with squamous and basal cell carcinomas referred over a 5-year period to two senior authors.

Results:
In total, 233 patients had a total of 312 lesions excised. Thirty-nine (12.5%) of these lesions (in 33 patients) demonstrated no residual tumor on pathologic examination. Twelve patients were managed nonoperatively (5.15%) and observed to have had no tumor recurrence with a mean observation period of 14.66 months (range 1–54 months). Thus, approximately 19.3% of all patients referred had no residual tumor.

Conclusion:
Based on our observations and low proclivity for metastases, nonoperative monitoring of NMSC may be a reasonable option for certain lesions less than 1 cm that are undiscernible at the time of referral.
Mineralocorticoid receptor antagonist treatment in patients with renal insufficiency and the associated risk of hyperkalemia and death
Authors: Hedlund Møller Sara , Haagensen Kofod Dea , Schou Morten , Torp-Pedersen Christian , Gislason Gunnar , Carlson Nicholas , Lindhardt Morten 
Published: December 2023

Objectives:
Mineralocorticoid receptor antagonist (MRA) treatment is kidney protective but not recommended to patients with advanced renal failure due to the risk of hyperkalemia and death. This study aimed to examine the impact of MRA treatment in patients with chronic kidney disease on risk of hyperkalemia and subsequent mortality.

Methods:
Rates of hyperkalemia were compared across strata of estimated glomerular filtration rate (eGFR) and MRA treatment based on cox regression using a nested case–control framework with 1 : 4 matching of patients with hyperkalemia (K+ ≥6.0 mmol/l) with controls from the Danish general population on age, sex, diabetes, and hypertension. Risk of subsequent 30-day mortality was assessed in a cohort study with comparisons across strata of eGFR and MRA treatment based on multiple Cox regression.

Results:
Thirty-two thousand four hundred twenty-six cases with hyperkalemia were matched with 127 038 controls. MRA treatment was associated with an increased rate of hyperkalemia with hazard ratios [95% confidence interval (95% CI)] of 8.28 (7.78–8.81), 5.12 (4.67–5.62), 3.58 (3.23–3.97), and 1.89 (1.60–2.23) in patients with eGFR at least 60, 45–59, 30–44, and less than 30 ml/min/1.73 m2, respectively (Reference: No MRA).
However, MRA-exposed patients had a lower 30-day mortality risk following hyperkalemia with absolute risks (95% CI) of 29.3% (27.8–31.1), 20.3% (18.7–22.4), 19.5% (17.9–21.7), and 19.7% (17.4–22.5) compared to 39.8% (38.8–40.8), 32.0% (30.7–33.1), 28.8% (27.5–31.2), and 22.5% (21.4–23.4) in patients without MRA exposure in patients with GFR at least 60, 45–59, 30–44, and less than 30 ml/min/1.7 3m2, respectively.

Conclusion:
MRA treatment was associated with an increased rate of hyperkalemia but decreased risk of subsequent 30-day mortality across all stages of renal impairment.
INDOCYANINE GREEN ANGIOGRAPHY OF OPTIC DISK GRANULOMA IN OCULAR SARCOIDOSIS
Authors: Soifer Matias , Nguyen Nam V. , Purt Boonkit , Bellur Sunil , Kodati Shilpa 
Published: December 2023

Purpose:
The aim of this study was to report novel indocyanine green angiography findings of optic disk granulomas secondary to sarcoidosis.

Methods:
This was an observational case report.

Results:
A 36-year-old White man, who had previously been evaluated for birdshot chorioretinopathy and tested HLA-A29 negative, was referred for evaluation of choroidal lesions in both eyes. Fundus examination revealed ovoid choroidal lesions bilaterally in the posterior pole. Optical coherence tomography demonstrated bilateral focal choroidal elevations in the posterior pole and optic disks consistent with granulomas. Indocyanine green angiography revealed diffuse choroidal hypocyanescent spots with late-phase focal hypercyanescence of the optic disks in both eyes corresponding to the granulomas. After 3 months of prednisone and immunomodulatory treatment, the granulomas improved, and the optic disk hypercyanescence resolved.

