bluuebunny/crossref_metadata_2025_split huggingface dataset:
Strategies for Virtual Bereavement Care
Authors: Carr Briana Marie 
Published: February 2023

ABSTRACT:
The contagiousness of some illnesses (e.g., COVID-19) limits the ways in which families can interact with their dying loved ones who have been admitted to the hospital, especially in the intensive care unit. As a result, nurses have developed culturally relevant strategies for virtual bereavement care for patients and families predeath, perideath, and postdeath. Specific ways nurses can support, communicate, and facilitate meaningful rituals when patients die in isolation are provided in this article.
In Vitro Exercise-Induced Endothelial Shear Stress Protects the Vascular Endothelium
Authors: Amador Manuel , Huerta Jonathan A. , Garcia Mario A. , Conde Daniel A. , Gurovich Alvaro N. 
Published: February 2023

Purpose:
To determine whether exercise-induced levels of endothelial shear stress (ESS) observed in vivo upregulates endothelial protective proteins in vitro.

Methods:
In vivo carotid ESS was obtained from previously published data. Human umbilical vein endothelial cells were seeded in a collagen-coated Y-luer slides with a bifurcation that mimics the common carotid artery and its bifurcation. Four duplicate groups were exposed to 5 hours of resting ESS (18 dynes/cm2) followed by 1 hour of ESS at 18 dynes/cm2 × heart rate (HR) 60 pulses per minute (ppm) (control), 35 dynes/cm2 × HR 100 ppm (low), 50 dynes/cm2 × HR 120 ppm (moderate), or 60 dynes/cm2 × HR 150 ppm (high). After ESS exposure, cells were stained to identify cell nucleus, phosphorylated endothelial NO synthase (eNOSp), and intracellular actin concentrations using immunohistochemistry. Confocal microscopy images captured areas exposed to varying degrees of shear stress within the “common” artery, the bifurcation, and the distal branches of the bifurcation.

Results:
Images showed a higher expression of eNOSp and actin that is generally intensity and location dependent. High shear stress (HSS) showed the greatest eNOSp expression compared with all conditions at the after-bifurcation site (P < .05). Interestingly, HSS continued to result in greater expression of actin at the bifurcation site across all 4 intensities, where blood flow is known to be more turbulent.

Conclusions:
These findings may support the hypothesis that high shear stress plays an important protective endothelial role in relation to individualized exercise prescription as a contribution to precision medicine.

Impact Statement:
Endurance exercise intensity has a direct impact in endothelial cell homeostasis at the physiological and molecular levels. When a physical therapist prescribes endurance exercise for cardiovascular diseases, the goal should be to deliver precision medicine to enhance patient's health outcomes.
Impact of COVID-19 on Families with Children: Examining Sociodemographic Differences
Authors: Gissandaner Tre D. , Lim Crystal S. , Sarver Dustin E. , Brown Dustin , McCulloh Russell , Malloch Lacy , Annett Robert D. 
Published: February 2023

Objective:
The COVID-19 pandemic has exacerbated differences related to employment and family psychological health. However, empirical evidence examining COVID-19–linked differences concerning children and families remains scant. This study addresses this gap by examining sociodemographic differences associated with COVID-19 on family access to resources and family psychological health.

Method:
A telephone survey of 600 caregivers living in Mississippi was conducted from August 2020 to April 2021. Caregivers answered questions about levels of worry regarding themselves or their child contracting COVID-19 and impact of the pandemic on household income, access to resources, and family psychological health.

Results:
Multivariate models demonstrated that Black caregivers (n = 273; 45.5%) had increased odds of agreeing that they worry about contracting COVID-19 (odds ratio [OR] = 2.57). Furthermore, as caregiver reported household annual income decreased, caregivers had increased odds of agreeing that they worry about contracting COVID-19 (OR = 1.16), lost job-related income (OR = 1.14), and had a hard time obtaining resources (OR = 1.16) because of the pandemic. No significant differences related to rural or urban residence were observed.

