bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk Factors for the Development of Multisite Pain in Children
Authors: Kaplan Chelsea M. , Schrepf Andrew , Boehnke Kevin F. , He Ying , Smith Tristin , Williams David A. , Bergmans Rachel , Voepel-Lewis Terri , Hassett Afton L. , Harris Richard E. , Clauw Daniel J. , Beltz Adriene M. , Harte Steven E. 
Published: July 2023

Objective:
Chronic pain has economic costs on par with cardiovascular disease, diabetes, and cancer. Despite this impact on the health care system and an increasing awareness of the relationship between pain and mortality, efforts to identify simple symptom-based risk factors for the development of pain, particularly in children, have fallen short. This is critically important as pain that manifests during childhood often persists into adulthood. To date no longitudinal studies have examined symptoms in pain-free children that presage a new, multisite manifestation of pain in the future. We hypothesized that female sex, sleep problems and heightened somatic complaints at baseline would be associated with the risk of developing new multisite pain one year later.

Methods:
Symptom assessments were completed by parents of youth (ages 9-10) enrolled in the Adolescent Brain Cognitive Development study. Multivariate logistic regression models focused on children who developed multisite pain one year later (n=331) and children who remained pain-free (n=3335) .

Results:
Female sex (OR=1.35; 95% CI=1.07, 1.71; P=0.01) , elevated non-painful somatic complaints (OR=1.17; 95% CI=1.06, 1.29; P<0.01) , total sleep problems (OR=1.20; 95% CI=1.07, 1.34; P< 0.01) , and attentional issues (OR=1.22; 95% CI=1.10, 1.35; P<0.001) at baseline were associated with new multisite pain one year later. Baseline negative affect was not associated with new multisite pain.

Discussion:
Identifying symptom-based risk factors for multisite pain in children is critical for early prevention. Somatic awareness, sleep and attention problems represent actionable targets for early detection, treatment, and possible prevention of multisite pain in youth.
Socioeconomic Characteristics Associated With Development of Chronic Pain After Pain Interference Experienced in Early Adulthood
Authors: Peace Jordan , Pooleri Anand , Frech Adrianne , Tumin Dmitry 
Published: July 2023

Objective:
Predictors of pain persistence have been identified among patients undergoing treatment for chronic pain or related conditions, but correlates of pain persistence in the general population remain underexplored. We identify socioeconomic variables associated with pain onset or persistence over a 6-10 year period in a nationally representative cohort.

Methods:
Using panel data from the National Longitudinal Survey of Youth-1997, we examined the presence of pain interference at age 29 and chronic pain at ages 35-39. Persistent pain was defined as pain present at both interview timepoints; new onset pain was defined as pain not reported at age 29, but present at ages 35-39; and transient pain was defined as experiencing pain interference at age 29 with no report of chronic pain at ages 35-39.

Results:
Based on a sample of 6,188 participants, we estimated that 4% experienced persistent pain, 11% experienced transient pain, and 7% experienced new-onset pain. Pain persistence was less likely among non-Hispanic Black respondents but more likely among formerly married respondents and those with poor health, health-related work limitation, or greater pain interference at the age 29 baseline. New onset pain was most likely among female respondents, respondents with some college education, and respondents with poor self-rated health or obesity at baseline.

Discussion:
Development of chronic pain by mid-late 30s was common among young adults experiencing pain interference at age 29. Race/ethnicity, gender, and educational attainment exhibited different associations with persistence as compared to new onset of pain problems.
No Evidence of Short-Term Changes in Muscle Activity Elicited by Dry Needling in Chronic Unilateral Shoulder Pain Patients
Authors: Intelangelo Leonardo , Mendoza Cristian , Lassaga Ignacio , Barbosa Alexandre Carvalho , Manresa José Biurrun , Mista Christian 
Published: July 2023

Objectives:
The aim of the study was to assess short-term changes in shoulder muscle activity elicited by dry needling in chronic unilateral shoulder pain patients.

Methods:
A double-blind, placebo-controlled clinical trial was conducted, in which 30 volunteers with unilateral shoulder pain (USP) were recruited and randomly assigned to either real or sham dry needling conditions. Pain intensity scores, pressure pain threshold (PPT), glenohumeral internal rotation angles, and electromyographic activity during isotonic shoulder tasks (shoulder flexion and extension) were assessed before, immediately and 72 h after the intervention in the infraspinatus and deltoid muscles.

Results:
A single application of real dry needling resulted in lower pain intensity scores and a larger range in glenohumeral internal rotation 72 h after the intervention in comparison with sham dry needling. No differences in PPT or muscle activity were observed due to the intervention.

