bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hypoxia‐inducible microRNA‐155 negatively regulates epithelial barrier in eosinophilic esophagitis by suppressing tight junction claudin‐7
Authors: Markey Gary E. , Ryan Sinéad , Furuta Glenn T. , Menard‐Katcher Calies , McNamee Eoin N. , Masterson Joanne C. 
Published: December 2023

AbstractMicroRNA (miRNA)‐mediated mRNA regulation directs many homeostatic and pathological processes, but how miRNAs coordinate aberrant esophageal inflammation during eosinophilic esophagitis (EoE) is poorly understood. Here, we report a deregulatory axis where microRNA‐155 (miR‐155) regulates epithelial barrier dysfunction by selectively constraining tight junction CLDN7 (claudin‐7). MiR‐155 is elevated in the esophageal epithelium of biopsies from patients with active EoE and in cell culture models. MiR‐155 localization using in situ hybridization (ISH) in patient biopsies and intra‐epithelial compartmentalization of miR‐155 show expression predominantly within the basal epithelia. Epithelial miR‐155 activity was evident through diminished target gene expression in 3D organotypic cultures, particularly in relatively undifferentiated basal cell states. Mechanistically, generation of a novel cell line with enhanced epithelial miR‐155 stable overexpression induced a functionally deficient epithelial barrier in 3D air–liquid interface epithelial cultures measured by transepithelial electrical resistance (TEER). Histological assessment of 3D esophageal organoid cultures overexpressing miR‐155 showed notable dilated intra‐epithelial spaces. Unbiased RNA‐sequencing analysis and immunofluorescence determined a defect in epithelial barrier tight junctions and revealed a selective reduction in the expression of critical esophageal tight junction molecule, claudin‐7. Together, our data reveal a previously unappreciated role for miR‐155 in mediating epithelial barrier dysfunction in esophageal inflammation.
Evaluating the success of an inpatient PA and NP program through trends in ED consults
Authors: Stock Laura , Turcotte Justin , Johnson Andrea , Holbert Samuel E. , Siska Matthew , Pipkin Karen , Patton Chad 
Published: December 2023

ABSTRACT

Objective:
We investigated the effect of an inpatient physician associate/assistant (PA) and NP program on consult volume, length of stay (LOS), and ED returns.

Methods:
A retrospective observational study of 4,118 orthopedic ED consults was conducted from January 2017 to March 2022. Univariate statistics were used to evaluate outcomes between cohorts and multivariate regression to evaluate the odds of an LOS of less than 24 hours.

Results:
After implementation of the PA and NP program, surgeon consults steadily declined and orthopedic consults increased markedly. Statistically significant differences were found in LOS of less than 24 hours and ED arrival-to-discharge time. Adjusting for case mix, patients were 47% more likely to be discharged within 24 hours. Survey results noted that more than 80% of surgeons felt on-call workload, disruptions to clinic and surgical schedules decreased, and quality of care increased.

Conclusions:
Implementation of an inpatient PA and NP program reduced orthopedic surgeon consults and hospital LOS while improving surgeon satisfaction with on-call workload, schedule disruptions, and quality of care.
A practical tool for managing change: Cross-sectional psychometric assessment of the safe surgery organizational readiness tool
Authors: Hayirli Tuna Cem , Meara John G. , Abahuje Egide , Alayande Barnabas , Augustin Sylvio , Barash David , Boatin Adeline A. , Kalolo Albino , Kengia James , Kingpriest Paul , Kissima Innocent , Lugazia Edwin R. , Mpirimbanyi Christophe , Ngonzi Joseph , Njai Abdoulie , Smith Victoria L. , Kapologwe Ntuli , Alidina Shehnaz 
Published: December 2023

Background:
Strengthening health systems through planned safety and quality improvement initiatives is an imperative to achieve more equitable, resilient, and effective care. And yet, years of organizational behavior research demonstrate that change initiatives often fall short because managers fail to account for organizational readiness for change. This finding remains true especially among surgical safety and quality improvement initiatives in low- and middle-income countries. In this study, our aim was to psychometrically assess the construct validity and internal consistency of the Safe Surgery Organizational Readiness Tool (SSORT), a short survey tool designed to provide change leaders with insight into facility infrastructure that supports learning and readiness to undertake change.

