bluuebunny/crossref_metadata_2025_split huggingface dataset:
A 7-Domain Framework That Can Bridge Clinical Care, Health Systems Science, and Health Equity: Lessons From the H&P 360
Authors: Williams Brent C. , Hayer Rupinder , Henderson David D. , Johnson Eric L. , Kulkarni-Date Mrinalini , Tang Joyce W. , Whisenant Ebony B. , Kirley Kate ,   for the American Medical Association Accelerating Change in Medical Education Chronic Disease Prevention and Management and H&P 360 Working Group
Published: January 2023

The H&P 360 is a reconceptualized history and physical (H&P), which clinical medical students have reported reveals clinically relevant information not elicited by the traditional H&P, informs care planning, promotes interprofessional team care, and enhances patient rapport. In addition to the traditional checklist focused on patients’ medical conditions, the H&P 360 includes prompts for gathering limited but critical information in 6 other domains directly relevant to patients’ overall health—patient values, goals, and priorities; mental health; behavioral health; social support; living environment and resources; and function. Clinicians are thus reminded to elicit relevant information from each domain appropriate to the context of each clinical encounter.
As health systems explore ways to identify and address social drivers of health, medical schools are rapidly expanding curricula beyond biomedical conditions, as reflected in the multifaceted health systems science curriculum. Many of today’s medical students struggle to find connections among the core tasks of mastering biomedical clinical medicine, their evolving professional identity and career trajectory, and addressing systemic and societal barriers to population health.
The authors argue that the 7-domain framework can serve as a conceptual bridge that links the care of individual patients with topics in the health systems science curriculum to promote health equity. The authors provide illustrative examples of the 7 domains as an organizing lens that can promote curiosity and understanding of seemingly disparate topics, such as interpersonal violence, social drivers of health, and structural racism, as well as help students expand and define their professional identities as physicians beyond diagnosis and treatment of biomedical conditions.
The authors invite discussion and experimentation around the use of the 7-domain framework in teaching, assessment, and curriculum development and point to resources for clinical educators for teaching and measuring the effects of the H&P 360 on learners, preceptors, and patients.
Perioperative Sleep Disturbance Following Mastectomy
Authors: Azizoddin Desiree R. , Soens Mieke A. , Beck Meghan R. , Flowers K. Mikayla , Edwards Robert R. , Schreiber Kristin L. 
Published: January 2023

Objectives:
Sleep disturbance negatively impacts the quality of life and recovery. Our objective was to evaluate the relationship between the individual patient and surgical factors with greater sleep disturbance following breast surgery.

Methods:
In this prospective longitudinal study, patients completed validated measures regarding sleep disturbance, pain, opioid use, and psychological symptoms preoperatively and then 2 weeks, 6 and 12 months postoperatively. Univariable and multivariable generalized estimating equations evaluated demographic, surgical, pain, and psychological predictors of sleep disturbance during the first year after breast surgery.

Results:
Female patients (n=259) reported varying degrees of sleep disturbance, which were longitudinally associated with pain and psychosocial factors (eg, anxiety, depression, and affect). Independent preoperative predictors of worse sleep disturbance included younger age (B=−0.09, P=0.006), opioid use (B=3.09, P=0.02), and higher pain (B=0.19, P=<0.001) and anxiety (B=0.45, P=<0.001) at baseline. In addition, higher baseline positive affect (B=−0.14, P=<0.012) and the surgical category total mastectomy without reconstruction (B=−2.81, P=<0.006) were independently associated with lower sleep disturbance. Those with worse baseline sleep required more opioid analgesics during surgical recovery, and continued use of opioids at 2 weeks postsurgery was associated with disturbed sleep.

Discussion:
Certain patient characteristics, including younger age and baseline anxiety, positive affect, pain, and opioid use, were associated with greater sleep disturbance in the first year after breast surgery. Sleep disturbance was also associated with the greater perioperative and postoperative opioid requirements. Preoperative interventions (eg, anxiety management, cultivating positive affect, and multimodal pain management) in high-risk individuals may enhance sleep and recovery postoperatively, and allow more moderate and less prolonged opioid use.
Douching and Genital Talc Use: Patterns of Use and Reliability of Self-reported Exposure
Authors: O’Brien Katie M. , Ogunsina Kemi , Wentzensen Nicolas , Sandler Dale P. 
Published: January 2023

Background:
Feminine hygiene products contain chemicals that may be harmful to human health. Observational studies of the long-term health effects of such products largely rely on self-reported, recalled exposure. We sought to capture patterns of use over the life course and evaluate the reliability of self-reported data.