Discussion:
A single application of real dry needling resulted in clinically significant changes in the short-term. No differences were detected in muscle activation in the infraspinatus or deltoid muscles. Complementary interventions and longer follow-up times may be required to observe changes in muscle activity.
Individualized Positive End-expiratory Pressure on Postoperative Atelectasis in Patients with Obesity: A Randomized Controlled Clinical Trial
Authors: Li Xiang , Liu He , Wang Jun , Ni Zhi-Lin , Liu Zhong-Xiao , Jiao Jia-Li , Han Yuan , Cao Jun-Li 
Published: July 2023

Background
Individualized positive end-expiratory pressure (PEEP) guided by dynamic compliance improves oxygenation and reduces postoperative atelectasis in nonobese patients. The authors hypothesized that dynamic compliance–guided PEEP could also reduce postoperative atelectasis in patients undergoing bariatric surgery.

Methods
Patients scheduled to undergo laparoscopic bariatric surgery were eligible. Dynamic compliance–guided PEEP titration was conducted in all patients using a downward approach. A recruitment maneuver (PEEP from 10 to 25 cm H2O at 5–cm H2O step every 30 s, with 15–cm H2O driving pressure) was conducted both before and after the titration. Patients were then randomized (1:1) to undergo surgery under dynamic compliance–guided PEEP (PEEP with highest dynamic compliance plus 2 cm H2O) or PEEP of 8 cm H2O. The primary outcome was postoperative atelectasis, as assessed with computed tomography at 60 to 90 min after extubation, and expressed as percentage to total lung tissue volume. Secondary outcomes included Pao
2/inspiratory oxygen fraction (Fio
2) and postoperative pulmonary complications.

Results
Forty patients (mean ± SD; 28 ± 7 yr of age; 25 females; average body mass index, 41.0 ± 4.7 kg/m2) were enrolled. Median PEEP with highest dynamic compliance during titration was 15 cm H2O (interquartile range, 13 to 17; range, 8 to 19) in the entire sample of 40 patients. The primary outcome of postoperative atelectasis (available in 19 patients in each group) was 13.1 ± 5.3% and 9.5 ± 4.3% in the PEEP of 8 cm H2O and dynamic compliance–guided PEEP groups, respectively (intergroup difference, 3.7%; 95% CI, 0.5 to 6.8%; P = 0.025). Pao
2/Fio
2 at 1 h after pneumoperitoneum was higher in the dynamic compliance–guided PEEP group (397 vs. 337 mmHg; group difference, 60; 95% CI, 9 to 111; P = 0.017) but did not differ between the two groups 30 min after extubation (359 vs. 375 mmHg; group difference, –17; 95% CI, –53 to 21; P = 0.183). The incidence of postoperative pulmonary complications was 4 of 20 in both groups.

Conclusions
Postoperative atelectasis was lower in patients undergoing laparoscopic bariatric surgery under dynamic compliance–guided PEEP versus PEEP of 8 cm H2O. Postoperative Pao
2/Fio
2 did not differ between the two groups.

Editor’s Perspective

What We Already Know about This Topic

What This Article Tells Us That Is New
Barriers to a Timely Diagnosis of Endometriosis
Authors: Davenport Sophie , Smith Diane , Green Dan J. 
Published: July 2023

OBJECTIVE:
The diagnosis of endometriosis, a common gynecologic condition, is characterized by delays of up to 11 years. During this time, women may experience persistent symptoms that affect their quality of life, productivity, and relationships, and the disease may progress. It is therefore a priority to understand the factors that contribute to this delay to help improve the diagnostic pathway. Our objective was to describe the diagnosis barriers of endometriosis from the patient and health care professional perspectives using a qualitative evidence synthesis.

DATA SOURCES:
We searched MEDLINE, PsycINFO, and Cumulative Index to Nursing and Allied Health Literature using combinations of the synonyms of endometriosis, diagnosis, and qualitative research. The search was restricted to English-language articles from database creation until May 2022.

METHODS OF STUDY SELECTION:
The initial search yielded 899 articles. Studies were included if they explored the experiences or views of affected women or health care professionals on the diagnosis of endometriosis and used qualitative methods for data collection and data analysis. Risk of bias was assessed with the Critical Appraisal Skills Programme checklist.

