bluuebunny/crossref_metadata_2025_split huggingface dataset:
A bidirectional cohort study to compare the outcomes of transperitoneal and retroperitoneal approaches in subjects undergoing laparoscopic live donor nephrectomy
Authors: S. Praveena , Krishnamoorthy Venkatesh , Tyagaraj Krishnaprasad 
Published: September 2023

AbstractBackgroundLaparoscopic transperitoneal donor nephrectomy (LDN) is currently the standard procedure for renal donation from living donors. Only a handful of clinical studies have compared the outcomes of retroperitoneoscopic donor nephrectomy (RLDN) and LDN. More robust data and systematic comparative analyses of the outcomes and complications of these 2 techniques are needed. This study aimed to elucidate the noninferiority of RLDN to LDN.Materials and methodsAll live renal donors who underwent either RLDN or LDN at our institution during the period of January 2015 to March 2021 were considered subjects, excluding those who refused to participate in the study. This was a bidirectional cohort study. Demographic and clinical data were collected and analyzed using standard statistical methods. Statistical significance was set atp< 0.05.ResultsOur study included 89 subjects: 40 in the LDN group and 49 in the RLDN group. The RLDN group had significantly shorter warm ischemia time (2.85 vs. 6.04 minutes), a lower fall in hemoglobin on postoperative day (POD)-1 (1.73 vs. 2.24 g/dL), lower estimated blood loss (601.93 vs. 797.27 mL), and lower pain on POD-1 (0.78 vs. 1.28). The improvement in recipient’s estimated glomerular filtration rate on POD-30 was significantly higher in the RLDN group (79.98 vs. 63.73 mL/min/1.73 m2). There was a significantly higher fall in estimated glomerular filtration rate of donor after nephrectomy in RLDN group on POD-30 (35.53 vs. 30.60 mL/min/1.73 m2). However, there were no significant differences in other parameters.ConclusionsOur study, conducted in India, showed that the majority of RLDN outcomes were better than those of LDN. Hence, RLDN is clearly non-inferior to the gold standard LDN. A well-designed randomized controlled study is required to elucidate the statistical superiority of one approach over another.
“Weight loss is my goal and being healthy is my goal… I can get over the hot flashes”: a qualitative exploration of menopausal transition experiences and preferences for weight management among White women
Authors: Kracht Chelsea L. , St. Romain Jessica , Hardee Julie C. , Santoro Nanette , Redman Leanne M. , Marlatt Kara L. 
Published: September 2023

Abstract

Objectives
A qualitative research study design was used to (1) describe experiences of White women during the menopausal transition, and (2) identify barriers and facilitators for participating in a lifestyle program targeting weight management.

Methods
Perimenopausal and postmenopausal White women who self-reported a desire to lose or maintain weight participated in focus groups. Women were queried about their past diet, exercise, and weight management practices; menopausal transition; and specific components and considerations for developing a lifestyle program for weight management. Thematic analysis was conducted on coded transcripts and four main themes emerged, each containing three to six subthemes.

Results
Twenty-eight White women (age 54 ± 3 y, body mass index 31.4 ± 9.5 kg/m2) were enrolled. Overall, women felt menopause was a major life event that coincided with weight gain and frustrating body changes. Women already engaged in many different types of exercises and diets to lose weight. Women also talked to healthcare professionals about menopause but were disappointed in the support they received. Women were interested in a lifestyle program that included menopause-specific education, which focused on results beyond weight, which was flexible to their busy lifestyle, and which provided opportunities to build camaraderie among other women experiencing menopause.

Conclusions
This cohort of White women were interested in receiving menopause information and improving their overall health as part of a lifestyle program targeting weight management during this transition. Building camaraderie with other women affected by menopause is important to women, as is creating a lifestyle program that is flexible with daily life.
Potential Role of Smartphone Technology in Advancing Work on Neurological Soft Signs with a Focus on Schizophrenia
Authors: Gray Lucy E. , Buchanan Robert W. , Keshavan Matcheri S. , Torous John 
Published: September 2023

Learning Objective: After participating in this CME activity, the psychiatrist should be better able to
• Outline and Identify potential benefits of using neurological soft signs (NSS) as biomarkers of schizophrenia.

