bluuebunny/crossref_metadata_2025_split huggingface dataset:
In‐Room Direct Nidal Flow Measurement by Digital Subtraction Angiography to Estimate Hemorrhage Risk in Brain Arteriovenous Malformations: A Pilot Study
Authors: Chen Ko‐Kung , Yang Huai‐che , Lee Cheng‐Chia , Lin Chun‐Fu , Chu Wei‐Fa , Hsu Sanford PC. , Chang Feng‐Chi , Su I‐Chang , Chiou Hong‐Jen , Lin Chung‐Jung 
Published: February 2023

Background
Noninvasive direct flow measurement from digital subtraction angiography (DSA) is challenging in brain arteriovenous malformations (BAVMs). We devised a method to estimate the blood volume flow rate of BAVM nidus using DSA, and assessed its association with angioarchitecture features in hemorrhagic presentation.

Methods
A total of 24 patients with BAVMs (10 controls and 14 with hemorrhage) who underwent DSA and magnetic resonance (MR) were retrospectively recruited. Fifteen patients underwent additional phase contrast MR imaging. The nidus volume was contoured on the MR time‐of‐flight data set. From DSA, flow velocities and volume flow rate were estimated along calibrated vascular center lines. The BAVM nidus volume flow rate was computed by adding feeding volume flow rate of arteries confirmed on DSA and then normalizing them with nidus volume to yield the nidus flow index. The correspondent phase‐contrast MR‐estimated nidus flow index was evaluated in each BAVM for comparison. Comparisons of hemodynamic parameters of the control and hemorrhage groups were conducted using the Wilcoxon rank sum test. A support vector machine was used for classifying BAVM patients using angioarchitectures and the nidus flow index.

Results

For the DSA results, the nidus flow index was higher in the hemorrhagic group than in the control group (
P
=0.0272). The flow index determined using phase‐contrast MR and nidus volume were not significant. The classification accuracy was higher when the DSA nidus flow index was added into angioarchitecture.

Conclusion
The BAVM nidus flow index can be directly estimated from DSA and may be associated with hemorrhagic BAVM. Peritherapeutic hemodynamic assessment of BAVMs inside the angio‐suite is feasible.
Approachability and Credibility of Virtual Character Faces: The Role of the Horizontal Viewing Angle
Authors: So Chaehan , Jung Kyuha 
Published: February 2023

Objective The present work explores how the horizontal viewing angle of a virtual character’s face influences perceptions of credibility and approachability. Background When encountering virtual characters, people rely both on credibility and approachability judgments to form a first impression of the depicted virtual character. Research shows that certain perceptions are preferred either on frontal or tilted faces, but not how approachability or credibility judgments relate to horizontal viewing angles in finer granularity between 0° and 45°. Method 52 participants performed a two-alternative forced choice (2AFC) task rating 240 pairwise comparisons of 20 virtual character faces shown in four horizontal viewing angles (0°, 15°, 30°, and 45°) on approachability and credibility. They also rated scales on individual differences based on the BIS-BAS framework (behavioral inhibition system, drive, and reward responsiveness), self-esteem, and personality traits (neuroticism, loneliness). Results Both approachability and credibility were negatively related to the horizontal viewing angle, but the negative relationship was less pronounced for approachability. Notably, 15° tilted faces were associated with higher approachability than frontal faces by people scoring high in reward responsiveness, drive, and self-esteem, and scoring low in neuroticism and loneliness. Conclusion Our findings highlight the conditions under which showing a virtual character’s face is preferred in a horizontally 15° tilted over a frontal position. Application The differential impact of the horizontal viewing angle on approachability and credibility should be considered when displaying virtual character faces.
Assessment of an Online Nutrition Education Program to Improve Mealtime Practices Among Families Receiving SNAP and WIC
Authors: Tripicchio Gina L. , Anderson Jennifer 
Published: February 2023