Conclusion:
The findings highlight the need for pragmatic responses that are attuned to differences by providing more equitable access to resources for families. The findings suggest that strategies addressing family worry, obtaining job-related income support, and helping families obtain tangible resources may positively affect family psychological health. As population changes in vaccination rates and COVID variants emerge, reassessment of family and community impact seems indicated. Limitations and future research directions are discussed.
An Introduction to Artificial Intelligence in Developmental and Behavioral Pediatrics
Authors: Aylward Brandon S. , Abbas Halim , Taraman Sharief , Salomon Carmela , Gal-Szabo Diana , Kraft Colleen , Ehwerhemuepha Louis , Chang Anthony , Wall Dennis P. 
Published: February 2023

ABSTRACT:
Technological breakthroughs, together with the rapid growth of medical information and improved data connectivity, are creating dramatic shifts in the health care landscape, including the field of developmental and behavioral pediatrics. While medical information took an estimated 50 years to double in 1950, by 2020, it was projected to double every 73 days. Artificial intelligence (AI)–powered health technologies, once considered theoretical or research-exclusive concepts, are increasingly being granted regulatory approval and integrated into clinical care. In the United States, the Food and Drug Administration has cleared or approved over 160 health-related AI-based devices to date. These trends are only likely to accelerate as economic investment in AI health care outstrips investment in other sectors. The exponential increase in peer-reviewed AI-focused health care publications year over year highlights the speed of growth in this sector. As health care moves toward an era of intelligent technology powered by rich medical information, pediatricians will increasingly be asked to engage with tools and systems underpinned by AI. However, medical students and practicing clinicians receive insufficient training and lack preparedness for transitioning into a more AI-informed future. This article provides a brief primer on AI in health care. Underlying AI principles and key performance metrics are described, and the clinical potential of AI-driven technology together with potential pitfalls is explored within the developmental and behavioral pediatric health context.
Microneedling in Combination With 15% Trichloroacetic Acid Peel Versus 25% Pyruvic Acid Peel in the Treatment of Acne Scars
Authors: Solanki Bhawna , Relhan Vineet , Sahoo Bijaylaxmi , Sarkar Rashmi , Choudhary Priya 
Published: February 2023

BACKGROUND
Acne scars are a permanent disfiguring sequel of acne.

OBJECTIVE
To compare the efficacy of microneedling with 15% trichloroacetic acid (TCA) peel versus microneedling with 25% pyruvic acid peel in the management of postacne scars.

MATERIAL AND METHODS
Thirty patients with atrophic acne scars were randomized into 2 groups receiving microneedling on both sides of the face at 0,6, and 12 weeks and 15% TCA on one side and 25% pyruvic acid on other side at 3,9, and 15 weeks. Acne scar scoring performed using the Echelle D'Evaluation Clinique des Cicatrices D'Acne (ECCA) and visual analogue scales by patient and physician were used to grade improvement at all visits and at 21 weeks.

RESULTS
The mean ECCA score on the TCA side declined from 151.17 ± 26.90 to 138.83 ± 30.56 and on the pyruvic side declined from 151.83 ± 27.53 to 141.33 ± 28.92 after 21 weeks (statistically significant: p-value <.05). Comparing the ECCA on the TCA and pyruvic sides at 21 weeks was not significant. VAS showed moderate-to-marked improvement after 3 months in both groups.

CONCLUSION
In our study, the combination modality showed early reduction in rolling and boxcar compared with icepick scars. These peels led to improvement in overall texture of the skin, hence more patient satisfaction. On comparing ECCA, a significant difference was not observed.
Combination Approaches to Hand Rejuvenation: A Review of the Literature and Discussion
Authors: Chandan Neha , Puyana Carolina , Haber Roger 
Published: February 2023

BACKGROUND
Various noninvasive/minimally invasive modalities for hand rejuvenation exist, and the efficacy and safety of these procedures as both monotherapy and same-day procedures is increasingly being studied.

OBJECTIVE
To review data on the efficacy and safety of hand rejuvenation modalities and suggest a practical combination approach for these procedures.

METHODS
The PubMed database was queried for peer-reviewed articles regarding hand rejuvenation techniques, including chemical peels, laser and light sources, sclerotherapy, autologous fat transfer, and injectable volumetric fillers.