Methods:
We collected retrospective data on douching and genital talc use in the US-based Sister Study at two-time points and evaluated the consistency of reporting. At enrollment (2003–2009), participants were asked to report use in the last year and during ages 10–13. On a follow-up questionnaire (2017–2019), participants were asked about their use of douche or genital talc over their lifetimes.

Results:
Among 36,202 women who completed both questionnaires, 14% initially reported ever douching and 27% initially reported ever using genital talc. On the follow-up questionnaire, 51% of participants reported ever douching and 32% reported ever using genital talc. Comparisons across the two questionnaires for use in the year before enrollment showed good consistency, with 90% providing the same responses about douching and 87% providing the same responses about genital talc use. Reliability did not vary by cancer status, race and ethnicity, attained education, or age, though there was some evidence of recall bias for genital talc use among ovarian cancer survivors.

Conclusions:
Classification of ever use of feminine hygiene products may be recalled with good consistency, but agreement was lower for specific time periods and trends may vary by subgroup. These potential differences warrant careful consideration in future studies.
Marked Decreases in Time Lost From Work Among COVID-19 Claimants During the SARS-CoV-2 Pandemic
Authors: Hunt Dan L. , Bernacki Edward J. , Kalia Nimisha , Lavin Robert A. , Yuspeh Larry , Tsourmas Nicholas F. , Leung Nina , Green-McKenzie Judith , Tao Xuguang (Grant) 
Published: January 2023

Objective
To explore the long-term persistence of COVID-19–related impairment and the ability to work after the acute phase of the illness.

Method
The 19,101 COVID-19 workers' compensation claims filed between January 1, 2020, and December 31, 2021, with follow-up to May 31, 2022, were analyzed.

Results
The average time lost from work decreased from 77 days in the first quarter of 2020 to 9.2 days in the fourth quarter of 2021, and the proportion of claims with 30 days or more of lost time decreased from 40.4% to 2.8 days in the same time frame.

Conclusion
COVID-19 indemnity claims filed in later quarters of the SARS-CoV-2 pandemic have much lower average time lost from work and lower proportions of workers' compensation claims with more than 30, 60, and 150 days of lost time compared with earlier quarters.
Prevalence and Risk Factors for Post-Discharge Feeding Problems in Children Born Extremely Preterm
Authors: Alm Stina , Stoltz Sjöström Elisabeth , Domellöf Magnus 
Published: January 2023

Objectives:
Preterm infants have a high risk of post-discharge feeding problems, but there is a lack of population-based studies in infants born extremely preterm and little is known about underlying mechanisms. The objectives were to assess the incidence of post-discharge feeding problems and underweight in a population-based cohort of infants born extremely preterm in Sweden (EXPRESS) and identify perinatal risk factors.

Methods:
Perinatal health data and prenatal/postnatal growth data was prospectively collected in the cohort. Data on clinical diagnoses related to feeding problems were obtained from the Swedish Patient Register and population prevalence data was also obtained. The main outcome was a composite of post-discharge feeding problem diagnosis and/or underweight at 2.5 years of age.

Results:
In total, 66 children (19%) had post-discharge feeding problems diagnosed before 2 years and/or underweight at 2.5 years of age. The risk of feeding problems when compared to the general population was significantly higher, with an odds ratio (OR) of 193 (95% confidence interval (CI) 137.6–270.9). The strongest risk factors for feeding problems were the number of days on mechanical ventilation during the first 8 postnatal weeks, OR of 1.59 (CI 95% 1.29–1.98), and the Clinical Risk Index for Babies-score, OR of 1.14 (CI 95% 1.03–1.26).

Conclusions:
Post-discharge feeding problems and underweight are common in children born extremely preterm. The strongest perinatal risk factor for later feeding problems was early treatment with mechanical ventilation. Identifying infants at risk of post-discharge feeding problems might be useful for targeting of nutritional support.
Clinical Nurse Specialist Tracheostomy Management Improves Patient Outcomes
Authors: Richardson Janette , Girardot Kellie , Powers Jan , Kadenko-Monirian Michele 
Published: January 2023

Background:
Patients with a tracheostomy are a low-volume, high-risk population with long lengths of hospital stay and high health care costs.

