bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intranasal CRMP2-Ubc9 inhibitor regulates NaV1.7 to alleviate trigeminal neuropathic pain
Authors: Loya-Lopez Santiago I. , Allen Heather N. , Duran Paz , Calderon-Rivera Aida , Gomez Kimberly , Kumar Upasana , Shields Rory , Zeng Rui , Dwivedi Akshat , Saurabh Saumya , Korczeniewska Olga A. , Khanna Rajesh 
Published: September 2023

Abstract
Dysregulation of voltage-gated sodium NaV1.7 channels in sensory neurons contributes to chronic pain conditions, including trigeminal neuropathic pain. We previously reported that chronic pain results in part from increased SUMOylation of collapsin response mediator protein 2 (CRMP2), leading to an increased CRMP2/NaV1.7 interaction and increased functional activity of NaV1.7. Targeting this feed-forward regulation, we developed compound 194, which inhibits CRMP2 SUMOylation mediated by the SUMO-conjugating enzyme Ubc9. We further demonstrated that 194 effectively reduces the functional activity of NaV1.7 channels in dorsal root ganglia neurons and alleviated inflammatory and neuropathic pain. Here, we used a comprehensive array of approaches, encompassing biochemical, pharmacological, genetic, electrophysiological, and behavioral analyses, to assess the functional implications of NaV1.7 regulation by CRMP2 in trigeminal ganglia (TG) neurons. We confirmed the expression of Scn9a, Dpysl2, and UBE2I within TG neurons. Furthermore, we found an interaction between CRMP2 and NaV1.7, with CRMP2 being SUMOylated in these sensory ganglia. Disrupting CRMP2 SUMOylation with compound 194 uncoupled the CRMP2/NaV1.7 interaction, impeded NaV1.7 diffusion on the plasma membrane, and subsequently diminished NaV1.7 activity. Compound 194 also led to a reduction in TG neuron excitability. Finally, when intranasally administered to rats with chronic constriction injury of the infraorbital nerve, 194 significantly decreased nociceptive behaviors. Collectively, our findings underscore the critical role of CRMP2 in regulating NaV1.7 within TG neurons, emphasizing the importance of this indirect modulation in trigeminal neuropathic pain.
Transitions in care: Piloting a neurocritical care clinic with nurse practitioners and physician associates
Authors: Michaelis Chloe , Hundt Elizabeth , Lombardi William , Howie Esquivel Jill 
Published: September 2023

ABSTRACT
The transition period from hospital to home is a vulnerable time for rehospitalization and adverse events for patients. Follow-up clinic visits within 7–14 days of discharge is an effective strategy for reducing hospital readmissions. Neurocritical care patients have a unique set of needs to safely transition to home. We evaluated the feasibility of a Neuroscience Rapid Follow-Up Clinic with nurse practitioners (NPs) and physician associates (PAs) to meet transitional care gaps in neurocritical care patients and prevent rehospitalization. Clinic procedures and documentation templates were customized for the pilot clinic. Five NPs and one PA underwent a brief training course for the ambulatory care setting. Eligible patients were tracked throughout the hospitalization and the team made follow-up appointments. The pilot clinic took place from October 2022 to January 2023. Nine patients were seen in the clinic approximately 8 days after discharge. The clinic attendance rate was 90%. Among the clinic attendees, 66% received referrals to a primary care provider or other services, one third received medication changes or refills and all received patient-specific education. There were no rehospitalizations among the clinic patients. Implementation of this pilot clinic was possible with the current departmental resources. This innovative model of care has the potential to reduce hospital readmissions.
Dietary fiber deficiency in individuals with metabolic syndrome: a review
Authors: Veluvali Arvind , Snyder Michael 
Published: September 2023

Purpose of review
Metabolic syndrome (MetS) refers to a group of risk factors, which increase the risk of cardiovascular disease (CVD), type 2 diabetes (T2D), and other chronic diseases. Dietary fiber has been shown to mitigate many of the effects of various risk factors associated with MetS. Our review summarizes the recent findings on the association between dietary fiber deficiency and MetS.

