bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of Slim Linear Echoendoscope on the Practice of EUS
Authors: Bang Ji Young , Willems Philippe , Navaneethan Udayakumar , Hawes Robert , Varadarajulu Shyam 
Published: November 2023

Background:
Standard linear echoendoscopes have a large distal tip and bending radius, which can preclude adequate examination in some patients.

Objective:
We examined the impact of having available slim linear echoendoscopes (SLE) on our endoscopic ultrasound (EUS) practice.

Materials and Methods:
As a quality improvement measure, data on the need for the use of SLE were documented in 2000 consecutive procedures performed over a 10-month period from February to November 2022. When examination using a standard size echoendoscope failed due to technical limitations, the procedure was reattempted in the same session using a SLE. The main outcome was the impact of SLE, which was defined as the establishment of a new diagnosis or if findings altered treatment plan.

Results:
A complete EUS examination failed in 23 of 2000 procedures (1.15%, 95% CI, 0.73-1.72%) performed using standard size echoendoscope (14 male, median age 73 y [IQR 66 to 79]). The examination was technically successful when using SLE in 22 of 23 (95.6%) patients. SLE impacted clinical management in all 22 patients (100%) by establishing tissue diagnosis in 19 and/or altering subsequent treatment plan in 5. Adverse event of transient hypoxia was observed in one patient (4.3%).

Conclusions:
A very experienced EUS team required SLE in 1.1% of consecutive examinations. Our findings suggest that when used, 95% of patients benefitted as it had a significant impact on their clinical management.
The Rosetta Stone of interactions of mucosa and associated bacteria in the gastrointestinal tract
Authors: Berberolli Serena , Wu Mengqi , Goycoolea Francisco M. 
Published: November 2023

Purpose of review
Gut microbiota–mucosa–epithelial cells co-exist in an intricate three-way relationship that underpins gut homeostasis, and ultimately influences health and disease conditions. The O-glycans of mucin glycoproteins have been uncovered as a centrepiece of this system, although understanding the phenomena at play at the molecular level has been challenging and subject to significant traction over the last years. The purpose of this review is to discuss the recent advances in the phenomena that mediate microbiota and mucus multidirectional interactions in the human gut.

Recent findings
The mucus biosynthesis and degradation by both commensal and pathogenic bacteria is under tight regulation and involves hundreds of carbohydrate-active enzymes (CAZy) and transporters. The fucosylation of O-glycans from mucin-2 seems to dictate binding by pathogenic species and to influence their virulence. Less clear is the influence of O-glycans in quorum sensing and biofilm formation. We have reviewed the advances in the in vitro models available to recreate the phenomena that capture the physiological context of the intestinal environment, emphasising models that include mucus and other aspects relevant to the physiological context.

Summary
The recent findings highlight the importance of merging advances in analytical (glycans analysis) and omics techniques along with original robust in vitro models that enable to deconstruct part of the high complexity of the living gut and expand our understanding of the microbes-mucosa relationships and their significance in health and disease.
Cavernous hemangioma of the breast: a case report
Authors: Adhikari Shankar , Bhatta Om Prakash , Bhetwal Prashant 
Published: November 2023

Background:
Hemangioma is a common benign tumor resulting from abnormal blood vessel growth but is infrequent in the breast. Preoperatively, it is challenging to diagnose breast hemangioma using clinical and conventional imaging modalities because of their lack of pathognomonic characteristics. An excisional biopsy can be used for tissue diagnosis in cases of diagnostic uncertainty.

Case presentation:
The authors report a case of cavernous hemangioma of the breast in a 15-year-old adolescent female complaining of a rapidly enlarging firm and mobile lump in the right breast. Breast ultrasonography revealed a well-circumscribed, encapsulated, heteroechoic mass with smooth margins in the retroareolar region of the right breast. Subsequent excision of the lump revealed features of a cavernous hemangioma, and the follow-up was uneventful.

Discussion:
Cavernous hemangioma of the breast is a rare entity, and its diagnosis poses a significant challenge for clinicians, as the lump may not be noticeable. The clinical diagnosis is challenging; therefore, imaging is required. Breast ultrasonography typically shows a hypoechoic lobulated mass with clear borders, although isoechoic and hyperechoic appearances are also possible. Breast mammography revealed a well-defined mass with areas of calcification. Surgical excision is often necessary when there is a discordance between imaging and histopathological findings, lesions greater than 2 cm, and atypical/malignant features.

