bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prophylactic Lymphovenous Bypass at the Time of Axillary Lymph Node Dissection Decreases Rates of Lymphedema
Authors: Deldar Romina , Spoer Daisy , Gupta Nisha , Towfighi Parhom , Boisvert Marc , Wehner Patricia , Greenwalt Ian T. , Wisotzky Eric M. , Power Katherine , Fan Kenneth L. , Tom Laura K. 
Published: May 2023

Background:
Breast cancer-related lymphedema impacts 30% to 47% of women who undergo axillary lymph node dissection (ALND). Studies evaluating the effectiveness of prophylactic lymphovenous bypass (LVB) at the time of ALND have had small patient populations and/or short follow-up. The aim of this study is to quantitatively and qualitatively evaluate prophylactic LVB in patients with breast cancer.

Methods:
A retrospective review of patients who underwent ALND from 2018 to 2022 was performed. Patients were divided into cohorts based on whether they underwent prophylactic LVB at the time of ALND. Primary outcomes included 30-day complications and lymphedema. Lymphedema was quantitatively evaluated by bioimpedance analysis, with L-dex scores >7.1 indicating lymphedema.

Results:
One-hundred five patients were identified. Sixty-four patients (61.0%) underwent ALND and 41 patients (39.0%) underwent ALND+LVB. Postoperative complications were similar between the cohorts. At a median follow-up of 13.3 months, lymphedema occurred significantly higher in the ALND only group compared with ALND+LVB group (50.0% vs 12.2%; P < 0.001). ALND without LVB was an independent risk factor for lymphedema development (odds ratio, 4.82; P = 0.003).

Conclusions:
Prophylactic LVB decreases lymphedema and is not associated with increased postoperative complications. A multidisciplinary team approach is imperative to decrease lymphedema development in this patient population.
A Cross-sectional Study of Perceived Stress and Racial Discrimination Among a National Sample of Young Men Who Have Sex With Men
Authors: Cordoba Evette , Garofalo Robert , Kuhns Lisa M. , Pearson Cynthia R. , Batey D. Scott , Bruce Josh , Radix Asa , Belkind Uri , Hidalgo Marco A. , Hirshfield Sabina , Schnall Rebecca 
Published: May 2023

AbstractResearch regarding the impact of racism on stress among young men who have sex with men (YMSM) is sparse. Secondary data were assessed from a 2018–2020 national mHealth prevention trial for YMSM aged 13–18 years (N= 542). Linear regression models examined associations between perceived stress and interpersonal and vicarious racism, adjusting for covariates. Stratified models by race/ethnicity were included. A subanalysis (n= 288) examined associations between nine interpersonal racial discriminatory events and perceived stress. Over 50% of participants experienced racial discrimination. In the multivariable models, exposure to interpersonal (β = 1.43,p-value: .038) and vicarious (β = 1.77,p-value: .008) racism was associated with perceived stress because there were four interpersonal racial discriminatory events. Stratified analysis by race/ethnicity found significant associations between interpersonal and vicarious racism and perceived stress among some racial/ethnic groups. Racial discrimination was common among YMSM, making them susceptible to the possible effects of vicarious and interpersonal racism on stress.
Psychological Capital Among Nursing Faculty
Authors: Singh Ashley 
Published: May 2023

Background:
Psychological Capital (PsyCap) consists of a set of internal resources an individual can access to navigate challenges and enhance job performance, satisfaction, and overall success. External factors within the academic environment may influence PsyCap.

Purpose:
The purpose was to explore PsyCap among nursing faculty and the impact of external factors on PsyCap and intent to seek leadership development.

Methods:
An exploratory descriptive study was conducted to examine nursing faculty's perceptions of their level of PsyCap through the Psychological Capital Questionnaire.