Materials and Methods:
To demonstrate generalizability and achieve a large sample size (n=1,706) to conduct exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), a collaboration between seven surgical and anesthesia safety and quality improvement initiatives was formed. Collected survey data from health care workers were divided into pilot, exploration, and confirmation samples. The pilot sample was used to assess feasibility. The exploration sample was used to conduct EFA, while the confirmation sample was used to conduct CFA. Factor internal consistency was assessed using Cronbach’s alpha coefficient.

Results:
Results of the EFA retained 9 of the 16 proposed factors associated with readiness to change. CFA results of the identified 9 factor model, measured by 28 survey items, demonstrated excellent fit to data. These factors (appropriateness, resistance to change, team efficacy, team learning orientation, team valence, communication about change, learning environment, vision for sustainability, facility capacity) were also found to be internally consistent.

Conclusion:
Our findings suggest that communication, team learning, and supportive environment are components of change readiness that can be reliably measured prior to implementation of projects that promote surgical safety and quality improvement in low- and middle-income countries. Future research can link performance on identified factors to outcomes that matter most to patients.
The efficacy and safety of hydrotherapy in patients with knee osteoarthritis: a meta-analysis of randomized controlled trials
Authors: Lei Changjiang , Chen Haiting , Zheng Su , Pan Qingyun , Xu Jing , Li Yuan , Liu Yang 
Published: December 2023

Background:
Currently, there is poor evidence of the effect of hydrotherapy on patients with knee osteoarthritis (OA). The authors performed a meta-analysis from randomized controlled trials to determine the efficacy and safety of a hydrotherapy program on measures of pain and knee function in individuals living with knee OA.

Methods:
A literature review included PubMed, EMBASE, Cochrane Library, Science Citation Index, ScienceDirect, and Ovid. Studies evaluating the efficacy of hydrotherapy for knee OA up to August 2023 were included. The research was reported based on the preferred reporting items for systematic reviews and meta-analysis guidelines to ensure the reliability and verity of results. Statistical analysis was performed using Stata/SE version 15.0.

Results:
A total of six randomized controlled trials were included for data extraction and meta-analysis. The present study revealed that there were significant differences between the two groups regarding the pain intensity at 1 week (WMD=−0.429; 95% CI: −0.679 to −0.179; P=0.001), 4 week (WMD=−0.308; 95% CI: −0.587 to −0.030; P=0.030) and 8 week (WMD=−0.724; 95% CI: −1.099 to −0.348, P<0.001). Furthermore, hydrotherapy was associated with improved outcome of the Western Ontario and McMaster Universities Arthritis index at 1 week (WMD=−3.314; 95% CI: −6.484 to −0.145, P=0.040), 4 week (WMD= −3.630; 95% CI: −6.893 to −0.366, P=0.029) and 8 week (WMD=−3.775; 95% CI: −7.315 to −0.235; P=0.037). No serious adverse events were observed in all patients who received hydrotherapy.

Conclusion:
Hydrotherapy is efficacious and safe for reducing pain and improving functional status in individuals with knee OA, without increasing the risk of adverse effects.
Spontaneous recurrent menstrual pneumothorax: a case report
Authors: Hirono Takae , Feng Ye , Wang Wenhui , Yu Huan 
Published: December 2023

Introduction and importance:
Endometriosis is most commonly found in the pelvic area, ~12% of people have it in other areas or organs, which is known as extrapelvic endometriosis. Thoracic endometriosis, which is also classified as extrapelvic endometriosis, manifests with four distinct forms: catamenial pneumothorax, catamenial hemothorax, catamenial hemoptysis, or lung nodules. Catamenial pneumothorax is the most common clinical symptom of these; however, it is frequently neglected by clinicians and goes undiagnosed and untreated. As a result, it is critical to raise awareness of this medical condition among clinicians.

Case presentation:
The authors present a case report of a 34-year-old woman of reproductive age who had recurrent episodes of spontaneous pneumothorax during menstruation and underwent treatment with thoracoscopic surgery as well as gynaecological hormonal drugs including oral progesterone and dienogest throughout this time. Based on her symptoms, a catamenial pneumothorax caused by thoracic endometriosis was suspected.

