bluuebunny/crossref_metadata_2025_split huggingface dataset:
Call to focus on digital health technologies in hospitalized children's pain care: clinician experts' qualitative insights on optimizing electronic medical records to improve care
Authors: Pope Nicole , Korki de Candido Ligyana , Crellin Dianne , Palmer Greta , South Mike , Harrison Denise 
Published: February 2023

Abstract
Most hospitalized children experience pain that is often inadequately assessed and undertreated. Exposure to undertreated childhood pain is associated with negative short-term and long-term outcomes and can detrimentally affect families, health services, and communities. Adopting electronic medical records (EMRs) in pediatric hospitals is a promising mechanism to transform care. As part of a larger program of research, this study examined the perspectives of pediatric clinical pain experts about how to capitalize on EMR designs to drive optimal family-centered pain care. A qualitative descriptive study design was used and 14 nursing and medical experts from 5 countries (United States, Canada, United Kingdom, Australia, and Qatar) were interviewed online using Zoom for Healthcare. We applied a reflexive content analysis to the data and constructed 4 broad categories: “capturing the pain story,” “working with user-friendly systems,” “patient and family engagement and shared decision making,” and “augmenting pain knowledge and awareness.” These findings outline expert recommendations for EMR designs that facilitate broad biopsychosocial pain assessments and multimodal treatments, and customized functionality that safeguards high-risk practices without overwhelming clinicians. Future research should study the use of patient-controlled and family-controlled interactive bedside technology to and their potential to promote shared decision making and optimize pain care outcomes.
Heart rate variability is not suitable as a surrogate marker for pain intensity in patients with chronic pain
Authors: Moens Maarten , Billet Bart , Molenberghs Geert , De Smedt Ann , Pilitsis Julie G. , De Vos Ruben , Hanssens Karel , Billot Maxime , Roulaud Manuel , Rigoard Philippe , Goudman Lisa 
Published: February 2023

Abstract
The search towards more objective outcome measurements and consequently surrogate markers for pain started decades ago; however, no generally accepted biomarker for pain has qualified yet. The goal is to explore the value of heart rate variability (HRV) as surrogate marker for pain intensity chronic pain setting. Pain intensity scores and HRV were collected in 366 patients with chronic pain, through a cross-sectional multicenter study. Pain intensity was measured with both the visual analogue scale and numeric rating scale, whereas 16 statistical HRV parameters were derived. Canonical correlation analysis was performed to evaluate the correlation between the dependent pain variables and the HRV parameters. Surrogacy was determined for each HRV parameter with point estimates between 0 and 1 whereby values close to 1 indicate a strong association between the surrogate and the true endpoint at the patient level. Weak correlations were revealed between HRV parameters and pain intensity scores. The highest surrogacy point estimate was found for mean heart rate as marker for average pain intensity on the numeric rating scale with point estimates of 0.0961 (95% confidence interval [CI] 0.0384-0.1537) and 0.0209 (95% CI 0-0.05) for patients without medication use and with medication, respectively. This study indicated that HRV parameters as separate entities are no suitable surrogacy candidates for pain intensity, in a population of chronic pain patients. Further potential surrogate candidates and clinical robust true endpoints should be explored, to find a surrogate measure for the highly individual pain experience.
What is really new in triglyceride guidelines?
Authors: Hussain Aliza , Al Rifai Mahmoud , Hermel Melody , Slipczuk Leandro , Virani Salim S. 
Published: February 2023

Purpose of review
In this review, we will summarize some of the landmark clinical trials of triglyceride-lowering therapies and review updates in clinical guidelines with regards to treatment of elevated triglyceride levels.

Recent findings
Accumulating evidence from epidemiologic and Mendelian randomization studies has shown that triglyceride and are causally linked to atherosclerotic cardiovascular disease (ASCVD) and contribute to atherosclerosis. However, most clinical trials evaluating use of triglyceride-lowering therapies, including fibrates, niacin and fish oils [combined eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)] have not been able to demonstrate significant cardiovascular risk reduction. REDUCE-IT is the only randomized clinical trial that showed significant cardiovascular benefit with the use of icosapent ethyl esters (a purified EPA), in patients with ASCVD or diabetes with elevated risk on maximally tolerate statin.

