bluuebunny/crossref_metadata_2025_split huggingface dataset:
Can active sun exposure decrease the risk of giant cell arteritis and polymyalgia rheumatica in women?
Authors: Gisslander Karl , de Boer Raïssa , Ingvar Christian , Turesson Carl , Isaksson Karolin , Jayne David , Mohammad Aladdin J 
Published: August 2023

Abstract

Objectives
To study if active sun exposure among women affects the risk of developing GCA or PMR in a prospective cohort study with restricted latitudinal variability.

Methods
We linked the response to questions relating to sun exposure from the Melanoma Inquiry in Southern Sweden (MISS) prospective cohort study in women to the risk of developing GCA or PMR. Healthcare data were gathered from the Skåne Healthcare Register (SHR), covering all public healthcare consultations. The direct effect of active sun exposure on the risk of developing GCA or PMR was assessed using Cox proportional hazards models adjusted for covariates based on a directed acyclic graph.

Results
A total of 14 574 women were included in the study; 601 women were diagnosed with GCA or PMR (144 and 457, respectively) during the follow-up time. Women with moderate or high sun exposure were not less likely to develop GCA or PMR compared with women that indicated they avoided sun exposure [hazard ratio (HR) 1.2 (CI 0.9, 1.6) and 1.3 (0.9, 1.9), respectively] when adjusted for diabetes, hyperlipidaemia, hypertension, smoking, obesity and stratified by age. Similar patterns were observed when studying only GCA [HR 1.2 (CI 0.7, 2.3) and 1.3 (0.7, 2.6)] and only PMR [HR 1.3 (CI 0.9, 1.8) and 1.4 (0.9, 2.0)].

Conclusion
Active sun exposure did not affect the risk of developing GCA or PMR in women in a cohort with restricted latitudinal variability.
Adopting Open Educational Resources as an Equity Strategy
Authors: Ernstmeyer Kimberly E. , Christman Elizabeth I. 
Published: August 2023

Abstract
Social determinants of learning (SDOL) impact students’ abilities to successfully complete their courses. An economic barrier for vulnerable students is the skyrocketing cost of textbooks. An innovative strategy to promote equity in educational delivery is the adoption of open educational resources (OER). The Open Resources for Nursing (Open RN) project published five OER textbooks with input from over 65 contributors and 300 reviewers. Open RN textbooks have received widespread national and international usage. Analysis of student outcomes indicates similar successful course completion rates by all students in OER course sections and increased rates of successful course completion by non-White students.
Low-dose Initiation of Buprenorphine in Hospitalized Patients on Full Agonist Opioid Therapy: A Retrospective Observational Study
Authors: Schult Rachel F. , Maynard Kaylee M. , Corvelli Jenna M. , Rappaport Stephen , McKinney Benjamin , Clarkson Trevor , Wiegand Timothy J. , Malcho Jade , Acquisto Nicole M. 
Published: August 2023

Objective
Buprenorphine can be challenging to initiate in hospitalized patients with opioid dependence because of difficulty tolerating an opioid-free period for buprenorphine induction. The objective of this study was to evaluate efficacy and safety of low-dose initiation of buprenorphine in hospitalized patients receiving full agonist opioids.

Methods
This is a retrospective observational study between January 1, 2019, and December 31, 2020, at an academic tertiary care center and affiliated community hospital. Participants included adult patients at least 18 years old receiving scheduled full agonist opioids who were given sublingual buprenorphine 0.5 mg or less with the intent of increasing to at least 4 mg daily. The primary endpoint was the proportion of patients reaching a target dose of at least 4 mg total per day. The secondary endpoints included the incidence of precipitated opioid withdrawal based on documentation of symptoms and change in morphine milligram equivalents before and after low-dose buprenorphine initiation.

Results
A total of 76 low-dose initiation attempts were performed in 71 predominantly male (68%) patients (some patients had multiple attempts). Most patients received low-dose initiation because of history of opioid use disorder (83%). Low-dose initiation was completed in 54 of 71 patients (76%) after 76 attempts. Precipitated withdrawal was identified in 2 patients (2.8%). Median morphine milligram equivalents excluding buprenorphine 24 hours before low-dose initiation was 1000 mg (interquartile range, 303.5–1720.5 mg) compared with 37.5 mg (interquartile range, 0–254 mg) after reaching target dose (P < 0.001).