Purpose This study examines if participation in an online nutrition education program holds promise for improving mealtime practices in families using SNAP and WIC. Design Pre-post self-report surveys. Setting Digital program delivered online, nationally in the United States. Sample Two hundred fifty-seven parents receiving SNAP and/or WIC. Intervention Parents signed up to participate in Affordable Flavors, an online self-guided 30-day meal plan, developed by culturally diverse dietitians, aligned with the Dietary Guidelines, and linked with social media support. Measures Overall program utilization and acceptability were assessed along with parent meal preparation practices, diet quality of meals served to children, self-efficacy, mealtime stress, grocery spending, and food insecurity. Analysis Paired t-tests (continuous variables) and McNemar’s tests (categorical variables). Results Overall program utilization and acceptability were high. Participants reported improvements in meal preparation practices (t(255) = 6.6, P < .001), diet quality of meals served to children (t(245) = 4.0, P < .001), and self-efficacy (t(251) = 10.0, P < .001), and decreases in grocery spending (t(175) = -4.3, P < .001), mealtime stress (t(256) = -8.8, P < .001) and food insecurity (26.8% vs 10.9%, P < .001). Conclusion Affordable Flavors is an acceptable, cost-effective, and easily disseminatable program that holds promise for improving parent self-efficacy to prepare and serve healthy meals to children and increase diet quality in families receiving SNAP and WIC. Engaging online nutrition education programs that can be used by a variety of health professionals, especially in settings where direct nutrition education services are not feasible or cost prohibitive, are needed.
Systematic review of ethical issues in perinatal mental health research
Authors: de Wet Mickie , Hannon Susan , Hannon Kathleen , Axelin Anna , Uusitalo Susanne , Bartels Irena , Eustace-Cook Jessica , Escuriet Ramón , Daly Deirdre 
Published: February 2023

Background Maternal mental health during the peripartum period is critically important to the wellbeing of mothers and their infants. Numerous studies and clinical trials have focused on various aspects of interventions and treatments for perinatal mental health from the perspective of researchers and medical health professionals. However, less is known about women’s experiences of participating in perinatal mental health research, and the ethical issues that arise. Aim To systematically review the literature on the ethical issues that emerge from pregnant and/or postpartum women’s experiences of taking part in perinatal mental health-related research. Methods Systematic review of nine bibliographic databases, from inception to July 2021. Qualitative, quantitative and mixed method studies were included if they reported on ethical issues experienced by perinatal women. Research ethical issues encompassed any issue relating to women’s experiences of being offered study information, recruitment, consent, retention and respect for autonomy. Titles, abstracts and full text screening, appraisal of the methodological quality of included studies, and data extraction, were conducted independently by two reviewers. Ethical considerations Ethical approval was not required for this systematic review. Findings A total of 9830 unique citations was retrieved. Six studies met the inclusion criteria. Studies were clinically and methodologically heterogenous, and only one was purposively designed to explore women’s experiences. The key finding was the establishment of trust between the researcher and participant in all stages of the research process. Findings are presented according to recruitment and consent processes, participation and retention, and study follow-up and completion. Conclusion The establishment of trust between the researcher and perinatal women leads to a dynamic with research ethical implications relevant to all stages of perinatal mental health-related research. Further research on the research ethical issues experienced by perinatal women is required because of the limited literature.
Positioning of psychodynamic psychotherapy in the treatment of depression: A comparison of the RANZCP 2020 and NICE 2022 guidelines
Authors: Malhi Gin S , Bell Erica , Bassett Darryl , Boyce Philip , Hazell Philip , Hopwood Malcolm , Lyndon Bill , Mulder Roger , Porter Richard , Murray Greg 
Published: February 2023

Objective To compare the 2022 NICE guidelines (NG222) and 2020 RANZCP clinical practice guidelines (MDcpg2020) recommendations for the treatment of depression using psychodynamic psychotherapy. Conclusions Both guidelines recommend psychological interventions first-line. However, only short-term psychodynamic psychotherapy (STPP) is recommended, and in the NG222 it is ranked last for less severe depression and 7th for more severe depression. In contrast, cognitive behavioural therapy and behavioural activation are deemed the more clinically effective and cost-effective psychological therapies. And antidepressants play a significant role – largely in more severe depression.
Using a mobile application for psychiatry training in medical students: a quasi-experimental study
Authors: Zolfaghari Mitra , Shirzadi Shahriar , Motamed Mahtab 
Published: February 2023

