bluuebunny/crossref_metadata_2025_split huggingface dataset:
Traumatic spinal injury-related hospitalizations in the United States, 2016–2019: a retrospective study
Authors: Sun Jiuxiao , Yuan Wenjian , Zheng Ruiyuan , Zhang Chi , Guan Bin , Ding Jiaming , Chen Zhuo , Sun Qingyu , Fu Runhan , Chen Lingxiao , Zhou Hengxing , Feng Shiqing 
Published: September 2023

Background:
Traumatic spinal injury (TSI) is associated with significant fatality and social burden; however, the epidemiology and treatment of patients with TSI in the US remain unclear.

Materials and methods:
An adult population was selected from the National Inpatient Sample database from 2016 to 2019. TSI incidence was calculated and TSI-related hospitalizations were divided into operative and nonoperative groups according to the treatments received. TSIs were classified as fracture, dislocation, internal organ injury, nerve root injury, or sprain injuries based on their nature. The annual percentage change (APC) was calculated to identify trends. In-hospital deaths were utilized to evaluate the prognosis of different TSIs.

Results:
Overall, 95 047 adult patients were hospitalized with TSI in the US from 2016 to 2019, with an incidence rate of 48.4 per 100 000 persons in 2019 (95% CI: 46.2–50.6). The total incidence increased with an APC of 1.5% (95% CI: 0.1–3%) from 2016 to 2019. Operative TSI treatment was more common than nonoperative (32.8 vs. 3.8; 95% CI: 32.3–33.2 vs. 3.6–4%). The number of operations increased from 37 555 (95% CI: 34 674–40 436) to 40 460 (95% CI: 37 372–43 548); however, the operative rate only increased for internal organ injury (i.e. spinal cord injury [SCI])-related hospitalizations (APC, 3.6%; 95% CI: 2.8–4.4%). In-hospital mortality was highest among SCI-related hospitalizations, recorded at 3.9% (95% CI: 2.9–5%) and 28% (95% CI: 17.9–38.2%) in the operative and nonoperative groups, respectively.

Conclusions:
The estimated incidence of TSI in US adults increased from 2016 to 2019. The number of operations increased; however, the proportion of operations performed on TSI-related hospitalizations did not significantly change. In 2019, SCI was the highest associated mortality TSI, regardless of operative or nonoperative treatment.
Implications of climate change on acute kidney injury
Authors: Freidin Natalie , Hayes Eily , Struthers Sarah A. 
Published: September 2023

Purpose of review
Climate change is an active and growing threat to human health. This review examines the evidence linking climate change to kidney diseases, with a focus on acute kidney injury (AKI).

Recent findings
A growing body of evidence documents the adverse impact of various environmental and occupational exposures on kidney health. Extreme heat exposure increases the risk for AKI in vulnerable populations, particularly outdoor workers. These effects are being seen in both developed and developing nations, impacting equatorial as well as more northern climates. Climate change is also increasing the risk of water-borne and vector-borne infections, which are important causes of AKI in tropical regions. Due to overlapping environmental and social risk factors, populations in low-income and middle-income countries are likely to be disproportionately affected by climate-related health impacts, including heightened risk for kidney diseases.

Summary
Climate change will adversely impact global kidney health over the course of the century through effects on temperature and risk of endemic infections. Alongside efforts to aggressively reduce carbon emissions, additional research is needed to guide public and environmental health policies aimed at mitigating the impact of climate change on human health.
Something to consider: rapid palatal expansion for treatment of obstructive sleep apnea in pediatric patients
Authors: Ahsan Muhammad , Narala Bhavya , Ednick Mathew , Kier Catherine 
Published: September 2023

Purpose of review
This review examines the potential of rapid palatal expansion (RPE) as a treatment for pediatric obstructive sleep apnea (OSA). The focus is on recent findings related to its efficacy, safety, patient selection, timing, appliance options, cost considerations, and long-term outcomes.