Conclusion:
The authors describe a case of ocular sarcoidosis mimicking birdshot-like lesions, and indocyanine green angiography findings revealed late hypercyanescence, which resolved with treatment.
OPTIC NERVE HYPOPLASIA AND BILATERAL PERSISTENT FETAL VASCULATURE DUE TO TUBA1A TUBULINOPATHY
Authors: Ramirez David A. , Anninger William V. , Scoles Drew 
Published: December 2023

Purpose:
To describe a case of TUBA1A-associated optic nerve hypoplasia and persistent fetal vasculature.

Methods:
Observational case report.

Results:
A female, full-term infant was found to have a Dandy–Walker malformation with cerebellar and brainstem hypoplasia, ventriculomegaly, and lissencephaly. Her ophthalmic examination was notable for persistent fetal vasculature, optic nerve hypoplasia, vitreous hemorrhage, and peripheral retinal nonperfusion. Subsequent genetic testing revealed a TUBA1A genetic variant.

Conclusion:
Persistent fetal vasculature, peripheral retinal vascular abnormalities, and optic nerve hypoplasia may be associated with TUBA1A variants. These patients should be carefully evaluated with dilated retinal examination and fluorescein angiography to detect retinal perfusion abnormalities requiring treatment.
Glaucoma surgical procedures under development
Authors: Levin Ariana M. , Sheybani Arsham 
Published: December 2023

Purpose of review
Rapid innovation in glaucoma surgery is expanding surgical options in the angle, subconjunctival space, and supraciliary space.

Recent findings
Advancements in glaucoma surgery make it possible for surgeons to provide treatments with less risk. In particular, new devices and lasers are available for minimally invasive glaucoma surgeries. There are also new implants and techniques for bleb-forming glaucoma surgery.

Summary
As glaucoma surgeons have access to an increasing number of procedures, devices, and treatments, it is important for evidence to drive decision-making.
An Analysis of Biopsychosocial Factors Associated With Chronic Pain Severity Among Hospitalized People Living With HIV in Shenzhen, China: A Cross-Sectional Study
Authors: Wu Ni , Kong Hanhan , Han Lu , Chen Yongfeng , Bai Jinbing , Liu Yanqun 
Published: December 2023

Abstract
Chronic pain is a primary health problem in people living with HIV (PWH). However, there is limited research regarding chronic pain among PWH in Chinese health care settings. To investigate biopsychosocial factors of chronic pain severity, we conducted a cross-sectional study in Shenzhen, China. Chronic pain was defined as pain lasting for more than three months. Pain intensity was measured using the numeric rating scale (NRS). Among 123 hospitalized PWH, 78.86% of participants had mild pain and 21.14% had moderate–severe pain. Multiple logistic regression results indicated that PWH in moderate–severe pain group were more likely to have higher levels of interleukin [IL]-6 (OR = 1.034, 95% CI: 1.003–1.066, p = .029) and anxiety (OR = 1.334, 95% CI: 1.071–1.662, p = .010) than those in the mild chronic pain group. Targeted pain management interventions should be explored in clinical practices and future studies regarding PWH with high levels of IL-6 and anxiety.
KRAS-mutant colorectal cancer cell lines cause a prothrombotic state through the upregulation of thrombin: experimental study
Authors: Xu Duogang , Liao Changkang , Tan Jing 
Published: December 2023

Background:
The KRAS genotype status is strongly associated with a prothrombotic state in colorectal cancer, and hypercoagulability and cancer-related thrombosis are among the significant events leading to poor prognosis. However, this correlation has not been confirmed at the cellular level. This study aimed to assess the maximum platelet aggregation rate and thrombin expression induced by colorectal cancer cells under different KRAS genotypes.