Conclusion:
Breast hemangiomas are rare benign tumors with nonspecific imaging features that require tissue sampling for diagnosis. Clinicians should be familiar with these characteristics to ensure proper management.
Understanding the Impact of Deviant Peer Association on Dual Systems Model Development
Authors: Wojciechowski Thomas 
Published: November 2023

Abstract
Recent research has indicated that deviant peers may play a role in cognitive development. This is particularly the case for the dual systems model, a key framework for understanding engagement in antisocial behavior during adolescence and emerging adulthood. However, limited research has examined how preexisting mental health concerns may moderate these relationships. This study used the Pathways to Desistance data to examine attention deficit hyperactivity disorder (ADHD) as a moderator of the relationships between deviant peer association and dual systems model constructs. Generalized estimating equations were used to test these relationships. Results indicated that deviant peer association and the presence of ADHD both predicted increased sensation-seeking and lower impulse control. ADHD significantly moderated the relationship between deviant peer association and impulse control, indicating a weaker impact of deviant peer association on impulse control among participants with ADHD. No significant interaction was observed for the relationship between deviant peer association and sensation-seeking.
Recommendations From a Systematic Review of Leadership Development to Support a New Nursing Practice Model
Authors: Foots Lozay , Swiger Pauline A. , Orina Judy , Campbell Caitlin Marley , Javed Mariyam , Hodson Patricia , Patrician Patricia A. 
Published: November 2023

OBJECTIVE
To develop a new nursing practice model for use within the US military, researchers aimed to create evidence-based recommendations for nursing leadership development based on current literature.

BACKGROUND
The role of nursing leadership has many implications, including better nurse and patient outcomes. Therefore, an actionable compilation of recommendations informing how to develop effective nurse leaders could be helpful for current and aspiring nurse leaders.

METHODS
Researchers conducted a systematic literature review of 5 databases searching for relevant articles published from 2001 to 2020.

RESULTS
Seventy-eight articles were synthesized to develop a list of 5 broad yet actionable recommendations for leadership development.

CONCLUSIONS
Leadership development is essential for current and future nurse leaders. The recommendations identified from this review can assist in developing leaders. Leaders can use these recommendations to guide leadership training initiatives, engage in self-development, or begin succession planning.
New Graduate Nurses' Competencies, Organizational Socialization, and Turnover Intention
Authors: Song Youngkwan , Kim Jung A 
Published: November 2023

OBJECTIVE
This study aimed to identify core competencies in new-graduate nurses (NGNs) by determining which competencies affected their organizational socialization (OS) and turnover intention (TI) in their 1st year of employment.

BACKGROUND
NGNs face stressful transitions with expanded nursing responsibilities that motivate them to leave their jobs. Therefore, NGN turnover in the 1st year of practice is higher than the overall nurse turnover rate. Previous research suggested that NGNs' competency levels affect their OS and TI. However, little research has been done to determine which competencies affect these variables.

METHODS
Multiple linear regression analysis was performed on cross-sectional survey data to determine the effects of NGN work competencies on OS and TI.

RESULTS
Health promotion, supervision, interpersonal communication, and direct care competencies significantly predicted NGNs' OS, and computer technology competency significantly predicted NGNs' TI.

CONCLUSIONS
NGNs should be given early opportunities for expanded hands-on clinical experiences along with clear awareness of the organization's goals and values. Moreover, they should be offered roles that take advantage of their computer technology skills and that challenge them to contribute to their organization and nursing care in new ways.
Death by Neurologic Criteria in Children Undergoing Extracorporeal Cardiopulmonary Resuscitation: Retrospective Extracorporeal Life Support Organization Registry Study, 2017–2021
Authors: Joye Raphael , Cousin Vladimir L. , Wacker Julie , Hoskote Aparna , Gebistorf Fabienne , Tonna Joseph E. , Rycus Peter T. , Thiagarajan Ravi R. , Polito Angelo 
Published: November 2023