Recent findings
Recent studies indicate that RPE can lead to significant improvements in pediatric OSA, with a 70% reduction in the Apnea Hypopnea Index (AHI) and increased oxygen saturation levels. It has been particularly effective in children with small or absent tonsils and has been found to reduce adenoid and tonsil size. Long-term follow-up studies suggest the need for ongoing monitoring, as some patients may experience relapse over time.

Summary
RPE shows promise as an additional treatment for pediatric obstructive sleep apnea. It offers improvements in respiratory function and reduced symptoms in certain patients. However, long-term efficacy and safety require further investigation. Comparative studies and patient-reported outcomes are necessary to optimize treatment approaches. Collaboration between orthodontists, sleep specialists, and ear-nose-throat (ENT) specialists may be essential for optimal outcomes in pediatric OSA patients treated with RPE.
Comparing Virtual Simulations to Paper Case Studies in Combination With Manikin-Based Medication Administration Simulations
Authors: Campbell Denise , Wilson Kristi , Turkelson Carman 
Published: September 2023

Background:
Medication errors are among the most common preventable adverse events in health care.

Methods:
A quasi-experimental approach with a pre/posttest design was used to explore the effectiveness of an enhanced medication administration simulation bundle that included the use of manikin-based simulation-based experiences (SBEs) in combination with either virtual SBEs (V-SBEs) for deliberate practice (DP) or traditional paper case studies for DP on safe medication administration in undergraduate nursing students.

Results:
Nursing students (n = 101) participated in multiple medication administration–focused SBEs including DP via V-SBEs or DP via traditional paper case studies. Student performance in the medication administration SBEs improved after the third experience. There was no statistically significant difference between the V-SBE groups compared with the traditional paper case study groups across the 3 medication administration–focused SBEs.

Conclusion:
Findings from this study highlight the importance of DP with medication administration for undergraduate nursing students.
Experiences of Undergraduate Male Students in Nursing
Authors: Englund Heather M. , Mott Jason , MacWilliams Brent 
Published: September 2023

Background:
Measures to improve gender diversity of the profession have yielded only a modicum of progress.

Purpose:
To investigate the relationship between marginalization and gender minorities in baccalaureate nursing programs in the United States.

Methods:
A descriptive cross-sectional study compared self-reported marginalization in male and female baccalaureate nursing students. The sample was drawn from the American Association of Colleges of Nursing database of US baccalaureate nursing programs, and the Englund Marginality Index (EMI) was used to measure marginalization, along with a demographic survey.

Results:
In the study, 6480 full-time baccalaureate students from a traditional face-to-face nursing program in the United States participated. The results show that male participants had higher EMI scores (mean = 40.0, SD = 9.1) compared with female nursing students (mean = 35.1, SD = 9.0); t
(6478) = 14.9, P < .001.

Conclusions:
Marginalizing behaviors must not be tolerated or promulgated. More needs to be done to better support and integrate men into nursing programs as they bring forth a unique perspective and skill set to the profession.
Moderate to Vigorous Intensity Locomotor Training After Stroke: A Systematic Review and Meta-analysis of Mean Effects and Response Variability
Authors: Boyne Pierce , Miller Allison , Kubalak Owen , Mink Caroline , Reisman Darcy S. , Fulk George 
Published: September 2023

Background and Purpose:
This meta-analysis quantified mean effects of moderate to vigorous intensity locomotor training (LTmv) on walking outcomes in subacute and chronic stroke, and the magnitude of variability in LTmv response.

Methods:
Databases were searched for randomized trials comparing LTmv with no intervention, nongait intervention, or low-intensity gait training. Comfortable gait speed (CGS), fastest gait speed (FGS), 6-minute walk test (6MWT), walking activity (steps per day), and adverse effect/event (AE) data were extracted. Pooled estimates were calculated for mean changes, AE relative risks, and the standard deviation of response (SDresponse) to LTmv versus control groups, stratified by study chronicity where possible.