Problem:
Because of the complex nature of caring for patients with a tracheostomy, it is essential to provide a standardized care approach with ongoing monitoring to optimize outcomes.

Approach:
A pre/postimplementation design was used. A formal tracheostomy care management process using clinical nurse specialists (CNSs) was implemented.

Outcomes:
Between April 2019 and December 2020, this process resulted in a significant reduction in time between tracheostomy placement and discharge, from 16 to 12.9 days (P = .02). Reductions were also seen in length of stay and incidence of tracheostomy-related pressure injuries.

Conclusions:
This project shows that a CNS-led care management process can improve patient outcomes. These improvements in patient outcomes resulted in a significant cost savings to the organization.
Trends in Follow-up Testing Among Patients Positive for Chlamydia and Gonorrhea in the Veterans Health Administration, 2013 to 2019
Authors: Schirmer Patricia , Sharma Aditya , Lucero-Obusan Cynthia , Oda Gina , Holodniy Mark 
Published: January 2023

Background
The Centers for Disease Control and Prevention (CDC) recommends testing patients with chlamydia (CT)/gonorrhea (GC) for other sexually transmitted infections (STIs) and repeating CT/GC testing 3 to 12 months later. We assessed repeat CT/GC testing and testing for HIV/syphilis in accordance with CDC guidelines in the US Veterans Health Administration.

Methods
Molecular laboratory testing for CT/GC during January 1, 2013–December 31, 2020 was retrieved from Veterans Health Administration data sources. Patients were evaluated for syphilis, HIV, and repeat CT/GC testing within 1 year after a positive CT/GC test result. Differences of CT/GC-positive patients associated with receiving recommended testing were assessed using χ
2/Fisher exact tests.

Results
A total of 41,630 of 1,005,761 CT (4.1%) and 17,649 of 1,013,198 GC (1.7%) results were positive. Median ages of positive CT/GC patients were 29 and 36 years, respectively. Repeat testing rates for CT/GC within 90 to 119 days were 3.9% and 2.9%, and rates within 90 to 365 days were 32.8% and 34.7%, with 8.6% and 15% being positive again, respectively. Guideline-compatible repeat testing in known HIV-positive patients nearly doubled (75.7% for CT and 67.8% for GC). The CDC-recommended HIV testing was performed for 72.4% and 65.5% CT and GC first positives, respectively, whereas syphilis testing was completed for 66.5% and 60.5% CT and GC, respectively. Compared with 25- to 34-year-old patients with CT or GC, those younger than 25 years had higher odds of guideline-discordant repeat testing but had lower odds of not receiving HIV/syphilis testing.

Conclusions
Nearly two-thirds of patients did not receive recommended repeat testing, and nearly one-third were not tested for HIV/syphilis. Veterans Health Administration providers may benefit from additional education on CDC-recommended sexually transmitted infection guidelines and testing recommendations.
Immobility and the High Risk of Not Recovering Function in Older Adults
Authors: Moersch Lila S. , Vandermause Roxanne K. , Fish Anne F. 
Published: January 2023

Abstract

Purpose
The objective of the study was to explore the experiences of older adults with immobility posthospitalization.

Design
We conducted a focused ethnography qualitative study.

Methods
Data collection included in-depth interviews with 10 individuals ages 69–82 years who had been hospitalized for at least 1 week, field notes, and observations of mobility. An inductive approach was used to analyze the data.

Findings
Older adults believe mobility is a central element in their life. Hospitalizations lasting 1 week or longer often result in a loss of the older adult's ability to function as before, a pattern that we identified as The Crushing Assault: Consequences of Immobility. Rehabilitation involves a Rocky Road to Regaining Mobility that is challenging but possible.

Conclusions
Immobility after hospitalization has unexpected and profound consequences that are life-changing and distressing for older adults at home. Recovering function is prolonged and difficult. An individualized training program that includes flexibility and progressive resistance exercises is recommended over longer periods and with extended medical follow-up.