Conclusions
Buprenorphine was safely initiated using low-dose initiation in hospitalized patients. This was associated with significant reduction in full agonist opioids.
Tumor Marker Trajectories and Survival Analysis in Patients with Normal Carcinoembryonic Antigen Ranges After Colorectal Cancer Resection
Authors: Chern Yih-Jong , Hsu Hsin-Yin , Hsu Yu-Jen , Hsu Le-Yin , Tsai Wen-Sy , Liao Chun-Kai , Jong Bor-Kang , You Jeng-Fu 
Published: August 2023

BACKGROUND:
Evidence regarding postoperative CEA for predicting long-term outcomes of colorectal cancer remains controversial, especially in patients with normal postoperative CEA.

OBJECTIVE:
To investigate the risk difference among different postoperative CEA trajectories in patients with normal postoperative CEA after curative colorectal cancer resection.

DESIGN:
This cohort study was conducted at a comprehensive cancer center and included data retrieved from a prospectively collected database between January 2006 and December 2018.

SETTINGS:
Retrospective cohort study.

PATIENTS:
Patients with colorectal cancer who underwent surgery for primary stage I–III colorectal adenocarcinoma were included. Patients with postoperative CEA >5 ng/mL were excluded.

INTERVENTIONS:
Standard curative radical resection was performed.

MAIN OUTCOME MEASURES:
Ten-year overall survival and disease-free survival were analyzed.

RESULTS:
The study population (n = 8156) was categorized into 6 trajectories, including persistently-ultralow (n = 2351), persistent-low (n = 2474), gradually-decrease (n = 401), persistent-medium (n = 1727), slightly-increase (n = 909), and around-upper-limit (n = 394). The median follow-up time was 7.8 years, and the median timeframe in which CEA was measured to determine trajectory was 2.6 years. The persistent-ultralow group had the highest 10-year overall survival (85.1%) and disease-free survival (82.7%). The around-upper-limit group had the lowest 10-year overall survival (55.5%) and disease-free survival (53.4%). The adjusted hazard ratio trend was comparable to crude hazard ratio of the persistent-ultralow group. Consequently, the higher initial serum CEA groups had higher hazard ratios of overall survival and disease-free survival. The adjusted hazard ratios of overall survival/disease-free survival were 2.96/2.66 (95% confidence interval: 2.39–3.66/2.18–3.69) for the around-upper-limit groups.

LIMITATIONS:
The study was limited by its retrospective design.

CONCLUSIONS:
The postoperative serum CEA trajectory is an independent factor associated with long-term outcomes. Although CEA levels were all within normal range, higher levels of postoperative serum CEA trajectory correlated with worse long-term oncological outcomes..
Small-aperture intraocular lens implantation after multiple penetrating keratoplasties secondary to penetrating ocular trauma
Authors: Vander Zee Brandon L. , Ferguson Tanner J. , Berdahl John P. , Kramer Brent A. 
Published: August 2023

Introduction:
The small-aperture intraocular lens (IOL) is a recently introduced IOL that can provide favorable central visual acuity in patients with irregular corneas. This case describes a patient with multiple prior penetrating keratoplasties secondary to ocular trauma that achieved a favorable outcome with the aforementioned IOL.

Patient and Clinical Findings:
A 66-year-old man presented with a penetrating corneal injury that was successfully repaired but was eventually complicated by fungal keratitis requiring a therapeutic penetrating keratoplasty (PKP). The patient had a prolonged postoperative course complicated by multiple graft failures and finally stabilized after a third PKP. Through the protracted course, the patient developed a brunescent cataract, and the multiple PKPs resulted in significant irregular astigmatism.

Diagnosis, Intervention, and Outcomes:
The patient underwent cataract surgery in the affected eye with implantation of a small-aperture IOL 18 months after his initial injury. The patient's uncorrected distance visual acuity was 20/20 at six months post-operatively and he reported excellent quality of vision.

Conclusions:
This case represents the first use of the small-aperture IOL in a patient with prior PKP since its U.S. Food and Drug Administration approval. The small-aperture IOL can overcome high levels of corneal irregularities and provide favorable visual acuity in complex eyes.
Development of an Interactive 3D Visualization Tutorial for Pathophysiology in Graduate Nursing Education
Authors: Rogers Julia L. , Reyes Abel , Yang Xiaoli 
Published: August 2023

Background:
A recent revision to the Nurse Practitioner Role Core Competencies will lead to robust changes in graduate education. Incorporating innovative technology into the core courses of advanced practice nursing will prepare practice-ready providers with a high level of competence leading to successful health outcomes, improved patient satisfaction, and decreased health care costs.

