bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical Decision Making in Forensic Nursing
Authors: Farzadfar Samira , Jafaraghaee Fateme , Karkhah Samad , Javadi-Pashaki Nazila , Kazemnezhad Leyli Ehsan , Sedghi Sabet Mitra 
Published: June 2023

ABSTRACT

Background
Appropriate clinical decision making (CDM) is very important for emergency nurses when working with forensic patients with violence-related injuries and can improve patient outcomes. Therefore, it is essential for emergency nurses to have the basic skills to make the right clinical decisions when working with forensic patients.

Aim
The aim of this study was to evaluate the CDM of emergency nurses when caring for forensic patients.

Methods
This study was conducted using a cross-sectional design. Nurses working in the seven emergency departments of Rasht hospitals, Guilan Province, Iran, were recruited to take part in the study. Data collection was performed via census sampling from September to November 2019. Data were collected via a two-part questionnaire developed by the researcher(s) that addressed (a) demographic characteristics and (b) simulated scenarios that assessed their CDM in caring for forensic patients.

Findings
One hundred ninety-two emergency nurses participated in this study. The mean score of CDM in forensic nursing was moderate (56.46; 95% CI [54.49, 58.43]). Of the participants, 60.42% of the emergency nurses had moderate CDM knowledge related to forensic nursing, whereas only 2.8% had desirable knowledge of CDM. There was a statistically significant relationship between CDM in forensic nursing and the history of encountering forensic patients (p = 0.008).

Conclusion
CDM scores regarding emergency nurses' knowledge of forensic nursing were moderate. Knowledge of and CDM in forensic nursing is very important and provides high-quality safe care for forensic patients.

Implications for Clinical Forensic Nursing Practice
This study highlights the importance of additional education and professional development in forensic nursing, for emergency nurses, and should be considered further by nursing administrators and nursing educators.
Can Telehealth Provide Timely and Equitable Quality Medical Forensic Services? Perspectives of Illinois Hospital Administrators
Authors: Pierre-Wright Marlise Jeanne , Mathey Lisa , Risser Heather J. 
Published: June 2023

ABSTRACT

Introduction
Research has shown the viability of telehealth consultations to provide medical forensic services, particularly in areas with a dearth of medical examiners. This study examined Illinois hospital administrators' willingness to utilize telehealth to meet new requirements under Illinois Public Act 100-0775, which intends to increase timely access to quality forensic examiners. Consequently, as of March 2021, roughly half of Illinois hospitals unable to meet these requirements have opted not to treat some or all patients presenting for medical forensic services of sexual assault.

Methods
We surveyed and conducted in-depth interviews (between October 2020 and April 2021) with 65 hospital administrators responsible for implementing Illinois Public Act 100-0775. Descriptive statistical analysis was used to analyze survey results.

Results
Our study found limited staffing resources and difficulties educating and training new forensic medical examiners were the major barriers to providing acute medical forensic services. The overwhelming majority of respondents (95%) saw opportunities to use telehealth across all aspects of the medical forsenic evaluation. Barriers to implementing telehealth included perceived patient discomfort with telehealth technology and current legislative restrictions.

Discussion
Legislative efforts to mandate timely access to qualified medical forensic examiners can unintentionally exacerbate disparities in access to care. Illinois hospital administrators are receptive to utilizing telehealth to improve access to forensic examiners, particularly in lower-resourced hospitals.

Conclusion
One method for responding to staffing shortages and improving equitable access to forensic sexual assault services may include implementing networks of qualified forensic examiners that support on-site clinicians in lower-resourced areas via telehealth.
COVID-19 and Elective Spine Surgery: The Older Persons' Experience of Going It Alone
Authors: Strayer Andrea L. , King Barbara J. 
Published: June 2023

