bluuebunny/crossref_metadata_2025_split huggingface dataset:
Attribution of neuropsychiatric symptoms and prioritization of evidence in the diagnosis of neuropsychiatric lupus: mixed methods analysis of patient and clinician perspectives from the international INSPIRE study
Authors: Sloan Melanie , Andreoli Laura , Zandi Michael S , Harwood Rupert , Pitkanen Mervi , Sloan Sam , Barrere Colette , Massou Efthalia , Wincup Chris , Bosley Michael , Naughton Felix , Ubhi Mandeep , Jayne David , Leschziner Guy , Brimicombe James , Diment Wendy , Middleton Kate , Gordon Caroline , D’Cruz David , Pollak Thomas A 
Published: December 2023

Abstract

Objective
Neuropsychiatric lupus (NPSLE) is challenging to diagnose. Many neuropsychiatric symptoms, such as headache and hallucinations, cannot be verified by tests or clinician assessment. We investigated prioritizations of methods for diagnosing NPSLE and attributional views.

Methods
Thematic and comparative analyses were used to investigate how clinicians prioritize sources of evidence from a 13-item list, and explore discordances in clinician (surveys n = 400, interviews n = 50) and patient (surveys n = 676, interviews n = 27) perspectives on attribution.

Results
We identified high levels of variability and uncertainty in clinicians’ assessments of neuropsychiatric symptoms in SLE patients. In attributional decisions, clinicians ranked clinicians’ assessments above diagnostic tests (many of which they reported were often unenlightening in NPSLE). Clinicians ranked patient opinion of disease activity last, and 46% of patients reported never/rarely having been asked if their SLE was flaring, despite experienced patients often having ‘attributional insight’. SLE patients estimated higher attributability of neuropsychiatric symptoms to the direct effects of SLE on the nervous system than clinicians (P &lt; 0.001 for all symptoms excluding mania), and 24% reported that their self-assessment of disease activity was never/rarely concordant with their clinicians. Reports of misattributions were common, particularly of non-verifiable diffuse symptoms. Terminology differed between clinicians and influenced attribution estimates.

Conclusion
NPSLE diagnostic tests and clinician assessments have numerous limitations, particularly in detecting diffuse neuropsychiatric symptoms that can be directly attributable and benefit from immunosuppression. Our findings suggest that incorporating patient attributional insights—although also subject to limitations—may improve attribution decision-making. Consensus regarding terminology and interpretations of ‘direct attributability’ is required.
Will you go the distance? A satisfaction survey of telemedicine in sexual medicine
Authors: Saffati Gal , Naeem Taher , Kassab Jordan , Orozco Rendon Daniela , Green Charles , Liphsultz Larry I , Khera Mohit 
Published: December 2023

Abstract

Background
The success of telemedicine depends on patient satisfaction with the care that they receive, which is impacted by the ease of use of the technology, quality of the connection, and perceived effectiveness of care.

Aim
The study sought to evaluate patient satisfaction with telemedicine services in a high-volume andrology clinic.

Methods
We included all patients who had a telemedicine appointment between January 1, 2020, and August 22, 2022. Demographic information was gathered, and a satisfaction survey was conducted using REDCap software. Data were grouped into 2 age categories, with ≥50 years as the cutoff (19-50 years; &gt;50 years). The data were analyzed according to age, distance from the patient’s home to our center, and survey responses. Pearson’s chi-square test and ordinal logistic regression analyses were performed.

Outcomes
The main outcome is satisfaction with telemedicine in a men’s sexual health context.

