bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors Influencing Self-Esteem After a Traumatic Brain Injury
Authors: Downing Marina , Elliot Bridget , Ponsford Jennie 
Published: June 2023

Objective:
Traumatic brain injury (TBI) and its consequences can significantly impact an individual's identity and self-esteem. However, there is limited research with respect to the trajectory of change over time and factors that may influence self-esteem levels. This study aimed to investigate: (1) changes in self-esteem over 3 years post-TBI; and (2) factors associated with self-esteem post-TBI.

Setting:
Outpatient.

Participants, Design, and Measures:
Self-esteem was measured in 1267 individuals with predominantly moderate to severe TBI (mean age = 36.38 years, mean days in posttraumatic amnesia = 26.16 days) using the Rosenberg Self-Esteem Scale at 1-, 2, and 3 years post-injury. Participants also completed the Structured Outcome Questionnaire and the Glasgow Outcome Scale-Extended (GOS-E).

Results:
Linear mixed modeling indicated that self-esteem significantly declined between 1 and 2 years but remained stable between 2 and 3 years post-injury. Higher self-esteem was significantly associated with better functional outcomes (as measured by the GOS-E), more years of education, more participation in leisure activities, and lower reported anxiety and depression levels.

Conclusions:
Findings suggest that functional impacts of injury and emotional functioning influence self-esteem increasingly between 1 and 2 years post-injury. This highlights the importance of timely psychological interventions to maximize self-esteem in individuals with TBI post-injury.
Long-term survival after female pelvic organ-sparing radical cystectomy versus standard radical cystectomy: a multi-institutional propensity score-matched analysis
Authors: Zhong Wenlong , Xia Kun , Liu Libo , Cheng Sida , Peng Hong , He Wang , Dong Wen , Liu Hao , Lai Yiming , Han Hao , Liu Cheng , Zhang Hongxian , Li Xinfei , Ding Guangpu , Li Xuesong , Ma Lulin , Zhou Liqun , Lin Tianxin , Huang Jian 
Published: June 2023

Background:
The application of pelvic organ preserving-radical cystectomy (POPRC) in female patients with bladder cancer has attracted more and more attention in recent years. In current study, we aim to compare the long-term oncological outcomes of pelvic organ preserving-radical cystectomy (POPRC) versus standard radical cystectomy (SRC) in a large multicenter retrospective cohort.

Patients and methods:
Data on female patients with bladder cancer who underwent POPRC or SRC in January 2006 and April 2018 were included from three Chinese urological centers. The primary outcome was overall survival (OS). Secondary outcomes were cancer-specific survival (CSS) and recurrence-free survival (RFS). To decrease the effect of unmeasured confounders associated with treatment selection, 1:1 propensity score matching (PSM) was performed.

Results:
Among 273 enrolled patients, 158 underwent POPRC (57.9%), and 115 underwent SRC (42.1%). The median follow-up time was 38.6 (15.9–62.5) months. After PSM, each cohort included 99 matched patients. The OS (P=0.940), CSS (P=0.957), and RFS (P=0.476) did not differ significantly from the two matched cohorts. Subgroup analysis confirmed that the OS was similar between the patients treated with POPRC and SRC across all subgroups examined (all P > 0.05). In multivariable analysis, the surgical method (SRC vs. POPRC) was not an independent risk factor for OS (HR 0.874, 95% CI 0.592–1.290; P=0.498).

Conclusions:
The results showed that no significant difference in long-term survival was determined between female patients undergoing SRC and those undergoing POPRC.
Detection of the gene mutation of epidermal growth factor receptor in lung adenocarcinoma by radiomic features from a small amount of PET data
Authors: Zhang Tianyou , Liu Zefeng , Lin Liying , Han Tao , Long Fenghua , Guo Hongyu , Han Li 
Published: June 2023

Objective
The purpose of this work was to identify the potential mutation of epidermal growth factor receptor in nonsmall cell adenocarcinoma by noninvasive method, and to explore whether the same or better effect can be achieved using a small amount of single-mode PET image data.

Method
A total of 115 patients were recruited and the results of their 18F-FDG PET images and gene detection after resection were obtained; 117 original radiation features and 744 wavelet transform features were extracted from PET images. Several methods were used to reduce the dimension of the data, and four classifier models were established to classify it. The above process was repeated to reduce the total amount of data and the area under the receiver operating characteristic curve (AUC) value that changed with the reduction of the data and the stability of the results was recorded.