Abstract
Since the late 1960s, NSS have been a focus of study across psychiatric illnesses, including depression, bipolar disorder, and schizophrenia in particular. Utilizing these subtle neurological impairments as biomarkers of illness has numerous benefits; NSS offer a direct connection between clinical presentation and neurological functioning, and assessments are cost-effective. However, incongruent measurement scales, confounding variables, and rating system subjectivity have hindered the advancement and scalability of NSS research and clinical implementation. This article provides a brief overview of the literature on NSS as related to schizophrenia, and proposes utilizing smartphone sensing technology to create standardized NSS assessments with objective scoring. Incorporating digital phenotyping into NSS assessment offers the potential to make measurement more scalable, accessible, and directly comparable across locations, cultures, and demographics. We conducted a narrative search in PubMed and APA PsycInfo using the following keywords: neurological soft signs, schizophrenia spectrum disorders, and psychotic illnesses. No date limitations were used. There is no other direct work on NSS and new smartphone methods like digital phenotyping; though, there is related work in neurology. Harnessing advances in smartphone technology could provide greater insight into and further our understanding of specific aspects of the NSS field. For instance, it could help us distinguish trait vs. state markers and better understand how distinct groups of signs may reflect different aspects of psychiatric illness and neurological impairment. In addition, such technology can help advance research on the capabilities of NSS as an effective diagnostic tool.
Persistent Localized Descemet Membrane Endothelial Keratoplasty Detachments Secondary to Corneal Ink Stain Marks
Authors: Patel Radhika Pooja , Price Liam , Bizrah Mukhtar , Din Nizar 
Published: September 2023

Purpose:The aim of this study was to describe 2 cases of persistent endothelial graft detachments secondary to corneal gentian violet ink stain marks.Methods:This study included a case review of hospital records of 2 eyes with localized Descemet's membrane detachments after Descemet membrane endothelial keratoplasty (DMEK) surgery.Results:Two patients underwent consecutive uncomplicated DMEK surgery for Fuchs endothelial dystrophy with identical techniques. The grafts were marked with an ink marker through a stromal window to ensure correct orientation during donor graft preparation. Both patients had localized detachments around the ink mark on day 1, week 1, and up to 1 month at postoperative review. The persistent detachment was believed to be due to the gentian violet marker used which had a higher concentration of isopropyl alcohol solvent than the standard marking pen routinely used.Conclusions:Ink markers with higher concentrations of isopropyl solvent may result in higher DMEK detachment rates and caution is advised when using these markers.
Survey on Changes in the Willingness to Receive the COVID-19 Vaccine Among Patients with Breast Cancer in the Postpandemic Era
Authors: Bai Lixiao , Li Jianbin , Yang Ailing , Ding Cuicui , Li Jiayi , Wang Yan , Li Liangying , Zhang Shaohua , Jiang Zefei 
Published: September 2023

Abstract
This study aimed to investigate the status of and changes in the vaccination willingness of patients with breast cancer to increase the coronavirus disease 2019 (COVID-19) vaccination rate among these patients. The first survey included patients from the Fifth Medical Center of the PLA General Hospital who participated in the Society of Clinical Oncology Breast Cancer Committee NCP-02 study conducted from September 16 to December 31, 2021. The second survey was conducted from December 9 to December 26, 2022, for those who had not received vaccines previously. In total, 266 patients completed two questionnaires. A total of 143 patients (53.8%) changed their willingness to receive the vaccination. Among them, 45, who were initially unwilling to be vaccinated, changed their stance to become hesitant and 15 changed to become willing. Among those with hesitant attitudes toward vaccines, 45 changed their stance to become willing, and 28 changed to become unwilling; 10 patients with willing attitudes toward vaccines changed to become hesitant. Those who received surgery (odds ratio (OR), 4.24; 95% confidence interval (CI), 1.45–12.42; P = 0.01) and who lived with older adults or children (OR, 2.03; 95% CI, 1.13–3.62; P = 0.02) were more likely to change their attitudes toward COVID-19 vaccines. This finding suggested that patients with breast cancer were cautious about receiving the COVID-19 vaccine. Multiple methods should be used to promote vaccination and reduce vaccine hesitancy.
The Quest for Understanding Cutaneous Leishmaniasis in Northern Province, Sri Lanka: An Analysis of Clinical Data From the District General Hospital, Vavuniya
Authors: Arulenthiran Rajadurai , Murugananthan Arumugam , Amarasinghe Kanchana P. , Mathivathani Umashankar 
Published: September 2023

Abstract
The study aimed to examine the clinical and epidemiological patterns of cutaneous leishmaniasis (CL) in patients attending the Dermatology Unit, District General Hospital in Vavuniya, Sri Lanka. A total of 77 patients clinically suspected for CL were interviewed through a structured questionnaire, and skin-lesion samples were obtained between January 2016 and January 2017. The definitive diagnosis of CL was made through microscopic identification of smears, histopathological examination of biopsies and kDNA PCR. Treatment modalities were chosen based on the location of the lesions on the body and complexity of the lesions. Of 77 suspected patients, 68 were confirmed for CL, with a mean age of 34.6 (±12.7) years, and included 54 males (79.4%) and 14 females (20.6%). Being a male was a significant risk factor (P = 0.032, OR = 4.82) associated with CL. Lesions were observed mainly on the exposed areas of the body, of which the forearm (22.1%) was the most commonly affected site. Single lesions (75.0%) and ulcerated nodules with central crust (39.7%) were the prominent features among the infected group. The age group of 21–40 years was significantly associated with healing lesions (P = 0.028, marginal effect = 0.55). However, a significant negative relationship was detected between ulcerated nodular lesions and lesion healing (P = 0.0436, marginal effect = −0.375). Males are at higher risk of CL. Early diagnosis and specific treatment, along with preventive measures such as protective clothing and sand fly repellents, can limit the spread of the disease. There is a need for a comprehensive approach to prevent and control the transmission of CL.
Increasing Knowledge in the Requesting of Clinical Investigations
Authors: Guest Brogan , Donaldson-Perrott Amy , Hickman Beck , Louis Chandran , Ritsema Tamara , Roberts Karen 
Published: September 2023