Results
A total of 4071 patients were identified based on attending a telemedicine visit. Hypogonadism was the most common diagnosis. Other diagnoses included erectile dysfunction, varicocele, Peyronie’s disease, vasectomy, and infertility. In total, 613 patients completed the survey, with a mean age of 56.6 years. Older patients were less likely to prefer telemedicine (odds ratio [OR], 0.55; 95% confidence interval [CI], 0.36-0.80; P &lt; .001), less likely to agree to a video visit because of privacy concerns (OR, 0.51; 95% CI, 0.35-0.75; P &lt; .001), and less likely to recommend a telemedicine visit compared with their younger counterparts (OR, 0.37; 95% CI, 0.27-0.51; P &lt; .001). The median distance was 22.4 (interquartile range, 7.5-57.5) miles. However, there was no significant association between distance and patients’ likelihood of preferring telehealth visits, including reviews of outside laboratories and imaging (OR, 1; 95% CI, 0.99-1; P = .35), belief in the quality of care provided via video visits (OR, 0.99, CI 0.99-1; P = .25), and overall preference for telehealth visits (OR, 0.99; 95% CI, 0.99-1; P = .35).

Clinical Implications
Healthcare providers should consider the age of patients when deciding to offer telemedicine while addressing privacy concerns to provide adequate reassurance to patients who may have concerns about the quality of care provided through telemedicine.

Strengths and Limitations
Our study achieved a substantial sample size that reached statistical significance. Conducted at a single academic center, our study was constrained, possibly introducing biases related to the institution’s advanced telemedicine system. Geographic and diagnostic limitations could lead to regional biases, affecting the generalizability of the findings.

Conclusion
Older patients exhibited a lower inclination toward preferring telemedicine, along with decreased odds of endorsing in-person visits.
Semiautomatic Assessment of Facet Tropism From Lumbar Spine MRI Using Deep Learning
Authors: Kowlagi Narasimharao , Kemppainen Antti , Panfilov Egor , McSweeney Terence , Saarakkala Simo , Nevalainen Mika , Niinimäki Jaakko , Karppinen Jaro , Tiulpin Aleksei 
Published: December 2023

Study Design.
This is a retrospective, cross-sectional, population-based study that automatically measured the facet joint (FJ) angles from T2-weighted axial magnetic resonance imagings (MRIs) of the lumbar spine using deep learning (DL).

Objective.
This work aimed to introduce a semiautomatic framework that measures the FJ angles using DL and study facet tropism (FT) in a large Finnish population-based cohort.

Summary of Data.
T2-weighted axial MRIs of the lumbar spine (L3/4 through L5/S1) for (n=1288) in the NFBC1966 Finnish population-based cohort were used for this study.

Materials and Methods.
A DL model was developed and trained on 430 participants’ MRI images. The authors computed FJ angles from the model’s prediction for each level, that is, L3/4 through L5/S1, for the male and female subgroups. Inter-rater and intrarater reliability was analyzed for 60 participants using annotations made by two radiologists and a musculoskeletal researcher. With the developed method, we examined FT in the entire NFBC1966 cohort, adopting the literature definitions of FT thresholds at 7° and 10°. The rater agreement was evaluated both for the annotations and the FJ angles computed based on the annotations. FJ asymmetry (

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was used to evaluate the agreement and correlation between the raters. Bland-Altman analysis was used to assess the agreement and systemic bias in the FJ asymmetry. The authors used the Dice score as the metric to compare the annotations between the raters. The authors evaluated the model predictions on the independent test set and compared them against the ground truth annotations.

Results.
This model scored Dice (92.7±0.1) and intersection over union (87.1±0.2) aggregated across all the regions of interest, that is, vertebral body (VB), FJs, and posterior arch (PA). The mean FJ angles measured for the male and female subgroups were in agreement with the literature findings. Intrarater reliability was high, with a Dice score of VB (97.3), FJ (82.5), and PA (90.3). The inter-rater reliability was better between the radiologists with a Dice score of VB (96.4), FJ (75.5), and PA (85.8) than between the radiologists and the musculoskeletal researcher. The prevalence of FT was higher in the male subgroup, with L4/5 found to be the most affected region.

