bluuebunny/crossref_metadata_2025_split huggingface dataset:
From distal to proximal to interactive: behavioral and brain synchrony during attraction, courtship, and sexual interaction—implications for clinical assessments of relationship style and quality
Authors: Pfaus James G , Safron Adam , Zakreski Ellen 
Published: August 2023

Abstract

Introduction
Synchronous behaviors between individuals are nonverbal signs of closeness and common purpose. In the flow from initial attraction to intimate sexual interaction, attention and synchrony move from distal to proximal to interactive and are mediated by sensitized activation of neural systems for sexual motivation, arousal, and desire and those that recognize and mimic common facial and body movements between individuals. When reinforced by sexual pleasure and other relationship rewards, this results in the strengthening of attraction and bonding and the display of more common motor patterns. As relationships falter, nonverbal behaviors likely become asynchronous.

Objectives
To define behavioral, romantic, and sexual synchrony during phases of attraction and how their disruption can be observed and utilized by clinicians to assess individual relationship styles and quality.

Methods
We review the literature on behavioral and attentional synchrony in humans and animals in an effort to understand experiential and innate mechanisms of synchrony and asynchrony and how they develop, as well as implications for attraction, relationship initiation, maintenance of romantic and sexual closeness, and relationship disintegration.

Results
Evidence is presented that behavioral synchrony and the neural mechanisms that underlie it are vital to relationship formation and satisfaction.

Conclusion
Behavioral synchrony helps to create feelings of sexual and romantic synergy, cohesion, and arousal among individuals. Asynchrony is aversive and can spark feelings of discontent, aversion, and jealousy. Thus, observing patterns of nonverbal sexual and romantic synchrony between individuals offers insights into the potential quality of their relationships.
Prebiotic effect of poly‐D‐3‐hydroxybutyrate prevents dyslipidemia in obese mice
Authors: Mishima Mayuko , Takeda Shiro , Nagane Masaki , Suzuki Takehito , Ogata Masaya , Shima Ayaka , Aihara Naoyuki , Kamiie Junichi , Suzuki Rimina , Mizugaki Hinano , Okamatsu‐Ogura Yuko , Satoh Takumi , Yamashita Tadashi 
Published: August 2023

AbstractObesity is a global health problem caused by genetic, environmental, and psychological factors and is associated with various health disorders. As such, there is a growing focus on the prevention of obesity and related diseases. The gut microbiota plays a crucial role in these diseases and has become a therapeutic target. Prebiotics, such as poly‐d‐3‐hydroxybutyric acid (PHB), have gained attention for their potential to alter the gut microbiota, promote beneficial bacterial growth, and alleviate obesity. In this study, we examined the prebiotic effects of PHB in obese mice. We found that, in C57BL/6N mice, PHB reduced blood lipid levels. Analysis of the intestinal microflora also revealed an increase in short‐chain fatty acid‐producing bacteria. When PHB was administered to obese mice, subcutaneous fat and dyslipidemia were reduced, and the number of beneficial bacteria in the intestinal microflora increased. Furthermore, fatty degradation and oxidative stress were suppressed in the liver. PHB regulates gut bacterial changes related to obesity and effectively inhibits dyslipidemia, suggesting that it could be a prebiotic agent for curing various obesity‐related diseases. In summary, PHB increases the beneficial gut microbiota, leading to an alleviation of obesity‐associated dyslipidemia.
Outcomes With Single-Site Dual-Lumen Versus Multisite Cannulation for Adults With COVID-19 Respiratory Failure Receiving Venovenous Extracorporeal Membrane Oxygenation*
Authors: O’Gara Brian P. , Tung Matthew G. , Kennedy Kevin F. , Espinosa-Leon Juan P. , Shaefi Shahzad , Gluck Jason , Raz Yuval , Seethala Raghu , Reich John A. , Faugno Anthony J. , Brodie Daniel , Garan A. Reshad , Grandin E. Wilson 
Published: August 2023

OBJECTIVES:
To determine whether multisite versus single-site dual-lumen (SSDL) cannulation is associated with outcomes for COVID-19 patients requiring venovenous extracorporeal membrane oxygenation (VV-ECMO).

DESIGN:
Retrospective analysis of the Extracorporeal Life Support Organization Registry. Propensity score matching (2:1 multisite vs SSDL) was used to control for confounders.