RESULTS
Chemical peels have been studied the least, with most studies evaluating the use of fillers and laser/light-based devices. Most studies reported overall good results with high patient satisfaction. Satisfaction rates were lower in laser/light-based treatments compared with other modalities. Transient erythema, edema, or pain after procedures was common; most studies did not report serious postprocedure complications. Importantly, there was no significant increase in adverse effects after same-day procedures.

CONCLUSION
Using same-day procedures allows practitioners to address hand rejuvenation from different aspects, seems to improve outcomes, and reduces time spent in the office for patients. The authors suggest a practical framework for combining cosmetic approaches to achieve the most optimal outcome for hand rejuvenation.
Eyebrow Shape Preference Across Age, Gender, and Self-reported Ethnic Group
Authors: Richer Vincent , Berkowitz Jonathan , Trindade de Almeida Ada 
Published: February 2023

BACKGROUND
Preference in eyebrow shape has been studied in young women, but less so in older adults, men, and a wide variety of ethnic groups.

OBJECTIVE
To identify preference in eyebrow shape across age groups, genders, and ethnic groups for both the survey responder and the observed subject.

METHODS
Digital images of subjects from 3 age groups (18–39, 40–59, and 60+ years), 2 genders (female and male), and 4 self-identified ethnic backgrounds (“Asian,” “Black,” “Latinx,” and “White”) were edited to correspond to 5 brow shapes (Anastasia, head-up, horizontal, rounded, and tail-up). Panels of images representing the same subject with different brow shapes were displayed and responders ranked them in order of attractiveness via an online survey.

RESULTS
Six hundred fifty-two responders answered the survey. Survey responders generally preferred the Anastasia shape, but not in all subgroups. Strength of preference in eyebrow shape was more marked when observing images of women and less marked when observing men.

CONCLUSION
An arched brow, such as the Anastasia shape, was the preferred eyebrow shape. This study is limited by its survey nature, underrepresentation of self-identified Black study responders, and categorization of data. Despite these findings, the authors advocate determining eyebrow shape preference individually with patients during cosmetic consultations.
Refining the Classification of Field Cancerization
Authors: Kitrell Bo , Crew Ashley , Wysong Ashley , Sutton Adam 
Published: February 2023

BACKGROUND
Field cancerization is a commonly encountered but poorly defined entity in dermatology. Lack of a consensus definition makes characterizing and studying this condition difficult.

OBJECTIVE
Propose a framework for defining and managing field cancerization patients.

METHODS
Clinical experience and available data in the literature was used to develop a proposed field cancerization disease classification system and chemoprevention algorithm.

RESULTS
The author group developed a field cancerization classification and treatment algorithm that stratifies patients into 5 different classes based on the extent of their field cancerization. They have started to recruit and study the highest risk cohort (Category 4 or 5) and have recruited 57 patients with 5 or more lifetime keratinocyte carcinomas for a prospective study evaluating chemoprevention strategies and disease burden. In these cohorts, the average number of skin cancers was greater than 12; however, less than 39% of these patients had used any chemoprevention in the prior 6 months.

CONCLUSION
A meaningful and clinically relevant disease stratification framework with chemoprevention guidance has the potential to highly impact the specialty and patients.
Skin Aging Exposome in Skin of Color Populations: Review of the Literature
Authors: Moutraji Rawan , Taylor Susan C. 
Published: February 2023

BACKGROUND
As life expectancy increases, the comorbidities related to aging require greater attention. Skin aging exposomes were only recently defined and need additional delineation, particularly in Skin of Color (SOC) populations.

OBJECTIVE
The primary objective is to shed the light and summarize the existing literature on skin aging exposome in SOC populations.

MATERIALS AND METHODS
We performed an extensive search in the PubMed and Google Scholar databases. We included peer-reviewed studies in SOC populations around the world regarding one or more of the skin aging exposome factors, and we grouped and organized the studies under each factor of the skin aging exposome.

RESULTS
Some environmental exposome factors are preventable or modifiable, for example, by applying broad-spectrum sunscreens with visible light protection, improving nutrition, and smoking cessation. Other factors such as air pollution will require more complex solutions. Our search revealed a paucity of references on skin aging exposome factors in SOC populations.

