bluuebunny/crossref_metadata_2025_split huggingface dataset:
Inhaled Prostacyclins for Acute Respiratory Distress Syndrome: A Systematic Review and Meta-Analysis
Authors: Torbic Heather , Saini Aftabh , Harnegie Mary Pat , Sadana Divyajot , Duggal Abhijit 
Published: June 2023

OBJECTIVES:
Studies evaluating inhaled prostacyclins for the management of acute respiratory distress syndrome (ARDS) have produced inconsistent results regarding their effect on oxygenation. The purpose of this systematic review and meta-analysis was to evaluate the change in the Pao
2/Fio
2 ratio after administration of an inhaled prostacyclin in patients with ARDS.

DATA SOURCES:
We searched Ovid Medline, Embase, Cumulative Index to Nursing and Allied Health Literature, Cochrane, Scopus, and Web of Science.

STUDY SELECTION:
We included abstracts and trials evaluating administration of inhaled prostacyclins in patients with ARDS.

DATA EXTRACTION:
Change in the Pao
2/Fio
2 ratio, Pao
2, and mean pulmonary artery pressure (mPAP) were extracted from included studies. Evidence certainty and risk of bias were evaluated using Grading of Recommendations Assessment, Development, and Evaluation and the Cochrane Risk of Bias tool.

DATA SYNTHESIS:
We included 23 studies (1,658 patients) from 6,339 abstracts identified by our search strategy. The use of inhaled prostacyclins improved oxygenation by increasing the Pao
2/Fio
2 ratio from baseline (mean difference [MD], 40.35; 95% CI, 26.14–54.56; p < 0.00001; I
2 = 95%; very low quality evidence). Of the eight studies to evaluate change in Pao
2, inhaled prostacyclins also increased Pao
2 from baseline (MD, 12.68; 95% CI, 2.89–22.48 mm Hg; p = 0.01; I
2 = 96%; very low quality evidence). Only three studies evaluated change in mPAP, but inhaled prostacyclins were found to improve mPAP from baseline (MD, –3.67; 95% CI, –5.04 to –2.31 mm Hg; p < 0.00001; I
2 = 68%; very low quality evidence).

CONCLUSIONS:
In patients with ARDS, use of inhaled prostacyclins improves oxygenation and reduces pulmonary artery pressures. Overall data are limited and there was high risk of bias and heterogeneity among included studies. Future studies evaluating inhaled prostacyclins for ARDS should evaluate their role in ARDS subphenotypes, including cardiopulmonary ARDS.
Xuanfeibaidu Granule Alleviates Coronavirus-Induced Pneumonia in Low Temperature and High Humidity Environments
Authors: Zhao Qianru , Zhao Ronghua , Geng Zihan , Bao Lei , Guo Shanshan , Wang Yu , Cui Xiaolan 
Published: June 2023

Objective:Our study aimed to investigate the action of Xuanfei Baidu granules (XFBD) and their mechanism of action in a model of coronavirus pneumonia under cold and damp conditions.Methods:A total of 60 Bagg Albino (BALB/c) mice were randomly assigned to different groups, including the control, model, low-dose XFBD (1.84 g/kg) medium-dose XFBD (3.67 g/kg) and high-dose XFBD (7.34 g/kg) groups. To simulate the model of coronavirus infection, a combination of cold and damp stimuli and coronavirus strain 229E (CoV 229E) was employed. Subsequently, XFBD was administered on the fifth day and lasted for 3 days. To evaluate the efficacy of XFBD in BALB/c mice, various parameters, including behavior, lung index, viral load, and pulmonary pathology, were observed. Levels of interleukin-6 (IL-6), IL-10, and tumor necrosis factor-α (TNF-α) were measured using enzyme-linked immunosorbent assay (ELISA). The fractions of CD4+T cells, CD8+T cells, and B cells were measured using flow cytometry.Results:The mice in the control group were active, in good condition, and exhibited shiny hair. After modeling, the mice demonstrated less activity, low energy levels, messy and less shiny hair, poor appetite, and soft stools. The symptoms of coronavirus pneumonia were all significantly improved after the administration of different doses of XFBD. At three dosage levels, XFBD effectively increased gastrin (GAS) content, whereas medium and high doses of XFBD reduced motilin (MTL) content. The high-dose XFBD group showed a significant reduction in pathological damage to lung tissue. Treatment with three doses of XFBD demonstrated significant downregulation of inflammatory factors and regulation of CD4+and CD8+T cell and B cell expression. The high-dose XFBD group exhibited enhanced efficacy compared to the other doses.Conclusions:XFBD showed a therapeutic effect on coronavirus pneumonia under cold and damp conditions, improved the behavioral characterization and gastrointestinal index, and reduced the lung virus titer and histopathology. This may be associated with the inhibition of inflammation and an increase in the number of lymphocytes.
In search of conditioned pain: an experimental analysis
Authors: Kang Sahaj , Van Ryckeghem Dimitri M.L. , Vlaeyen Johan W.S. , De Paepe Annick L. , Crombez Geert 
Published: June 2023