ABSTRACT

BACKGROUND: Older people with debilitating degenerative spine disease may benefit from surgery. However, recovery is described as a circuitous process. In general, they describe feeling powerless and receiving depersonalized care during hospitalization. Institution of hospital no-visitor policies to reduce COVID-19 spread may have caused additional negative consequences. The purpose of this secondary analysis was to understand experiences of older people who underwent spine surgery during early COVID-19. METHODS: Grounded theory guided this study of people 65 years or older undergoing elective spine surgery. Fourteen individuals were recruited for 2 in-depth interviews at 2 time points: T1 during hospitalization and T2, 1 to 3 months post discharge. All participants were affected by pandemic-imposed restrictions with 4 interviews at T1 with no visitors, 10 with a 1-visitor policy, and 6 interviews at T2 rehabilitation setting with no visitors. Discriminate sampling of data in which participants described their experiences with COVID-19 visitor restrictions was used. Open and axial coding (consistent with grounded theory) was used for data analysis. RESULTS: Three categories, worry and waiting, being alone, and being isolated, emerged from the data. Participants had delays (waiting) in getting their surgery scheduled, which produced worry that they would lose more function, become permanently disabled, have increased pain, and experience more complications such as falls. Participants described being alone during their hospital and rehabilitation recovery, without physical or emotional support from family and limited nursing staff contact. Being isolated often occurred from institution policy, restricting participants to their rooms leading to boredom and, for some, panic. CONCLUSIONS: Restricted access to family after spine surgery and during recovery resulted in emotional and physical burden for participants. Our findings support neuroscience nurses advocating for family/care partner integration into patient care delivery and investigation into the effect of system-level policies on patient care and outcomes.
Characteristics, treatment and research development of bertolotti’s syndrome: a bibliometric analysis and systematic review
Authors: Zhu Wenhao , Ding Xing , Zheng Jiale , Zeng Fan , Zhang Fan , Wu Xuequn , Sun Yijun , Ma Junming , Yin Mengchen 
Published: June 2023

Purpose:
Bertolotti’s syndrome is a prevalent congenital deformity. However, many physicians fail to include it in their differential diagnosis for low back pain (LBP), which results in missed diagnosis or misdiagnosis. There is still a lack of standardized treatment and management strategies for Bertolotti’s syndrome. This study aimed to review the clinical characteristics and management of Bertolotti’s syndrome and reports bibliometric insights in advancements in Bertolotti’s syndrome research.

Methods:
Studies published until September 30, 2022 were systematically reviewed according to the PRISMA guidelines. Three independent reviewers extracted the data and assessed the quality and risk of bias of the studies based on the methodological index of non-randomized studies (MINORS). SPSS, VOS viewer, and the Citespace software were used for the systematic review, visual analysis, data mining, mapping, and clustering of the retrieved articles, which presented clear and visual presentations of the structural patterns of published research in graphs.

Result:
A total of 118 articles, describing a total of 419 patients with Bertolotti’s syndrome, were included. There was an upward trend with a steady increase in the number of publications. The world map distribution showed that most publications were predominantly from North America and Asia. The most cited articles were published in the following journals: Spine, The Journal of Bone and Joint Surgery, and Radiology. The mean age of the patients was 47.7 years, and 49.6% of them were male. A total of 159 (96.4%) patients had low back pain symptoms. The mean symptom duration was 41.4 months (74.8%), and most of the patients had Castellvi type II. Disc degeneration was the most reported comorbid spinal diseases. The mean MINORS score was 4.16±3.95 points (range, 1−21). A total of 265 (68.3%) patients underwent surgical treatments. Minimally invasive surgical techniques, prevalence, image classification, and disc degeneration were the current main research areas of Bertolotti’s syndrome.

Conclusions:
The steady increase in the number of publications demonstrated the increased attention of researchers on this topic. Our results showed a significant prevalence of Bertolotti’s syndrome in patients with LBP and a long symptom duration before the initiation of treatment. Surgical treatments were commonly used to treat patients with Bertolotti’s syndrome after a non-effective conservative treatment. Minimally invasive surgical techniques, prevalence, image classification, and disc degeneration are the major research areas of Bertolotti’s syndrome.
Intratumoral Tumor Infiltrating Lymphocytes (TILs) are Associated With Cell Proliferation and Better Survival But Not Always With Chemotherapy Response in Breast Cancer
Authors: Wu Rongrong , Oshi Masanori , Asaoka Mariko , Yan Li , Benesch Matthew G.K. , Khoury Thaer , Nagahashi Masayuki , Miyoshi Yasuo , Endo Itaru , Ishikawa Takashi , Takabe Kazuaki 
Published: June 2023

Objective:
To investigate the clinical relevance of intratumoral tumor infiltrating lymphocytes (TILs) in breast cancer as measured by computational deconvolution of bulk tumor transcriptomes.

Summary Background Data:
Commonly assessed TILs, located in tumor stroma without direct contact with cancer cells (stromal TILs), correlate with breast cancer treatment response and survival. The clinical relevance of intratumoral TILs has been less studied partly due to their rarity; however, they may have nonnegligible effects given their direct contact with cancer cells.