CONCLUSION
We identified the need for more dedicated studies in SOC populations to advance knowledge on skin aging exposome factors. This knowledge will provide a better understanding of approaches to minimize extrinsic skin aging in these populations.
Patient Anxiety Related to Patient-Perceived Delays in Surgical Treatment of Skin Cancer
Authors: Daly Caroline M. , Scott Jeffrey F. , Bibee Kristin P. 
Published: February 2023

BACKGROUND
Patients undergoing dermatologic surgery report higher anxiety levels than those undergoing nonsurgical treatments. However, little is known about the association between patient-perceived delays in skin cancer surgery and patient-reported anxiety.

OBJECTIVE
To examine the relationship between patient-perceived delays in surgery and patient-reported anxiety.

METHODS & MATERIALS
Patients undergoing wide local excision or Mohs micrographic surgery were recruited to complete a survey to assess perception of surgical delay and anxiety related to skin cancer surgery using the validated Psychosocial Screen for Cancer–Revised. Demographic and surgical characteristics were collected through chart review. Chi-square and Student t-tests were used to compare demographic and surgical information between patients who did and did not perceive a surgical delay. Differences in anxiety and depression scores for patients who did and did not report a delay were assessed using univariate and multivariate regressions.

RESULTS
Twenty-seven percent (N = 33) of patients perceived a surgical delay. Perception of surgical delay was associated with increased time between biopsy and surgery (p = .0001) and increased self-reported anxiety scores after controlling for various demographic and surgical factors (p = .038).

CONCLUSION
Patient-perceived delays in dermatologic surgery are associated with increased time to surgery and patient-reported anxiety.
Statin Treatment Intensity, Discontinuation, and Long-Term Outcome in Patients With Acute Myocardial Infarction and Impaired Kidney Function
Authors: Khedri Masih , Szummer Karolina , Lundman Pia , Jernberg Tomas , Desta Liyew , Lindahl Bertil , Erlinge David , Jacobson Stefan H. , Spaak Jonas 
Published: February 2023

Abstract:
Statin dosage in patients with acute myocardial infarction (AMI) and concomitant kidney dysfunction is a clinical dilemma. We studied discontinuation during the first year after an AMI and long-term outcome in patients receiving high versus low–moderate intensity statin treatment, in relation to kidney function. For the intention-to-treat analysis (ITT-A), we included all patients admitted to Swedish coronary care units for a first AMI between 2005 and 2016 that survived in-hospital, had known creatinine, and initiated statin therapy (N = 112,727). High intensity was initiated in 38.7% and low–moderate in 61.3%. In patients with estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m2, 25% discontinued treatment the first year; however, the discontinuation rate was similar regardless of the statin intensity. After excluding patients who died, changed therapy, or were nonadherent during the first year, 84,705 remained for the on-treatment analysis (OT-A). Patients were followed for 12.6 (median 5.6) years. In patients with eGFR 30–59 mL/min, high-intensity statin was associated with lower risk for the composite death, reinfarction, or stroke both in ITT-A (hazard ratio [HR] 0.93; 95% confidence interval, 0.87–0.99) and OT-A (HR 0.90; 0.83–0.99); the interaction test for OT-A indicated no heterogeneity for the eGFR < 60 mL/min group (P = 0.46). Similar associations were seen for all-cause mortality. We confirm that high-intensity statin treatment is associated with improved long-term outcome after AMI in patients with reduced kidney function. Most patients with reduced kidney function initiated on high-intensity statins are persistent after 1 year and equally persistent as patients initiated on low–moderate intensity.
Subtherapeutic Exposure of Ganciclovir in Children Despite Appropriate Dosing: A Short Communication
Authors: Marfil Sjanene , Märtson Anne-Grete , Toren-Wielema Marlous , Leer-Buter Coretta , Schölvinck Elisabeth H. , Alffenaar Jan-Willem C. , Touw Daan J. , Sturkenboom Marieke G. G. 
Published: February 2023