Clinical discussion:
The clinical symptoms, pathogenesis, diagnosis, and treatment of Catamenial Pneumothorax are analyzed. Furthermore, the usage of gynaecological hormone medications in this condition has been discussed. The mechanisms of oral contraceptives and progestin-based medications are evaluated by comparing the patient’s treatment process, highlighting their pros and cons.

Conclusions:
Thoracoscopic surgery combined with postoperative gynaecological hormonal medications may be the most effective treatment for this issue. Several gynaecological hormonal medicines are available, each of which has its own set of pros and cons, and must be thoroughly evaluated as well as correctly tailored to the patient’s specific circumstances to have a positive therapeutic outcome.
Diagnosis of systemic sarcoidosis in a patient with bilateral granulomatous pan-uveitis: a case report
Authors: Thapaliya Shreeya , Pant Prashant , Paudel Sandip , Ghimire Sujha 
Published: December 2023

Introduction and importance:Sarcoidosis is a systemic disease usually presenting with features of hilar lymphadenopathy like persistent cough, dyspnoea, cough, night sweats. However, its first and only manifestation can be ocular symptoms consistent with uveitis.Case presentation:The authors present such association in a 53-year-old female who had ocular symptoms on and off, designated as uveitis. Despite medications, her symptoms rather flared up. On diagnostic assesement done years later, chest X-ray showed bilateral hilar lymphadenopathy, serum angiotensin-converting enzyme levels were also raised, and the diagnosis of systemic sarcoidosis was confirmed.Clinical discussion:Eye involvement can occur way before the systemic presence of the disease is detected and can be present clinically as an isolated entity which makes diagnosis of underlying sarcoidosis a challenge.Conclusion:Consideringsarcoidosis as one of the differential diagnosis when attending patients with non-resolving uveitis remains the mainstay of this report.
Evaluating Skill-Mix Models of Care
Authors: Cermak Carly A. , Bruno Frances , Jeffs Lianne 
Published: December 2023

OBJECTIVE
To synthesize the literature on measures and outcomes for skill-mix models of care.

BACKGROUND
To address the human health resource crisis, changes to skill mix within models of care are being implemented emphasizing the need to synthesize evaluation methods for skill-mix models in the future.

METHODS
A scoping review of the literature using a rigorous search strategy and selection process was completed to identify articles that examined skill-mix models in an effort to identify related concepts.

RESULTS
Ten studies examined skill-mix models. Areas of measurement in assessing the impact of skill-mix models included patient outcomes, patient satisfaction, nurse satisfaction, cost, and nurse perceptions of role changes, model effectiveness, and quality of care. Studies examining nurse satisfaction, patient satisfaction, and/or cost generally reported improvements upon skill-mix model implementation. Studies examining patient outcomes related to skill mix were inconsistent.

CONCLUSIONS
Factors for consideration upon implementation of a skill-mix change include education of role clarity, the number of unregulated staff who require supervision, and professional practice support.
Microneedling Radiofrequency Enhances Poly-L-Lactic Acid Penetration That Effectively Improves Facial Skin Laxity without Lipolysis
Authors: Wu Xianglei , Cen Qingqing , Wang Xue , Xiong Ping , Wu Xiujuan , Lin Xiaoxi 
Published: December 2023

Background:
Microneedle fractional radiofrequency (MFR) is commonly used for skin laxity treatment, and poly-L-lactic acid (PLLA) can stimulate collagen synthesis in the body. However, the synergy of their combination for skin rejuvenation has not been proven. The authors aimed to evaluate the combined efficacy of PLLA and MRF and the potential mechanism underlying skin laxity.

Methods:
This prospective, randomized study included C57BL/6 mice treated with MFR, MFR plus PLLA, and carbon dioxide laser plus PLLA and 32 patients who underwent split-face treatments with MFR or MFR plus PLLA twice every 2 months. The Global Aesthetic Improvement Scale, Facial Laxity Rating scale of the whole face, the Echelle d’Evaluation Clinique des Cicatrices d’Acne grading scale of acne scars, and VISIA parameters on both treated sides were evaluated. Dermatologic changes were measured by ultrasonography in the submental space, and adverse events were documented.