Conclusion.
The authors developed a DL-based framework that enabled us to study FT in a large cohort. Using the proposed method, the authors present the prevalence of FT in a Finnish population-based cohort.
Anatomical Breast Implant Assessment Using Ultrasound: A Case Series from the International Breast Implant Check Clinic
Authors: Jaeger Marie , Randquist Charles , Gahm Jessica 
Published: December 2023

Background:
Breast augmentation with anatomic implants can achieve a natural look, but over time, implant-related complications can occur. This includes a risk of potential rotation, which can cause a change in breast shape. Reported rates of rotation vary widely (0%–42%). Implant rotation is often detected by physical examination only or as a perioperative finding. Change in breast shape after augmentation requires clinical evaluation. In-office ultrasound allows for detailed assessment of implants for rotation and other complications.

Methods:
Women with anatomical breast implants seeking follow-up at the International Breast Implant Check Clinic in Stockholm, Sweden, from April 2020 to July 2022 were included in the study. Using a standardized protocol, subjective symptoms were recorded, and a physical examination followed by an ultrasound assessment was performed by a single board-certified plastic surgeon (M.J.) trained in implant assessment via ultrasound. Rotation was defined as an implant rotated past 30 degrees off the breast midline at 6 o’clock.

Results:
The study included 308 women (mean age 40.1, range 20-78) with bilateral anatomical implants. Overall, 40 women (13.0%) reported a change in breast shape; 35 had one or more implant-related complications, including five with rotation on ultrasound. Of the 308 women, 11 (3.6%) had rotations upon physical examination, and an additional 10 cases were identified using ultrasound.

Conclusions:
Rotation is a potential complication of anatomical breast implants. However, in this study, change in breast shape was more commonly caused by other implant-related complications. Ultrasound is a valuable tool in evaluating causes of change in breast shape.
An Evaluation of Patient-reported Outcome Measures and Minimal Clinically Important Difference Usage in Hand Surgery
Authors: Nielsen Colby , Merrell Dallin , Reichenbach Rachel , Mayolo Patrick , Qubain Leeann , Hustedt Joshua W. 
Published: December 2023

Background:
This study was designed to examine the current use of patient-reported outcome measures (PROMs) and minimal clinically important difference (MCID) calculations in the hand surgery literature in an effort to standardize their use for research purposes.

Methods:
A systematic review of the hand surgery literature was conducted. All nonshoulder upper extremity articles utilizing PROMs were compared between different journals, different surgical indications, and differing usage. MCID values were reported, and calculation methods assessed.

Results:
In total, 4677 articles were reviewed, and 410 met the inclusion criteria of containing at least one PROM. Of the 410 articles reporting PROMs, 148 also mentioned an associated MCID. Of the articles that mentioned MCIDs, 14 calculated MCID values based on their specific clinical populations, whereas the remainder referenced prior studies. An estimated 35 different PROMs were reported in the study period; 95 different MCID values were referenced from 65 unique articles.

Conclusions:
There are many different PROMs currently being used in hand surgery clinical reports. The reported MCIDs from their related PROMs are from multiple different sources and calculated by different methods. The lack of standardization in the hand surgery literature makes interpretation of studies utilizing PROMs difficult. There is a need for a standardized method of calculating MCID values and applying these values to established PROMs for nonshoulder upper extremity conditions.
Central and Peripheral Involvement of the Retina in the Initial Stages of Diabetic Retinopathy
Authors: Santos Ana Rita , Almeida Ana Catarina , Rocha Ana Cláudia , Reste-Ferreira Débora , Marques Inês Pereira , Cunha-Vaz Martinho António , Mendes Luís , Santos Torcato , Lewis Warren , Cunha-Vaz José 
Published: December 2023

Purpose:
To determine the degree of central microvascular closure using optical coherence tomography angiography (OCTA) in eyes of type 2 diabetes patients with visible lesions only in the central retina or only in the periphery.

Methods:
Cross-sectional study. All 127 eyes underwent Ultra-Widefield Fundus Photography (UWF-FP) 200° examinations with OPTOS California (Optos, Dunfermline, UK) and Cirrus Angioplex OCT-Angiography 3x3mm acquisitions (ZEISS, Dublin, CA, USA).