Summary
Current guidelines and expert consensus documents from multiple societies strongly endorse therapeutic lifestyle interventions to effectively lower TG as the first-line therapy for treatment of hypertriglyceridemia. Evaluation and treatment of secondary causes of hypertriglyceridemia including optimal glycaemic control is crucial. Statins lower ASCVD risk in patients with elevated triglycerides and are first-line for treatment of elevated triglyceride. In a patient with residual mild to moderate hypertriglyceridemia on maximally tolerate statin and elevated cardiovascular risk icosapent, ethyl ester may be used for further ASCVD risk reduction.
Role of 18F-fluorodeoxyglucose PET/computed tomography in the diagnosis and treatment response assessment of primary bone lymphoma
Authors: Pu Yongzhu , Wang Chun , Xie Ran , Zhao Sheng , Li Kun , Yang Conghui , Li Jindan , Xiang Anshi , Wang Yasong , Chen Long , Sun Hua 
Published: February 2023

Objective
Primary bone lymphoma (PBL) is a rare type of extranodal lymphoma, and the clinical application value of 18F-fluorodeoxyglucose PET/computed tomography (18F-FDG PET/CT) in PBL has not been fully evaluated. This study aimed to determine the imaging characteristics of PBL and investigate the value of 18F-FDG PET/CT parameters.

Methods
A total of 25 patients with PBL who underwent PET/CT examination before treatment were included in this study. The clinicopathological parameters and PET/CT parameters were analyzed.

Results
Among the 25 patients, 7 patients had single lesions, 15 patients had nonsingle lesions (≥2) and 3 patients had diffuse distribution in the medullary cavity. The bone destruction types included osteolytic, osteogenic, normal density, mixed lytic and osteogenic. All patients showed increased FDG uptake, and the CT detection rate was 88%. Five patients underwent PET/CT assessment mid-treatment, and when assessed using the Deauville five-point scale, four patients were PET-negative and one patient was PET-positive. There were two PET-positive and three PET-negative patients when assessed using the Δ maximum standardized uptake value (SUVmax) method. Six patients underwent PET/CT imaging at the end of treatment. When assessed using the Deauville five-point scale, five patients (83%) were PET-negative and one patient (17%) was PET-positive. The same results were obtained when evaluated by the ΔSUVmax method.

Conclusion
PET/CT plays a substantial role in the diagnosis and treatment efficacy evaluation of PBL, and it should be recognized by clinicians and radiologists. Changes in metabolic parameters such as SUV, metabolic tumor volume and total lesion glycolysis have considerable potential for application in PBL diagnostics and treatment efficacy evaluation.
Neonatal Golden Hour: a review of current best practices and available evidence
Authors: Lamary Michelle , Bertoni C. Briana , Schwabenbauer Kathleen , Ibrahim John 
Published: February 2023

Purpose of review
Recommendations made by several scientific bodies advocate for adoption of evidence-based interventions during the first 60 min of postnatal life, also known as the ‘Golden Hour’, to better support the fetal-to-neonatal transition. Implementation of a Golden Hour protocol leads to improved short-term and long-term outcomes, especially in extremely premature and extreme low-birth-weight (ELBW) neonates. Unfortunately, several recent surveys have highlighted persistent variability in the care provided to this vulnerable population in the first hour of life.

Recent findings
Since its first adoption in the neonatal ICU (NICU) in 2009, published literature shows a consistent benefit in establishing a Golden Hour protocol. Improved short-term outcomes are reported, including reductions in hypothermia and hypoglycemia, efficiency in establishing intravenous access, and timely initiation of fluids and medications. Additionally, long-term outcomes report decreased risk for bronchopulmonary dysplasia (BPD), intraventricular hemorrhage (IVH) and retinopathy of prematurity (ROP).

Summary
Critical to the success and sustainability of any Golden Hour initiative is recognition of the continuous educational process involving multidisciplinary team collaboration to ensure coordination between providers in the delivery room and beyond. Standardization of practices in the care of extremely premature neonates during the first hour of life leads to improved outcomes.

Video Abstract

http://links.lww.com/MOP/A68.
Physical Fitness Among Adolescents Who are Hispanic With Overweight or Obesity
Authors: Benzo Roberto M. , St. George Sara M. , Messiah Sarah E. , Lovan Padideh , Leite Rafael , Patel Anmol , Lee Tae K. , Prado Guillermo J. 
Published: February 2023

Purpose:
To describe cardiorespiratory, strength, muscular endurance, and flexibility fitness outcomes in a sample of adolescents who are Hispanic aged 11 to 15 years with overweight or obesity, stratified by age and sex.