Objective Microlearning and gamification through mobile technology can significantly enhance knowledge acquisition and satisfaction. Roozbehyar application, was designed using microlearning and gamification approaches for psychiatry clerkship training. Method This quasi-experimental study was conducted in Roozbeh Hospital, in 2021. The intervention group was assigned to the Roozbehyar during a 4-week course. Knowledge and satisfaction were assessed after 4 weeks. Results We recruited 27 (F/M: 19/8) and 35 students (F/M: 22/13) in the intervention and control groups, respectively. Learning through Roozbehyar was associated with higher scores in the final written exam ( p value: 0.031). No difference was seen in the final global assessment scores. The satisfaction scores of the students regarding the content and learners’ aspect of the application were above average, yet scores in structural and support aspects were below average. Conclusions We highlighted the effect of a microlearning mobile application in increasing knowledge and satisfaction in psychiatry training in medical students.
Updates in the Treatment of Non-Metastatic Castrate-Resistant Prostate Cancer: The Benefit of Second-Generation Androgen Receptor Antagonists
Authors: Hadfield Matthew J. , Lyall Vikram , Holle Lisa M. , Dennison Morgan 
Published: February 2023

Objective: To review pharmacology, efficacy, safety, and considerations for use, of second-generation androgen receptor (AR) antagonists in treatment of nonmetastatic castrate-resistant prostate cancer (M0CRPC). Data Sources: Conducted search in PubMed and Google scholar (January, 1, 2002—December 31, 2022), using relevant terms. Study Selection and Data Extraction: Relevant English-language studies, conducted in humans evaluating second-generation AR antagonists for M0CRPC, and additional articles and package inserts were considered. Data Synthesis: Apalutamide, darolutamide, and enzalutamide are effective in delaying the time to development of metastatic prostate cancer in men with M0CRPC with a rapid prostate-specific antigen (PSA) doubling time (<10 months). No head-to-head, randomized, clinical trials have been conducted. The most common adverse effects include fatigue and hypertension, and quality of life is maintained in most patients. Cost is similar among the agents (~$15,000/month). Drug-drug interactions vary among these agents and should be considered, when selecting therapy as well as likely adherence. Darolutamide is administered twice daily with the others once daily. Relevance to Patient Care and Clinical Practice: Second-generation AR antagonists are effective in reducing time to development of metastatic disease and prolonging overall survival in patients with M0CRPC and a PSA doubling time of <10 months. Recent imaging advances may alter how we evaluate outcomes. Conclusions: Second-generation AR antagonists improve disease control and overall survival. Generally, they are well tolerated and QOL is maintained. Selection of the best agent is based on the adverse effect profile, potential for drug- and disease-interactions, administration, cost, and patient preference.
Acute Management of Hypertriglyceridemia With a Disease-Specific Intravenous Insulin Infusion Order Set
Authors: Ibarra Francisco 
Published: February 2023

Background: Hypertriglyceridemia-associated acute pancreatitis is a disease lacking a standardized management approach. Objective: The main objective of this study was to evaluate the safety and efficacy of a continuous intravenous insulin infusion order set specifically designed for managing hypertriglyceridemia. Methods: This study compared the safety and efficacy of a standardized (postintervention) approach to managing hypertriglyceridemia to a nonstandardized (preintervention) approach. The primary efficacy outcome was the percentage of patients who achieved a triglyceride level less than 500 mg/dL. Additional outcomes included the time to achieving a triglyceride level less than 500 mg/dL and the percent reduction in triglyceride levels. The primary safety outcome was the number of patients who experienced hypoglycemia (glucose less than 70 mg/dL). Results: Twenty patients were included in both the preintervention and postintervention groups. There was a significantly greater reduction in triglyceride levels observed in the postintervention group. The number of patients who achieved a triglyceride level less than 500 mg/dL in the preintervention and postintervention groups were 10 (50%) and 17 (85%), respectively, P = 0.018. Within the postintervention group, the time to achieving a triglyceride level less than 500 mg/dL in those with and without diabetes was 56.8 hours (38.2-64.0) versus 27.6 hours (19.7-45.0), respectively, P = 0.028. Conclusion and Relevance: Our findings demonstrate that insulin infusions are safe and effective when therapy is standardized and accounts for nursing to patient ratios. Our results provide the medical community with a standardized approach to acutely managing hypertriglyceridemia.
Unusual Microsatellite-Instable Mixed Neuroendocrine and Non-neuroendocrine Neoplasm: A Clinicopathological Inspection and Literature Review
Authors: Pereira Daniela , White Daley , Mortellaro Michael , Jiang Kun 
Published: February 2023