Results:
Seventy nursing faculty participated. Faculty yield higher levels of PsyCap (M = 4.5). The level of PsyCap did not correlate with intent to seek leadership development. Results also suggested that organizational support was a positive predictor of PsyCap (β= .26, t = 2.4, P = .021), and incentives for development were close to significant (P = .058)

Conclusions:
External factors can hinder, promote, and predict PsyCap, yielding both personal and professional implications; however, further exploration is warranted.
Comprehensive Training of Community Diagnosis and the Community-Oriented Primary Health Care Model in Nursing Education
Authors: Savitsky Bella , Shulman Ira , Kagan Ilya 
Published: May 2023

Background:
Community-oriented primary health care is a health promotion model that includes community diagnosis of a targeted community.

Purpose:
This educational project aimed to develop and implement an innovative approach of applying the principles of evidence-based practice in the teaching of community diagnosis, where the class of nursing students serves as an example of community.

Methods:
The method consisted of a lecture and an evidence-based simulation of community diagnosis based on data collection regarding the lifestyle and health behaviors of third-year nursing students from a 4-year academic nursing program (200 students; 90% response rate).

Results:
The data analysis revealed insufficient consumption of fruits, vegetables, and unsweetened fluids; excessive consumption of red and processed meat; insufficient engagement in physical activity; high anxiety level; and sleep deprivation.

Conclusions:
This educational approach allowed an interactive presentation of community health diagnostic methodology as well as community health problem prioritization applying the principles of an evidence-based approach. The method also improves students' awareness of their health and makes them better ambassadors of promoting a healthy lifestyle.
Comparing Static Perimetry Protocols of Central Field Testing among Glaucoma Patients
Authors: Behera Geeta , Nath Ayush , Ramasamy Amala , Kaliaperumal Subashini 
Published: May 2023

ABSTRACT

Significance
On comparing the Humphrey Field Analyzer (HFA) HFA 24-2C Faster, which tests ten additional points in the central field with the 24-2 Swedish Interactive Thresholding Algorithm (SITA) Standard for detecting central field defects, we found that the HFA 24-2C Faster may be used for the initial field evaluation in glaucoma with the advantage of a shorter testing time.

Purpose
To compare the HFA 24-2C Faster with 24-2 SITA Standard and 10-2 among glaucoma patients for the number of defective central points, global indices, and testing time.

Methods
Sixty eyes of 60 patients with glaucoma and glaucomatous visual field defects on the 24-2 SITA Standard algorithm underwent the 24-2C Faster and 10-2 field tests. The number of central points detected, global indices, and reliability indices were compared for 24-2C Faster with 24-2 SITA Standard and 10-2 field tests.

Results
The 24-2C Faster, on average, detected 5.5 defective points more on the total deviation plot and 2 defective points more on the pattern deviation plot than the 24-2 SITA Standard in central 10 degrees. The 10-2 algorithm detected 2.5 times more points on the total deviation plot than the 24-2C Faster. There was excellent consistency by intraclass correlation coefficient (ICC) of 0.95 for the mean deviation (MD) and 0.93 for the pattern standard deviation (PSD) between 24-2C Faster with the 24-2 SITA Standard. There was good consistency by ICC for MD and PSD being 0.80 for both between 24-2C Faster with the 10-2. The testing time was significantly lower with the 24-2C Faster compared to the 24-2 SITA Standard and 10-2 test.

Conclusion
Our study demonstrates that the HFA 24-2C Faster may be used for the initial evaluation of the visual field in glaucoma with the added advantage of a shorter testing time compared with the 24-2 SITA Standard program.
Application of Rasch Analysis to Timed Instrumental Activities of Daily Living in Low Vision: A Validation Study
Authors: Gobeille Micaela R. , Fujiwara Kyoko , Massof Robert W. 
Published: May 2023

ABSTRACT

Significance
This work validates Rasch analysis of a performance-based low vision outcome measure evaluated in patients’ own homes to ensure real world relevance. Inclusion of sources of variance from the patient’s home environment in functional outcome measures introduced non-uniform variance in measurements, but did not preclude estimation of valid measures.

Purpose
Validate Rasch analysis of a performance-based outcome measure with real-world relevance.