Methods:
The sample included 280 adolescents (mean age: 13.0 ± 0.83 years, mean body mass index percentile: 94.6). Anthropometric measures included height, weight, body mass index percentile, and waist and hip circumference. Fitness measures included handgrip strength, sit-ups in 60 seconds, sit-and-reach test, and 6-minute walk test. We report mean scores for each fitness outcome measure and correlation coefficients with anthropometric measures.

Results:
Mean handgrip was 23.7 ± 6.48 kg, sit-and-reach test was 25.3 ± 8.13 cm, average sit-ups in 60 seconds were 19.4 ± 9.28, and 6-minute walk distance was 1960 ± 271 ft. Males outperformed females in all tests except sit-and-reach test.

Discussion:
Compared with published fitness values of healthy weight adolescents, our sample of adolescents who are Hispanic with overweight/obesity living in southern Florida is unconditioned in terms of cardiorespiratory fitness, strength, muscular endurance, and flexibility.
Barriers and Facilitators to the Acceptance of eHealth Interventions by Dutch Pediatric Physical Therapists in Times of the COVID-19 Pandemic: A Mixed-Methods Approach
Authors: Pelckmans Maud , Nijmolen Petra , Bloemen Manon , Kuijpers Eline , Meershoek Agnes , Rameckers Eugene 
Published: February 2023

Background:
The COVID-19 pandemic created an urgent need for eHealth as the relevance of infection control and social distancing continues. Evidence describing the acceptability of implementing eHealth into pediatric physical therapy services is limited.

Purpose:
To investigate the determinants of eHealth acceptance by Dutch pediatric physical therapists during the COVID-19 pandemic.

Methods:
A mixed-methods approach was used. It included a quantitative exploratory questionnaire of 154 pediatric physical therapists and qualitative in-depth interviews of 16 pediatric physical therapists.

Results:
The eHealth interventions were beneficial for collaboration between health care professionals and face-to-face therapy. eHealth interventions were, however, found to be unsuitable especially in the diagnostic phase. Barriers to more extensive application include costs, technical difficulties, and a perceived negative attitude of children.

Conclusion:
Pediatric physical therapists used eHealth interventions extensively in times of the COVID-19 pandemic. However, the acceptance of eHealth interventions is dependent on the pediatric physical therapist's perception of usefulness in private practice, rehabilitation setting, or clinical hospital.
Item Analysis of Functional Measure Indicators in the National Health and Nutrition Examination Survey: A Cross-sectional Study
Authors: Gore Shweta , Gochyyev Perman , Tiwari Devashish 
Published: February 2023

Abstract

Objective
This study aimed to develop a function, activities, and participation measurement scale using the questions on the National Health and Nutrition Examination Survey (NHANES) by applying Item response theory (IRT) approaches.

Design
Cross-sectional.

Participants
Survey data was collected from 2,512 participants within the NHANES.

Methods
Twenty questions from the NHANES physical functioning section were included. We conducted exploratory and confirmatory factor analysis (EFA & CFA) to evaluate the factorial structure and model fit of the NHANES instrument. A multidimensional Rasch modeling was used to model the response data after confirming its model fit. To assess validity across subgroups, we conducted differential item functioning test with respect to sex and race using the three-dimensional partial credit model.

Results
Item fit indices indicated a good fit (RMSEA = 0.049, SRMR = 0.052, Tucker Lewis index = 0.975). Rasch analysis indicated that “Stoop/crouch/kneel,” “Stand for long periods,” and “Push/pull large objects” were the three most difficult items, while “Walk between rooms,” “Use fork/knife”, and “Leisure at home” were the easiest. The measure demonstrated good internal consistency overall (Cronbach’s α = 0.90).

Conclusion
The NHANES function, activities, and participation measure demonstrates sufficient evidence of reliability, internal consistency, and validity in non-institutionalized community-dwelling population.
Long-term patient reported outcomes and complication rates in pre-pectoral versus sub-pectoral two-stage implant-based breast reconstruction after nipple-sparing mastectomy
Authors: Alcon Andre , Rosser Micaela , Gedallovich Jodi , Foster Robert D. , Sbitany Hani , Piper Merisa 
Published: February 2023

Background:
Implant-based breast reconstruction remains the most commonly used method following mastectomy, but data is lacking regarding differences in complications and long-term patient-reported outcomes for two-stage sub-pectoral versus pre-pectoral reconstruction. We sought to better understand the risks and impact of these reconstructive approaches on overall satisfaction.

