bluuebunny/crossref_metadata_2025_split huggingface dataset:
Broad- Versus Narrow-Spectrum Perioperative Antibiotics and Outcomes in Pediatric Congenital Heart Disease Surgery: Analysis of the Vizient Clinical Data Base
Authors: Cooch Peter B , Kim Mi-Ok , Swami Naveen , Tamma Pranita D , Tabbutt Sarah , Steurer Martina A , Wattier Rachel L 
Published: April 2023

Abstract

Background
Despite guidelines recommending narrow-spectrum perioperative antibiotics (NSPA) as prophylaxis for most children undergoing congenital heart disease (CHD) surgery, broad-spectrum perioperative antibiotics (BSPA) are variably used, and their impact on postoperative outcomes is poorly understood.

Methods
We used administrative data from U.S. hospitals participating in the Vizient Clinical Data Base. Admissions from 2011 to 2018 containing a qualifying CHD surgery in children 0–17 years old were evaluated for exposure to BSPA versus NSPA. Propensity score-adjusted models were used to compare postoperative length of hospital stay (PLOS) by exposure group, while adjusting for confounders. Secondary outcomes included subsequent antimicrobial treatment and in-hospital mortality.

Results
Among 18 088 eligible encounters from 24 U.S. hospitals, BSPA were given in 21.4% of CHD surgeries, with mean BSPA use varying from 1.7% to 96.1% between centers. PLOS was longer for BSPA-exposed cases (adjusted hazard ratio 0.79; 95% confidence interval [CI]: 0.71–0.89, P &lt; .0001). BSPA was associated with higher adjusted odds of subsequent antimicrobial treatment (odds ratio [OR] 1.24; 95% CI: 1.06–1.48), and there was no significant difference in adjusted mortality between exposure groups (OR 2.06; 95% CI: 1.0–4.31; P = .05). Analyses of subgroups with the most BSPA exposure, including high-complexity procedures and delayed sternal closure, also did not find (but could not exclude) a measurable benefit from BSPA on PLOS.

Conclusions
BSPA use was common in high-risk populations, and varied substantially between centers. Standardizing perioperative antibiotic practices between centers may reduce unnecessary broad-spectrum antibiotic exposure and improve clinical outcomes.
Coping strategies, illness perceptions, and relationship dynamics contribute to female sexual function and sexual distress in Sjögren’s syndrome
Authors: McCready Jemma L , Deary Vincent , Collins Tracy L , Lendrem Dennis W , Hackett Katie L 
Published: April 2023

Abstract

Background
Sexual dysfunction and sexual distress are common complaints for women with the autoimmune rheumatic disease Sjögren’s syndrome (SS); however, the role of psychosocial and interpersonal factors has not previously been explored in SS.

Aim
This study investigated whether psychosocial variables, such as coping strategies, illness perceptions, and relationship dynamics, contributed to sexual function and sexual distress for women with SS.

Methods
Participants with SS completed an online cross-sectional survey that included prevalidated questionnaires assessing sexual function, sexual distress, disease-related symptom experiences, cognitive coping strategies, illness perceptions, relationship satisfaction, and partners’ behavioral responses. Multiple linear regression was used to identify factors significantly associated with sexual function (total Female Sexual Function Index [FSFI] score) and sexual distress (total Female Sexual Distress Scale score) for women with SS.

Outcomes
Study outcome measures were the FSFI, Female Sexual Distress Scale, EULAR Sjӧgren’s Syndrome Patient Reported Index, numeric rating scale for vaginal dryness (0-10), Profile of Fatigue and Discomfort, Cognitive Emotion Regulation Questionnaire (CERQ), Brief Illness Perceptions Questionnaire (B-IPQ), West Haven–Yale Multidimensional Pain Inventory (WHYMPI), and Maudsley Marital Questionnaire.

Results
A total of 98 cisgender women with SS participated in the study (mean age = 48.13 years, SD = 13.26). Vaginal dryness was reported by 92.9% of participants, and clinical levels of sexual dysfunction (total FSFI score &lt;26.55) were observed in 85.2% (n = 69/81) of cases. More vaginal dryness, lower CERQ positive reappraisal, and higher CERQ catastrophizing were significantly associated with poorer self-rated sexual function (R2 = 0.420, F3,72 = 17.394, P &lt; .001). Higher CERQ rumination, lower CERQ perspective, lower WHYMPI distracting responses, and higher B-IPQ identity were significantly associated with higher sexual distress (R2 = 0.631, F5,83 = 28.376, P &lt; .001).