PATIENTS:
The matched cohort included 2,628 patients (1,752 multisite, 876 SSDL) from 170 centers. The mean (sd) age in the entire cohort was 48 (11) years, and 3,909 (71%) were male. Patients were supported with mechanical ventilation for a median (interquartile range) of 79 (113) hours before VV-ECMO support.

INTERVENTIONS:
None.

MEASUREMENTS:
The primary outcome was 90-day survival. Secondary outcomes included survival to hospital discharge, duration of ECMO support, days free of ECMO support at 90 days, and complication rates.

MAIN RESULTS:
There was no difference in 90-day survival (49.4 vs 48.9%, p = 0.66), survival to hospital discharge (49.8 vs 48.2%, p = 0.44), duration of ECMO support (17.9 vs 17.1 d, p = 0.82), or hospital length of stay after cannulation (28 vs 27.4 d, p = 0.37) between multisite and SSDL groups. More SSDL patients were extubated within 24 hours (4% vs 1.9%, p = 0.001). Multisite patients had higher ECMO flows at 24 hours (4.5 vs 4.1 L/min, p < 0.001) and more ECMO-free days at 90 days (3.1 vs 2.0 d, p = 0.02). SSDL patients had higher rates of pneumothorax (13.9% vs 11%, p = 0.03). Cannula site bleeding (6.4% vs 4.7%, p = 0.03), oxygenator failure (16.7 vs 13.4%, p = 0.03), and circuit clots (5.5% vs 3.4%, p = 0.02) were more frequent in multisite patients.

CONCLUSIONS:
In this retrospective study of COVID-19 patients requiring VV-ECMO, 90-day survival did not differ between patients treated with a multisite versus SSDL cannulation strategy and there were only modest differences in major complication rates. These findings do not support the superiority of either cannulation strategy in this setting.
Infraclavicular, Ultrasound-Guided Percutaneous Approach to the Axillary Artery for Arterial Catheter Placement: A Randomized Trial
Authors: Gawda Ryszard , Marszalski Maciej , Piwoda Maciej , Molsa Maciej , Pietka Marek , Filipiak Kamil , Miechowicz Izabela , Czarnik Tomasz 
Published: August 2023

OBJECTIVES:
To examine whether an ultrasound-guided infraclavicular cannulation of the axillary artery is noninferior to an ultrasound-guided cannulation of the common femoral artery for arterial catheter placement in critically ill patients.

DESIGN:
Prospective, investigator-initiated, noninferiority randomized controlled trial.

SETTING:
University-affiliated ICU in Poland.

PATIENTS:
Mechanically ventilated patients with indications for arterial catheter placement.

INTERVENTIONS:
Patients were randomly assigned into two groups. In the axillary group (A group), an ultrasound-guided infraclavicular, in-plane cannulation of the axillary artery was performed. In the femoral group (F group), an ultrasound-guided, out-of-plane cannulation of the common femoral artery was performed.

MEASUREMENTS AND MAIN RESULTS:
A total of 1,079 mechanically ventilated patients were screened, of whom 110 were randomized. The main outcome was the cannulation success rate. The secondary outcomes included the artery puncture success rate, the first-pass success rate, number of attempts required to puncture, and the rate of early mechanical complications. The cannulation success rate in the A group and F group was 96.4% and 96.3%, respectively. The lower limit of 95% CI for the difference in cannulation success rate was above the prespecified noninferiority margin of—7% demonstrating noninferiority of infraclavicular approach. No significant differences were found between the groups in terms of puncture success rate and the rate of early mechanical complications.

CONCLUSIONS:
An ultrasound-guided infraclavicular cannulation of the axillary artery is noninferior to the cannulation of the common femoral artery in terms of procedure success rate. We found no significant differences in early mechanical complications between the groups.
Incidence of postoperative residual neuromuscular blockade − A multicenter, observational study in Portugal (INSPIRE 2)
Authors: Esteves Simão , Correia de Barros Filinto , Nunes Catarina S , Puga Andreia , Gomes Blandina , Abelha Fernando , Machado Humberto , Ferreira Milene , Fernandes Nuno , Vítor Paula , Pereira Sandra , Lapa Teresa A. , Pinho-Oliveira Vítor 
Published: August 2023

Abstract

Background:
Although the use of neuromuscular blocking agents (NMBAs) optimizes surgical conditions and facilitates tracheal intubation, it can lead to residual neuromuscular blockade (RNMB), with postoperative complications. This study aimed to assess RNMB incidence and management in Portugal.