Methods:
Patients who underwent unilateral or bilateral nipple-sparing mastectomy and two-stage implant-based reconstruction from 2014 to 2019 were identified from the electronic medical records and contacted via email to complete the BREAST-Q survey. Overall satisfaction was measured by the question, “How happy are you with the outcome of your breast reconstruction?” using a six-point Likert scale. Patients were grouped into sub-pectoral or pre-pectoral cohorts. Complications were evaluated retrospectively. Only patients who were at least six months from their final reconstruction were included in the analysis.

Results:
Of the 582 patients contacted, 206 (35%) responded. The sub-pectoral (n = 114) and pre-pectoral (n=38) groups did not differ significantly by demographic or treatment characteristics. BREAST-Q scores were also comparable. Complication rates were similar, but pre-pectoral patients had a significantly higher rate of capsular contracture (16% vs 4%, p < 0.05). Bivariate ordered logistic regression identified pre-pectoral implant placement, having any post-operative complication, and capsular contracture as predictors of less overall happiness.

Conclusion:
Our study suggests that pre-pectoral patients may have slightly higher complication rates but are as satisfied as sub-pectoral patients after at least a year of follow-up. Further studies should investigate risk factors for capsular contracture, how the risk changes over time, and how it impacts patient satisfaction.
“Bone Tissue Engineering in the Growing Calvaria: A 3D Printed Bioceramic Scaffold to Reconstruct Critical-Sized Defects in a Skeletally Immature Pig Model”
Authors: DeMitchell-Rodriguez Evellyn M. , Shen Chen , Nayak Vasudev V. , Tovar Nick , Witek Lukasz , Torroni Andrea , Yarholar Lauren M. , Cronstein Bruce N. , Flores Roberto L. , Coelho Paulo G. 
Published: February 2023

Background:
3D-printed bioceramic scaffolds composed of 100% beta(β)-tricalcium phosphate augmented with dipyridamole (3DPBC-DIPY) can regenerate bone across critically sized defects in skeletally mature and immature animal models. Prior to human application, safe and effective bone formation should be demonstrated in a large translational animal model. This study evaluated the ability of 3DPBC-DIPY scaffolds to restore critically sized calvarial defects in a skeletally immature, growing minipig.

Methods:
Unilateral calvarial defects (~1.4cm) were created in six-week-old Göttingen minipigs (n=12). Four defects were filled with a 1000µ M 3DPBC-DIPY scaffold with a cap (a solid barrier on the ectocortical side of the scaffold to prevent soft tissue infiltration), four defects were filled with a 1000µM 3DPBC-DIPY scaffold without a cap, and four defects served as negative controls (no scaffold). Animals were euthanized 12-weeks post-operatively. Calvaria were subjected to micro-computed tomography, 3D-reconstruction with volumetric analysis, qualitative histologic analysis, and nanoindentation.

Results:
Scaffold-induced bone growth was statistically greater than negative controls (p≤0.001) and the scaffolds with caps produced significantly more bone generation compared to the scaffolds without caps (p≤0.001). Histological analysis revealed woven and lamellar bone with the presence of haversian canals throughout the regenerated bone. Additionally, cranial sutures were observed to be patent and there was no evidence of ectopic bone formation or excess inflammatory response. Reduced elastic modulus (Er) and hardness (H) of scaffold-regenerated bone were found to be statistically equivalent to native bone (p = 0.148 for Er of scaffolds with and without caps, and p = 0.228 and p = 0.902, for H of scaffolds with and without caps, respectively).

Conclusion:
3DPBC-DIPY scaffolds have the capacity to regenerate bone across critically sized calvarial defects in a skeletally immature translational pig model.
Investigation of the correlation between knee joint position sense and physical functional performance in individuals with transtibial amputation
Authors: Demirdel Senem , Ekinci Yasin , Demirdel Ertuğrul , Erbahçeci Fatih 
Published: February 2023

Introduction:
In individuals with transtibial amputation, the distal part of the lower extremity is lost. Therefore, the knee joint is of greater importance to be able to provide physical performance. The aim of this study was to evaluate the correlation between knee joint position sense and physical functional performance in individuals with transtibial amputation.

Methods:
The study included 21 subjects with transtibial amputation. A digital inclinometer was used to evaluate the joint position sense of the amputated side knee joint. The timed up and go test, the 4-square step test, and 10-m walk test were used to evaluate physical functional performance. Linear regression analysis was used to investigate the associations between independent variables and functional performance tests.