Problem:
Graduate education lacks effective, innovative, and interactive visualization tools to study pathophysiology. There is a lack of evidence for the use of 3-dimensional (3D) augmented reality (AR) and virtual reality in advanced practice core courses.

Approach:
A collaborative iterative approach was used to design, develop, analyze, update, and reiterate a 3D AR tutorial for advanced pathophysiology.

Outcomes:
Students had a positive experience and perceive 3D AR as a learning tool that can increase examination scores. The visualization connected the pathophysiologic process of a disease to the pathogenesis, clinical manifestations, and associated treatments.

Conclusions:
3D AR tutorials are an effective solution to facilitate learning difficult concepts in pathophysiology by incorporating following multiple learning techniques: visual, aural, verbal, kinesthetic, and logical.
Using a Clinical Triggers System to Improve Early Recognition of Clinical Changes
Authors: Lee Betty , Leng Jennifer , Kerbel Russell 
Published: August 2023

Purpose
A medical-surgical telemetry unit implemented a clinical triggers system for early recognition of clinical deterioration and bedside management between nurses and providers. The goal was to decrease cardiopulmonary arrest events.

Description of the Project
A clinical triggers system was developed to help nurses to identify clinical markers early and advocate for prompt bedside assessment and interventions. When clinical triggers were identified, the nurse notified the provider, who performed a bedside assessment within 15 minutes. If the provider did not respond promptly, the rapid response team was activated.

Outcomes
Before intervention, the unit experienced 14 cardiopulmonary arrest events (rate of 1.37 per 1000 patient days). Incidences decreased annually to 5, 4, and 3 events (rates of 0.49, 0.39, and 0.3 per 1000 patient days) during the 3-year implementation period.

Conclusions
The clinical triggers system was successful in achieving the project objective of decreasing unit cardiopulmonary arrest events through early recognition and response to patient deterioration during the implementation period. The clinical nurse specialist helped nurses to use the clinical triggers system to detect and respond to clinical changes. Nurses were empowered to address concerns and promote patient safety.
Transparency films: intraoperative templating to prevent limb deformity
Authors: Stine Sasha , Joiner Jonathan Daniel , Andersen Daniel , Schweller Eric , Vaidya Rahul 
Published: August 2023

Abstract:
Operative management of fractures and malunions can be challenging when restoring native anatomy is not straightforward. Comminuted fractures and managing deformity correction in the setting of osteolysis, callus, and even complete fracture healing must include careful planning. Preoperative planning has been popularized and taught as an integral part of a surgeon's skill set, with critical evaluation and assessment of the implemented plan being the final step in the process. We present a robust, reproducible, and cost-effective technique for intraoperative fracture fixation assessment with case examples, used routinely at our institution.
Nd:YAG Laser Capsulotomy: Efficacy and Outcomes Performed by Optometrists
Authors: Lighthizer Nathan , Johnson Spencer , Holthaus Jared , Holthaus Kathleen , Cherian Bibin , Swindell Ryan , Weber Brianna , Weise Karli , Cockrell David , Lewis Stephen , Wroten Christopher , Anastasio Jeff , Ellen Jason , Miller Jeffrey M. 
Published: August 2023

ABSTRACT

SIGNIFICANCE
An increasing number of optometrists are performing Nd:YAG laser capsulotomy procedures; however, there is limited published information on the outcomes of these procedures.

PURPOSE
This study aimed to assess the efficacy and safety of capsulotomy procedures performed by optometrists.

METHODS
Subjects diagnosed with posterior capsule opacification causing reduced vision and subjective visual complaints were recruited for this study. A baseline examination was performed to ensure that the subjects met all the necessary criteria. The procedure was performed by a licensed doctor of optometry at six different clinics, and each subject was monitored for visual outcome and any potential complications.

RESULTS
Subjects' Snellen visual acuity improved from an average of 20/40 to 20/23 (P < .001) with no complications of increased intraocular pressure, inflammation, visually significant lens pitting, macular edema, or retinal detachment. Of 78 subjects who responded to a post-procedure survey, 77 (99%) reported subjective improvement in vision after capsulotomy.