Methods:
Prospective observational study of patients admitted for elective surgery requiring general anesthesia with nondepolarizing NMBAs between July 2018 and July 2019 at 10 Portuguese hospitals. The primary endpoint was the proportion of patients arriving at postanesthesia care unit (PACU) with a TOF ratio <0.9.

Results:
A total of 366 patients were included, with a median age of 59 years, and 89.1% classified as ASA II or III. Rocuronium was the most used NMBA (99.5%). A total of 96.2% of patients received a reversal agent, 96.6% of which sugammadex and 3.4% neostigmine. Twenty patients displayed a TOF ratio <0.9 at PACU arrival, representing an RNMB incidence of 5.5% (95% CI, 3.1%–7.8%). Only two patients displayed a TOF ratio <0.7. RNMB incidence was 16.7% with neostigmine and 5.3% with sugammadex (P = .114). In patients with intraoperative neuromuscular blockade (NMB) monitoring, RNMB incidence was 5% (95% CI, 2%–8%), which varied significantly according to the type of monitoring (P = .018). Incidence of adverse events was 3.3% (2 severe and 10 moderate).

Conclusions:
The reported overall incidence of 5.5% is numerically lower than results from similar observational studies. An appropriate pharmacological neuromuscular reversal strategy, guided by quantitative neuromuscular monitoring, has the potential to achieve even better results, converting RNMB from an unusual to a very rare or even inexistent event.
Prognostic value of circumferential radial margin involvement in esophagectomy for esophageal cancer: A case series
Authors: Boerner Thomas , Carr Rebecca , Hsu Meier , Tan Kay See , Sigel Carlie , Tang Laura , Harrington Caitlin , Ku Geoffrey Y. , Ilson David H. , Janjigian Yelena Y. , Wu Abraham J. , Sihag Smita , Bains Manjit S. , Bott Matthew J. , Isbell James M. , Park Bernard J. , Jones David R. , Molena Daniela 
Published: August 2023

Background:
Residual tumor at the proximal or distal margin after esophagectomy is associated with worse survival outcomes; however, the significance of the circumferential resection margin (CRM) remains controversial. In this study, we sought to evaluate the prognostic significance of the CRM in patients with esophageal cancer undergoing resection.

Materials and Methods:
We identified patients who underwent esophagectomy for pathologic T3 esophageal cancer from 2000 to 2019. Patients were divided into three groups: CRM– (residual tumor >1 mm from the CRM), CRM-close (residual tumor >0-1 mm from the CRM), and CRM+ (residual tumor at the surgical CRM). CRM was also categorized and analyzed per Royal College of Pathologists (RCP) and College of American Pathologists (CAP) classifications.

Results:
Of the 519 patients included, 351 (68%) had CRM–, 132 (25%) had CRM-close, and 36 (7%) had CRM+. CRM+ was associated with shorter disease-free survival (DFS; CRM+ vs. CRM–: hazard ratio [HR], 1.53 [95% CI, 1.03-2.28]; P=0.034) and overall survival (OS; CRM+ vs. CRM–: HR, 1.97 [95% CI, 1.32-2.95]; P<0.001). Survival was not significantly different between CRM-close and CRM–. After adjustment for potential confounders, CAP+ was associated with poor oncologic outcomes (CAP+ vs. CAP–: DFS: HR, 1.47 [95% CI, 1.00-2.17]; P=0.050; OS: HR, 1.93 [95% CI, 1.30-2.86]; P=0.001); RCP+ was not (RCP+ vs. RCP-: DFS: HR, 1.21 [95% CI, 0.97-1.52]; P=0.10; OS: HR, 1.21 [95% CI, 0.96-1.54]; P=0.11).