Purpose
Overtesting, ordering diagnostic investigations that do not help diagnose or manage a patient, is well-recognized as a problem across multiple healthcare settings in developed countries. One of the reasons often cited for overtesting is a lack of confidence or knowledge, so this article addresses our attempt to reduce overtesting through an investigation-specific course for a physician associate (PA) program based in the United Kingdom. We found no evidence of pedagogical literature that focused on clinical diagnostics teaching and assessment for PAs, so we aim to be the first to provide this research.

Methods
To assess student confidence, student feedback was collected through open-ended focus groups and qualitative surveys. The effectiveness of the course was evaluated through students' scores on investigation single best answer assessments.

Results
Overall, qualitative feedback from students showed an increase in knowledge in accurate investigation requests and interpretation. Students' assessment scores show a marked improvement after the implementation of the course.

Conclusion
This approach to an investigation-specific course, with a focus on limiting overinvestigating, demonstrates improved student performance on investigation assessments at the university level.
Physician Assistant Faculty Perceptions Regarding Ongoing Self-assessment and Accreditation
Authors: Kulo Violet , Cawley James F. , Fleming Shani , Gordes Karen L. , Jun Hyun-Jin , Kayingo Gerald 
Published: September 2023

PurposeWhile the processes of ongoing self-assessment and accreditation provide significant benefits to physician assistant (PA) programs, faculty members are often challenged by the required procedures and standards set by accreditation agencies. This study explored faculty perspectives regarding the processes of ongoing self-assessment and accreditation in PA programs.MethodsA qualitative research design centered around semistructured interviews was used. A total of 26 participants were recruited, including PA program directors, associate program directors, directors of assessment and accreditation, past Accreditation Review Commission on Education for the Physician Assistant commissioners, accreditation consultants, deans, and PA Education Association leaders.Data CollectionSemistructured one-on-one interviews were conducted by 8 members of the research team through Zoom video conferencing. Data were collected until saturation was reached.Data AnalysisThe interview recordings were transcribed and analyzed independently by 3 researchers. The transcripts were imported into NVivo, a qualitative data analysis software, for coding and inductive thematic analysis.ResultsSix emergent themes were identified under 2 major categories: facilitators and challenges. Facilitators for conducting continuous programmatic review and analysis include it takes a village, internal and external support, and sustained faculty development, whereas challenges are lack of knowledge and time, unclear expectations, and inflexibility.ConclusionThe study highlights factors associated with facilitating the ongoing self-assessment process. However, a number of challenges were also identified. The study suggests opportunities for intervention at the program, institution, and profession level.
Retrospective Evaluation of Mycoplasma genitalium Prevalence and Macrolide Resistance in a Study Cohort of Pregnant Women in Birmingham, AL, From 1997 to 2001
Authors: Totten Arthur H. , Xiao Li , Van Der Pol Barbara , Szychowski Jeff , Subramaniam Akila , Geisler William M. 
Published: September 2023

Abstract
In a prospective study conducted in 2020 to 2021, macrolide resistance–associated mutations were found in 41% of pregnant persons in Birmingham, AL, with Mycoplasma genitalium detected. We retrospectively evaluated M. genitalium in 203 pregnant persons participating in a study conducted in 1997 to 2001 in Birmingham and adjacent areas and found a prevalence of 11% (95% confidence interval, 6.9%–15.7%), but no macrolide resistance–associated mutations.
Advancing Face Transplantation: A Critical Analysis of Revisions and Long-Term Surgical Outcomes in 10 Cases
Authors: Mookerjee Vikram G. , Kauke-Navarro Martin , Hauc Sacha C. , Huelsboemer Lioba , Formica Richard N. , Pomahac Bohdan 
Published: September 2023

Background:
Face transplantation has emerged as a viable solution for reconstructing the most complex facial injuries. Previous work has demonstrated that surgical revisions are necessary to optimize outcomes. The authors’ group has updated the previous report of revisions in their cohort, quantified and described which revisions were performed for functional, aesthetic, or mixed indications, and described the rationale, safety, and long-term outcomes of these revisions.