Abstract:
Therapeutic drug monitoring (TDM) results for ganciclovir in 12 different treatment episodes showed large intraindividual and interindividual variabilities in the trough concentration and area under the 24-hour concentration–time curve (AUC24). Despite adequate valganciclovir dosing, subtherapeutic concentrations were found in 30% of the treatment episodes. A decrease in viral load was observed regardless of subtherapeutic exposure. These findings show the need for target concentration evaluation and assessment of the applicability of ganciclovir TDM in children.
Volumetric Absorptive Microsampling to Enhance the Therapeutic Drug Monitoring of Tacrolimus and Mycophenolic Acid: A Systematic Review and Critical Assessment
Authors: Leino Abbie D. , Takyi-Williams John , Pai Manjunath P. 
Published: February 2023

Background:
Volumetric absorptive microsampling (VAMS) is an emerging technique that may support multisample collection to enhance therapeutic drug monitoring in solid organ transplantation. This review aimed to assess whether tacrolimus and mycophenolic acid can be reliably assayed using VAMS and to identify knowledge gaps by providing granularity to existing analytical methods and clinical applications.

Methods:
A systematic literature search was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The PubMed, Embase, and Scopus databases were accessed for records from January 2014 to April 2022 to identify scientific reports on the clinical validation of VAMS for monitoring tacrolimus and mycophenolic acid concentrations. Data on the study population, sample sources, analytical methods, and comparison results were compiled.

Results:
Data from 12 studies were collected, including 9 studies pertaining to tacrolimus and 3 studies on the concurrent analysis of tacrolimus and mycophenolic acid. An additional 14 studies that provided information relevant to the secondary objectives (analytical validation and clinical application) were also included. The results of the clinical validation studies generally met the method agreement requirements described by regulatory agencies, but in many cases, it was essential to apply correction factors.

ConclusionsS
Current evidence suggests that the existing analytical methods that use VAMS require additional optimization steps for the analysis of tacrolimus and mycophenolic acid. The recommendations put forth in this review can help guide future studies in achieving the goal of improving the care of transplant recipients by simplifying multisample collection for the dose optimization of these drugs.
Area-Under-Curve–Guided Versus Trough-Guided Monitoring of Vancomycin and Its Impact on Nephrotoxicity: A Systematic Review and Meta-Analysis
Authors: Lim Ashley Shiyuan , Foo Sharlene Hui Wen , Benjamin Seng Jun Jie , Magdeline Ng Tao Tao , Chng Hui Ting , Han Zhe 
Published: February 2023

Background:
Conventionally, vancomycin trough levels have been used for therapeutic drug monitoring (TDM). Owing to the increasing evidence of trough levels being poor surrogates of area under the curve (AUC) and the advent of advanced pharmacokinetics software, a paradigm shift has been made toward AUC-guided dosing. This study aims to evaluate the impact of AUC-guided versus trough-guided TDM on vancomycin-associated nephrotoxicity.

Methods:
A systematic review was conducted using PubMed, Embase, Web of Science, Cumulative Index to Nursing and Allied Health Literature, Google scholar, and Cochrane library databases; articles published from January 01, 2009, to January 01, 2021, were retrieved and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Studies that evaluated trough-guided or AUC-guided vancomycin TDM and vancomycin-associated nephrotoxicity were included. Random-effects models were used to compare the differences in nephrotoxicity.

Results:
Of the 1191 retrieved studies, 57 were included. Most studies included adults and older adults (n = 47, 82.45%). The pooled prevalence of nephrotoxicity was lower in AUC-guided TDM [6.2%; 95% confidence interval (CI): 2.9%–9.5%] than in trough-guided TDM (17.0%; 95% CI: 14.7%–19.2%). Compared with the trough-guided approach, the AUC-guided approach had a lower risk of nephrotoxicity (odds ratio: 0.53; 95% CI: 0.32–0.89). The risk of nephrotoxicity was unaffected by the AUC derivation method. AUC thresholds correlated with nephrotoxicity only within the first 96 hours of therapy.

Conclusions:
The AUC-guided approach had a lower risk of nephrotoxicity, supporting the updated American Society of Health-System Pharmacists guidelines. Further studies are needed to evaluate the optimal AUC-derivation methods and clinical utility of repeated measurements of the AUC and trough levels of vancomycin.