Clinical Implications
This study suggests that interpersonal and psychosocial factors are important contributors to sexual function and distress in women with SS and that the development of psychosocial interventions for this population is warranted.

Strengths and Limitations
This study is one of the first to explore the impacts of coping strategies, illness perceptions, and relationship dynamics on sexual function and sexual distress for women with SS. Limitations of our study include its cross-sectional nature and narrow sample demographic, which limit the generalizability of our results to other population groups.

Conclusion
Women with SS who utilized adaptive coping strategies had better sexual function and lower levels of sexual distress than women who utilized maladaptive coping strategies.
Expansion and line-binned opacities of samarium ions for the analysis of early kilonova emission from neutron star mergers
Authors: Carvajal Gallego H , Deprince J , Palmeri P , Quinet P 
Published: April 2023

ABSTRACTOpacity calculations performed within the expansion and the line-binned formalisms are reported for Sm V–X ions in this paper. These were determined by means of new large-scale atomic structure and radiative rate computations carried out using the pseudo-relativistic Hartree-Fock (HFR) method from which energy levels, wavelengths, and oscillator strengths were deduced for more than 100 millions of spectral lines in the considered samarium ions. In the absence of any experimental data, the reliability of HFR results was roughly estimated by comparison with those obtained with an independent theoretical approach, namely the fully relativistic multiconfiguration Dirac-Hartree-Fock method, in Sm VI and Sm VII. The opacities were estimated for typical conditions corresponding to early phases of kilonovae following neutron star mergers, i.e. for a density ρ = 10−10 g cm−3, a time after the merger t = 0.1 day and temperatures ranging from 25 000 to 70 000 K. In addition, the atomic calculations allowed us to establish the ground level for each of the Sm ions considered (still unknown until now), as well as reliable partition functions that are crucial for the determination of the ionization balance by solving the Saha equation and for accurate opacity calculations.
A Randomized Clinical Trial of Transgender Women Switching to B/F/TAF: The (mo)BETTA Trial
Authors: Lake Jordan E , Hyatt Ana N , Feng Han , Debroy Paula , Kettelhut Aaren , Miao Hongyu , Peng Liming , Bhasin Shalender , Bell Susan , Rianon Nahid , Brown Todd T , Funderburg Nicholas T 
Published: April 2023

Abstract

Background
Cardiometabolic disease in transgender women (TW) is affected by gender-affirming hormonal therapies (GAHTs), HIV, and antiretroviral therapy (ART). We evaluated the 48-week safety/tolerability of switching to bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF) vs continued ART in TW on GAHT.

Methods
TW on GAHT and suppressive ART were randomized 1:1 to switch to B/F/TAF (Arm A) or continue current ART (Arm B). Cardiometabolic biomarkers, sex hormones, bone mineral density (BMD) and lean/fat mass by DXA scan, and hepatic fat (controlled continuation parameter [CAP]) were measured. Wilcoxon rank-sum/signed-rank and χ2 tests compared continuous and categorical variables.

Results
TW (Arm A n = 12, Arm B n = 9) had a median age of 45 years. Ninety-five percent were non-White; 70% were on elvitegravir or dolutegravir, 57% TAF, 24% abacavir, and 19% TDF; 29% had hypertension, 5% diabetes, and 62% dyslipidemia. There were no adverse events. Arm A/B had 91%/89% undetectable HIV-1 RNA at week 48 (w48). Baseline (BL) osteopenia (Arm A/B 42%/25%) and osteoporosis (17%/13%) were common, without significant changes. BL lean/fat mass were similar. At w48, Arm A had stable lean mass but increased limb (3 lbs) and trunk (3 lbs) fat (within-arm P &lt; .05); fat in Arm B remained stable. No changes occurred in lipid or glucose profiles. Arm B had a greater w48 decrease (−25 vs −3 dB/m; P = .03) in CAP. BL and w48 concentrations of all biomarkers were similar.