Recent findings
A number of studies have shown that dietary fiber deficiency is associated with an increased risk of MetS. The main mechanisms by which dietary fiber may reduce the risk of MetS include reduction of cholesterol levels; improvement of blood sugar control; reduction of inflammation; and promotion of weight loss.

Summary
Literature suggests that a deficiency in dietary fiber consumption is a risk factor for MetS. An increase in dietary fiber intake may help to reduce the risk of developing MetS and its associated chronic diseases.
Intestinal microbiome in short bowel syndrome: diagnostic and therapeutic opportunities
Authors: Chowdhury Fariha , Hill Lee , Shah Nyah , Popov Jelena , Cheveldayoff Paige , Pai Nikhil 
Published: September 2023

Purpose of review
The intestinal microbiome plays a strong, complementary role in the development and integrity of the intestinal epithelium. This biology is crucial for intestinal adaptation, particularly after the mucosal insults that lead to short bowel syndrome (SBS). The purpose of this review is to discuss relationships between the intestinal microbiota and the physiology of intestinal adaptation.

Recent findings
We will address interactions between the intestinal microbiome and nutritional metabolism, factors leading to dysbiosis in SBS, and common compositional differences of the gut microbiome in SBS patients as compared to healthy controls. We will also discuss novel opportunities to expand diagnostic and therapeutic interventions in this population, by using our knowledge of the microbiome to manipulate luminal bacteria and study their resultant metabolites. As microbial therapeutics advance across so many fields of medicine, this review is timely in its advocacy for ongoing research that focuses on the SBS population.
Our review will discuss 4 key areas: 1) physiology of the intestinal microbiome in SBS, 2) clinical and therapeutic insults that lead to a state of dysbiosis, 3) currently available evidence on microbiome-based approaches to SBS management, and 4) opportunities and innovations to inspire future research.

Summary
The clinical implications of this review are both current, and potential. Understanding how the microbiome impacts intestinal adaptation and host physiology may enhance our understanding of why we experience such clinical variability in SBS patients’ outcomes. This review may also expand clinicians’ understanding of what ‘personalized medicine’ can mean for this patient population, and how we may someday consider our nutritional, therapeutic, and prognostic recommendations based on our patients’ host, and microbial physiology.
Comparative Different Interventions to Improve Exercise Adherence in Patients in the Postoperative Breast Cancer Phase of Care
Authors: Ma Ximei , Zhuang Simin , Hou Jiawen , Zhao Yanan , Xiao Guanghong , Chen Mengyun , Wang Yanhong 
Published: September 2023

Background
Global Cancer Statistics 2020 reported that breast cancer had exceeded lung cancer as the most frequently diagnosed cancer. Surgery is the primary treatment modality for breast cancer, but postoperative upper limb dysfunction often occurs; functional exercise can alleviate this and restore upper limb function. However, exercise compliance is low in postoperative breast cancer patients; thus, many studies have been conducted in recent years to improve patient compliance with exercise.

Objective
The aim of this study was to compare the effectiveness of different interventions to improve exercise adherence in postoperative breast cancer patients.

Methods
We searched PubMed, Cochrane Library, Web of Science, EMBASE, Wan Fang, CNKI, VIP, and CBM databases for eligible studies. Exercise adherence rate and quality-of-life difference were assessed as outcomes. Sensitivity analysis and inconsistency detection were performed to evaluate whether the exclusion of high-risk studies affected the validity. Risk of bias was assessed using the risk-of-bias table in RevMan 5.4. Surface under the cumulative ranking was used to estimate the rankings among different interventions.

Results
Twenty-five randomized controlled trials involving 9 interventions were included, and the network meta-analysis results showed that patients in the pedometer + counseling group had the best exercise adherence.

Conclusion
Pedometer + counseling care measures are recommended to improve exercise adherence in postoperative breast cancer patients.