Methods:
In all, 5870 breast cancer patients from TCGA, METABRIC, GSE96058, GSE25066, GSE163882, GSE123845, and GSE20271 cohorts were analyzed and validated.

Results:
The intratumoral TIL score was established by the sum of all types of lymphocytes using the xCell algorithm. This score was the highest in triple-negative breast cancer (TNBC) and the lowest in the ER-positive/HER2-negative subtype. It correlated with cytolytic activity and infiltrations of dendritic cells, macrophages, and monocytes, and uniformly enriched immune-related gene sets regardless of subtype. Intratumoral TIL-high tumors correlated with higher mutation rates and significant cell proliferation on biological, pathological, and molecular analyses only in the ER-positive/HER2-negative subtype. It was significantly associated with pathological complete response after anthracycline- and taxane-based neoadjuvant chemotherapy in about half of the cohorts, regardless of the subtype. Intratumoral TIL-high tumors correlated with better overall survival in HER2-positive and TNBC subtypes consistently in 3 cohorts.

Conclusions:
Intratumoral TILs estimated by transcriptome computation were associated with increased immune response and cell proliferation in ER-positive/HER2-negative and better survival in HER2-positive and TNBC subtypes, but not always with pathological complete response after neoadjuvant chemotherapy.
Duration of antimicrobial treatment for complicated intra-abdominal infections after definitive source control: A systematic review, meta-analysis, and practice management guideline from the Eastern Association for the Surgery of Trauma
Authors: Ra Jin H. , Rattan Rishi , Patel Nimitt J. , Bhattacharya Bishwajit , Butts Christopher A. , Gupta Shailvi , Asfaw Sofya H. , Como John J. , Sahr Sheryl M. , Bugaev Nikolay 
Published: June 2023

BACKGROUND
Recent studies have evaluated outcomes associated with duration of antimicrobial treatment for complicated intra-abdominal infections (cIAI). The goal of this guideline was to help clinicians better define appropriate antimicrobial duration in patients who have undergone definitive source control for cIAI.

METHODS
A working group of Eastern Association for the Surgery of Trauma (EAST) performed a systematic review and meta-analyses of the available data pertaining to the duration of antibiotics after definitive source control of cIAI in adult patients. Only studies that compared patients treated with short vs. long duration antibiotic regimens were included. The critical outcomes of interest were selected by the group. Noninferiority of short compared with long duration of antimicrobial treatment was defined as an indicator for a potential recommendation in favor of shorter antibiotics course. The Grading of Recommendations Assessment, Development and Evaluation methodology was used to assess the quality of the evidence and to formulate recommendations.

RESULTS
Sixteen studies were included. The short duration ranged from 1 dose to ≤10 days, with an average of 4 days, and the long duration ranged >1 day to 28 days, with an average of 8 days. There were no differences between short and long duration of antibiotics in terms of mortality (odds ratio [OR], 0.90; 95% confidence interval [CI], 0.56–1.44), rate of surgical site infection (OR, 0.88; 95% CI, 0.56–1.38); persistent/recurrent abscess (OR, 0.76; 95% CI, 0.45–1.29); unplanned interventions (OR, 0.53; 95% CI, 0.12–2.26); hospital length of stay (mean difference, −2.62 days; CI, −7.08 to 1.83 days); or readmissions (OR, 0.92; 95% CI, 0.50–1.69). The level of evidence was assessed as very low.

CONCLUSION
The group made a recommendation for shorter (four or less days) versus longer duration (eight or more days) of antimicrobial treatment in adult patients with cIAIs who had definitive source control.

LEVEL OF EVIDENCE
Systematic Review and Meta-Analysis; Level III.
Incidence, outcomes and costs of severe sepsis and septic shock in geriatric trauma patients: Analysis of 2,563,463 hospitalizations at 3,284 hospitals
Authors: Fakhry Samir M. , Shen Yan , Wyse Ransom J. , Dunne James R. , Berg Gina M. , Garland Jeneva M. , Ludwig Ashley , Shillinglaw William C. , Hightower Todd D. , Hunt Darrell L. , Watts Dorraine D. 
Published: June 2023

BACKGROUND
Severe sepsis/septic shock (sepsis) is a leading cause of death in hospitalized trauma patients. Geriatric trauma patients are an increasing proportion of trauma care but little recent, large-scale, research exists in this high-risk demographic. The objectives of this study are to identify incidence, outcomes and costs of sepsis in geriatric trauma patients.