Background Mixed neuroendocrine and non-endocrine neoplasms (MiNENs) are challenging to diagnose and manage clinically. The current understanding of MiNENs’ pathobiology, molecular mechanisms, and management is incomplete. Though microsatellite instability (MSI) is known to impact carcinogenesis, reports examining MSI mechanisms for MiNENs are rare. Methods We report an unusual colonic MSI-MiNEN uncovered in an 89-year-old woman and the review of the literature. Results Pathologic inspection revealed a high-grade carcinoma composed of tumor cells with neuroendocrine histologic traits and immunophenotype intermixed with mucin-containing signet ring–like cells arranged in nested and micronodular patterns. Loss of MLH1 and PMS2 mismatch repair proteins was detected in tumor cells. INSM1 immunostaining highlighted about 50% of the tumour, further reinforcing the MiNEN diagnosis. Next-generation sequencing identified multiple carcinogenic mutations. Because of the advanced stage of the tumor and its adhesion to the adjacent organs, surgical resection was aborted; immunotherapy was initiated. The tumor is in remission 30 months following initiation of treatment, and the patient remains asymptomatic. Conclusion This unique MSI MiNEN was characterized by its immunohistochemical and molecular signatures and illustrated how correctly diagnosing MSI can strongly improve a patient’s outcomes.
The Sacred Space: Using Stages of Change Model With Motivational Interviewing to Promote Patient-Centered Healing
Authors: Dixon Lynette , Berger Carol , Smalley Brandie 
Published: February 2023

Objective: Help patients make necessary life changes to reach desired health outcomes. Methods: By combining the transtheoretical stages of the change model with motivational interviewing, nurse practitioners can hone powerful skills to enable patients to make their desired life changes. Results: Nurses and nurse practitioners can make a difference in patients’ lives by connecting and partnering with them to create positive change for improved health outcomes. Conclusions: Nurse educators should provide opportunities for nurses at all levels to learn and incorporate these skills into their practice.
Short report: The role of oral hypersensitivity in feeding behaviors of young autistic children
Authors: Thompson Kelsey , Wallisch Anna , Nowell Sallie , Meredith Jessica , Boyd Brian 
Published: February 2023

Feeding problems are common among autistic children and are linked to negative health consequences. Therefore, understanding feeding problems and factors that influence these behaviors is important for developing supports for children and families. While certain sensory processing patterns are commonly associated with feeding problems, less is known about the link between sensory processing and feeding behaviors in autism, as well as how parent behaviors and feelings during mealtime differ based on child sensory preferences. This research examined two groups of young autistic children who were reported to be picky eaters by their parents: those with and those without oral hypersensitivity. Children with oral hypersensitivity had more difficulty with food acceptance, and their parents reported more negative feelings around feeding their child. However, the two groups of children (oral hypersensitive and not) did not differ in their medical/oral motor symptoms, mealtime behavior, or parent use of strategies at mealtimes. This research supports the need for personalized treatment strategies based on the child’s sensory preferences to support both the child and parent in managing mealtimes. Lay abstract Feeding problems are common among autistic children and are linked to negative health consequences. Therefore, understanding feeding problems and factors that influence these behaviors is important for developing supports for children and families. While certain sensory processing patterns are commonly associated with feeding problems, less is known about the link between sensory processing and feeding behaviors in autism, as well as how parent behaviors and feelings during mealtime differ based on child sensory preferences. This research examined two groups of young autistic children who were reported to be picky eaters by their parents: those with and those without oral hypersensitivity. Children with oral hypersensitivity had more difficulty with food acceptance and their parents reported more negative feelings around feeding their child. However, the two groups of children (oral hypersensitive and not) did not differ in their medical/oral motor symptoms, mealtime behavior, or parent use of strategies at mealtimes. This research supports the need for personalized treatment strategies based on the child’s sensory preferences to support both the child and parent in managing mealtimes.
Correlation Between Indocyanine Green Fluorescence Patterns and Grade of Differentiation of Hepatocellular Carcinoma: A Western Prospective Cohort Study
Authors: Piccolo Gaetano , Barabino Matteo , Santambrogio Roberto , Lecchi Francesca , Di Gioia Giulio , Opocher Enrico , Bianchi Paolo Pietro 
Published: February 2023