OBJECTIVES:To determine factors associated with brain death in children treated with extracorporeal cardiopulmonary resuscitation (E-cardiopulmonary resuscitation).DESIGN:Retrospective database study.SETTINGS:Data reported to the Extracorporeal Life Support Organization (ELSO), 2017–2021.PATIENTS:Children supported with venoarterial extracorporeal membrane oxygenation (ECMO) for E-cardiopulmonary resuscitation.INTERVENTION:None.MEASUREMENTS AND MAIN RESULTS:Data from the ELSO Registry included patient characteristics, blood gas values, support therapies, and complications. The primary outcome was brain death (i.e., death by neurologic criteria [DNC]). There were 2,209 children (≥ 29 d to < 18 yr of age) included. The reason for ECMO discontinuation was DNC in 138 patients (6%), and other criteria for death occurred in 886 patients (40%). Recovery occurred in 1,109 patients (50%), and the remaining 76 patients (4%) underwent transplantation. Fine and Gray proportional subdistribution hazards’ regression analyses were used to examine the association between variables of interest and DNC. Age greater than 1 year (p< 0.001), arterial blood carbon dioxide tension (Paco2) greater than 82 mm Hg (p= 0.022), baseline lactate greater than 15 mmol/L (p= 0.034), and lactate 24 hours after cannulation greater than 3.8 mmol/L (p< 0.001) were independently associated with greater hazard of subsequent DNC. In contrast, the presence of cardiac disease was associated with a lower hazard of subsequent DNC (subdistribution hazard ratio 0.57 [95% CI, 0.39–0.83]p= 0.004).CONCLUSIONS:In children undergoing E-cardiopulmonary resuscitation, older age, pre-event hypercarbia, higher before and during ECMO lactate levels are associated with DNC. Given the association of DNC with hypercarbia following cardiac arrest, the role of Paco2management in E-cardiopulmonary resuscitation warrants further studies.
The Impact of Mindfulness-Based Interventions on Objective Physiological Measures of Autonomic Function for Individuals With Medical Conditions: A Review of the Evidence
Authors: Churchill Rachel , Swartz Brenda , Johnston-Dumerauf Anneka , Halaris Angelos 
Published: November 2023

ABSTRACT

Objective
Autonomic dysregulation is common in many medical conditions and can have a widespread, negative impact on multiple bodily systems, leading to poorer health outcomes. Thus, addressing autonomic dysregulation as part of a comprehensive treatment plan is important. The goal of this study was to gain a better understanding of the physiological benefits of a mindfulness-based intervention (MBI) for a population with medical conditions, using validated, objective measures of autonomic functioning.

Methods
We conducted a review of the literature and followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocols. Studies were included if a) participants were diagnosed with a medical condition, b) an MBI was used, and c) objective pre/post measurements of autonomic nervous system function were collected. Medical conditions were included as a category for this review when a minimum of three articles met the criteria for inclusion.

Results
Ten articles met the criteria and included oncology, cardiac, and chronic pain conditions. Clinical recommendations were made based on the Clinical Practice Guideline Process Manual, 2017 Edition by the American Academy of Neurology.

Conclusions
Based on level of evidence, only oncology met the criteria for “possibly effective.” However, there was some evidence of the benefit of MBIs for all three medical conditions, based on individual study findings.
Financial Hardship and Age-Related Decrements in Kidney Function Among Black and White Adults in the Midlife in the United States Study
Authors: Surachman Agus , Harhay Meera , Santos Alexis R. , Daw Jonathan , Alexander Lacy M. , Almeida David M. , Coe Christopher L. 
Published: November 2023

ABSTRACT

Objective
This analysis examined if financial hardship was associated with age-related decrements in kidney function using a material-psychosocial-behavioral framework. We also tested if this association was mediated by comorbidity of cardiometabolic risk factors (obesity, elevated blood pressure, and insulin resistance).

Methods
Data from 1361 non-Hispanic Black and White adults (ages 26–94 years; non-Hispanic Black = 258) were obtained from the Wave 3 and Refresher phases of the Midlife in the United States project. Kidney function was based on serum creatinine–based estimated glomerular filtration rate (eGFR; Chronic Kidney Disease Epidemiology Collaboration formula without race adjustment). Financial hardship was evaluated in three domains: material (income to poverty line ratio, health insurance coverage, and public/government financial assistance), psychological (perceived financial status, control over financial status, and perceived financial strains), and behavioral responses (financial adjustment/coping such as sold possessions and cutting back on spending).