TABULATION, INTEGRATION, AND RESULTS:
Thirty-seven articles were considered for full review, with 13 eligible articles identified for inclusion. Thematic synthesis was used to identify four key themes: 1) individual factors (n=6), 2) interpersonal influences (n=6), 3) health system factors (n=13), and 4) factors specific to endometriosis (n=13). These encompassed 12 subthemes that represented barriers to the diagnosis of endometriosis: 1) difficulty establishing pathologic symptoms from normal menstruation and the use of self-care techniques; 2) menstrual stigma and the normalization of menstrual pain; 3) attitudes and lack of training for health care professionals, delayed referrals to specialist services, and poor explanation of oral contraceptive pill use in the diagnostic process; and 4) variability in presenting symptoms, overlap with other conditions, lack of a noninvasive method of diagnosis, and concerns about the value of a diagnosis.

CONCLUSION:
This review identified barriers to the timely diagnosis of endometriosis from the perspective of affected individuals and health care professionals. It highlights areas for improvement along the diagnostic pathway, which may guide future strategies to reduce delays.
Development and Validation of an ICU Delirium Playbook for Provider Education
Authors: Makhija Hirsh , Fine Janelle M. , Pollack Daniel , Novelli Francesca , Davidson Judy E. , Cotton Shannon A. , Diaz De Leon Bianca , Reyes Paola Alicea , Montoya Jessica L. , Arroyo-Novoa Carmen Mabel , Figueroa-Ramos Milagros I. , Song Yeonsu , Fuentes Ana Lucia , LaBuzetta Jamie Nicole , Moore Alison A. , Ely E. Wesley , Malhotra Atul , Needham Dale M. , Martin Jennifer L. , Kamdar Biren B. 
Published: July 2023

OBJECTIVES:
Although delirium detection and prevention practices are recommended in critical care guidelines, there remains a persistent lack of effective delirium education for ICU providers. To address this knowledge-practice gap, we developed an “ICU Delirium Playbook” to educate providers on delirium detection (using the Confusion Assessment Method for the ICU) and prevention.

DESIGN:
Building on our previous ICU Delirium Video Series, our interdisciplinary team developed a corresponding quiz to form a digital “ICU Delirium Playbook.” Playbook content validity was evaluated by delirium experts, and face validity by an ICU nurse focus group. Additionally, focus group participants completed the quiz before and after video viewing. Remaining focus group concerns were evaluated in semi-structured follow-up interviews.

SETTING:
Online validation survey, virtual focus group, and virtual interviews.

SUBJECTS:
The validation group included six delirium experts in the fields of critical care, geriatrics, nursing, and ICU education. The face validation group included nine ICU nurses, three of whom participated in the semi-structured feedback interviews.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
The 44-question quiz had excellent content validity (average scale-level content validity index [S-CVI] of individual items = 0.99, universal agreement S-CVI = 0.93, agreement κ ≥ 0.75, and clarity p ≥ 0.8). The focus group participants completed the Playbook in an average (sd) time of 53 (14) minutes, demonstrating significant improvements in pre-post quiz scores (74% vs 86%; p = 0.0009). Verbal feedback highlighted the conciseness, utility, and relevance of the Playbook, with all participants agreeing to deploy the digital education module in their ICUs.

CONCLUSIONS:
The ICU Delirium Playbook is a novel, first-of-its-kind asynchronous digital education tool aimed to standardize delirium detection and prevention practices. After a rigorous content and face validation process, the Playbook is now available for widespread use.
USP25 promotes hepatocellular carcinoma progression by interacting with TRIM21 via the Wnt/β-catenin signaling pathway
Authors: Liu Yinghui , Ma Jingjing , Lu Shimin , He Pengzhan , Dong Weiguo 
Published: July 2023

Abstract

Background:
Hepatocellular carcinoma (HCC) is one of the most common malignant tumors in the world. The ubiquitin-specific peptidase 25 (USP25) protein has been reported to participate in the development of several cancers. However, few studies have reported its association with HCC. In this study, we aimed to investigate the function and mechanism of USP25 in the progression of HCC.

Methods:
We analyzed USP25 protein expression in HCC based on The Cancer Genome Atlas (TCGA) and International Cancer Genome Consortium (ICGC) database cohorts. Then, we constructed USP25-overexpressing and USP25-knockdown HepG2, MHCC97H, and L-O2 cells. We detected the biological function of USP25 by performing a series of assays, such as Cell Counting Kit-8 (CCK-8), colony formation, transwell, and wound healing assays. Western blotting and quantitative real-time polymerase chain reaction (qRT-PCR) analyses were performed to detect the interaction between USP25 and the Wnt/β-catenin signaling pathway. The relationship between USP25 and tripartite motif-containing 21 (TRIM21) was assessed through mass spectrometry and co-immunoprecipitation (Co-IP) analysis. Finally, we constructed a mouse liver cancer model with the USP25 gene deletion to verify in vivo role of USP25.