Results:
There were 19 eligible studies (total N = 1096): 14 in chronic stroke (N = 839) and 5 in subacute stroke (N = 257). Compared with control interventions, LTmv yielded significantly greater increases in CGS (chronic, +0.06 m/s [95% confidence interval (CI), 0.01-0.10]; subacute, +0.16 [0.12-0.19]; subacute vs chronic, P = 0.03), FGS (chronic, +0.07 m/s [0.02-0.13]; subacute, +0.21 [0.01, 0.41]; P = 0.04), and 6MWT (chronic, +33 m [24-42]; subacute, +51 [26-77]; P = 0.054) but not steps/day (+260 [−1159 to 1679]). There were no treatment-related serious AEs among 398 LTmv participants in 14 AE-reporting studies. SDresponse estimates indicated substantial response variability: CGS, 0.11 m/s [0.00-0.15]; FGS, 0.14 m/s [−0.00 to 0.20]; and 6MWT, 41 m [27-51].

Discussion and Conclusions:
LTmv improves mean walking capacity outcomes in subacute and chronic stroke and does not appear to have high risk of serious harm. Response magnitude varies within and between chronicity subgroups, and few studies have tested effects on daily walking activity or non-serious AEs.

Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1 available at: http://links.lww.com/JNPT/A452).
Prevalence Trend of Myopia during the Post–COVID-19 Epidemic Period among Preschoolers: A Prospective School-based Study
Authors: Li Qin , Zhou Wen , Liao Ya , Chen Hongyan , Sun Yanmei , Wang Mei , Wang Xiaojuan , Wang Wei 
Published: September 2023

SIGNIFICANCE
Changes in behavior and lifestyle during the post–coronavirus disease 2019 (COVID-19) epidemic may have some impact on myopia rates in preschoolers, and exploring the changes in myopia rates in preschool children may inform the formulation of myopia prevention and control policies.

PURPOSE
This study aimed to investigate the prevalence of myopia in preschool children during the post–COVID-19 epidemic period in Xuzhou, China.

METHODS
A series of cross-sectional school-based studies was conducted. A total of 117,632 preschool children aged 3 to 6 years were subjected to annual vision screening from 2019 to 2021. Spot photo screening was used to record the spherical equivalent refraction for each child and to analyze the prevalence of myopia by age, sex, and region during the post–COVID-19 epidemic period.

RESULTS
A total of 113,979 preschool children were included in the analysis, of whom 60,784 (53.3%) were male and 53,195 (46.7%) were female. For all children, the mean ± standard deviation spherical equivalent refraction in 2019, 2020, and 2021 was +0.32 ± 0.50, +0.34 ± 0.55, and +0.34 ± 0.54 D, respectively (all P < .05), indicative of a very slight hyperopic shift. In all age groups, the change in mean spherical equivalent refraction and its distribution were relatively stable. From 2019 to 2021, the overall prevalence of myopia in preschool children was 3.1, 3.3, and 3.5%, respectively. The rise in myopia rates was minimal. The largest increase in the annual prevalence of myopia was seen among children aged 6 years, at 0.5%, followed by those aged 5 years (0.4%) and aged 3 years (0.4%). The prevalence was higher in boys than girls and in urban versus rural areas.

CONCLUSIONS
During the post–COVID-19 epidemic period, the refractive status of Xuzhou preschool children remained stable.
Pediatric Death After Withdrawal of Life-Sustaining Therapies: A Scoping Review
Authors: Francoeur Conall , Silva Amina , Hornby Laura , Wollny Krista , Lee Laurie A. , Pomeroy Alexandra , Cayouette Florence , Scales Nathan , Weiss Matthew J. , Dhanani Sonny 
Published: September 2023

OBJECTIVES:
Evaluate literature on the dying process in children after withdrawal of life sustaining measures (WLSM) in the PICU. We focused on the physiology of dying, prediction of time to death, impact of time to death, and uncertainty of the dying process on families, healthcare workers, and organ donation.