Results:
Twenty-five eyes showed visible lesions only in the central retina (inside the 7-ETDRS fields area), 57 only in the peripheral retina (outside the 7-ETDRS fields) and 45 presented visible lesions in entire retina (both locations). The group with visible lesions only in the periphery showed definite closure in the superficial capillary plexus (SCP) in 49% of the eyes, whereas the group with visible lesions only in the central 7-ETDRS fields area showed a definite closure in 64%.

Conclusions:
Central capillary closure is already present in the initial stages of diabetic retinopathy even when lesions are only visible in the peripheral retina. Capillary closure in the SCP is three times more frequent than in the DCP, demonstrating earlier closure of the SCP. Eyes with visible lesions only in the periphery show a milder form of retinopathy.
Late Subacute Cerebral Hematoma Mimicking a Metastasis on PSMA PET/CT
Authors: Vaz Nuno , Dietsche Eric , Mooney Michael A. , Choudhury Atish D. , Jacene Heather A. 
Published: December 2023

AbstractA 64-year-old man with history of prostate cancer was found to have rising prostate-specific antigen after radical prostatectomy.18F-DCFPyL PET/CT demonstrated a prostate-specific membrane antigen–avid brain lesion in the left frontal lobe and no other findings to account for rising prostate-specific antigen. Brain MRI demonstrated a small intraparenchymal hematoma with late subacute features in this location. The patient reported a seizure 3 weeks before but was otherwise asymptomatic, and neurologic examination was normal. Follow-up MRI demonstrated gradual decrease in size of the hematoma without treatment.
Ketamine as an Alternative Anesthetic for Augmenting Seizure Durations During Electroconvulsive Therapy
Authors: Mutoh Sarara , Kinoshita Michiko , Maeda Yuki , Tanaka Katsuya 
Published: December 2023

Objective
Electroconvulsive therapy (ECT) is highly effective for severe psychiatric disorders; however, short seizure durations may lead to ineffective therapy. This retrospective study aimed to examine the risks and benefits of switching to ketamine anesthesia to augment seizure durations during an acute course of ECT.

Methods
We included 33 patients who underwent ketamine anesthesia due to suboptimal seizures during an acute course of ECT. We assessed seizure duration, stimulus dose, hemodynamic variability, and postseizure complications before and after switching to ketamine.

Results
Age was significantly associated with suboptimal seizures during ECT (P = 0.040). After switching to ketamine, 32 patients (97%) experienced prolonged seizure duration. Ketamine significantly prolonged both electroencephalogram and motor seizure durations with a mean difference of 34.6 seconds (95% confidence interval [CI], 26.4–42.7 seconds; P < 0.001) and 26.6 seconds (95% CI, 19.6–33.6 seconds; P < 0.001), respectively. It also significantly reduced stimulus dose (mean difference, −209.5 mC [95% CI, −244.9 to −174.1 mC]; P < 0.001). In addition, maximum changes in systolic blood pressure and heart rate during ECT sessions significantly increased with ketamine (mean difference, 27.2 mm Hg [95% CI, 12.0–42.4 mm Hg; P = 0.001]; 25.7 beats per minute [95% CI, 14.5–36.8 beats per minute; P < 0.001], respectively). Patients reported more headaches with ketamine (P = 0.041).

Conclusions
Our results provide evidence that ketamine as an alternative anesthetic can augment seizure durations in specific patients experiencing suboptimal seizures during an acute course of ECT. However, its use requires greater attention to circulatory management and postseizure complications.
The aesthetic valve: how aesthetic appreciation may switch emotional states from anxiety to curiosity
Authors: Barbieri Paolo , Sarasso Pietro , Lodico Fabio , Aliverti Alice , Murayama Kou , Sacco Katiuscia , Ronga Irene 
Published: December 2023