Results
The classifier with the best comprehensive performance under this dataset was logistic regression, whose AUC value is 0.843. And similar results can be obtained from only 30 cases of data.

Conclusion
A similar or better result could be achieved using a small number of single-mode PET images. In addition, significant results could be obtained using only the PET images of 30 patients.
How reliable is the high-volume definition in prostate cancer patients: the potential game-changing role of PSMA
Authors: Güven Osman , Karyağar Savaş , Arici Serdar , Özülker Tamer , Can Orçun 
Published: June 2023

Purpose
To evaluate whether metabolic and volumetric data from 68Ga-PSMA PET/CT performed during staging of de-novo high-volume mCSPC patients who received docetaxel could be used to predict survival.

Methods
Forty-two de-novo high-volume mCSPC patients, who received ADT + Docetaxel and underwent 68Ga-PSMA PET/CT for staging, were included in the study. The association between patients’ pathological data, all PSA measurements, treatments they received, the data obtained from 68Ga-PSMA PET/CT and progression-free and overall survival were examined.

Results
In the multivariate analysis, PSMA-TV (primary) and PSMA-TV (WB) variables were shown to be independent negative predictors of overall survival. For the threshold value of 19.91 cm3 obtained for PSMA-TV (primary), HR was calculated as 6.31, the 95% confidence interval (CI): 1.01–39.18, P = 0.048. For the threshold value of 1226.5 cm3 obtained for PSMA-TV (WB) variable, HR was calculated as 58.62, the 95% CI: 2.55–1344.43, P = 0.011. In our study, SUVmax (WB) variable was found to be an independent and negative predictor of progression-free survival. For the determined threshold value of 17.74, HR was calculated as 16.24, 95% CI: 1.18–22.76, P = 0.037.

Conclusion
Metabolic and volumetric data obtained from 68Ga-PSMA PET/CT can be used to predict survival in de-novo high-volume mCSPC. Our results show that in ADT + Docetaxel receiving patients, a subgroup with higher PSMA-TV (WB) values have a significantly worse prognosis. This situation suggests that the high-volume disease definition in the literature may be insufficient for this group, and that 68Ga-PSMA PET/CT can play an essential role in demonstrating the heterogeneity within the group.
Gaps in Postnatal Support for Intended Parents
Authors: Salera-Vieira Jean 
Published: June 2023

Abstract

Purpose:
To identify gaps in postnatal depression screening and support services for intended parents (parents who are intended to receive the baby from a gestational surrogacy pregnancy), also known as commissioned parents.

Study Design and Methods:
This descriptive study used quantitative and free-text survey questions designed to assess postnatal depression screening and postnatal services available for all parents and, more specifically, for intended parents.

Sample:
The survey was sent to 2,000 randomly selected postpartum nurses in the United States who are members of the Association of Women's Health, Obstetric and Neonatal Nurses.

Results:
Completion of the survey was offered to the 125 nurses who responded that they provided care for intended parents. Thirty-seven percent of respondents indicated that postpartum support services are available for both parents. Free-text responses describe a gap in postnatal services for intended parents. Although 85% of survey respondents reported that postpartum depression screening occurs in their setting, nurses reported neither fathers nor intended parents are screened for postnatal depression.

Clinical Implications:
This study expands the known gap in postnatal support services for intended parents, including postnatal depression screening. Recommendations for nurses working in the perinatal setting include providing consistent support for all parents as they transition to parenthood. Creating standardized policies and practices reflecting the diverse needs and cultures of intended parents can help direct all clinicians toward providing more significant support. Adapting current postnatal screening and support systems could provide a continuum of support for all families.
Tuberous Breast: A Wide Spectrum of Features of the Same Disorder—13-Year Experience-Based Classification and Reconstructive Algorithm
Authors: Innocenti Alessandro , Melita Dario 
Published: June 2023

Background:
A multitude of variants of tuberous breast exist, and a reconstructive algorithm could help in assessment of all features that affect the breast and planning the most appropriate surgical correction strategy. Although several efficient techniques have been described in the literature, the authors propose their experience to help standardize a diagnostic and therapeutic approach. The aim of this article is to assess the pathologic hallmarks of each type of tuberous breast and to propose a one-step reconstructive algorithm tailored to the patient characteristics based on the use of three different adipo-glandular flaps.