Clinical Relevance
Lingering problems with immobility at home are frequently overlooked. Active programming promoting preservation of function and an optimistic attitude as well as focusing on milestones to reach are key to optimal function.
Occurrence and Severity of Suicidal Ideation in Adults With Neurofibromatosis Participating in a Mind–Body RCT
Authors: Lester Ethan G. , Wang Katherine E. , Blakeley Jaishri O. , Vranceanu Ana-Maria 
Published: January 2023

Background:
Emotional distress can lead to suicidal ideation and potentially suicide completion, yet there is very little literature on suicidal ideation in individuals with a diagnosis of neurofibromatosis (NF; NF1, NF2, and schwannomatosis).

Objective:
To examine the baseline occurrence, severity, and clinical correlates of suicidal ideation in adults with NF.

Method:
Individuals with NF (N = 220) completed assessments measuring depression (Patient Health Questionnaire–9), anxiety (Generalized Anxiety Disorder–7), perceived stress (Perceived Stress Scale–10), pain (Graded Chronic Pain Scale and PROMIS Pain Interference Short Form 8a), and general quality of life (World Health Organization Quality of Life–Brief version) before beginning a two-arm, single-blind randomized control trial of a live-video mind–body program for stress management and resiliency.

Results:
Nineteen percent (n = 42) of the individuals experienced suicidal ideation (ie, >0; ideation present several days or greater). More individuals with NF2 experienced suicidal ideation compared with those with NF1 or schwannomatosis. All of the clinical variables except pain intensity were significantly correlated (P < 0.01) with greater suicidal ideation. Suicidal ideation in individuals with NF was comparable to or higher than that in other medical populations (eg, cancer, dermatological, neurologic). Depression and poor psychological quality of life significantly increased the risk for suicidal ideation.

Conclusion:
Suicidal ideation was relatively prevalent in individuals with NF seeking participation in a mind–body randomized controlled trial. NF clinicians should be prepared to discuss these concerns and provide resources when suicidal ideation is present.

Clinical Trial Registration:
ClinicalTrials.gov (Identifier NCT03406208).
Memory for the News: Does Event Transience Matter?
Authors: Nester Caroline O. , Malone Christopher , Munro Catherine , Madigan Nancy , Hoffschmidt Sara , Sweeney Joan , Zink Tyler , O’Connor Margaret 
Published: January 2023

Background:
Health providers frequently probe patients’ recall of current and/or remote news events to determine the extent of memory loss. Impaired memory for transient events (ie, in the news for a circumscribed time) may provide information regarding the onset of cognitive impairment.

Objective:
To use the Transient News Events Test (TNET) to explore how memory changes over time in both older adults with cognitive impairment (CI) and noncognitively impaired (NCI) older adults. We also investigated the role of episodic and semantic memory on TNET performance.

Method:
Sixty-seven older adults completed the TNET as part of a comprehensive neuropsychological assessment. Analyses included t tests to evaluate group differences for TNET score and correlations between TNET and neuropsychological measures, including episodic and semantic memory tests.

Results:
NCI adults demonstrated better memory for TNET items than adults with CI. The NCI and CI groups did not differ regarding memory for remote events; however, the CI group exhibited worse memory for recent events. There was a significant association between TNET score and the capacity for episodic and semantic memory in the CI group. In the NCI group, TNET score was significantly associated with episodic memory.

Conclusion:
Findings support the use of transient news events to assess remote memories in older adults. Novel remote memory measures broaden the scope of memory assessment far beyond what is feasible with traditional neuropsychological assessment and may provide insight into the onset of memory changes.
Co-administration of prism adaptation and methylphenidate needs striatal integrity to alleviate spatial neglect
Authors: Beaudoin-Gobert Maude , Benistant Faustine , De Lanversin Maxence , Javouhay Jules , Jacquin-Courtois Sophie , Rode Gilles , Rossetti Yves , Luauté Jacques 
Published: January 2023