Results:
PLLA was delivered by channels produced by MFR but not carbon dioxide laser in the mouse model. Thirty patients were treated with split-face MFR plus PLLA or MFR, revealing an improvement in VISIA wrinkle percentile (0.020) compared with the age-matched controls (0.000). The thickness of the dermis increased, whereas the fat layer did not change significantly. No adverse effects were observed.

Conclusions:
PLLA can be delivered through microchannels produced by MFR. PLLA enhances the efficacy of MFR for skin laxity without lipolysis.
Surgical Outcomes of Vertical Rectus Abdominis Myocutaneous Flap Pelvic Reconstruction
Authors: Asaad Malke , Mitchell David , Slovacek Cedar , Hassan Abbas M. , Rajesh Aashish , Liu Jun , Kapur Sahil , Baumann Donald , Butler Charles E. 
Published: December 2023

Background:
The vertical rectus abdominis myocutaneous (VRAM) flap has emerged as the workhorse flap for perineal and pelvic reconstruction. The authors aimed to evaluate outcomes of the VRAM flap over a 20-year period and the role of mesh abdominal wall reinforcement following VRAM flap–based reconstruction.

Methods:
The authors conducted a retrospective review of all consecutive patients who underwent pelvic reconstruction with a VRAM flap between January of 2001 and March of 2021. Our primary outcome measure included recipient and donor surgical-site occurrences (SSOs).

Results:
The authors identified a total of 546 patients (55% women) with a mean age of 58 years and mean body mass index of 27 kg/m2. Mesh was used at the time of VRAM reconstruction to reinforce the abdominal donor site in 36% of patients. Recipient SSOs occurred in 38% of patients, and donor SSOs occurred in 17% of patients. Hernia was identified in 9.9% of patients, and bulge developed in 6.4% of patients. The Cox proportional hazards regression model for hernia occurrence identified age, body mass index, tobacco use (hazard ratio, 2.03; 95% CI, 1.02 to 4.04), and use as an extended VRAM flap (hazard ratio, 2.13; 95% CI, 1.04 to 4.36). The use of mesh or component separation were not independent protective factors for hernia occurrence.

Conclusions:
The pedicled VRAM flap is versatile and is our preferred flap for reconstruction of pelvic and perineal defects. The use of mesh/component separation to allow for fascial closure was not shown to reduce donor-site hernia occurrence.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, IV.
Community engagement tools in HIV/STI prevention research
Authors: Li Chunyan , Zhao Peipei , Tan Rayner K.J. , Wu Dan 
Published: December 2023

Purpose of review
Community engagement is key to the success of sustainable public health interventions. This review highlights recent published studies that describe the use of community-engaged methods in sexually transmitted infection (STI) prevention research.

Recent findings
We organized the findings using a socio-ecological model. At the individual level, communities were engaged through participation in formative research, short-term consultations and community advisory board participation, as well as co-creation activities. At the interpersonal level, studies reviewed described peer-led interventions that leverage the influence and guidance of peers, patient-led interventions in the form of patient navigation and notification, as well as those that mobilize social networks and the power of social relationships to promote health. At the organizational and community level, multisectoral, multifacility collaborations between community, government, and academic stakeholders were highlighted. At the policy and population level, communities were engaged through community dialogues to disseminate research findings, as well as in developing strategic frameworks and clinical guidelines. Digital tools have also been leveraged for effective community engagement.

Summary
Communities have an effective role to play in STI prevention and can be engaged at multiple levels. Future efforts may consider the use of community engagement tools highlighted in this review, including digital technologies that have the potential to reach more diverse end-users.
Skin and soft tissue infections in solid organ transplants
Authors: Peghin Maddalena , Graziano Elena , Grossi Paolo Antonio 
Published: December 2023

Purpose of review
Skin and soft tissue infections (SSTI) in solid organ transplant (SOT) recipients may be a great challenge for clinicians caring for SOT due to the involvement of both common and opportunistic pathogens associated with a blunted immune response. The purpose of this review is to outline current literature and describe open issues on the management of SSTI in this special population.

Recent findings
Clinical presentation in SOT recipients can manifest as isolated skin lesions after primary inoculation or be the sign of a disseminated infection. Tissue samples for microscopy and histopathology are crucial to making an accurate diagnosis given the nonspecific and heterogeneous appearance of skin lesions. Multidisciplinary teams are required for a comprehensive diagnosis and management.