Methods:
A retrospective analysis of the authors’ 10 face transplants from April of 2009 to February of 2023 was performed. The patients’ medical records, preoperative facial defects, and operative reports (index and secondary revisions) were reviewed.

Results:
Nine patients were included. One patient underwent irreversible acute-on-chronic allograft rejection and received a second face transplant. The average number of revisions was 5.2 per patient (range, 2 to 11 procedures). The median time interval from transplantation to first revision was 4 months (range, 1 to 21 months). Median follow-up was 106 months (range, 39 to 142 months). Most interventions consisted of debulking the allograft or revising the periorbital tissues.

Conclusions:
In the current study, the authors report longer-term data on revision procedures needed in face transplant recipients. Patients should expect to undergo revisions for both functional and aesthetic considerations. Although the majority of revisions are performed within 2 years after transplantation, revisions can be safely performed at any time point. Shared decision-making between the patient and provider team is essential in deciding which revisions are performed and when.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, V.
American Association for the Surgery of Trauma/American College of Surgeons Committee on Trauma: Clinical protocol for damage-control resuscitation for the adult trauma patient
Authors: LaGrone Lacey N. , Stein Deborah , Cribari Christopher , Kaups Krista , Harris Charles , Miller Anna N. , Smith Brian , Dutton Richard , Bulger Eileen , Napolitano Lena M. 
Published: September 2023

ABSTRACT
Damage-control resuscitation in the care of critically injured trauma patients aims to limit blood loss and prevent and treat coagulopathy by combining early definitive hemorrhage control, hypotensive resuscitation, and early and balanced use of blood products (hemostatic resuscitation) and the use of other hemostatic agents. This clinical protocol has been developed to provide evidence-based recommendations for optimal damage-control resuscitation in the care of trauma patients with hemorrhage.
Gamification as a tool to teach key concepts in microbiology to bachelor students in biology: a case-study using microbial interactions and soil functioning
Authors: Estoppey Aislinn , Tinguely Camille , Cravero Melissa , Blandenier Estelle , Brand Lucie , Court Julien , Zaninetti Marie , Bindschedler Saskia , Junier Pilar 
Published: September 2023

Microbiology is a difficult topic to teach given that the objects of study are for the most invisible to the learner. The majority of university students starting their training in biology are more interested in natural objects that can be seen with the naked eye. Nonetheless, microorganisms are key components of the biosphere and a good microbiological background is required for a thorough training in natural sciences. Lecturing is still a common teaching format at the university. However, it is a passive learning format that is no longer considered the most adequate approach in most teaching situations. Instead, alternatives consisting in more active teaching formats have been recognized to better motivate students to acquire and consolidate knowledge. In addition, other transferable skills such as effective communication, critical thinking, and time management, are acquired simultaneously. A similar engagement can be obtained using games as part of the teaching experience. In this study, we designed a card game to teach key concepts in basic bacteriology and mycology to bachelor level students. The first task consistent in creating and designing microbial characters based on a list of species. This proved very useful for second-year bachelor students to learn concepts such as cell morphologies, taxonomy, and life cycles. In the second task, third-year students used the characters created in the second-year class to develop a game based on an ecological function, forest litter degradation. In addition, they also considered experimental validation of the microbial activities and incorporated knowledge acquired in other fields.
Sperm competition influences sperm quality and seminal plasma protein expression among territorial males of the courtship cichlid
Authors: Morita Masaya , Satoh Shun , Ito Takeshi , Kohda Masanori , Awata Satoshi 
Published: September 2023

AbstractSperm competition drives the plasticity of sperm quality and seminal fluid. However, how environmental and behavioral factors influence sperm competition and its outcome on the plasticity of sperm quality are unknown. In this study, we show males can asses the sperm competition level, and their fertilization-promoting sperm traits changes according to intensity. The promiscuous Tanganyikan cichlidsOphthalmotilapia ventralisperform their fertilization in the female mouth cavity. Sperm competition occurs in the female mouth as sperm is collected from multiple males. Behavioral (i.e., courtship success rates [CSR]) and environmental (density of spawning sites [DS]) factors are related to sperm collection. Seminal plasma glycoprotein 120 (SPP120) aids in sperm immobilization and aggregation, and sperm quality (longevity and velocity) could increase the probability of siring offspring. Based on an assumption of the involvement of DS and CSR on sperm collection, DS and CSR could influence the expression of SPP120 and sperm quality. We examined how sperm quality and SPP120 affect sperm competition-associated CSR and DS. Sperm longevity and velocity were positively correlated with DS. SPP120 expression was also positively correlated with CSR and DS. The plasticity of sperm quality and amount of SPP120 result in high fertilization competency according to sperm competition level.