Methods
Low vision patients (N = 161) receiving services from an occupational therapist (OT) performed Timed Instrumental Activity of Daily Living (TIADL) tasks in their homes. Rasch analysis was applied to error count and performance time data. Internal validity was assessed with evaluations of accuracy and precision of estimated measures. External validity was assessed by comparing TIADL measures to measures estimated from the Activity Inventory (AI, i.e., from self-reported difficulty ratings).

Results
Task measures were well targeted to person measures estimated from task performance time, but were poorly targeted for measures estimated from task performance errors, for which most task trials (72%) were performed without error at baseline. Error-based person measures had larger standard errors with a smaller pseudo-R2 than time-based person or task measures and error-based task measures. Person measure infits for time- and error-based estimates conformed with expected values. The linear regressions between time-based person and task measures and corresponding error-based estimates had slopes of approximately 0.5, an observation consistent with larger estimation error variance for error-based measures than for time-based measures. Time-based TIADL person measures (x) and AI person measures (estimated from all items, y) were colinear, but weakly correlated (R = 0.19).

Conclusions
Functional ability measures estimated from performance times of instrumental activity of daily living tasks in patients’ homes demonstrate good internal and external validity. The ceiling effect from the infrequency of task performance errors in our dataset limits use of TIADL error data to measure rehabilitation outcomes.
Characteristics and Outcomes of Medicare Patients Treated in Inpatient Rehabilitation Facilities: 2013–2018
Authors: Deutsch Anne , Palmer Lauren , Neumann Holly , Potelle John , Ignaczak Magdalena , McMullen Tara , Ingber Melvin J. 
Published: May 2023

Abstract

Purpose
The aim of this study was to describe the characteristics and outcomes of Medicare patients treated in inpatient rehabilitation facilities (IRFs) in 2013 through 2018.

Design
A descriptive study was conducted.

Methods
A total of 2,907,046 IRF Medicare fee-for-service and Medicare Advantage patient stays that ended in 2013 through 2018 were analyzed.

Results
The number of Medicare patients treated in IRFs increased by about 9%, from 466,092 in 2013 to 509,475 in 2018. Although IRF patients’ age and racial/ethnic composition remained similar across the years, there was a shift in patients’ primary rehabilitation diagnosis, with more patients with stroke, neurological conditions, traumatic and nontraumatic brain injury, fewer patients with orthopedic conditions, and fewer coded as having medically complex conditions. Across the years, the percentage of patients discharged to the community was between 73.0% and 74.4%.

Clinical Relevance to the Practice of Rehabilitation Nursing
Rehabilitation nurses should have training and expertise in the management of patients with stroke and neurological conditions to provide high-quality IRF care.

Conclusions
Between 2013 and 2018, the number of Medicare patients treated in IRFs increased overall. There were more patients with stroke and neurological conditions and fewer patients with orthopedic conditions. Changes to IRF and other post-acute care policies, Medicaid expansion, and alternative payment programs may partially be driving these changes.
Premature aging in children and adults with a Fontan circulation
Authors: Drury Nigel E , Stickley John , Gaffey Thomas P , Guo Wei , Yang Xiaojing , Chew Yap Ching , Dhillon Rami , Clift Paul F 
Published: May 2023

AbstractThe Fontan circulation predisposes to multiple morbidities typically associated with older age but occurring in their third and fourth decades, consistent with premature aging. In this pilot study, we evaluated whether the Fontan circulation is associated with premature epigenetic aging. We found that in whole blood, Δage, the difference between chronological age and estimated epigenetic DNAge™, was significantly higher in those living with a Fontan circulation than in a reference cohort (z=5.59, p<0.0001), with a mean Δage in adults post-Fontan of +4.9 years (95% CI 3.3-6.5, p<0.0001). Our results suggest that the Fontan circulation is associated with accelerated epigenetic aging, mirroring the premature aging clinical phenotype. In a life-limiting condition with few treatment options, targeting epigenetic aging may represent a novel opportunity for intervention.
Inequalities in Healthcare Use during the COVID-19 Pandemic
Authors: Frey Arun , Tilstra Andrea M. , Verhagen Mark D. 
Published: May 2023