CONCLUSIONS
Based on the outcomes of this study, YAG laser capsulotomies are effective treatments to improve patient vision that can be safely and effectively performed by optometrists.
Reporting Rigor of Cancer Rehabilitation Interventions: Application of the CReDECI-2 Guidelines
Authors: Brick Rachelle , Voss Lauren , Arbid Sasha , Joshi Yash , Tome Genevieve , El Hassanieh Dima , Sleight Alix G. , Klein Caroline , Sabir Aisha , Wechsler Stephen , Campbell Grace , Campbell Kristin L. , Lam Adrienne , Lyons Kathleen D. , Padgett Lynne , Jones Jennifer 
Published: August 2023

Abstract
Clear reporting of cancer rehabilitation interventions is critical for interpreting and translating research into clinical practice. This study sought to examine the completeness of intervention reporting of cancer rehabilitation interventions addressing disability and to identify which elements are most frequently missing. This was a secondary analysis of randomized controlled trials included in two systematic reviews examining effectiveness of cancer rehabilitation interventions that address cancer-related disability, including functional outcomes. Eligible trials were reviewed for intervention reporting rigor using the Criteria for Reporting the Development and Evaluation of Complex Interventions in Healthcare-2 (CReDECI-2) checklist. Intervention descriptions for cancer rehabilitation interventions were generally incomplete. Approximately 85% (n = 157) of trials described ≤50% of CReDECI-2 checklist items. Commonly underreported items included description of the intervention’s underlying theoretical basis, fidelity, description of process evaluation or external conditions influencing intervention delivery, and costs or required resources for intervention delivery. The findings reveal that cancer rehabilitation intervention descriptions lacked necessary detail in this body of literature. Poor descriptions limit the translation of research to clinical practice. To ensure higher quality study design and reporting, future intervention research should incorporate an intervention reporting checklist to ensure more complete descriptions for research and practice.
Parental Preconception Posttraumatic Stress Symptoms and Maternal Prenatal Inflammation Prospectively Predict Shorter Telomere Length in Children
Authors: Rinne Gabrielle R. , Carroll Judith E. , Guardino Christine M. , Shalowitz Madeleine U. , Ramey Sharon Landesman , Dunkel Schetter Christine 
Published: August 2023

ABSTRACT

Objective
Parental trauma exposure and trauma-related distress can increase the risk of adverse health outcomes in offspring, but the pathways implicated in intergenerational transmission are not fully explicated. Accelerated biological aging may be one mechanism underlying less favorable health in trauma-exposed individuals and their offspring. This study examines the associations of preconception maternal and paternal posttraumatic stress disorder (PTSD) symptoms with child telomere length, and maternal prenatal C-reactive protein (CRP) as a biological mechanism.

Methods
Mothers (n = 127) and a subset of the fathers (n = 84) reported on PTSD symptoms before conception. Mothers provided blood spots in the second and third trimesters that were assayed for CRP. At age 4 years, children provided buccal cells for measurement of telomere length. Models adjusted for parental age, socioeconomic status, maternal prepregnancy body mass index, child biological sex, and child age.

Results
Mothers’ PTSD symptoms were significantly associated with shorter child telomere length (β = −0.22, SE = 0.10, p = .023). Fathers’ PTSD symptoms were also inversely associated with child telomere length (β = −0.21, SE = 0.11), although nonsignificant (p = .065). There was no significant indirect effect of mothers’ PTSD symptoms on child telomere length through CRP in pregnancy, but higher second-trimester CRP was significantly associated with shorter child telomere length (β = −0.35, SE = 0.18, p = .048).

Conclusions
Maternal symptoms of PTSD before conception and second-trimester inflammation were associated with shorter telomere length in offspring in early childhood, independent of covariates. Findings indicate that intergenerational transmission of parental trauma may occur in part through accelerated biological aging processes and provide further evidence that prenatal proinflammatory processes program child telomere length.

Open Science Framework Preregistration:
https://osf.io/7c2d5/?view_only=cd0fb81f48db4b8f9c59fc8bb7b0ef97.
Respiratory Interoception and Pathological Illness Anxiety: Disentangling Bias
Authors: Slotta Timo , Wolters Carolin , Marx Zeynep , Witthöft Michael , Gerlach Alexander L. , Pohl Anna 
Published: August 2023

ABSTRACT

Objective
Biased interoception decoupled from physiology might be relevant in the etiology of pathological illness anxiety (PIA). Empirical evidence for interoceptive deviations in illness anxiety is scarce but potentially informative to optimize treatments. We hypothesized that persons with PIA differ fundamentally in the classification of bodily sensations from those without PIA.