Materials and methods:
Platelet aggregation rate assay and western blotting analysis were used to detect platelet aggregation and thrombin expression induced by four colorectal cancer cells with different KRAS genotypes, including RKO, HCT116, SW480, and SW620. FVIIa/tissue factor and thrombin inhibitors were added to explore changes in platelet aggregation rates induced by colorectal cancer cells and the association between KRAS genotype status and hypercoagulable state.

Results:
KRAS-mutant cells were more likely to increase maximal platelet aggregation, with RKO, HCT116, SW480, and SW620 inducing 34.7%, 55.4%, 44.4%, and 63.8% of platelet aggregation, respectively. The maximum platelet aggregation rate was higher in the metastatic rectal cancer tumour strain SW620 than in the primary rectal cancer strain SW480. RKO cells had lower thrombin expression than the other three cells. Furthermore, the addition of thrombin inhibitors caused a more significant decrease in the platelet aggregation rate in KRAS-mutant cell lines compared to KRAS wild-type cell lines.

Conclusion:
Compared to KRAS wild-type colorectal cancer cells, KRAS-mutant colorectal cancer cell lines were more likely to be hypercoagulable through the upregulation of thrombin expression, which was mainly achieved through the TF-thrombin pathway.
Women Veterans’ Barriers to Care-Seeking for Cardiovascular Disease Prevention
Authors: Orshak Jennifer , Ondoma Cissy , Johnson Heather M. , Lauver Diane 
Published: December 2023

Background
Women veterans have a high prevalence of traditional and nontraditional risks for cardiovascular disease (CVD) including obesity and posttraumatic stress disorder. Experts from the U.S. Department of Veterans Affairs have called for actions to improve the cardiovascular health of this population. One approach is to assess women veterans’ barriers to care-seeking for CVD prevention, to inform future intervention research.

Objective
The objective of this study was to describe women veterans’ barriers to care-seeking for CVD prevention, guided by the theory of care-seeking behavior and concept awareness.

Methods
Using a cross-sectional, descriptive design, a national sample of 245 women veterans participated in an online survey about barriers to care-seeking. Participants provided narrative responses to open-ended items, endorsements to closed-ended items, and rankings of their top five barriers. Researchers conducted poststratification weighting of numerical data to reflect the women veteran population.

Results
Narrative responses described unaffordable and inaccessible services, feeling harassed or not respected in healthcare settings, and lack of awareness of risks for CVD. Frequently endorsed barriers were unaffordable and inaccessible services. Frequently ranked barriers were feeling not respected in healthcare settings and clinicians not recommending CVD prevention.

Discussion
Findings support concepts in theory of care-seeking behavior and concept awareness. Understanding women veterans’ barriers to care-seeking for CVD prevention can inform clinicians and researchers as they address these barriers.
Systematic Review and Meta-Analysis of Psychological Distress and Acute Exacerbation of Chronic Obstructive Pulmonary Disease and Consequences
Authors: Kham-ai Prasert , Heaton Karen , Xiao Chunhong , Wheeler Pariya 
Published: December 2023

Background
People with chronic obstructive pulmonary disease (COPD) occasionally develop acute exacerbation of COPD—a potentially fatal condition. Psychological distress was associated with acute exacerbation of COPD. However, the evidence on the effect of psychological distress on acute exacerbation of COPD remains unclear.

Objective
The aim of this study was to explore the influence of psychological distress on acute exacerbation of COPD and its consequences.

Methods
The current review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines using three databases (PubMed, CINAHL, and PsyINFO) that were searched to identify relevant articles. Pooled risk ratios and 95% confidential interval were calculated from the included studies’ data with random-effect methods to estimate the effect of psychological distress on acute exacerbation of COPD and its consequences.