METHODS
Patients at short-term, nonfederal hospitals 65 years or older with ≥1 injury International Classification of Diseases, Tenth Revision, Clinical Modification code were selected from 2016 to 2019 Centers for Medicare & Medicaid Services Medicare Inpatient Standard Analytical Files. Sepsis was defined as International Classification of Diseases, Tenth Revision, Clinical Modification diagnosis codes R6520 and R6521. A log-linear model was used to examine the association of Sepsis with mortality, adjusting for age, sex, race, Elixhauser score, and Injury Severity Score. Dominance analysis using logistic regression was used to determine the relative importance of individual variables in predicting Sepsis. Institutional review board exemption was granted for this study.

RESULTS
There were 2,563,436 hospitalizations from 3,284 hospitals (62.8% female; 90.4% White; 72.7% falls; median ISS, 6.0). Incidence of Sepsis was 2.1%. Sepsis patients had significantly worse outcomes. Mortality risk was significantly higher in septic patients (adjusted risk ratio, 3.98, 95% confidence interval, 3.92–4.04). Elixhauser score contributed the most to the prediction of Sepsis, followed by ISS (McFadden's R
2 = 9.7% and 5.8%, respectively).

CONCLUSION
Severe sepsis/septic shock occurs infrequently among geriatric trauma patients but is associated with increased mortality and resource utilization. Pre-existing comorbidities influence Sepsis occurrence more than Injury Severity Score or age in this group, identifying a population at high risk. Clinical management of geriatric trauma patients should focus on rapid identification and prompt aggressive action in high-risk patients to minimize the occurrence of sepsis and maximize survival.

LEVEL OF EVIDENCE
Therapeutic/Care Management; Level III.
The undisclosed disclosures: The dollar-outcome relationship in resuscitative endovascular balloon occlusion of the aorta
Authors: Bhogadi Sai Krishna , Colosimo Christina , Hosseinpour Hamidreza , Nelson Adam , Rose Maya I. , Calvillo Antonia R. , Anand Tanya , Ditillo Michael , Magnotti Louis J. , Joseph Bellal 
Published: June 2023

BACKGROUND
Despite its rapid evolution, resuscitative endovascular balloon occlusion of the aorta (REBOA) remains a controversial intervention that continues to generate active research. Proper conflict of interest (COI) disclosure helps to ensure that research is conducted objectively, without bias. We aimed to identify the accuracy of COI disclosures in REBOA research.

METHODS
Literature search was performed using the keyword “REBOA” on PubMed. Studies on REBOA with at least one American author published between 2017 and 2022 were identified. The Centers for Medicare and Medicaid Services Open Payments database was used to extract information regarding payments to the authors from the industry. This was compared with the COI section reported in the manuscripts. Conflict of interest disclosure was defined as inaccurate if the authors failed to disclose any amount of money received from the industry. Descriptive statistics were performed.

RESULTS
We reviewed a total of 524 articles, of which 288 articles met the inclusion criteria. At least one author received payments in 57% (165) of the articles. Overall, 59 authors had a history of payment from the industry. Conflict of interest disclosure was inaccurate in 88% (145) of the articles where the authors received payment.

CONCLUSION
Conflict of interest reports are highly inaccurate in REBOA studies. There needs to be standardization of reporting of conflicts of interest to avoid potential bias.

LEVEL OF EVIDENCE
Prognostic and Epidemiological; Level IV.
Brain structure reflects empathy and psychopathy in incarcerated males
Authors: Radecki Marcin A. , Sampaolo Erika , Lettieri Giada , Handjaras Giacomo , Harenski Carla L. , Palumbo Sara , Pellegrini Silvia , Pietrini Pietro , Kiehl Kent A. , Cecchetti Luca 
Published: June 2023