DATA SOURCES:
MEDLINE, Embase, Cochrane Central Register of Controlled Trials, PsycINFO, CINAHL, and Web of Science.

STUDY SELECTION:
We included studies that discussed the dying process after WLSM in the PICU, with no date or study type restrictions. We excluded studies focused exclusively on adult or neonatal populations, children outside the PICU, or on organ donation or adult/pediatric studies where pediatric data could not be isolated.

DATA EXTRACTION:
Inductive qualitative content analysis was performed.

DATA SYNTHESIS:
Six thousand two hundred twenty-five studies were screened and 24 included. Results were grouped into four categories: dying process, perspectives of healthcare professionals and family, WLSM and organ donation, and recommendations for future research. Few tools exist to predict time to death after WLSM in children. Most deaths after WLSM occur within 1 hour and during this process, healthcare providers must offer support to families regarding logistics, medications, and expectations. Providers describe the unpredictability of the dying process as emotionally challenging and stressful for family members and staff; however, no reports of families discussing the impact of time to death prediction were found. The unpredictability of death after WLSM makes families less likely to pursue donation. Future research priorities include developing death prediction tools of tools, provider and parental decision-making, and interventions to improve end-of-life care.

CONCLUSIONS:
The dying process in children is poorly understood and understudied. This knowledge gap leaves families in a vulnerable position and the clinical team without the necessary tools to support patients, families, or themselves. Improving time to death prediction after WLSM may improve care provision and enable identification of potential organ donors.
A Cost-Effective, Three-Dimensionally Printed Simulation Model Facilitates Learning of Bilobed and Banner Flaps for Mohs Nasal Reconstruction: A Pilot Study
Authors: Lerner Julia L. , Vishwanath Neel , Borrelli Mimi R. , Rao Vinay , Crozier Joseph , Woo Albert S. 
Published: September 2023

Summary:
Flap design for Mohs reconstruction is a complex 3-dimensional process. Simulation offers trainees the chance to practice techniques safely before performing them in the operating room. To aid in teaching, the authors developed a high-fidelity, cost-effective model of the face using three-dimensional printing to simulate flap reconstruction after Mohs surgery. A model face was sculpted digitally to include skin, bone, and cartilage. Negative molds were printed and used to cast silicone, representing external skin. The cartilage and bone models were combined to create a single three-dimensionally printed base. Surgical residents practiced performing banner and bilobed flaps on the simulation model, and improvement was assessed using boards-style pretests and posttests assessing flap design on clinical photographs. Medical students were randomized to complete a similar practice session with the model or a reading on the topic, after which they completed the same assessment. Participants also completed a questionnaire about the model’s didactic and monetary value. Residents showed significant improvement after use of the model (banner flap: P = 0.002, bilobed flap: P = 0.04). Medical students who used the model scored significantly higher than those assigned to train by reading (P = 0.001). Subjective comfort with flap design and execution increased after practice with the model (P = 0.001). The cost of materials for each model was $2.50; participants reported willingness to pay $24.36 (mean) for this tool. This accessible model was superior to traditional teaching materials for Mohs reconstruction, and aided the comfort and proficiency of trainees.
Validation of Photoplethysmography Using a Mobile Phone Application for the Assessment of Heart Rate Variability in the Context of Heart Rate Variability–Biofeedback
Authors: van Dijk Willeke , Huizink Anja C. , Oosterman Mirjam , Lemmers-Jansen Imke L.J. , de Vente Wieke 
Published: September 2023

ABSTRACT

Objective
Heart rate variability–biofeedback (HRV-BF) is an effective intervention to reduce stress and anxiety and requires accurate measures of real-time HRV. HRV can be measured through photoplethysmography (PPG) using the camera of a mobile phone. No studies have directly compared HRV-BF supported through PPG against classical electrocardiogram (ECG). The current study aimed to validate PPG HRV measurements during HRV-BF against ECG.