Conclusions
In this cohort of TW, switch to B/F/TAF was safe and metabolically neutral, though greater fat gain occurred on B/F/TAF. Further study is needed to better understand cardiometabolic disease burden in TW with HIV.
The OPAQUE1/DISCORDIA2 myosin XI is required for phragmoplast guidance during asymmetric cell division in maize
Authors: Nan Qiong , Liang Hong , Mendoza Janette , Liu Le , Fulzele Amit , Wright Amanda , Bennett Eric J , Rasmussen Carolyn G , Facette Michelle R 
Published: April 2023

AbstractFormative asymmetric divisions produce cells with different fates and are critical for development. We show the maize (Zea mays) myosin XI protein, OPAQUE1 (O1), is necessary for asymmetric divisions during maize stomatal development. We analyzed stomatal precursor cells before and during asymmetric division to determine why o1 mutants have abnormal division planes. Cell polarization and nuclear positioning occur normally in the o1 mutant, and the future site of division is correctly specified. The defect in o1 becomes apparent during late cytokinesis, when the phragmoplast forms the nascent cell plate. Initial phragmoplast guidance in o1 is normal; however, as phragmoplast expansion continues o1 phragmoplasts become misguided. To understand how O1 contributes to phragmoplast guidance, we identified O1-interacting proteins. Maize kinesins related to the Arabidopsis thaliana division site markers PHRAGMOPLAST ORIENTING KINESINs (POKs), which are also required for correct phragmoplast guidance, physically interact with O1. We propose that different myosins are important at multiple steps of phragmoplast expansion, and the O1 actin motor and POK-like microtubule motors work together to ensure correct late-stage phragmoplast guidance.
Knowing, Telling, Trusting
Authors: Holton Richard 
Published: April 2023

Abstract
This paper falls into three parts. The first looks at wh-constructions, focussing on the so-called factual whs, ‘X knows where… ’, ‘when’, ‘who’, ‘what’ etc. I suggest, drawing on both linguistic considerations and evidence from developmental psychology, that these constructions take things as their objects, not propositions; and that this may be why they are learned before those taking sentential complements. The second part moves to the case of telling-wh: to constructions such as telling someone who is at the door. This construction brings a very particular set of requirements, not just to tell the truth, but to tell all the relevant truths and nothing but. The third section, in a critical discussion of Katherine Hawley's work, argues that an account of trust and testimony focussing on the telling-wh construction brings better results than one focussed on the blander idea of assertion.
Physical Therapists Use Different Motivational Strategies for Stroke Rehabilitation Tailored to an Individual’s Condition: A Qualitative Study
Authors: Oyake Kazuaki , Sue Keita , Sumiya Motofumi , Tanaka Satoshi 
Published: April 2023

Abstract

Objective
Various strategies are used to motivate individuals with stroke during rehabilitation. However, how physical therapists select the motivational strategies that they use for each individual is yet to be established. Therefore, this study aimed to explore how physical therapists use different motivational strategies for individuals in stroke rehabilitation programs.

Methods
A criterion sample of 15 physical therapists who have worked in rehabilitation for over 10 years and were interested in an individual’s motivation participated in one-on-one semi-structured online interviews. The interviews explored their perspectives and experiences regarding the motivational strategies used depending on each individual’s condition. The collected data were analyzed with thematic analysis.

Results
A total of 9 themes emerged from the data upon thematic analysis and inductive coding. Participants used different strategies to encourage individuals’ active participation in physical therapy depending on (1) their mental health, (2) their physical difficulties, (3) their level of cognitive function, (4) their personality, (5) their activities and participation, (6) their age, (7) their human environment, and (8) the type of rehabilitation service where the individual underwent treatment. For example, in cases where an individual lost self-confidence, participants offered practice tasks that the individual could achieve with little effort to make them experience success. The interviews also revealed (9) motivational strategies used regardless of the individual’s condition. For instance, patient-centered communication was used to build rapport with individuals, irrespective of their condition.

Conclusion
This qualitative study suggests that physical therapists use different strategies depending on the individual’s mental health conditions, physical problems, level of cognitive function, personality, activities and participation, age, human environment, and the type of rehabilitation service where the individual undergoes treatment to motivate individuals with stroke during physical therapy.