Pursuing new knowledge in the entropic environment is pivotal for survival. However, dealing with uncertainty is a costly challenge for the agent surrounded by the stochastic sensory world, giving rise to different epistemic emotions, such as curiosity and anxiety. We recently proposed that aesthetic appreciation may have the role of associating pleasant feedback with the update of predictive representations. According to this idea, aesthetic appreciation and its associated rewarding feeling could drive people to seek new knowledge over anxiety. However, the relationship between aesthetic appreciation, curiosity, and anxiety has been still under-examined in the literature. Here, we explore the relationship between these epistemic emotions in a series of three experiments. In study 1, we examined whether music-induced aesthetic appreciation would influence curiosity in a gambling task. In studies 2a and 2b, we explore the relationship between music-induced aesthetic appreciation and anxiety state. Overall, aesthetic appreciation promoted curiosity-driven behaviour while it was negatively associated with anxiety. These results were consistent with the idea that aesthetic appreciation could act as a ‘valve’, prompting the individual to perceive curiosity (i.e. to consider novelty as a valuable opportunity to acquire new knowledge) rather than anxiety (i.e. to consider novelty as a risk to be avoided).
This article is part of the theme issue ‘Art, aesthetics and predictive processing: theoretical and empirical perspectives’.
Surfing uncertainty with screams: predictive processing, error dynamics and horror films
Authors: Miller Mark , White Ben , Scrivner Coltan 
Published: December 2023

Despite tremendous efforts in psychology, neuroscience and media and cultural studies, it is still something of a mystery why humans are attracted to fictional content that is horrifying, disgusting or otherwise aversive. While the psychological benefits of horror films, stories, video games, etc. has recently been demonstrated empirically, current theories emphasizing the negative and positive consequences of this engagement often contradict one another. Here, we suggest the predictive processing framework may provide a unifying account of horror content engagement that provides clear and testable hypotheses, and explains why a ‘sweet spot’ of fear and fun exists in horror entertainment.
This article is part of the theme issue ‘Art, aesthetics and predictive processing: theoretical and empirical perspectives’.
The Canadian platform for research online to investigate health, quality of life, cognition, behaviour, function, and caregiving in aging (CAN-PROTECT): study protocol, platform description, and preliminary analyses
Authors: Ismail Zahinoor , Guan Dylan , Vellone Daniella , Ballard Clive , Creese Byron , Corbett Anne , Pickering Ellie , Bloomfield Adam , Hampshire Adam , Sekhon Ramnik , Roach Pamela , Smith Eric E. 
Published: December 2023

ABSTRACTBackgroundPreventing or reducing the risk of cognitive decline and dementia is of great public health interest. Longitudinal data from diverse samples are needed to properly inform clinicians, researchers, and policy makers. CAN-PROTECT is a recently launched online observational cohort study that assesses factors contributing to both risk for incident cognitive decline and dementia and resilience against brain aging, in participants across the lifespan.MethodsMeasures of cognition, behaviour, and quality of life administered to both participants and study partners were compared using partial Spearman correlations adjusted for participant and study partner age, sex, and education. In participants, relationships between cognition, behaviour, function, and quality of life were examined using adjusted multivariable linear and negative binomial regression models.ResultsIn the first three-month window, 2150 participants spanning all Canadian provinces enrolled; 637 nominated study partners had already completed assessments. Engagement with the study was excellent, with many optional assessments completed. Initial analyses demonstrated relationships between cognition, behaviour, function, and quality of life.DiscussionThese preliminary results speak to the utility and feasibility of CAN-PROTECT to obtain data relevant to brain health, highlighting the public interest in participating in studies on cognition. The online portal facilitated participation of a geographically diverse sample. This group is ideal to study brain aging, dementia prevention, and early detection of neurodegenerative disease. Longitudinal data will provide additional insights. Several features of CAN-PROTECT are important to consider in terms of assessing risk and resilience in Canadians, and for further development and recruitment of a research-ready cohort.HIGHLIGHTSCAN-PROTECT is a longitudinal online study of risk and resilience to brain agingNeuropsychological testing and health– and aging-related outcomes are obtainedData presented are from the first 2150 participants, mean age 62.9 (77.6% female)Associations between cognition, behaviour, function, and quality of life were foundCAN-PROTECT is a feasible platform to obtain participant and study partner data