Results:
USP25 was highly expressed in HCC tissue and HCC cell lines. Importantly, high expression of USP25 in tissues was closely related to a poor prognosis. USP25 knockdown markedly reduced the proliferation, migration, and invasion of HepG2 and MHCC97H cells, whereas USP25 overexpression led to the opposite effects. In addition, we demonstrated that USP25 interacts with TRIM21 to regulate the expression of proteins related to epithelial–mesenchymal transition (EMT; E-cadherin, N-cadherin, and Snail) and the Wnt/β-catenin pathway (β-catenin, Adenomatous polyposis coli, Axin2 and Glycogen synthase kinase 3 beta) and those of their downstream proteins (C-myc and Cyclin D1). Finally, we verified that knocking out USP25 inhibited tumor growth and distant metastasis in vivo.

Conclusions:
In summary, our data showed that USP25 was overexpressed in HCC. USP25 promoted the proliferation, migration, invasion, and EMT of HCC cells by interacting with TRIM21 to activate the β-catenin signaling pathway.
Vaccination against coronavirus disease 2019 in patients with pulmonary hypertension: A national prospective cohort study
Authors: Wu Xiaohan , Li Jingyi , Ma Jieling , Liu Qianqian , Wang Lan , Zhu Yongjian , Cui Yue , Wang Anyi , Wen Cenjin , Qiu Luhong , Yang Yinjian , Lu Dan , Xu Xiqi , Zhu Xijie , Cheng Chunyan , Wang Duolao , Jing Zhicheng 
Published: July 2023

Abstract

Background:
Coronavirus disease 2019 (COVID-19) has potential risks for both clinically worsening pulmonary hypertension (PH) and increasing mortality. However, the data regarding the protective role of vaccination in this population are still lacking. This study aimed to assess the safety of approved vaccination for patients with PH.

Methods:
In this national prospective cohort study, patients diagnosed with PH (World Health Organization [WHO] groups 1 and 4) were enrolled from October 2021 to April 2022. The primary outcome was the composite of PH-related major adverse events. We used an inverse probability weighting (IPW) approach to control for possible confounding factors in the baseline characteristics of patients.

Results:
In total, 706 patients with PH participated in this study (mean age, 40.3 years; mean duration after diagnosis of PH, 8.2 years). All patients received standardized treatment for PH in accordance with guidelines for the diagnosis and treatment of PH in China. Among them, 278 patients did not receive vaccination, whereas 428 patients completed the vaccination series. None of the participants were infected with COVID-19 during our study period. Overall, 398 patients received inactivated severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine, whereas 30 received recombinant protein subunit vaccine. After adjusting for baseline covariates using the IPW approach, the odds of any adverse events due to PH in the vaccinated group did not statistically significantly increase (27/428 [6.3%] vs. 24/278 [8.6%], odds ratio = 0.72, P = 0.302). Approximately half of the vaccinated patients reported at least one post-vaccination side effects, most of which were mild, including pain at the injection site (159/428, 37.1%), fever (11/428, 2.6%), and fatigue (26/428, 6.1%).

Conclusions:
COVID-19 vaccination did not significantly augment the PH-related major adverse events for patients with WHO groups 1 and 4 PH, although there were some tolerable side effects. A large-scale randomized controlled trial is warranted to confirm this finding. The final approval of the COVID-19 vaccination for patients with PH as a public health strategy is promising.
Choice of intraocular lens calculation formula for cataract patients with prior pars plana vitrectomy
Authors: Zhang Jiaqing , Han Xiaotong , Chen Xiaoyun , Liu Zhenzhen , Zhang Yu , Qiu Xiaozhang , Tan Xuhua , Luo Lixia , Liu Yizhi 
Published: July 2023