Implications for Practice
Oncology nurses can improve patients’ exercise compliance through counseling and by giving them pedometers to wear.
Assessing Nurse Competency in the Veterans Health Administration Registered Nurse Transition-to-Practice Residency Program
Authors: Barrett Blake , Toyinbo Peter , Couig Mary Pat , Chavez Margeaux , Rugs Deborah , Melillo Christine , Cowan Linda , DeMasi Kim , Sullivan Sheila Cox , Powell-Cope Gail 
Published: September 2023

Background:
New graduate registered nurse (RN) competencies are complex and difficult to measure. Psychometrically sound tools are needed to evaluate competencies for nurses participating in nurse residencies.

Purpose:
Project aims were to develop an item pool for a tool to measure new graduate RN competencies for the Veterans Health Administration RN Transition-to-Practice Residency Program; validate item pool content; and use consensus methods to improve item pool content validity.

Methods:
A sequential, mixed-methods design was used. Item pool creation, content validation, and revisions included a collaborative process with the evaluation team, operational stakeholders, and subject matter experts (SMEs).

Results:
Inclusion of SMEs in item development enhanced item pool content validity to measure nurse competency. Stakeholder feedback ensured programmatic logistical and evaluation concerns were met.

Conclusions:
Engaging SMEs in conceptualization, item development, and aligning existing standards enhanced item pool content validity to measure nurse competencies for new graduate RNs.
Self-efficacy in Quality Improvement Competency of Frontline Acute Care Registered Nurses
Authors: Ledbeter Lauri 
Published: September 2023

Background:
Registered nurses (RNs) are attuned to health care quality and safety concerns but may lack competency in quality improvement (QI) to advance care quality.

Purpose:
To describe frontline acute care RNs' self-efficacy in QI competencies, evaluate differences based on educational attainment, and evaluate relationships based on years of RN experience.

Methods:
The study used a descriptive, quantitative, correlational, comparative cross-sectional survey design to evaluate RNs' self-efficacy in QI competency using the 2021 American Association of Colleges of Nursing The Essentials: Core Competencies for Professional Nursing Education.

Results:
Frontline RNs' overall QI self-efficacy showed variability in knowledge, skills, and attitudes, with no relationship between self-efficacy and years of RN experience, nor difference based on educational attainment.

Conclusions:
Insufficient self-efficacy signals the need for further QI focus in nursing education, nursing practice, and health care policy to harness RNs' ability to advance care outcomes.
Cross-sectional Study Exploring Vision-related Quality of Life in Dry Eye Disease in a Norwegian Optometric Practice
Authors: Erøy Åsmund André , Utheim Tor Paaske , Sundling Vibeke 
Published: September 2023

SIGNIFICANCE
Dry eye disease causes ocular pain, blurred vision, reduced visual quality of life, and reduced workplace performance. This disease is underreported and underdiagnosed despite being highly prevalent in optometric care.

PURPOSE
This study aimed to explore the vision-related quality of life of patients with dry eye disease and the potential benefits of screening for dry eye disease in Norwegian optometric practice.

METHODS
This study adopted an observational, prospective, cross-sectional design. All patients between 18 and 70 years of age who were examined between June 8 and July 5, 2018, at Erøy Optikk, Kristiansand, Norway, were invited to participate. Dry eye disease was assessed according to Tear Film & Ocular Surface Society International Dry Eye Workshop II report recommendations. Vision-related quality of life was assessed with the National Eye Institute 25-item Visual Function Questionnaire.

RESULTS
Forty-nine patients participated in the study; 29 (59%) were female, and 29 (59%) had dry eye disease. The patients with dry eye disease reported significantly more ocular pain and (vision-specific) role difficulties than the patients without dry eye disease. After adjusting for age, sex, and habitual visual acuity, dry eye disease was found to be an independent predictor of both ocular pain (r
2 = 0.328, P = .001) and (vision-specific) role difficulties (r
2 = 0.240, P = .02). Both habitual visual acuity and dry eye disease were predictors of reduced general vision, a reduced score for near activity and reduced (vision-specific) mental health.