Impact
The findings of this study can provide experience-based recommendations regarding the selection of motivational strategies for stroke rehabilitation.
Dendritic spine dynamics in associative memory: A comprehensive review
Authors: Guo Hongling , Ali Tahir , Que Jianyu , Zhou Yanmei , Bai Yang 
Published: April 2023

AbstractAssociative learning and memory are fundamental behavioral processes through which organisms adapt to complex environments. Associative memory involves long‐lasting changes in synaptic plasticity. Dendritic spines are tiny protrusions from the dendritic shaft of principal neurons, providing the structural basis for synaptic plasticity and brain networks in response to external stimuli. Mounting evidence indicates that dendritic spine dynamics are crucial in different associative memory phases, including acquisition, consolidation, and reconsolidation. Causally bridging dendritic spine dynamics and associative memory is still limited by the suitable tools to measure and control spine dynamics in vivo under behaviorally relevant conditions. Here, we review data providing evidence for the remodeling of dendritic spines during associative memory processing and outline open questions.
Relax to Heal? Perspectives of Patients with Diabetic Foot Ulcers and Health Professionals on Relaxation Sessions for Wound Healing
Authors: Ferreira Gabriela , Bernardo Ana Cristina , Carvalho André , Pereira M. Graça 
Published: April 2023

ABSTRACT

OBJECTIVE
To explore patients’ and healthcare professionals’ (HPs’) perspectives on the suitability/acceptability of a relaxation intervention, its effects on patients’ well-being and diabetic foot ulcer (DFU) healing, and its incorporation into the multidisciplinary management of patients with diabetic foot.

METHODS
This qualitative study was nested within a three-arm pilot randomized controlled trial. Patients with a chronic DFU received four relaxation sessions. Investigators then interviewed patients, physicians, and nurses involved with diabetic foot consultations. Interviews were audio-recorded, transcribed, and analyzed using thematic content analysis.

RESULTS
Five themes emerged from patient’s interviews about the suitability/acceptability of the relaxation intervention: perceptions regarding the psychological intervention, distress, the relaxation technique, changes in the patient’s life, and changes in DFU/contribution to healing. Three themes emerged from interviews with HPs: perceptions regarding relaxation, changes in the patient, and changes in DFU/healing. Regarding the feasibility of the relaxation intervention, three themes emerged for both patients and HPs: suggested modifications, stressors/difficulties, and impact of COVID-19 pandemic. The utility theme emerged only in HP interviews, with subthemes of patients’ distress, psychological interventions, relaxation intervention, and integration of the psychologist in the team.

CONCLUSIONS
These findings provide evidence for the suitability/acceptability, feasibility, and utility of a relaxation intervention in diabetic foot consultations.
Pre-Existing Audiometric Hearing Loss is a Predictor of Significant Threshold Shift Following Injury During Combat Deployment
Authors: Joseph Antony R. , MacGregor Andrew J. , Dougherty Amber L. 
Published: April 2023

Objectives:
Military personnel are exposed to multiple risk factors for hearing loss, particularly on the battlefield. The objective of this study was to determine whether pre-existing hearing loss predicted hearing threshold shift in male U.S. military personnel following injury during combat deployment.

Design:
This was a retrospective cohort study with 1573 male military personnel physically injured in Operations Enduring and Iraqi Freedom between 2004 and 2012. Audiograms before and after injury were analyzed and used to calculate significant threshold shift (STS), defined as a 30 dB or greater change in the sum of hearing thresholds at 2000, 3000, and 4000 Hz in either ear on the postinjury audiogram, relative to the same frequencies on the preinjury audiogram.

Results:
Twenty-five percent (n = 388) of the sample had preinjury hearing loss, which mostly occurred in the higher frequencies (i.e., 4000 and 6000 Hz). The prevalence of postinjury STS ranged from 11.7% to 33.3% as preinjury hearing level moved from better to worse. In multivariable logistic regression, preinjury hearing loss was a predictor of STS, and there was a dose-response relationship between severity of preinjury hearing threshold and postinjury STS, specifically for preinjury hearing levels of 40 to 45 dBHL (odds ratio [OR] = 1.99; 95% confidence interval [CI] = 1.03 to 3.88), 50 to 55 dBHL (OR = 2.33; 95% CI = 1.17 to 4.64), and >55 dBHL (OR = 3.77; 95% CI = 2.25 to 6.34).