Abstract
There is an ongoing debate about whether pain can be classically conditioned, but surprisingly, evidence is scarce. Here, we report 3 experiments investigating this idea. In a virtual reality task, healthy participants were approached and touched near or on their hand with a coloured pen (blue or yellow). During acquisition, participants learned that one of the colours of the pen (CS+) was predictive of a painful electrocutaneous stimulus (ECS) whereas the other coloured pen (CS−) was not. During the test phase, more frequent reports of experiencing an US when none was delivered (“false alarm”) for the CS+ vs CS− qualified as evidence of conditioned pain. Notable differences between experiments were that the US was delivered when the pen touched a spot between the thumb and index finger (experiment 1; n = 23), when it virtually touched the hand (experiment 2; n = 28) and when participants were informed that the pen caused pain rather than simply predicting something (experiment 3; n = 21). The conditioning procedure proved successful in all 3 experiments: Self-reported fear, attention, pain, fear, and US expectancy were higher (P < 0.0005) for the CS+ than the CS−. There was no evidence for conditioned pain in experiment 1, but there was some evidence in experiments 2 and 3. Our findings indicate that conditioned pain may exist, albeit most likely in rare cases or under specific situations. More research is needed to understand the specific conditions under which conditioned pain exists and the underlying processes (eg, response bias).
Variation in the management of adhesive small bowel obstruction in the Netherlands: a prospective cross-sectional study
Authors: Krielen Pepijn , Kranenburg Lisa P.A. , Stommel Martijn W.J. , Bouvy Nicole D. , Tanis Pieter J. , Willemsen Jorn J. , Migchelbrink Jorne , de Ree Rick , Bormans Esther M.G. , van Goor Harry , ten Broek Richard P.G. ,   ASBO Snapshot Study Group
Published: June 2023

Background:
ASBO is a frequent abdominal surgical emergency and a leading cause of morbidity and mortality in emergency surgery. The aim of this study is to provide insight into the current management of adhesive small bowel obstruction (ASBO) and associated outcomes.

Methods and materials:
A nationwide prospective cross-sectional cohort study was conducted. All patients with clinical signs of ASBO admitted to participating Dutch hospitals were included during a 6 months inclusion period between April 2019 and December 2020. Ninety-day clinical outcomes were described and compared for nonoperative management (NOM) and laparoscopic and open surgery.

Results:
In 34 participating hospitals, 510 patients were included, of whom 382 (74.9%) had a definitive diagnosis of ASBO. Initial management consisted of emergency surgery in 71 (18.6%) patients and NOM in 311 (81.4%) patients, 119 (31.1%) of whom required delayed surgery after failure of NOM. Surgical interventions started laparoscopically in 51.1%, of which 36.1% were converted to laparotomy. Intentional laparoscopy resulted in shorter hospital stays compared with open surgery (median 8.0 vs. 11.0 days; P<0.001) and comparable hospital mortality (5.2 vs. 4.3%; P=1.000). Oral water-soluble contrast use was associated with a decreased length of stay (P=0.0001). Hospital stay for surgical patients was shorter in patients who were operated on within 72 h of admission (P<0.001).