Results
Nineteen articles were included in the review. Most revealed that psychological distress was significantly associated with increased risk of acute exacerbation of COPD and its consequences. The meta-analyses showed that psychological distress increased risk of acute exacerbation of COPD, COPD-related hospitalization, and death.

Conclusion
Psychological distress had negative effects on acute exacerbation of COPD and its consequences. The results of the meta-analyses show that persons with COPD and psychological distress had a greater risk of acute exacerbation of COPD, hospitalization, and death.
The relation of body mass index and total symptom burden in female oncologic patients
Authors: Correa Ady M. , Molinares Diana , Tiozzo Eduard , Huang Laura 
Published: December 2023

Objectives:
Examine the relationship between obesity and symptom burden (SB) among female oncologic patients evaluated in cancer rehabilitation (CR) clinics. Secondary aims included evaluation of the relationship between obesity and SB among race, types of cancer, comorbid conditions and differences in symptom severity on the Edmonton Symptom Assessment Scale (ESAS) questionnaire across body mass index.

Background:
Obesity is a risk factor for some types of breast and gynecologic cancers. Studies have shown an increased risk for pain persistence and higher symptom severity experienced by obese female patients who undergo oncologic treatments. The severity of symptom burden (SB), however, has not been studied in obese oncologic patients in the rehabilitation medicine setting.

Methods:
Retrospective chart review study in CR clinics, single institution. All the medical records of female patients (n = 61) who completed ESAS on initial evaluation in CR clinics were evaluated, from August 2020 to January 2022.

Results:
Obese female patients reported increased SB based on the ESAS questionnaire, specifically three symptom domains: pain, drowsiness, and spiritual distress.

Conclusions:
Nutrition counseling and lifestyle modifications in CR clinics may positively impact SB.
Goal attainment with integrated upper limb spasticity management including botulinum toxin-A (BoNT-A): Subanalysis of Australian data from the ULIS-III study
Authors: Luk Edwin , Baguley Ian J. , Olver John , Nunan Rachael , Estell John , Gonzalez Senen , Marinkovich Dion , Grandoulier Anne-Sophie , Turner-Stokes Lynne 
Published: December 2023

Background:
Primary results from the international upper limb international spasticity-III study provided robust evidence for the benefit of repeated cycles of botulinum toxin-A (BoNT-A) for upper limb spasticity.

Objectives:
Internationally, patients with active function goals tended to require more frequent injections, and we hypothesized that reimbursement restrictions in Australia (which typically limited the number of injections received) may have adversely impacted outcomes compared with the international cohort.

Methods:
Upper Limb International Spasticity-III was a prospective, observational study following adults living with spasticity over 2 years of goal-directed upper limb spasticity management including repeated BoNT-A treatment.

Results:
The Australian subgroup included 115 patients (mean±SD age 53.8±16.9 years, 56% male, 79% stroke etiology), of whom 74% had previously been treated with BoNT-A. Australian participants had fewer injection cycles [2.7 (2.3, 3.0) vs. 4.1 (4.0, 4.3)] with longer injection intervals [330.6 (280.3, 381.0) vs. 200.3 (189.4, 211.1) days] than the international cohort. Across each evaluation cycle, patients in the Australian subgroup showed a change from baseline in Goal Attainment Scaling (GAS) T scores of >10, confirming relevant improvement. At 2 years, cumulated GAS T scores were 47.9 (46.4, 49.4) for the Australian subgroup versus 49.7 (49.3, 50.1) in the international cohort. Active function goals were generally underachieved in the Australian subgroup (mean cumulated GAS-T-score 43.6 (41.6, 45.6) vs. 47.4 (46.5, 48.3) internationally].

Conclusions:
As anticipated, the Australian cohort had fewer injection cycles with longer intervals than seen internationally. Their overall goal attainment was lower than for the total cohort, which appeared to be driven by less active function goal attainment. Among other possible factors, these data support the idea that restricted reimbursement may have impacted BoNT-A injection frequency and consequently, patient outcomes.