AbstractThe COVID-19 pandemic has led to severe reductions in non-COVID related healthcare use, but little is known whether this burden is shared equally across the population. This study investigates whether the reduction in administered care disproportionately affected certain sociodemographic strata, in particular marginalised groups. Using detailed medical claims data from the Dutch universal health care system and rich registry data that cover all residents in The Netherlands, we predict expected healthcare use based on pre-pandemic trends (2017– Feb 2020) and compare these expectations with observed healthcare use in 2020. Our findings reveal a substantial 10% decline in the number of weekly treated patients in 2020 relative to prior years. Furthermore, declines in healthcare use are unequally distributed and are more pronounced for individuals below the poverty line, females, the elderly, and foreign-born individuals, with cumulative relative risk ratios ranging from 1.09 to 1.22 higher than individuals above the poverty line, males, young, and native-born. These inequalities stem predominantly from declines in middle and low urgency procedures, and indicate that the pandemic has not only had an unequal toll in terms of the direct health burden of the pandemic, but has also had a differential impact on the use of non-COVID healthcare.
T cell differentiation drives the negative selection of pathogenic mtDNA variants
Authors: Franklin Imogen G. , Milne Paul , Childs Jordan , Boggan Róisín M. , Barrow Isabel , Lawless Conor , Gorman Gráinne S , Ng Yi Shiau , Collin Matthew , Russell Oliver M. , Pickett Sarah J. 
Published: May 2023

AbstractPathogenic mitochondrial (mt)DNA single nucleotide variants are the most common cause of adult mitochondrial disease. Whilst levels of the most common heteroplasmic variant (m.3243A>G) remain stable in post-mitotic tissues, levels in mitotic tissues, such as blood, decrease with age. Given differing division rates, longevity and energetic requirements within haematopoietic lineages, we hypothesised that variant level decline is driven by cell-type specific mitochondrial metabolic requirements. To address this, we coupled cell sorting with mtDNA sequencing to investigate mtDNA variant levels within progenitor, myeloid and lymphoid lineages from 26 individuals harbouring pathogenic mtDNA variants. We report that whilst the level of m.3243A>G declines with age in all analysed cell types, the T-cell lineage shows a significantly greater decline. This was confirmed for a second pathogenic tRNA variant; m.8344A>G, indicating that this phenomenon is not limited to m.3243A>G. High-throughput single cell analysis revealed that decline is driven by increasing proportions of cells that have cleared the variant genome, following a hierarchy that follows the current orthodoxy of T-cell differentiation and maturation. This work identifies the unique ability of T-cell subtypes to selectively purify their mitochondrial genomes, and identifies pathogenic mtDNA variants as a new means to track blood cell differentiation status.
Ankle proprioception in children with cerebral palsy
Authors: Boyer Elizabeth , Huang Qiyin , Ngwesse Stacy , Nelson Jennifer , Oh Jinseok , Konczak Jürgen 
Published: May 2023

1.ABSTRACTPurposeThere is no established clinical standard to evaluate ankle proprioception in children with cerebral palsy (CP). This study compared ankle position sense of children with CP to age-matched children typically developing (TD).MethodsChildren aged 6-17 years participated (15 CP, 58 TD). Using a custom-built device, the ankle was passively rotated to 2 positions for 25 trials. Using a psychophysical forced-choice paradigm, participants indicated which position was more plantarflexed. A psychometric function was fitted to the response data to determine the just noticeable difference (JND) threshold and the associated uncertainty (random error) for ankle position sense.ResultsMedian JND thresholds for the CP group were elevated (CP: 4.3°, TD: 3.0°). Three children with CP exceeded the 95thpercentile of TD. No differences in random error were found.ConclusionThis method assessed ankle proprioception relative to norm data and identified position sense impairments in children with CP. Using this method can provide data on proprioceptive status in CP, augmenting the assessment of motor impairment.
Temporal Trend in Mortality from COVID-19 Associated with Cardiovascular Disease
Authors: Sarau Alexandra , Luo Shengyuan , Chen Elaine Yi-Shuan , Gawel Susan , Desai Pankaja , Tippireddy Nagarjuna , Saldanha Anil J. , Suboc Tisha , Cloherty Gavin , Landay Alan , Volgman Annabelle Santos 
Published: May 2023