AbstractContextA previous study demonstrated a long-term functional improvement of spatial neglect after methylphenidate combined with prismatic adaptation in a group of patients suffering from left spatial neglect after a right stroke (RITAPRISM study).Objectivewe hypothesized that the functional improvement after MP combined with PA depends on striatal integrity in responders patients.MethodsWe conducted an MRI study in “MP+PA” program to identify lesional pattern in responders and non-responders patients in the RITAPRISM cohort. Using anatomical segmentation on morphological MRI, we compared lesional pattern in the striatum between responders and non-responders patients.ResultsThe beneficial effect of MP+PA co-administration should require striatal integrity in neglect patients. More specifically, our results suggest that the short-term effect is mediated by the ventral striatum whereas the long-term effect is mediated by the posterior putamen.ConclusionBenefical effet of MP+PA could rely on reinforcement processes at early stage of the MP+PA program and visuospatial substrates at long-term.
Targeted Sequencing of Pancreatic Ductal Adenocarcinoma Tissue
Authors: Thailli Kiruthikah , Benzing Christian , Quaglia Alberto , Sarker Debashis , Wells Claire M 
Published: January 2023

AbstractPancreatic ductal adenocarcinoma (PDAC) is an aggressive cancer and the majority of patients present with metastatic disease. Metastatic spread requires a reorganisation of the actin cytoskeleton, a process that is dependent on the Rho family GTPases and their interaction with subsequent downstream effectors. The p21 activated kinases (also known as the PAKs) are effectors of Rho GTPases Cdc42 and Rac and play key roles in cell migration and survival. PAK4 is overexpressed in PDAC and can reciprocally activate the PI3K pathway. Hepatocyte growth factor (HGF), via c-Met, is an established activator of PAK4 and the PI3K pathway and may promote PDAC invasion. Next generation sequencing (NGS) was performed on 31 PDAC tissue using a pre-determined targeted panel to attempt to identify novel mutations in the PAK: PI3K pathway. Targeted NGS identified several recurrent mutations including 5 PAK4 mutations in PDAC tissue.
An efficient context-aware approach for whole slide image classification
Authors: Shen Hongru , Wu Jianghua , Shen Xilin , Hu Jiani , Liu Jilei , Zhang Qiang , Sun Yan , Chen Kexin , Li Xiangchun 
Published: January 2023

AbstractComputational pathology for gigapixel whole slide images (WSIs) at slide-level is helpful in disease diagnosis and remains challenging. We propose a context-aware approach termedWSIInspection via Transformer (WIT) for slide-level classification via holistically modeling dependencies among patches on the WSI. WIT automatically learns feature representation of WSI by aggregating features of all image patches. We evaluate classification performance of WIT along with state-of-the-art baseline method. WIT achieved an accuracy of 82.1% (95% CI, 80.7% - 83.3%) in the detection of 32 cancer types on the TCGA dataset, 0.918 (0.910 - 0.925) in diagnosis of cancer on the CPTAC dataset and 0.882 (0.87 - 0.890) in the diagnosis of prostate cancer from needle biopsy slide, outperforming the baseline by 31.6%, 5.4% and 9.3%, respectively. WIT can pinpoint the WSI regions that are most influential for its decision. WIT represents a new paradigm for computational pathology, facilitating the development of effective tools for digital pathology.
AnnoSpat annotates cell types and quantifies cellular arrangements from spatial proteomics
Authors: Mongia Aanchal , Saunders Diane C. , Wang Yue J. , Brissova Marcela , Powers Alvin C. , Kaestner Klaus H. , Vahedi Golnaz , Naji Ali , Schwartz Gregory W. , Faryabi Robert B. 
Published: January 2023

AbstractCellular composition and anatomical organization influence normal and aberrant organ functions. Emerging spatial single-cell proteomic assays such as Image Mass Cytometry (IMC) and Co-Detection by Indexing (CODEX) have facilitated the study of cellular composition and organization by enabling high-throughput measurement of cells and their localization directly in intact tissues. However, annotation of cell types and quantification of their relative localization in tissues remain challenging. To address these unmet needs, we developed AnnoSpat (Annotator and Spatial Pattern Finder) that uses neural network and point process algorithms to automatically identify cell types and quantify cell-cell proximity relationships. Our study of data from IMC and CODEX show the superior performance of AnnoSpat in rapid and accurate annotation of cell types compared to alternative approaches. Moreover, the application of AnnoSpat to type 1 diabetic, non-diabetic autoantibody-positive, and non-diabetic organ donor cohorts recapitulated known islet pathobiology and showed differential dynamics of pancreatic polypeptide (PP) cell abundance and CD8+T cells infiltration in islets during type 1 diabetes progression.