Conclusion:
This nationwide cross-sectional study demonstrates shorter hospital stay in ASBO patients who received water-soluble contrast, were operated within 72 h of admission or were operated with minimally invasive techniques. Results may support the standardization of ASBO treatment.
Textbook outcomes in liver surgery for gallbladder cancer patients treated with curative-intent resection: a multicenter observational study
Authors: Liu Zhi-Peng , Guo Wei , Yin Da-Long , Chen Wei-Yue , Wang Jiao-Yang , Li Xue-Lei , Yue Ping , Yu Chao , Wu Zhao-Ping , Ding Rui , Zhu Yi , Huang Fan , Zhou Jin-Xue , Zhang Dong , Chen Wei , Jiang Yan , Bai Jie , Wang Jing-Jing , Zhang Yan-Qi , Dai Hai-Su , Lau Wan Yee , Chen Zhi-Yu 
Published: June 2023

Background:
Cholecystectomy, hepatectomy, and lymphadenectomy are recommended as the curative treatment for resectable gallbladder cancer (GBC). Textbook outcomes in liver surgery (TOLS) is a novel composite measure that has been defined by expert consensus to represent the optimal postoperative course after hepatectomy. This study aimed to determine the incidence of TOLS and the independent predictors associated with TOLS after curative-intent resection in GBC patients.

Methods:
All consecutive GBC patients who underwent curative-intent resection between 2014 and 2020 were enrolled from a multicenter database from 11 hospitals as the training and the internal testing cohorts, and Southwest Hospital as the external testing cohort. TOLS was defined as no intraoperative grade greater than or equal to 2 incidents, no grade B/C postoperative bile leaks, no postoperative grade B/C liver failure, no 90-day postoperative major morbidity, no 90-day readmission, no 90-day mortality after hospital discharge, and R0 resection. Independent predictors of TOLS were identified using logistic regression and were used to construct the nomogram. The predictive performance was assessed using the area under the curve and calibration curves.

Results:
TOLS was achieved in 168 patients (54.4%) and 74 patients (57.8%) from the training and internal testing cohorts, and the external testing cohort, respectively. On multivariate analyses, age less than or equal to 70 years, absence of preoperative jaundice (total bilirubin≤3 mg/dl), T1 stage, N0 stage, wedge hepatectomy, and no neoadjuvant therapy were independently associated with TOLS. The nomogram that incorporated these predictors demonstrated excellent calibration and good performance in both the training and external testing cohorts (area under the curve: 0.741 and 0.726).

Conclusions:
TOLS was only achieved in approximately half of GBC patients treated with curative-intent resection, and the constructed nomogram predicted TOLS accurately.
Concomitant Introduction of New Robotic Systems (Hugo RAS and Versius) at a Single Center: Analysis of First Clinical Cases of Radical Prostatectomy by a Single Surgeon
Authors: Rocco Bernardo , Turri Filippo , Sangalli Mattia , Centanni Stefano , Stocco Matteo , Chiumello Davide , Assumma Simone , Coelho Rafael Ferreira , Sarchi Luca , Grasso Angelica , Piacentini Igor , Dell’Orto Paolo , Calcagnile Tommaso , Sighinolfi Maria Chiara 
Published: June 2023

Abstract

Introduction:
Radical prostatectomy is a standard option for clinically localized prostate cancer. The first robot-assisted radical prostatectomy (RARP) was performed in 2001 with the DaVinci surgical system (Intuitive Surgical Inc., Sunnyvale, CA); after 2 decades from the first procedure and the expiry of the patents, new systems are entering the market to improve the existing technology and increase the whole accessibility to robotic surgery. Currently, a face-to-face comparison of systems is still unavailable. The aim of the study was to report the first case of concomitant introduction of new systems—Hugo robot-assisted surgery (RAS) and Versius surgical system—at a single center already equipped with a Da Vinci.

Methods:
This is a prospective study that analyzes the first cases performed with the Hugo RAS and Cambridge Medical Robotics Versius for RARP at a single center. Three patients with clinical organ-confined prostate cancer were selected to receive a Hugo RAS, a CMR Versius, or a DaVinci—as standard reference—radical prostatectomy. All procedures were recorded, and videos were reviewed by internal and external reviewers. RARP was evaluated according to the definition of metric errors and critical errors (Mottrie et al, BJU 2020) (See Supplemental Data, http://links.lww.com/JU9/A20). The primary end point is to evaluate the safety of novel systems; outcome measure is the absence of critical errors or intraoperative adverse events.

Results:
Surgical procedures were fully completed with all robotic systems. No intraoperative adverse events occurred, nor surgical errors classified as “critical” according to the European Association of Urology Robotic Urology Section metric system. None of the metric error nor technological issues were clinically significant to invoke a change in surgical strategy.