CONCLUSIONS
Dry eye disease was an independent predictor of ocular pain (vision-specific), role difficulties, and reduced general vision, near vision, and (vision-specific) mental health. Optometrists should consider dry eye disease as a cause of reduced vision and quality of vision. Furthermore, we propose that screening for dry eye disease in Norwegian optometric practice can promote better vision and health among patients.
Predictors of Lumpectomy Size after Breast-Conserving Surgery in Patients with Breast Cancer: A Retrospective Cohort Study
Authors: Makineli Seher , Strijbis Rogier , Tsehaie Jonathan , Schellekens Pascal P. A. , Moman Maaike R. , Veenendaal Liesbeth M. , Ferdinandus Patrick I. , Witkamp Arjen J. , Richir Milan C. , Maarse Wies 
Published: September 2023

Background:
Oncoplastic reconstructive surgery as an extension of breast-conserving surgery leads to better aesthetic results, an increase in tumor-free margins, and a reduction in reexcision rates. Oncologic resection is often more extensive than expected, sometimes resulting in the plastic surgeon deviating from the predetermined plan. For optimal planning of the reconstruction, it is mandatory to estimate volume defects after lumpectomy as accurately as possible. The authors aimed to identify preoperative predictors of lumpectomy resection size.

Methods:
All consecutive patients diagnosed with invasive breast carcinoma or carcinoma in situ and treated primarily with breast-conserving surgery between 2018 and 2020 at the University Medical Center Utrecht or Alexander Monro Hospital were included. Patient and tumor characteristics were measured. Data were analyzed in a multiple linear regression analysis.

Results:
A total of 410 patients (423 cases) were included, with a median age of 58 years (range, 32 to 84 years) and a mean body mass index (BMI) of 25.0 (SD 9.3). The mean maximum radiologic tumor diameter was 18.0 mm (SD 13.2), and the mean maximum lumpectomy diameter was 58.8 mm (SD 19.2). Multiple linear regression analysis found an explained variance of R2 = 0.60 (P < 0.00), corrected for operating surgeon. Significant predictors for postoperative lumpectomy size were BMI, breast size, and maximum preoperative radiologic tumor diameter. A predictive tool for lumpectomy size was developed and a web-based application created to facilitate use of the tool in a clinical setting.

Conclusions:
Postoperative lumpectomy size can be predicted using BMI, breast size, and radiologic tumor size. This model could be beneficial for breast surgeons in planning reconstructions and preparing and informing their patients more accurately.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Risk, III.
Simultaneous Reconstruction of Smiling Eye Using V-Shaped Long Latissimus Dorsi Muscle Transfer in Patients with Flaccid Facial Paralysis
Authors: Okazaki Mutsumi , Miyamoto Shimpei , Tomioka Yoko , Fujisawa Kou 
Published: September 2023

Summary:
Various neurovascular free muscle transfers for smile reconstruction in patients with facial paralysis have been reported. However, these methods focused on perioral smiling rather than eye smiling. Although the lower eyelid does not contribute significantly to eyelid closure, dynamic reanimation of the upward movement of the lower eyelid with bulging of the malar region during smiling is important in smile reconstruction. The authors present a novel procedure for smiling eye and perioral smiling. The V-shaped latissimus dorsi muscle flap containing the descending branch (DB) of the thoracodorsal nerve (TDN) was used. Muscle A (15 to 17 cm), which is located along the main trunk of the DB, is much longer than muscle B (10 to 12 cm), which is along the branch of DB. A distal stump of the TDN involved in muscle B was prepared. The true trunk and distal stump of the TDN were sutured to the contralateral facial and ipsilateral masseteric nerves, respectively. The central region of muscle A was positioned at the lateral part of the lower eyelid; the distal end of long muscle A was affixed to the temporal region, which enabled periocular movements and narrowing of the palpebral fissures alongside perioral smiling when muscle A contracted. Nine patients with complete flaccid facial paralysis were treated. All patients attained muscle contraction induced by the ipsilateral masseteric and contralateral facial nerves. The smiling eye appearance was observed in 7 of 9 patients. This procedure simultaneously improves paralytic ectropion at rest and aids eyelid closure and enables early voluntary smile and a later spontaneous smile.
Three Pedicle–Based Nipple-Sparing Skin-Reducing Mastectomy Combined with Prepectoral Implant-Based Breast Reconstruction
Authors: La Padula Simone , Pensato Rosita , Al-Amer Rasmieh , Hersant Barbara , Meningaud Jean Paul , Noel Warren , D’Andrea Francesco , Rocco Nicola 
Published: September 2023