Conclusion:
CRM status has critical prognostic significance for patients undergoing esophagectomy: CRM+ was associated with worse outcomes, and outcomes between CRM-close and CRM– were similar.
School Belongingness as a Mediator in the Relationship Between Self-Reported PTSD and Cyber Victimization
Authors: Atalan Ergin Derya , Akgül Gülendam 
Published: August 2023

Abstract
The incidence of posttraumatic stress disorder (PTSD) has increased during the COVID-19 pandemic. Traumatized adolescents might cope with maladaptive strategies such as increased Internet usage, which might be a risk for cyber victimization. We investigated the relationship between self-reported PTSD and cyber victimization and the mediator role of school belongingness in this relationship. The sample consisted of 292 adolescents ages 11–14 years old (M = 12.53, SD = 0.71; n
female = 165, 56.1%; n
male = 129, 43.9%). Results show that males are more likely to be cyber victims and have lower levels of school belongingness than females. In addition, results supported the association between higher levels of PTSD and higher levels of cyber victimization. Traumatized adolescents with high levels of school belongingness are less likely to be cyber victims. These findings highlight the importance of school-related personal and relational characteristics in promoting adolescent mental health.
The Evolving Landscape of Genetic Carrier Screening: Clinical Considerations and Challenges
Authors: Buckley Lauren E. , Hopkins Maeve K. , Kuller Jeffrey A. 
Published: August 2023

ABSTRACT

Importance
Genetic carrier screening is performed to identify carriers of rare genetic diseases. Identification of carriers allows patients to make informed reproductive health choices and can decrease the incidence of genetic disorders with serious medical implications.

Objective
This review aims to provide an overview of the history of prenatal genetic screening and the various forms of carrier screening, a synopsis of recent changes in society recommendations and current practice guidelines, and discussion of clinical challenges associated with carrier screening.

Evidence Acquisition
Published practice guidelines from relevant professional societies were reviewed and synthesized. PubMed search was performed for relevant history and clinical considerations of carrier screening.

Results
Information and evidence summarized in this review include professional society practice guidelines, review articles, and peer-reviewed research articles.

Conclusions and Relevance
Current practice guidelines differ between stakeholder professional organizations. Expanded carrier screening offers increased identification of rare disease carriers allowing for more informed reproductive choices. However, there are several barriers to the implementation of expanded carrier screening for all patients.

Target Audience
Obstetricians and gynecologists, family physicians.

Learning Objectives
After completing this activity, the learner should be better able to describe the difference between ethnicity-based, pan-ethnic, and expanded carrier screening; explain current practice guidelines from the American College of Obstetricians and Gynecologists and the American College of Medical Genetics and Genomics; and identify the barriers to implementation of expanded carrier screening.
An Update on Human Papillomavirus Vaccination in the United States
Authors: Boitano Teresa K. L. , Ketch Peter W. , Scarinci Isabel C. , Huh Warner K. 
Published: August 2023

ABSTRACT
Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States in adults, and although most cases are transient, 10%–20% of infections can persist and progress to various forms of cancer. The HPV vaccine prevents more than 90% of HPV infections and HPV-associated cancers. The vaccine is most effective at preventing all types of HPV-related dysplasia in patients with no prior exposure to HPV. Reasons for decreased compliance include parent-specific factors such as education, safety concerns, absence of professional recommendation, and apprehension about supporting sexual behavior, whereas professional-level barriers include lack of time to discuss vaccination, knowledge gaps, vaccine access, and financial concerns.
This clinical expert series highlights the evidence supporting the HPV vaccine as a safe and effective way to prevent cervical cancer. Most HPV infections are acquired in individuals aged 14–24 years with increasing prevalence with each year. Shared decision-making should be used for patients aged 27–45 years, in whom the vaccine has been demonstrated to be safe and effective, but the population advantage of vaccination is expected to be limited. Unvaccinated health care workers exposed to the virus in their practices should be vaccinated between the ages of 27 and 45 years. A previous HPV infection should not be a reason to not receive the vaccine, and it is not necessary to screen individual patients before vaccination. The vaccine is efficacious against other HPV types regardless of which HPV strain an individual may be positive for at the time of vaccination. Regarding women with HPV-related dysplasia such as high-grade squamous intraepithelial lesions that undergo excisional procedures, up to 15% will experience persistent or recurrent disease, and these women are at higher risk of developing a new HPV-associated lesion. Therefore, vaccination may provide a significant reduction in future disease in this patient population.
The World Health Organization Strategic Advisory Group of Experts on Immunization recently evaluated the current scheduling regimens for the HPV vaccine and concluded that a single dose may provide enough protection in individuals younger than age 21; however, the Centers for Disease Control and Prevention is yet to comment. An ongoing large randomized, controlled, double-blinded, noninferiority trial (ESCUDDO) is currently evaluating a single-dose versus 2-dose regimen that will help elucidate whether vaccine scheduling in the United States may change to a single-dose paradigm.
The strongest predictor of vaccine uptake is health care professional recommendation, and patients with prior infection or excision should still be offered the vaccine. Finally, although vaccination national guidelines are in place for individuals aged 9–26 years, certain patient populations older than 26 years may benefit from the vaccine.
Documented Penicillin Allergies on Antibiotic Selection at Pediatric Emergency Department Visits
Authors: Carter Eileen J. , Zavez Katherine , Rogers Steven C. , deMayo Richelle , Harel Ofer , Gerber Jeffrey S. , Aseltine Robert H. 
Published: August 2023