Results
More severe financial hardship (overall score and in each domain) was associated with age-related decrements in eGFR, even after adjusting for sociodemographic, education, and health-related covariates. The association between financial hardship and age-related decrements in eGFR was conditional on sex but not race. Finally, cardiometabolic risk factors mediated the association between financial hardship and age-related decrements in eGFR.

Conclusions
These findings affirm the negative effects of financial hardship on age-related decrements in renal clearance. In addition to incorporating traditionally used indicators of SES, such as education and income, future research on social hallmarks of aging should also consider the role of financial hardship on the aging process and age-related diseases.
Association Between Global Sleep Quality and Coronary Microvascular Function in Male Physicians With Occupational Burnout
Authors: von Känel Roland , Princip Mary , Holzgang Sarah A. , Rossi Alexia , Giannopoulos Andreas A. , Buechel Ronny R. , Zuccarella-Hackl Claudia , Pazhenkottil Aju P. 
Published: November 2023

ABSTRACT

Objective
Occupational burnout has been associated with an increased risk of coronary heart disease, although the mechanisms involved are elusive. We investigated whether poor global sleep quality is associated with impaired coronary microvascular function in male physicians, a professional group at increased risk of burnout.

Methods
Study participants were 30 male physicians with clinical burnout and 30 controls without burnout defined by the Maslach Burnout Inventory. Global sleep quality was measured with the Pittsburgh Sleep Quality Index (PSQI). Endothelium-dependent (cold pressor test) and endothelium-independent (adenosine challenge) coronary microvascular functions were quantified with myocardial perfusion positron emission tomography. In multivariable analyses, the interaction between burnout and the PSQI global score was regressed on measures of coronary microvascular function, adjusting for age, body mass index, physical activity, alcohol consumption, and main effects of burnout and PSQI score.

Results
The prevalence of poor sleepers (PSQI score >5) was 40% in the burnout group and 10% in the control group. Adjusting for covariates, burnout-by-global PSQI score interactions were observed for myocardial blood flow (MBF) at rest (r partial = −0.30, p = .025), endothelium-dependent coronary flow reserve (r partial = −0.26, p = .062), MBF response (r partial = −0.30, p = .028), and hyperemic MBF (r partial = −0.34, p = .012). The global PSQI score was inversely associated with these MBF measures in the burnout group relative to the control group. No significant interactions emerged for endothelium-independent MBF.

Conclusions
In male physicians with occupational burnout, poor global sleep quality was associated with reduced endothelium-dependent coronary microvascular function, suggesting a mechanism by which burnout may affect cardiovascular health.
Primary Neurorraphy of the Frontotemporal Branch of the Facial Nerve in Pediatric Patients
Authors: Üstün G. Gencay , Açil M. Furkan , Sert Gökhan , Menkü Özdemir F. Damla , Uzun Hakan 
Published: November 2023

Injuries to the frontotemporal nerve cause visual field deficits, in addition to mental and emotional problems due to the associated facial paralysis. This study aimed to evaluate children treated with primary neurorrhaphy of the frontotemporal nerve and to identify the factors that affect treatment outcome. This retrospective study included children that underwent primary neurorrhaphy between 2015 and 2021 due to frontotemporal nerve injury. Medical records, including patient sex and age, the time from injury to surgery, injury zone, the postsurgery week that frontalis muscle activity was first observed, and the postsurgery week that full symmetry with the opposite eyebrow was achieved, were reviewed. The relationship between treatment success, and age group, sex, postinjury timing of surgery (≤72 versus >72 h), and injury zone, was analyzed. The study included 17 patients (9 males and 8 females) with a mean age of 8.8 years. In all, 11 (64.7%) patients achieved full symmetry following surgery and 3 (17.6%) patients gained some muscle activity, but not symmetrically. Among the patients, 9 underwent surgery within 24 hours of injury, versus 5 patients 3 to 7 days postinjury and 3 patients >1 week after injury. Age, sex, and timing of surgery were not significantly correlated with treatment success. There were significant differences in outcome according to injury zone. Surgical success can be obtained with timely primary neurorrhaphy in pediatric patients with traumatic frontotemporal nerve injury. The most important factor affecting the outcome of primary neurorrhaphy for frontotemporal nerve injury is the injury zone.