Methods:
From September of 2006 to December of 2019, 118 patients were treated for tuberous breast in a one-step procedure using tailored local flaps according to the preoperatively assessed clinical variant. Minimum follow-up was 12 months. All the procedures were performed under local anesthesia.

Results:
A total of 220 tuberous breasts (98 hypoplastic and 122 normoplastic) were treated. Mean patient age was 20.2 years. Mean follow-up was 36.5 months. Six minor complications (capsular contracture and nipple-areola complex hypesthesia) but no major complications were reported. In 9% of cases, minor secondary procedures, including lipofilling, scar revisions, and breast implant substitution, were performed.

Conclusion:
The proposed algorithm, including a comprehensive classification, preoperative planning, and surgical approach derived from the authors’ experience, presents a tailored surgical approach for each type of tuberous breast.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, IV.
99mTc-MIBI SPECT/CT Evaluation of a Renal Collision Tumor
Authors: Ali Adil A. , Sivathapandi Thangalakshmi , Gupta Ritu , Master Viraj A. , Marcus Charles 
Published: June 2023

Abstract
Preoperative differentiation of oncocytomas from renal cell carcinoma (RCC) is often challenging. 99mTc-MIBI imaging could play a potential role in differentiating oncocytoma from RCC, which in turn could guide surgical decision-making. We present the use of 99mTc-MIBI SPECT/CT to characterize a renal mass in a 66-year-old man with a complex medical history, including history of bilateral oncocytomas. 99mTc-MIBI SPECT/CT showed features suspicious of a malignant tumor, which was confirmed postnephrectomy as a chromophobe and papillary RCC collision tumor. This case supports 99mTc-MIBI imaging for preoperative differentiation of benign versus malignant renal tumors.
FDG-Avid But Pentixafor-Negative in EBV-Associated T-Cell Lymphoproliferative Disorders
Authors: Shu Qiaoqiao , He Xubing , Chen Yue , Cai Liang 
Published: June 2023

Abstract
An 18-year-old woman with intermittent fever, pancytopenia, abnormal liver function, and enlarged lymph nodes and hepatosplenomegaly was clinically suspected as hemophagocytic lymphohistiocytosis. 18F-FDG PET/CT showed increased metabolism in multiple lymph nodes, which were highly suggestive of lymphoma. No increased CXCR4 expression in lymph nodes was demonstrated on 68Ga-pentixafor PET/CT. Subsequent right neck lymph node biopsy pathology revealed EBV-associated lymphoproliferative disorders. Our case shows that 68Ga-pentixafor PET/CT may have potential value in differentiating EBV-associated lymphoproliferative disorders from lymphomas.
The Use of Conventional Lower-Frequency Color Doppler Ultrasound for Flap Planning in the Lower Extremity
Authors: Chim Harvey , Sullivan Brianne 
Published: June 2023

Background
Handheld Doppler is often inaccurate in localization of perforators for pedicled and free flaps. Color Doppler ultrasound (CDU), in contrast, allows more accurate mapping and characterization of perforators to facilitate rapid flap harvest.

Methods
Forty-seven flaps harvested from the lower extremity were evaluated preoperatively with CDU by a single surgeon with a conventional low-frequency ultrasound device (Philips Sparq, Cambridge, Mass). Flaps evaluated included profunda artery perforator flaps (n = 36), anterolateral thigh flaps (n = 2), pedicled propeller perforator flaps (n = 7), and toe transfers (n = 2).

Results
In all cases where a free profunda artery perforator or anterolateral thigh flap was used, the location of the dominant perforator visualized preoperatively correlated exactly with intraoperative findings. In cases where CDU was used preoperatively to locate a large perforator close to a lower extremity defect for reconstruction with a propeller perforator flap, all perforators could be used, and all flaps were successful.