Background:
Nipple-sparing mastectomy (NSM) and immediate breast reconstruction have demonstrated positive aesthetic outcomes and high patient satisfaction. However, challenges arise when performing NSM on patients with large and ptotic breasts because of the higher risk of nipple-areola complex (NAC) necrosis. This study proposes a new technique: the three pedicle–based nipple-sparing skin-reducing mastectomy (TP-NSSRM), combined with direct-to-implant (DTI) breast reconstruction, aimed at reducing complications.

Methods:
A prospective study was conducted from November of 2021 to April of 2022, enrolling patients with large and drooping breasts requiring mastectomy for breast cancer treatment or risk reduction. Patient selection criteria included a sternal notch–to-nipple distance of greater than or equal to 23 cm, grade 3 ptosis, and eligibility for immediate prepectoral DTI breast reconstruction. Patient satisfaction was assessed using BREAST-Q modules.

Results:
Seventy-two TP-NSSRM procedures combined with immediate DTI-based breast reconstruction were performed on a total of 45 patients. High patient satisfaction was observed, and statistically significant improvements were noted in postoperative BREAST-Q scores (P = 0.001). The complication rate was low, and preservation of the nipple-areola complex was achieved in all cases.

Conclusions:
The TP-NSSRM technique offers a potential solution for patients with large and drooping breasts undergoing NSM. It aims to minimize complications and achieve satisfactory outcomes. This study demonstrates favorable results in terms of patient satisfaction and quality of life. Further research and long-term follow-up are necessary to validate these findings and evaluate the long-term outcomes of this technique.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, IV.
A core outcome set for appendicitis: A consensus approach utilizing modified Delphi methodology
Authors: Butts Christopher A. , Byerly Saskya , Nahmias Jeffry , Gelbard Rondi , Ziesmann Markus , Bruns Brandon , Davidson Giana H. , Di Saverio Salomone , Esposito Thomas J. , Fischkoff Katherine , Joseph Bellal , Kaafarani Haytham , Mentula Panu , Podda Mauro , Sakran Joseph V. , Salminen Paulina , Sammalkorpi Henna , Sawyer Robert G. , Skeete Dionne , Tesoriero Ronald , Yeh Daniel Dante 
Published: September 2023

BACKGROUND
Appendicitis is one of the most common pathologies encountered by general and acute care surgeons. The current literature is inconsistent, as it is fraught with outcome heterogeneity, especially in the area of nonoperative management. We sought to develop a core outcome set (COS) for future appendicitis studies to facilitate outcome standardization and future data pooling.

METHODS
A modified Delphi study was conducted after identification of content experts in the field of appendicitis using both the Eastern Association for the Surgery of Trauma (EAST) landmark appendicitis articles and consensus from the EAST ad hoc COS taskforce on appendicitis. The study incorporated three rounds. Round 1 utilized free text outcome suggestions, then in rounds 2 and 3 the suggests were scored using a Likert scale of 1 to 9 with 1 to 3 denoting a less important outcome, 4 to 6 denoting an important but noncritical outcome, and 7 to 9 denoting a critically important outcome. Core outcome status consensus was defined a priori as >70% of scores 7 to 9 and <15% of scores 1 to 3.

RESULTS
Seventeen panelists initially agreed to participate in the study with 16 completing the process (94%). Thirty-two unique potential outcomes were initially suggested in round 1 and 10 (31%) met consensus with one outcome meeting exclusion at the end of round 2. At completion of round 3, a total of 17 (53%) outcomes achieved COS consensus.

CONCLUSION
An international panel of 16 appendicitis experts achieved consensus on 17 core outcomes that should be incorporated into future appendicitis studies as a minimum set of standardized outcomes to help frame future cohort-based studies on appendicitis.

LEVEL OF EVIDENCE
Diagnostic Test or Criteria; Level V.