AbstractWhether brain structure could reflect empathy and psychopathy in the same antisocial population is unknown. In White adult males from prison (N = 549, Mage= 34 ± 11 years), we measured empathy with the Perspective Taking (IRI-PT) and Empathic Concern (IRI-EC) subscales of the Interpersonal Reactivity Index, and psychopathic traits with the Psychopathy Checklist–Revised or Youth Version (PCL-R/YV). A subsample (N = 278, Mage= 36 ± 11 years) underwent MRI, from which we derived cortical thickness (CT) and surface area (SA). CT did not relate to IRI-PT or IRI-EC, while SA of the left inferior temporal gyrus (L ITG) related negatively to IRI-PT and positively to PCL-R and PCL-R item 8 (Callousness/Lack of Empathy). L-ITG SA predicted scores on IRI-PT – but not IRI-EC – in an out-of-sample test (R2= 0.030). Mapping onto the histological BigBrain gradient, higher scores on IRI-PT – but not IRI-EC – entailed a progressive SA reduction from Bin 1 (sensorimotor) to Bin 5 (limbic). Psychopaths (PCL-R/YV ≥ 30, N = 73/39) had: (1) reduced IRI-PT and IRI-EC scores (Cohen’s Ds = -0.423, – 0.564, respectively); (2) increased L-ITG SA (Cohen’s D = 0.560); (3) increased global SA (Cohen’s D = 0.480); and (4) reduced SA covariance between the left precentral and left isthmus-cingulate cortices. There were no group differences in global, modular, or nodal SA covariance, as indexed by canonical graph-theoretical metrics. We provide novel insights into the brain correlates of empathy and psychopathy in incarcerated males.
Harmonization techniques for machine learning studies using multi-site functional MRI data
Authors: El-Gazzar Ahmed , Thomas Rajat Mani , van Wingen Guido 
Published: June 2023

AbstractIn recent years, the collection and sharing of resting-state functional magnetic resonance imaging (fMRI) datasets across multiple centers have enabled studying psychiatric disorders at scale, and prompted the application of statistically powerful tools such as deep neural networks. Yet, multi-center datasets introduce non-biological heterogeneity that can confound the biological signal of interest and produce erroneous findings. To mitigate this problem, the neuroimaging community has adopted harmonization techniques previously proposed in other domains to remove site-effects from fMRI data. The reported success of these approaches in improving the generalization of the models have varied significantly. It remains unclear whether harmonization techniques could boost the final outcome of multi-site fMRI studies, to what extent, and which approaches are best suited for this task. In an attempt to objectively answer these questions, we conduct a standardized rigorous evaluation of seven different harmonization techniques from the neuroimaging and computer vision literature on two large-scale multi-site datasets (N= 2169 andN= 2366) to diagnose autism spectrum disorder and major depression disorder from static and dynamic representations of fMRI data. Interestingly, while all harmonization techniques removed site-effects from the data, they had little influence on disorder classification performance in standard k-fold and leave-one-site-out validation settings over a well-tuned baseline. Further investigation shows that the baseline model implicitly learns site-invariant features which could well explain its competitiveness with explicit harmonization techniques and suggest orthogonality between latent disease features and site discrminative features. However, additional experiments show that harmonization methods could be critical to report faithful results in settings where there is high intra-site class imbalance and the learning algorithm is prone to overfit on spurious features confounding the final outcome of the study.
The tRNA Gm18 Methyltransferase TARBP1 Promotes Hepatocellular Carcinoma Progression via Metabolic Reprogramming of Glutamine
Authors: Shi Xiaoyan , Zhang Yangyi , Wang Yuci , Wang Jie , Gao Yang , Wang Ruiqi , Wang Liyong , Xiong Minggang , Ou Ningjing , Liu Qi , Ma Honghui , Cai Jiabin , Chen Hao 
Published: June 2023

ABSTRACTCancer cells rely on metabolic reprogramming to sustain the prodigious energetic requirements for rapid growth and proliferation. Glutamine metabolism is frequently dysregulated in cancers and is being exploited as a potential therapeutic target. In current study, we identified TARBP1 (TAR (HIV-1) RNA Binding Protein 1) as a novel driver gene critical for glutamine metabolic reprogramming in tumor through the CRISPRi/Cas9 screening. Ourin vivoandin vitroassays demonstrated that TARBP1 is the methyltransferase of Guanosine 2’-O-methylation targeting position 18 (G18) of tRNAGln(TTG/CTG)and tRNASer(TGA/GCT), and loss of Gm18 modification diminishes the stability of tRNAs. Therefore, TARBP1 is critical for maintaining efficient translation of mRNA, in particular the glutamine transportor-ASCT2 (also known as SCL1A5). Importantly, TARBP1 is frequently amplified and overexpressed in HCC, consequentially promotes the protein synthesis of ASCT2 and glutamine import to fuel the growth of cancer cell, which is associated with poor patient survival. Taken together, this study reveals the critical role of TARBP1 in HCC progression through glutamine metabolic reprogramming and provides a potential target for tumor therapy.