Conclusions
Preoperative CDU is particularly useful for flap planning where knowledge of the location of the dominant perforator is critical. This includes planning of thin and superthin free flaps, as well as freestyle perforator flaps. Our clinical experience suggests that this technology should be routinely adopted in certain aspects of reconstructive microsurgery.
The Mechanism of Cannabichromene and Cannabidiol Alone Versus in Combination in the Alleviation of Arthritis-Related Inflammation
Authors: Grogan Graham , Stephens Kristen , Chou Jesse , Timko Michael P. , Cottler Patrick , DeGeorge Brent R. 
Published: June 2023

BackgroundPatients suffering from arthritis have limited treatment options for nonoperative management. In search of pain relief, patients have been taking over-the-counter cannabinoids. Cannabidiol (CBD) and cannabichromene (CBC) are minor cannabinoids with reported analgesic and anti-inflammatory properties and have been implicated as potential therapeutics for arthritis-related pain. To this end, we utilized a murine model to investigate the effectiveness of and mechanism by which CBC alone, CBD alone, or CBD and CBC in combination may provide a reduction in arthritis-associated inflammation.MethodsForty-eight mice were included in the study, which were separated into 4 groups: control group (n = 12), treatment with CBD alone (n = 12), treatment with CBC alone (n = 12), and treatment with CBD + CBC (n = 12). We induced inflammation in each mouse utilizing the collagen-induced arthritis model. At scheduled timepoints, mice were clinically assessed for weight gain, swelling, and arthritis severity. In addition, inflammation-associated serum cytokine levels were analyzed for each animal.ResultsThirty-five of 48 mice survived the duration of the study resulting in the following group numbers: control group (n = 8), treatment with CBD alone (n = 9), treatment with CBC alone (n = 9), and treatment with CBD + CBC (n = 9). Animals treated with CBC and CBD + CBC showed significant weight gain between 3 and 5 weeks. Irrespective of treatment, regression analysis comparing all cytokine measurement and physical outcomes found a significant positive correlation between levels of 5 individual cytokines and both arthritis scores and swelling. Animals treated with CBD + CBC showed a significant decrease in swelling between 3 and 5 weeks compared with the control group. Cannabinoid treatment selectively affected the gene expression of eotaxin and lipopolysaccharide-induced CXC chemokine with combined treatment of CBC + CBD.ConclusionTreatment with cannabinoids resulted in decreased clinical markers of inflammation. Further, the anti-inflammatory effect of CBC and CBD in conjunction was associated with a greater anti-inflammatory effect than either minor cannabinoid alone. Future work will elucidate the possibility of synergistic or entourage effects of minor cannabinoids used in combination for the treatment of arthritis-related pain and inflammation.
APPRAISE-HRI: AN ARTIFICIAL INTELLIGENCE ALGORITHM FOR TRIAGE OF HEMORRHAGE CASUALTIES
Authors: Stallings Jonathan D. , Laxminarayan Srinivas , Yu Chenggang , Kapela Adam , Frock Andrew , Cap Andrew P. , Reisner Andrew T. , Reifman Jaques 
Published: June 2023

ABSTRACT

Background: Hemorrhage remains the leading cause of death on the battlefield. This study aims to assess the ability of an artificial intelligence triage algorithm to automatically analyze vital-sign data and stratify hemorrhage risk in trauma patients. Methods: Here, we developed the APPRAISE–Hemorrhage Risk Index (HRI) algorithm, which uses three routinely measured vital signs (heart rate and diastolic and systolic blood pressures) to identify trauma patients at greatest risk of hemorrhage. The algorithm preprocesses the vital signs to discard unreliable data, analyzes reliable data using an artificial intelligence–based linear regression model, and stratifies hemorrhage risk into low (HRI:I), average (HRI:II), and high (HRI:III). Results: To train and test the algorithm, we used 540 h of continuous vital-sign data collected from 1,659 trauma patients in prehospital and hospital (i.e., emergency department) settings. We defined hemorrhage cases (n = 198) as those patients who received ≥1 unit of packed red blood cells within 24 h of hospital admission and had documented hemorrhagic injuries. The APPRAISE-HRI stratification yielded a hemorrhage likelihood ratio (95% confidence interval) of 0.28 (0.13–0.43) for HRI:I, 1.00 (0.85–1.15) for HRI:II, and 5.75 (3.57–7.93) for HRI:III, suggesting that patients categorized in the low-risk (high-risk) category were at least 3-fold less (more) likely to have hemorrhage than those in the average trauma population. We obtained similar results in a cross-validation analysis. Conclusions: The APPRAISE-HRI algorithm provides a new capability to evaluate routine vital signs and alert medics to specific casualties who have the highest risk of hemorrhage, to optimize decision-making for triage, treatment, and evacuation.
High-risk Prescribing Following Surgery Among Payer Types for Patients on Chronic Opioids
Authors: Sharif Limi , Gunaseelan Vidhya , Lagisetty Pooja , Bicket Mark , Waljee Jennifer , Englesbe Michael , Brummett Chad M. 
Published: June 2023