Results:
The mean age of the participants was 52.52 ± 15.68 years. The mean of the error in knee joint position sense was 5.33 degree (standard deviation = 3.08 degree). The error in knee joint position sense of the amputated limb predicted 45% of the variance in the 4-square step test and 22% of the variance in the 10-m walk test (P < 0.05).

Conclusions:
The knee joint position sense on the amputated side was found to be associated with physical functional performance in individuals with transtibial amputation. Residual limb knee joint position sense should be considered when prescribing prostheses and planning rehabilitation programs.
Adaptation, reliability, and validation of the Turkish version of the Bad Sobernheim Stress Questionnaire-Deformity in patients with adolescent idiopathic scoliosis
Authors: Akçay Burçin , Kuru Çolak Tuğba , Apti Adnan 
Published: February 2023

Background:
There is a limited number of disease-specific outcome measurement scales in Turkish, which can be used for individuals with adolescent idiopathic scoliosis (AIS). The aim of this study was to translate, adapt, and evaluate the validity and reliability of the Turkish version of the Bad Sobernheim Stress Questionnaire-Deformity (TRv.BSSQD) questionnaire in Turkish patients with AIS.

Objective(s):
After the translation and back-translation process, the TRv.BSSQD and Scoliosis Research Society-22 questionnaires were completed in face-to-face interviews with 49 patients with AIS. The TRv.BSSQD questionnaire was readministered to the same patients 2 weeks later to assess test-retest reliability.

Results:
The Cronbach alpha value calculated for internal reliability was 0.806. The intraclass correlation coefficient values of the items of the TRv.BSSQD ranged from 0.809 (P < 0.001) (question 8) to 0.955 (P < 0.001) (question 7). The test-retest correlation coefficient for the item-total score was 0.960 (P < 0.001). Validity analysis showed a significantly positive correlation between the TRv.BSSQD total score and pain, self-image, and mental subgroup and the total scores of the SRS-22r scale (P < 0.05).

Conclusions:
This patient-reported outcome instrument, the TRv.BSSQD, showed good internal consistency, good reliability with test-retest analysis, and construct validity, suggesting that it is an appropriate assessment instrument for Turkish patients with AIS.
Safety and efficacy of long-acting injectable cabotegravir as preexposure prophylaxis to prevent HIV acquisition
Authors: Fonner Virginia A. , Ridgeway Kathleen , van der Straten Ariane , Lorenzetti Lara , Dinh Nhi , Rodolph Michelle , Schaefer Robin , Schmidt Heather-Marie A. , Nguyen Van Thi Thuy , Radebe Mopo , Peralta Hortencia , Baggaley Rachel 
Published: February 2023

Objective:
HIV remains a significant burden, despite expanding HIV prevention tools. Long-acting injectable cabotegravir (CAB-LA) is a new preexposure prophylaxis (PrEP) product. We reviewed existing evidence to determine the efficacy and safety of CAB-LA as PrEP to inform global guidelines.

Design:
Systematic review and meta-analysis.

Methods:
We systematically reviewed electronic databases and conference abstracts for citations on CAB-LA from January 2010 to September 2021. Outcomes included HIV infection, adverse events, drug resistance, pregnancy-related adverse events, and sexual behavior. We calculated pooled effect estimates using random-effects meta-analysis and summarized other results narratively.

Results:
We identified 12 articles/abstracts representing four multisite randomized controlled trials. Study populations included cisgender men, cisgender women, and transgender women. The pooled relative risk of HIV acquisition comparing CAB-LA to oral PrEP within efficacy studies was 0.21 (95% confidence interval: 0.07–0.61), resulting in a 79% reduction in HIV risk. Rates of adverse events were similar across study groups. Of 19 HIV infections among those randomized to CAB-LA with results available, seven had integrase strand transfer inhibitor (INSTI) resistance. Data on pregnancy-related adverse events were sparse. No studies reported on sexual behavior.

Conclusions:
CAB-LA is highly efficacious for HIV prevention with few safety concerns. CAB-LA may lead to an increased risk of INSTI resistance among those who have acute HIV infection at initiation or become infected while taking CAB-LA. However, results are limited to controlled studies; more research is needed on real-world implementation. Additional data are needed on the safety of CAB-LA during pregnancy (for mothers and infants) and among populations not included in the trials.