Background. Most of the available evidence on the use of indocyanine green (ICG) fluorescence in clinical practice consists of articles published by surgeons of the Asian-Pacific area. We performed a prospective cohort study to assess the patterns of ICG fluorescence in Western hepatocellular carcinoma (HCC) counterparts. Methods. From April 2019 to January 2022, a total of 31 consecutive patients who underwent laparoscopic liver resection (LLR) for superficial HCC were enrolled in this prospective study. All patients underwent laparoscopic staging with both laparoscopic ultrasound (LUS) and ICG fluorescence imaging. Results. A total of 38 hepatocellular carcinomas (HCCs) were enrolled: 23 superficial (surfacing at the liver’s Glissonian capsule), 5 exophytic, 5 shallow (<8 mm from the hepatic surface) and 5 deep (>10 mm from the hepatic surface). The detection rate with preoperative imaging (abdominal CT/MRI), LUS, ICG fluorescence and combined modalities (ICG and LUS) was 97.4%, 94.9%, 89.7% and 100%, respectively. The five deep seated lesions underwent ultrasound-guided laparoscopic thermal ablation. The other 33 HCCs were treated with minimally invasive liver resection. Intraoperative ultrasound patterns were registered for each single nodule resected. The ICG fluorescence pattern was classified in two types: total fluorescence (all the tumoral tissue showed strong and homogeneous fluorescence), n = 9/33 (27.3%), and non-total fluorescence (partial and rim fluorescence), n = 24/33 (72.7%). There was a statistical correlation between ICG patterns and grade of differentiation. Almost all lesions with uniform fluorescence pattern were well-differentiated HCCs (G1-G2), while partial and rim-type fluorescence pattern were more common among moderately and poorly differentiated HCCs (G3-G4) (88.9% vs 11.1%, 37.5% vs 62.5%, P = .025, respectively). Conclusions. ICG fluorescence imaging could be used to identify early the grade of HCC, ie intraoperatively, thus influencing the intraoperative treatment.
Cross-contamination rate of reusable flexible bronchoscopes: A systematic literature review and meta-analysis
Authors: Travis Helena S , Russell Rasmus V , Kovaleva Julia 
Published: February 2023

Background Bronchoscopy is generally a safe and efficient procedure. However, the risk of cross-contamination with reusable flexible bronchoscopes (RFB) has been detected in several outbreaks worldwide. Aim To estimate the average cross-contamination rate of patient-ready RFBs based on available published data. Methods We performed a systematic literature review in PubMed and Embase to investigate the cross-contamination rate of RFB. Included studies identified indicator organisms or colony forming units (CFU) levels, and total number of samples >10. The Contamination threshold was defined according to the European Society of Gastrointestinal Endoscopy and European Society of Gastrointestinal Endoscopy Nurse and Associates (ESGE-ESGENA) guidelines. To calculate the total contamination rate, a random effects model was applied. Heterogeneity was analysed via a Q-test and illustrated in a forest plot. Publication bias was analysed via the Egger’s regression test and illustrated in a funnel plot. Results Eight studies fulfilled our inclusion criteria. The random effects model included 2169 samples and 149 events (positive tests). The total RFB cross-contamination rate was 8.69% ± 1.86 (standard division [SD]) (95% confidence interval [CI]: 5.06–12.33%). The result showed significant heterogeneity of 90% and publication bias. Discussion Significant heterogeneity and publication bias is likely associated with varying methodology and aversion towards publishing negative findings, respectively. Based on the cross-contamination rate an infection control paradigm shift is needed to ensure patient safety. We recommend to follow the Spaulding classification and classify RFBs as critical items. Accordingly, infection control measures such as obligatory surveillance, and implementing single-use alternatives must be considered where feasible.