Level of Evidence:
Level III—case-control study.
Association Between Storage Time of Transfused Red Blood Cells and Infection After Clean-contaminated Surgery
Authors: Xu Xiaohan , Zhang Yuelun , Gan Jia , Ye Xiangyang , Yu Xuerong , Huang Yuguang 
Published: November 2023

Objective:
To investigate the association between the storage time of transfused red blood cells (RBCs) and risks of infections after clean-contaminated surgery.

Background:
Storage lesions of RBCs can aggravate transfusion-related immunomodulation. Very few randomized controlled trials have investigated the impacts of storage time on postoperative outcomes in noncardiac patients.

Methods:
We included adult patients who had undergone clean-contaminated surgery from 2014 to 2018 and received allogeneic RBC transfusion. In transfusion episode-level analysis, the exposure was the storage time of each transfusion episode. In patient-level analysis, the exposures were the mean, weighted mean, maximum storage time, and Scalar Age of Blood Index of RBCs transfused into each patient. The primary outcome was infections that developed after transfusions within postoperative day 30.

Results:
The 4046 patients were included who received 11604 transfusion episodes. Of these, 1025 (25.3%) patients developed postoperative infections. An increased storage time of transfused RBCs was not associated with increased odds of postoperative infections in either transfusion episode-level analysis [odds ratio (OR), 1.03 per 5 days, 95% CI, 0.95–1.11] or patient-level analysis (mean: OR, 1.02, 95% CI, 0.95–1.10; weighted mean: OR, 1.02, 95% CI, 0.95–1.10; maximum: OR, 1.06, 95% CI, 0.98–1.14; Scalar Age of Blood Index: OR, 0.99, 95% CI, 0.96–1.03), after adjusting 17 confounders.

Conclusions:
Prolonged storage time of transfused RBCs was not associated with increased risks of infections after clean-contaminated surgery.
A metabolomic and proteomic analysis of pathologic hypercoagulability in traumatic brain injury patients after dura violation
Authors: Coleman Julia R. , D’Alessandro Angelo , LaCroix Ian , Dzieciatkowska Monika , Lutz Patrick , Mitra Sanchayita , Gamboni Fabia , Ruf Wolram , Silliman Christopher C. , Cohen Mitchell J. 
Published: November 2023

BACKGROUND
The coagulopathy of traumatic brain injury (TBI) remains poorly understood. Contradictory descriptions highlight the distinction between systemic and local coagulation, with descriptions of systemic hypercoagulability despite intracranial hypocoagulopathy. This perplexing coagulation profile has been hypothesized to be due to tissue factor release. The objective of this study was to assess the coagulation profile of TBI patients undergoing neurosurgical procedures. We hypothesize that dura violation is associated with higher tissue factor and conversion to a hypercoagulable profile and unique metabolomic and proteomic phenotype.

METHODS
This is a prospective, observational cohort study of all adult TBI patients at an urban, Level I trauma center who underwent a neurosurgical procedure from 2019 to 2021. Whole blood samples were collected before and then 1 hour following dura violation. Citrated rapid and tissue plasminogen activator (tPA) thrombelastography (TEG) were performed, in addition to measurement of tissue factory activity, metabolomics, and proteomics.

RESULTS
Overall, 57 patients were included. The majority (61%) were male, the median age was 52 years, 70% presented after blunt trauma, and the median Glasgow Coma Score was 7. Compared with pre-dura violation, post-dura violation blood demonstrated systemic hypercoagulability, with a significant increase in clot strength (maximum amplitude of 74.4 mm vs. 63.5 mm; p < 0.0001) and a significant decrease in fibrinolysis (LY30 on tPAchallenged TEG of 1.4% vs. 2.6%; p = 0.04). There were no statistically significant differences in tissue factor. Metabolomics revealed notable increases in metabolites involved in late glycolysis, cysteine, and one-carbon metabolites, and metabolites involved in endothelial dysfunction/arginine metabolism/responses to hypoxia. Proteomics revealed notable increase in proteins related to platelet activation and fibrinolysis inhibition.

CONCLUSION
A systemic hypercoagulability is observed in TBI patients, characterized by increased clot strength and decreased fibrinolysis and a unique metabolomic and proteomics phenotype independent of tissue factor levels.