Conclusions:
This is the first analysis of concomitant introduction of new robotic systems at a single institution. Even if the shift from one model to another is expected to pose some challenges for surgeons, RARP is feasible with HugoRAS and Versius systems by an already experienced surgeon with the Da Vinci. A proper structured training is mandatory; the impact of prior console expertise is unknown and still unmeasured, but is expected to have significance. The current clinical experience supports the feasibility of the implementation of a new surgical system into surgical practice; however, further studies are required to evaluate outcomes in an unselected cohort.
The psychosocial impact of thyroid cancer
Authors: Haymart Parker , Levin Nina Jackson , Haymart Megan R. 
Published: June 2023

Purpose of Review
This review discusses the psychosocial impact of thyroid cancer diagnosis and management. It summarizes recent findings, presents management options, and briefly discusses future directions.

Recent Findings
A thyroid cancer diagnosis and its downstream management can impact patients in a variety of ways, including contributing to distress, worry, worse quality of life, and in some cases, anxiety and depression. Racial/ethnic minorities, those with lower education, women, adolescents/young adults, and individuals with a prior mental health conditions are a few of the patient groups at greater risks for adverse psychosocial effects from their thyroid cancer diagnosis and management. Findings are mixed, but some studies suggest treatment, for example, more intensive treatment as opposed to less, may be associated with a greater psychosocial impact. Clinicians providing care to thyroid cancer patients use a variety of resources and techniques, some more effective than others, to provide support.

Summary
A thyroid cancer diagnosis and its subsequent treatment can greatly impact a patient's psychosocial wellbeing, particularly for at-risk groups. Clinicians can help their patients by informing them of the risks associated with treatments and by offering education and resources for psychosocial support.
Peripartum Pubic Symphysis Diastasis
Authors: Anastasio Mary Katherine , Anastasio Albert T. , Kuller Jeffrey A. 
Published: June 2023

Importance
Peripartum separation of the pubic symphysis is a rare but potentially severe complication of childbirth, which may lead to prolonged immobilization. Thus, prompt diagnosis and treatment are paramount.

Objective
The purpose of this review is to define peripartum separation of the pubic symphysis and provide a thorough review of its etiology, clinical manifestations, diagnostic imaging techniques, management, and prognosis.

Evidence Acquisition
This was a literature review using PubMed and Google Scholar.

Results
Peripartum pubic symphysis separation is defined as disruption of the pubic symphysis joint and ligamentous structures with greater than 1 cm of separation during delivery. Risk factors include fetal macrosomia, nulliparity, and precipitous labor. Patients often present with a sensation of something “giving way” in the pubic symphysis area at the time of delivery, or with severe pain in the pubic symphysis region with attempted mobilization postpartum. In severe cases, associated hematomas, pelvic fractures, sacroiliac joint disruption, and urinary tract injury may be seen. Imaging such as x-ray or ultrasound may be used to confirm the diagnosis. Although most patients recover well with conservative management, orthopedic surgical intervention may be indicated in more severe or unresolved cases.

Conclusions and Relevance
Pubic symphysis separation is increasingly identified peripartum due enhanced accessibility and utilization of imaging modalities. It can be debilitating and lead to prolonged immobility postpartum. Therefore, early recognition and diagnosis are important, as this can guide decision-making for management. A multidisciplinary team approach, including coordination with obstetrics, orthopedic surgery, physical therapy, and occupational therapy should be used for early detection and treatment to ensure optimal patient outcomes.

Target Audience
Obstetricians and gynecologists, family physicians.

Learning Objectives
After completing this activity, learners should be better able to define peripartum separation of the pubic symphysis and discuss the relevant anatomy involved; identify risk factors associated with peripartum separation of the pubic symphysis; describe the typical presentation of a patient with separation of the pubic symphysis and next steps in making the diagnosis; and explain both conservative and orthopedic surgical intervention methods for treatment of peripartum separation of the pubic symphysis.
Changing Practice: Clinical Application of Resistance Training Evidence for Children With Cerebral Palsy
Authors: Hedgecock James B. , Harris Nicole M. , Rapport Mary Jane 
Published: June 2023

Purpose:
Describe the development and application of a progressive resistance exercise (PRE) program for children with cerebral palsy (CP), which became a standard care model at an urban specialty hospital network.