Summary
SSTI are frequent contributors to morbidity and mortality in SOT. Specific research focused on the clinical presentation, risk factors and management in this special population is needed.
177Lu-DOTATATE in the Treatment of Recurrent Pheochromocytoma With Multiple Metastases
Authors: Su Dan , Zhang Yu , Li Zhuoyuan , Yang Hongyu , Chen Yue 
Published: December 2023

Abstract
The treatment of metastatic pheochromocytoma is challenging. We report a case of a woman with recurrent pheochromocytoma with multiple metastases who achieved excellent response after 4 cycles of 177Lu-DOTATATE therapy. She did not experience any observable adverse effects. Her disease was still stable 6 months after the fourth cycle of treatment.
“It’s Incapacitated me in so Many Ways”
Authors: Keny Christina , Dillon Ellis C. , Russell Marcia M. , Colley Alexis , Yank Veronica , Tang Victoria 
Published: December 2023

Objective:
This qualitative study aimed to explore the challenges faced by older adults regarding the postoperative symptom experience following major elective surgery.

Background:
Although extensively studied in oncology settings, the impact of postoperative symptom burden remains largely underexplored in elective major surgery among older adults.

Methods:
We employed convenience sampling to recruit adults aged ≥65 years undergoing major elective surgery at the University of California, San Francisco. Semi-structured interviews regarding the surgical experience were conducted at one and three months postoperatively. An inductive qualitative approach was used to identify emerging themes. Symptoms revealed by participants during interviews were also captured.

Results:
Nineteen participants completed a one-month postoperative interview, and seventeen additionally completed a three-month interview. Three themes emerged: 1) postoperative symptoms significantly impacted valued life activities and psychosocial well-being, 2) participants felt “caught off guard” by the intensity and duration of postoperative symptoms, and 3) participants expressed the need for additional support, resources, and education on symptom management. The most frequently mentioned symptoms were postoperative pain (n=12, 63.1%), gastrointestinal discomfort (n=8, 42.1%), and anxiety/stress (n=8, 42.1%) at one-month post-surgery, compared to pain and depression (both n=6, 35.3%) at three months.

Conclusions:
Study participants were surprised by the negative impact of postoperative symptoms on their psychosocial well-being and ability to engage in valued life activities. Symptom burden is an important patient-reported outcome that should be assessed postoperatively. Interventions to minimize postoperative symptom burden in older adults could optimize quality of life and participation in meaningful activities during surgical recovery.
A Systematic Review of Literatures: To Identify Non-Cancer Drugs Repurposed for Lung Cancer
Authors: Samadder Saikat 
Published: December 2023

AbstractAimThe aim of this study is to identify literature suggesting drug repurposing based on various medicines found to possess enhanced efficacy against lung cancer in humans based on pre-clinical and retrospective analysis. Often pre-clinical and retrospective study findings may deviate from the results of randomized prospective clinical studies, this study intends to identify the efficacious new drugs against lung cancer in placebo-controlled studies.MethodsA systematic review of literature was performed in PubMed database on 30thAugust 2023 without any fixed timeline with terms related to ‘drug repurposing’ and ‘Lung cancer’. Post screening of literature, the names of non-chemo drugs identified were further searched inclinicaltrials.govadditionally NCT# was searched in google scholar, in-case the trial results were not available in respective source to validate the study findings.ResultsIn PubMed 513 articles were found, 9% articles mentioned about drugs with potential efficacy against lung cancer in humans. In these 45 articles 61 non-chemo drugs were identified from specific 293 clinical studies. Among these 30 studies for 23 drugs were in advanced clinical stage and 9 non-chemo medicines were identified to have positive results in randomized controlled clinical trials, rest of the drugs failed to attend designated clinical efficacy till-date. Anti-alcoholism, anti-bacterial, anti-emetics, cox-2 inhibitors, and HMG-CoA reductase inhibitor are the drugs that could potentially effective against advanced non-small cell lung cancer.ConclusionApplying the advanced search methodology to identify drugs repurposed or approved for targeted disease. All these 9 non-chemo were screened under randomized trial and currently only one drug disulfiram was found to enhance survival and response, reduced disease progression, in advanced NSCLC originally indicated for anti-alcoholism.