Methods
In a respiratory categorization task, participants breathed into a pulmonary training device. Inspiration effort was varied by eight resistive loads. The lower/higher four loads were introduced as belonging to arbitrary categories “A”/”B,” respectively. Participants memorized respiratory sensations in a first experimental block and were asked to label the resistances in a second block. We calculated the sensitivity of resistance classification according to category and response bias in terms of categorical misclassification. Data of 39 participants with PIA and 35 controls were compared with regard to sensitivity and response bias by group, resistive load, and their interaction in a multiple regression.

Results
With similar sensitivity, patients more often labeled loads above the categorical border erroneously as belonging to category A, thus underestimating their resistance (β = −0.06, p = .001; η
2 = 0.02).

Conclusions
Individuals with PIA showed a systematic “wait and see” approach. Altered respiroception in PIA might stem from biased perception during training phase, the recognition phase, biased memory, or a combination of these. Its exact characteristics remain unknown, and future research must address the challenge of developing reliable and valid paradigms accounting for the variability of interoceptive biases.

Registration
This work was preregistered on OSF (https://osf.io/9shcw).
An Innovative Stent Consisting of Expanded Polytetrafluoroethylene and Ear Cartilage in Rhinoplasty For Asians: Application I of Dai’s Exogenous Extension Stent Concept
Authors: Yu Bao-Fu , Chen Ai-Hong , Chen Xiao-Xue , Wang Zi , Xu Meng-Qiong , Dai Chuan-Chang , Wei Jiao 
Published: August 2023

Background:
Restricted ventilation is common after rhinoplasty with an endogenous extension stent. The authors proposed an exogenous extension stent concept for Asian rhinoplasty patients to avoid this problem. Herein, we introduce an innovative stent in rhinoplasty for Asians, which is an application of this concept.

Methods:
An L-shaped expanded polytetrafluoroethylene is hand-carved, and the long arm is placed at the nose back to improve the flatness of the nose, while the short arm supports the nasal column to raise the nose tip. The prosthesis does not occupy nasal volume and therefore theoretically does not affect nasal ventilation. The fan-shaped ear cartilage was placed at the nasal tip to prevent visualization of the nasal tip. The safety and effectiveness of this method were verified through 20 years of clinical practice. The difficulty of learning and popularizing the method was tested through the course of rhinoplasty among 22 plastic surgeons.

Results:
After 20 years of clinical practice, it was found that this stent could not only effectively improve the nasal dorsum and tip morphology, but also did not actually affect the nasal volume and thus did not affect the nasal ventilation of patients. Among the trainees in plastic surgery, we found that it was not difficult to learn this method of rhinoplasty and the trainees could complete the prosthesis carving well after standardized training.

Conclusion:
This stent consisting of expanded polytetrafluoroethylene and ear cartilage is suitable in rhinoplasty for Asians with significant advantages, one of which is that it has no risk of resulting in restricted nasal ventilation.

Level of Evidence:
Level IV.
CCL2 and Neuronal Inflammation: Implications for Neurodegenerative Diseases
Authors: zihang Zeng , qingyi Mo , tianhuan Qi , Si-Yan Li 
Published: August 2023

AbstractMicroglia, the resident immune cells of the central nervous system, play a pivotal role in maintaining brain homeostasis and responding to various pathological conditions1,2. Neuroinflammation, characterized by the activation of microglia and subsequent release of pro-inflammatory cytokines, has been implicated in the pathogenesis of numerous neurodegenerative diseases. Among these cytokines, chemokine (C-C motif) ligand 2 (CCL2) has gained significant attention due to its role in attracting immune cells and its potential contribution to neuronal inflammation. This review aims to comprehensively elucidate the involvement of microglial CCL2 in neuronal inflammation and its relevance to neurodegenerative diseases. We discuss the molecular mechanisms underlying CCL2 production, its receptors on neurons, and the downstream signaling pathways that initiate and perpetuate neuroinflammation. Furthermore, we explore the bidirectional communication between microglia and neurons, highlighting how neuronal dysfunction can trigger microglial CCL2 release and subsequent immune responses3-5. Additionally, we examine the implications of CCL2-mediated neuroinflammation in neurodegenerative disorders such as Alzheimer’s disease6,7, Parkinson’s disease8, and amyotrophic lateral sclerosis. Lastly, we discuss potential therapeutic strategies targeting the microglial CCL2 axis to modulate neuroinflammation and ameliorate neurodegenerative processes.