Summary of Key Points:
Muscle structure and performance have been shown to impact function and participation in children with CP. Use of PRE to achieve function and participation goals is supported by a growing body of evidence. A novel guideline, focused on individualized, goal-focused PRE dosing, professional development, program monitoring, and outcome measures use, facilitated application of a new clinical practice.

Conclusions:
Practice change was accomplished by translating evidence using a clinical guideline resulting in positive child function and participation outcomes.

Recommendations for Clinical Practice:
This Special Communication provides an example of addressing goal-related muscle performance impairments in children with CP. Clinicians should consider updating long-standing physical therapy intervention strategies by incorporating goal-specific PRE into practice.
Integrating Contact Tracers Into Point-of-Care Testing Workflow to Accelerate the Tracing of People With Exposure to COVID-19, August-December 2020, New York City
Authors: Udeagu Chi-Chi N. , Gbedemah Misato , Pitiranggon Masha , Feldman Samantha , Cordoba Evette , Goldenberg Shifra , Keeley Chris , Blaney Kathleen , Vora Neil M. , Long Theodore 
Published: June 2023

Objectives:
We assessed the timeliness of contact tracing following rapid-positive COVID-19 test result at point-of-care testing (POCT) sites in New York City (NYC).

Design:
Interviewed case-patients to elicit exposed contacts and conducted COVID-19 exposure notifications.

Settings:
Twenty-two COVID-19 POCT sites in NYC, the 2 NYC international airports, and 1 ferry terminal.

Participants:
Case-patients with rapid-positive COVID-19 test results and their named contacts.

Main Outcome Measures:
We quantified the proportions of interviewed individuals with COVID-19 and notified contacts and assessed the timeliness between the dates of the rapid-positive COVID-19 test results and the interviews or notifications.

Results:
In total, 11 683 individuals with rapid-positive COVID-19 test results were referred for contact tracing on the day of their diagnosis; 8878 (76) of whom were interviewed within 1 day of diagnosis, of whom 5499 (62%) named 11 486 contacts. A median of 1.24 contacts were identified from each interview. The odds of eliciting contacts were significantly higher among individuals reporting COVID-19 symptoms than among persons with no symptoms (51% vs 36%; adjusted odds ratio [aOR] = 1.37; 95% confidence interval [CI], 1.11-1.70) or living with 1 or more persons than living alone (89% vs 38%; aOR = 12.11; 95% CI, 10.73-13.68). Among the 8878 interviewed case-patients, 8317 (94%) were interviewed within 1 day of their rapid-positive COVID-19 test results and 91% of contact notifications were completed within 1 day of contact identification. The median interval from test result to interview date and from case investigation interview to contact notification were both 0 days (IQR = 0).

Conclusions:
The integration of contact tracers into COVID-19 POCT workflow achieved timely case investigation and contact notification. Accelerated contact tracing can be used to curb COVID-19 transmission during local outbreaks.
The Emerging Leaders in Public Health Initiative: Individual Leadership Transformation
Authors: Orton Stephen , Schenck Anna P. , Suttie Janet , Carter-Edwards Lori , Herrick Jeannine , Dinkin Donna R. , Meadows Phyllis 
Published: June 2023

The Emerging Leaders in Public Health (ELPH) Initiative, sponsored by The Kresge Foundation, provided leadership development to local governmental public health leaders. An adaptive leadership framework was used to shape the curriculum. The coleads attended multiday convenings and webinars over a 16- to 18-month period. Key components of the initiative included using applied learning to solidify their leadership skills as they worked to develop a new role for their agencies provision of a resource grant from The Kresge Foundation to support agency transformation and technical assistance and consultation provided by a National Program Office.
An external evaluator conducted a multicomponent evaluation of individual leadership skill change. Graduates assessed change in their own leadership and change in their colead. Colleagues of ELPH participants were surveyed about their observed changes in the leadership actions of the program graduates.
One hundred four leaders from 30 states participated in the initiative in 3 successive cohorts. Leaders demonstrated improvement as shown by self-report and external observation. Improved ability to communicate in a way that inspires others was one of the most significant changes in leadership behaviors. Additional leadership actions were strengthened including the ability to create and maintain high-performing teams, the ability to ask transformational questions, and the ability to actively listen to understand.
The pandemic has shown the importance of developing the field, starting with leadership. Leadership development and agency transformation are synergistic; they depend on each other and support each other.