Purpose:To determine the optimal intraocular lens (IOL) calculation formula for vitrectomized eyes with diverse surgical and biometric characteristics.Setting:Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.Design:Retrospective consecutive case series study.Methods:This study included 974 vitrectomized eyes (974 patients) scheduled for phacoemulsification with IOL implantation. 11 formulas were evaluated: Barrett Universal II (BUII), Emmetropia Verifying Optical, Hoffer-QST, Kane, Ladas Super Formula, Pearl-DGS, Radial Basis Function (RBF), Haigis, HofferQ, Holladay1, and SRK/T. Risk factors for prediction error (PE) exceeding 1 diopter (D) were determined using multiple logistic regression. Subgroup analyses were performed based on surgical history and biometric parameters.Results:The risk of hyperopic PE (>1 D) was higher in patients with silicone oil tamponade (odds ratio [OR], 1.82) and longer axial length (AL) (OR, 1.55), while patients with previous scleral buckling (OR, 2.43) or ciliary sulcus IOL implantation (OR, 6.65) were more susceptible to myopic PE (<−1 D). The Kane formula had the highest overall prediction accuracy, and also the best in silicone oil-filled eyes and the flat cornea subgroup. The BUII and RBF displayed the optimal performance in eyes with previous scleral buckle and steep cornea, respectively. In eyes with an AL ≥ 26 mm, the Holladay1 with the nonlinear version of the Wang-Koch AL adjustment (Holladay1-WKn) showed the lowest absolute PE and highest percentage within ± 1.0 D of PE.Conclusions:The Kane achieved the highest overall prediction accuracy in vitrectomized eyes. The optimal formula for eyes with previous scleral buckle, steep cornea, or long AL was BUII, RBF, and Holladay1-WKn, respectively.
Participant Heterogeneity of Systemic Scleroderma Interventional Trials Worldwide
Authors: Shi Li-Qing , Zhou Shi-Hang , Ruan Ping-Lang , Zhang Bo , Xin Yue , Zhao Cheng , Yao Xu , Tian Jing-Ru , Lu Qian-Jin 
Published: July 2023

Objective:
Heterogeneity of participants in clinical trials distorts intervention efficacy. However, factors associated with participant heterogeneity in randomized clinical trials (RCTs) focusing on systemic sclerosis (SSc) are not clear. We conducted this systematic review to establish normative standards for future research and help develop management guidelines.

Methods:
Three databases and 4 registries were searched to identify characteristics of SSc RCTs across different countries. Risk of bias was assessed by the Cochrane Collaboration’s tool and logistic regression was performed to calculate crude and adjusted odds ratios.

Results:
In total, 261 trials met our inclusion criteria. The quality of SSc RCTs worldwide was relatively poor, with no trend of improvement in recent years, and only 12.2% were ranked as having a low risk of bias. Trials with a low risk of bias as well as single-center, single-country, or open-label trials tended to have better participant adherence than trials with a high risk of bias and multiple-center, multiple-country, or double-blind trials. Interestingly, trial registration and primary outcome definition contributed to high withdrawal. National income was also relevant; participant adherence in high-income countries, but not in upper- and lower-middle-income countries, was significantly altered by different variables.

Conclusion:
Overall, the risk of bias, national income, and trial design may lead to participant heterogeneity of SSc RCTs and ultimately confound the general clinical utility of the results. Trials with a rigorous design and transparent conduction protocol are crucial for obtaining unbiased data that can serve as a reference and for maintaining the fundamental repeatability of SSc RCTs.
EFFICACY OF 308 NM MONOCHROMATIC EXCIMER LAMP AND TOPICAL TACROLIMUS COMBINATION THERAPY IN LOCALIZED VITILIGO: A STUDY IN VIETNAM
Authors: Do Thi Thu Hien , Nguyen Thai Minh Hao , Kanekura Takuro 
Published: July 2023

Objective:
Combination therapy of a 308 nm monochromatic excimer lamp and topical tacrolimus is widely used in the treatment of localized vitiligo; however, there are no published studies investigating this combination therapy in Vietnamese patients with vitiligo. This study was performed to evaluate the efficacy of combined excimer lamp and topical tacrolimus therapy for patients with localised vitiligo in Vietnam.

Methods:
We performed a pre-post clinical trial of 30 patients diagnosed with localised vitiligo in Vietnam. The patients were treated with an excimer lamp twice weekly and with topical tacrolimus twice daily. Effectiveness was evaluated based on the reduction rate of the vitiligo area scoring index (VASI).

Results:
After 12 weeks of treatment, response was excellent or good in 16 patients (53.3%), moderate in 8 patients (26.7%), and poor in 6 patients (20%). The excellent or good responses increased over time from 3 patients (10%) at 6 weeks to 16 patients (53.3%) at 12 weeks (p=0.001). Earlier initiation of repigmentation was associated with a better response to treatment (r=-0.71; p=0.02). Patients with a perifollicular repigmentation pattern responded better to treatment than those with combined or marginal repigmentation patterns (p=0.003). Side effects occurred in 13 patients (43.3%), including burning (43.3%), pruritus (10%), and mild blistering (6.7%), and none of these interrupted the treatment.

Conclusion:
Combination therapy with excimer lamp and topical tacrolimus appears to be effective and safe in treating patients with localised vitiligo in Vietnam.