Methods
Fifty-seven healthy participants (70% women) with a mean (standard deviation) age of 26.70 (9.86) years received HRV-BF in the laboratory. Participants filled out questionnaires and performed five times a 5-minute diaphragmatic breathing exercise at different paces (range, ~6.5 to ~4.5 breaths/min). Four HRV indices obtained through PPG, using the Happitech software development kit, and ECG, using the validated NeXus apparatus, were calculated and compared: RMSSD, pNN50, LFpower, and HFpower. Resonance frequency (i.e., optimal breathing pace) was also compared between methods.

Results
All intraclass correlation coefficient values of the five different breathing paces were “near perfect” (>0.90) for all HRV indices: lnRMSSD, lnpNN50, lnLFpower, and lnHFpower. All Bland-Altman analyses (with just three incidental exceptions) showed good interchangeability of PPG- and ECG-derived HRV indices. No systematic evidence for proportional bias was found for any of the HRV indices. In addition, correspondence in resonance frequency detection was good with 76.6% agreement between PPG and ECG.

Conclusions
PPG is a potentially reliable and valid method for the assessment of HRV. PPG is a promising replacement of ECG assessment to measure resonance frequency during HRV-BF.
Association Between Estradiol and Human Aggression: A Systematic Review and Meta-Analysis
Authors: Wang Yalan , Wang Haifang , Cai Jianzheng , Yu Weixia , Zhang Yingying , Zhang Ying , Tang Zhaofang 
Published: September 2023

ABSTRACT

Objective
Although several studies have examined the association between estradiol and human aggression, a consistent understanding of their correlation has yet to be established. This study aimed to investigate this relationship comprehensively.

Methods
We systematically searched five English databases (PubMed, Web of Science, EMBASE, Cochrane Library, and CINAHL) from their inception to June 5, 2023. Two authors independently screened publications and extracted data based on predefined inclusion and exclusion criteria. Statistical analyses were performed using Review Manager 5.4, and a random-effects model was used to pool the data.

Results
We identified 14 eligible studies comprising data from 1820 participants that met the inclusion criteria. This meta-analysis indicated a positive correlation between estradiol and human aggression, albeit a weak one. The pooled Fisher z value was 0.16 (95% confidence interval = 0.05–0.26; I
2 = 73%, p<.00001). Furthermore, we found that participants’ sex and age, the measures of aggression, and the literature quality might be sources of heterogeneity.

Conclusions
Human aggression exhibited a weak positive correlation with estradiol concentration, whereas this relationship was influenced by participants’ sex and age, the measure of aggression used, and the quality assessment of the literature. Gaining a better understanding of the association between estradiol and aggression could aid in the identification of populations prone to aggression.
Current drug treatment of myasthenia gravis
Authors: Vanoli Fiammetta , Mantegazza Renato 
Published: September 2023

Purpose of review
Myasthenia Gravis (MG) is a rare neurological disorder affecting the neuromuscular junction. Clinical hallmarks are fatigability and weakness affecting the extraocular, axial, limb and/or respiratory muscles. Despite immunosuppressive treatment, mainly based on corticosteroids and nonsteroidal immunosuppressants, the burden of MG is still significant, both in terms of inadequate disease control and burdensome side effects. Driven by such limits, the past years have been characterized by an escalation of MG drug development, with novel molecules which now focuses on having a more targeted effect, with a higher safety and efficacy profile.

Recent findings
As the pathogenic mechanism of MG are slowly being unravelled, new potential targets for treatments are being considered. This has led since 2017 to the Food and Drug Administration (FDA)-approval of three new drugs that either act by blocking the complement system (i.e., eculizumab and ravulizumab) or by blocking the neonatal Fc receptor thus preventing immunoglobulin recycling and reducing imunoglobulin G (IgG) antibodies (i.e., efgartigimod). Other drugs, with similar mechanism of action, are currently under review for approval.

Summary
The repertoire of available and developmental therapies for MG is rapidly expanding, finally responding to the unmet need of a more targeted and effective therapeutic approach in MG.