Conclusions:
These findings suggest that better preinjury hearing provides increased resistance to threshold shift than impaired preinjury hearing. Although STS is calculated using 2000 to 4000 Hz, clinicians must closely attend to the pure-tone response at 6000 Hz and use this test frequency to identify service members at-risk for STS prior to combat deployment.
Percutaneous Posterior Pelvic Fixation of Spinopelvic Dissociation: A Multicenter Series of Displaced Patterns
Authors: Moo Young Justin P. , Savakus Jonathan C. , Obey Mitchel R. , Pereira Daniel E. , Hills Jeffrey M. , McKane Ava , Babcock Sharon N. , Miller Anna N. , Stephens Byron F. , Mitchell Phillip M. 
Published: April 2023

Objective:
To characterize the success and complications of percutaneous posterior pelvic fixation in the treatment of displaced spinopelvic dissociation patterns.

Design:
Retrospective cohort study.

Setting:
Three Level I trauma centers.

Patients:
53 patients with displaced spinopelvic patterns were enrolled.

Intervention:
Percutaneous iliosacral screw fixation was used.

Main outcome measures:
Main outcome measures include incidence of union, fixation failure, and soft tissue complications.

Results:
All patients had displaced, unstable patterns with a mean preoperative kyphosis of 29.7 ± 15.4 degrees (range, 0–70). Most of the patients treated were neurologically intact (72%) or had an unknown examination at the time of fixation (15%). The median follow-up was 254 days (interquartile range, 141–531). The union rate was 98%. Radiographic and clinical follow-up demonstrated 1 case (2%) of nonunion. Two patients (4%) had radiographic evidence of screw loosening at the final follow-up, both of whom had fixation with a single sacroiliac-style screw placed bilaterally and went on to uneventful union. Neurologic recovery occurred at an average of 195 ± 114 days (range, 82–363 days). When present, long-term neurologic sequelae most commonly consisted of radicular pain and paresthesias at the final follow-up (n = 3, 6%).

Conclusions:
Percutaneous posterior pelvic fixation of select displaced spinopelvic dissociation seems to be safe with a low complication rate and reliable union. In a cohort of displaced fractures that were fixed in situ, we found a 2% rate of fixation failure/nonunion. Although rare, radicular pain and paresthesias were the most common long-term neurologic sequela.

Level of Evidence:
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Does a Modified Frailty Index Predict 30-day Complications After Long-Bone Nonunion or Malunion Surgery?
Authors: Chinta Sree , Fisher Nina D. , Tejwani Nirmal C. 
Published: April 2023

Objective:
To assess the ability of a modified frailty index (mFI-5) score, which includes the presence of congestive heart failure, hypertension, chronic obstructive pulmonary disease, diabetes, and nonindependent functional status, and to identify patients at increased risk of complications after surgical treatment of long-bone nonunions/malunions.

Design:
Retrospective.

Setting:
Hospitals participating in the 2005–2018 American College of Surgeons National Surgical Quality Improvement Program.

Patients/Participants:
Patients in the American College of Surgeons National Surgical Quality Improvement Program database with upper extremity and lower extremity fractures were enrolled.

Intervention:
Surgical repair of nonunions/malunions of upper and lower extremity long bones.

Main Outcome Measure:
Postoperative complications after long-bone nonunion/malunion surgery.

Results:
Respective univariate analysis of the 2964 UE [1786 (60.3%) with mFI-5 of 0 and 386 (13.0%) with mFI-5 ≥2] and 3305 LE [1837 (55.6%) with mFI-5 of 0 and 498 (15.1%) with mFI-5 ≥2] showed that increasing mFI-5 score was associated with medical complications, extended longer length of stay, adverse discharge, and readmission. Binomial logistic regression showed that UE patients with mFI-5 ≥2 had increased risk of wound complications [odds ratio (OR) 2.512, 95% (confidence interval) CI: 1.037–6.086, P = 0.041), adverse discharge (OR 1.735, 95% CI: 1.204–2.499, P = 0.003), and unplanned readmission (OR 2.102, 95% CI: 1.038–4.255, P = 0.039), while LE patients with mFI-5 ≥2 had an increased risk of medical complications (OR 1.847, 95% CI: 1.307–2.610, P = 0.001), cumulative morbidity (OR 1.835, 95% CI: 1.342–2.510, P < 0.001), extended longer length of stay (OR 1.809, 95% CI: 1.233–2.654, P = 0.002), and adverse discharge (OR 1.841, 95% CI: 1.394–2.432, P < 0.001).

Conclusions:
mFI-5 score ≥2 is associated with significant increase in postoperative complications after surgical repair of long-bone nonunions/malunions.

Level of Evidence:
Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.