Background
Penicillin or amoxicillin are the recommended treatments for the most common pediatric bacterial illnesses. Allergies to penicillin are commonly reported among children but rarely true. We evaluated the impact of reported penicillin allergies on broad-spectrum antibiotic use overall and for the treatment of common respiratory infections among treat-and-release pediatric emergency department (ED) visits.

Methods
Retrospective cohort study of pediatric patients receiving antibiotics during a treat-and-release visit at a large, pediatric ED in the northeast from 2014 to 2016. Study exposure was a reported allergy to penicillin in the electronic medical record. Study outcomes were the selection of broad-spectrum antibiotics and alternative (second-line) antibiotic therapy for the treatment of acute otitis media (AOM) and group A streptococcus (GAS) pharyngitis. We used unadjusted and adjusted generalized estimating equation models to analyze the impact of reported penicillin allergies on the selection of broad-spectrum antibiotics. We used unadjusted and adjusted logistic regression models to determine the probability of children with a documented penicillin allergy receiving alternative antibiotic treatments for AOM and GAS.

Results
Among 12,987 pediatric patients, 810 (6.2%) had a documented penicillin allergy. Penicillin allergies increased the odds of children receiving a broad spectrum versus narrow spectrum antibiotic (adjusted odds ratio, 13.55; 95% confidence interval (CI), 11.34–16.18). In our adjusted logistic regression model, the probability of children with a documented penicillin allergy receiving alternative antibiotic treatment for AOM was 0.97 (95% CI, 0.94–0.99) and for GAS was 0.97 (95% CI, 0.92–0.99).

Conclusions
Antibiotic stewardship efforts in pediatric EDs may consider the delabeling of penicillin allergies particularly among children receiving antibiotics for an acute respiratory infection as a target for intervention.
Characteristics, outcomes, and its associated factors among patients hospitalized with mild traumatic brain injuries
Authors: Lee Se Won , Werner Bryan , Anireddy Saswatha , Ayutyanont Napatkamon 
Published: August 2023

Abstract

Objective
To investigate the characteristics and hospital outcomes of patients with mild traumatic brain injuries (mTBI).

Design
A total of 1,940 patients with mTBI from 7 community hospitals between 2017 and 2019 were identified using International Classification of Disease (ICD) codes and an documented initial Glasgow Coma Scale (GCS) score of 13 to 15. A stepwise logistic regression was used to identify demographics and clinical characteristics associated with in-hospital mortality and home discharge.

Results
The median age was 69 years old with 66.6% associated with falls at admission. Subdural hemorrhage was the most common brain lesion and more common in the group with falls. Increased age, male sex, epidural hemorrhage, presence of hemiplegia, paraplegia, renal disease, cancer, hospital-acquired sepsis, anemia, and use of direct vasodilator were associated with increased odds of in-hospital mortality. Increased age, medical coverage by Medicare, cerebral edema, lower initial GCS, length of stay, comorbidity of acute myocardiac infarction, and use of thiamine and opioids were associated with decreased likelihood of discharge to home.

Conclusion
Recognizing characteristics of hospitalized patients with mTBI and their association with increased in-hospital mortality and non-home discharge can be useful for improving care of this vulnerable population.