Objective:Among those on chronic opioids, to determine whether patients with Medicaid coverage have higher rates of high-risk opioid prescribing following surgery compared with patients on private insurance.Summary Background Data:Following surgery, patients on chronic opioids experience gaps in transitions of care back to their usual opioid prescriber, but differences by payer type are not well understood. This study aimed to analyze how new high-risk opioid prescribing following surgery compares between Medicaid and private insurance.Methods:In this retrospective cohort study through the Michigan Surgical Quality Collaborative, perioperative data from 70 hospitals across Michigan were linked to prescription drug monitoring program data. Patients with either Medicaid or private insurance were compared. The outcome of interest was new high-risk prescribing, defined as a new occurrence of: overlapping opioids or benzodiazepines, multiple prescribers, high daily doses, or long-acting opioids. Data were analyzed using multivariable regressions and a Cox regression model for return to usual prescriber.Results:Among 1,435 patients, 23.6% (95% CI: 20.3%-26.8%) with Medicaid and 22.7% (95% CI: 19.8%-25.6%) with private insurance experienced new, postoperative high-risk prescribing. New multiple prescribers was the greatest contributing factor for both payer types. Medicaid insurance was not associated with higher odds of high-risk prescribing (OR: 1.067, 95% CI: 0.813–1.402).Conclusion:Among patients on chronic opioids, new high-risk prescribing following surgery was high across payer types. This highlights the need for future policies to curb high-risk prescribing patterns, particularly in vulnerable populations that are at risk of greater morbidity and mortality.
A thermodynamic basis for teleological causality
Authors: Deacon Terrence W. , García-Valdecasas Miguel 
Published: June 2023

We show how distinct terminally disposed self-organizing processes can be linked together so that they collectively suppress each other's self-undermining tendency despite also potentiating it to occur in a restricted way. In this way, each process produces the supportive and limiting boundary conditions for the other. The production of boundary conditions requires dynamical processes that decrease local entropy and increase local constraints. Only the far-from-equilibrium dissipative dynamics of self-organized processes produce these effects. When two such complementary self-organizing processes are linked by a shared substrate—the waste product of one that is the necessary ingredient for the other—the co-dependent structure that results develops toward a self-sustaining target state that avoids the termination of the whole, and any of its component processes. The result is a perfectly naturalized model of teleological causation that both escapes the threat of backward influences and does not reduce teleology to selection, chemistry or chance.This article is part of the theme issue ‘Thermodynamics 2.0: Bridging the natural and social sciences (Part 1)’.
Diagnostic and therapeutic challenges of isolated genital tuberculosis and drug resistant urogenital tuberculosis- case series
Authors: Bala Kiran , Xess Ashit , Das Rojaleen , Singla Neeta , Seth Amlesh , Singh Urvashi B 
Published: June 2023

Genitourinary tuberculosis (GUTB) has varied presentation such as recurrent urinary tract infection, sterile pyuria with/without hematuria, irritating voiding symptoms, infertility, hydronephrosis and renal failure. Genital tuberculosis usually associated with renal TB but isolated cases may occur. Very few case reports of isolated tuberculous epididymo-orchitis have been published in literature. Epididymal TB may be the only clinically evident location of infection in rare cases of GUTB. Epididymal TB presents with non-specific local insidious and progressive symptoms which are difficult to differentiate with cysts, tumours and other infections. Suspicion of tubercular etiology becomes stronger with bilateral epididymal involvement along with testicular lesion and resistant to multiple courses of antibiotics. Tuberculous epididymo-orchitis has significant impact on fertility, as sperm count and motility may be reduced by blockage of the vas and/or secondary atrophy. Timely diagnosis and treatment will prevent late sequaele of disease such as non-functioning kidney and thimble bladder and infertility. We are presenting three cases of GUTB, two cases (Case 1 & 3) were isolated case of tuberculous epididymo-orchitis in a 20 year old male and a 35 year old male and one case (case 2) of complicated drug resistant genitourinary tuberculosis in a 29 year old male. These rare cases were managed successfully with diagnostic and therapeutic challenges.