AbstractBackgroundThe COVID-19 pandemic has endured for over three years with over twelve variants afflicting humans worldwide. The impact and longevity of the pandemic has driven the medical community and researchers to identify high-risk populations, yet few studies have explored temporal trends during the pandemic. The objective of this study is to investigate trends in all-cause mortality associated with co-morbid cardiovascular disease (CVD) throughout the consecutive waves of the COVID-19 pandemic.MethodsA retrospective cohort study was conducted on patients with COVID-19 infection who received care at a tertiary care center in Chicago between March 2020 and September 2022.Multivariable logistic regression was used to investigate associations between co-existing CVD (defined as congestive heart failure, myocardial infarction, cerebrovascular disease, peripheral vascular disease) and mortality, adjusting for age, sex, race, and comorbidities defined in the Charlson comorbidity index.ResultsThe study included 38651 participants (mean age 45 years, 57.6% female, 11.4% with co-existing CVD). All-cause mortality in COVID-19 patients was highest during the Delta wave and remained elevated until the late Omicron wave. Mortality associated with co-existing CVD increased during the early pandemic waves, decreased in the later waves, but remained elevated relative to the overall population. When adjusted for age, sex, and race, all-cause mortality was 2.3-fold higher in patients with co-existing CVD compared to those with non-CVD comorbidities (OR = 2.30, 95% CI 1.95 – 2.62; p < 0.001).ConclusionsWhile overall mortality rates declined toward the later waves of the pandemic, all-cause mortality associated with CVD remained elevated compared to individuals without CVD.Clinical PerspectiveWhat is new?-This study found that individuals with co-existing CVD have 2.3-fold higher risk of all-cause mortality compared to those with non-CVD comorbidities.-Mortality associated with co-existing CVD was highest during the early waves of the pandemic and declined during the later waves, yet remained elevated relative to the overall population.What are the clinical implications?-Increased all-cause mortality in COVID-19 patients with co-morbid CVD may be multifactorial from socioeconomic, psychosocial, behavioral, and biological variables.-Individuals with co-existing CVD who become infected with COVID-19 should be considered an at-risk population for increased mortality.
Early metabolic disruption and predictive biomarkers of delayed-cerebral ischemia in aneurysmal subarachnoid haemorrhage
Authors: Chikh Karim , Tonon David , Triglia Thibaut , Lagier David , Buisson Anouk , Alessi Marie-Christine , Defoort Catherine , Benatia Sherazade , Velly Lionel J , Bruder Nicolas , Martin Jean-Charles 
Published: May 2023

AbstractBACKGROUNDDelayed cerebral ischaemia (DCI) following aneurysmal subarachnoid haemorrhage (aSAH) is a major cause of complications and death. Here we set out to identify high-performance predictive biomarkers of DCI and its underlying metabolic disruptions using metabolomics and lipidomics approaches.METHODSThis single-centre retrospective observational study enrolled 61 consecutive patients with severe aSAH requiring external ventricular drainage between 2013 and 2016. Of these 61 patients, 22 experienced a DCI and were classified as DCI+ and the other 39 patients were classified as DCI-. A further 9 patients with other neurological features were included as non aSAH controls. Blood and cerebrospinal fluid (CSF) were sampled within the first 24 h after admission. We carried out LC-MS/MS-based plasma and CSF metabolomic profiling together with total lipid fatty acids analysis.RESULTSWe identified a panel of 20 metabolites that together showed high predictive performance for DCI (area under the receiver operating characteristic curve: 0.968, specificity: 0.88, sensitivity: 0.94). This panel of metabolites included lactate, cotinine, salicylate, 6 phosphatidylcholines, and 4 sphingomyelins. Analysis of the whole set of metabolites to highlight early biological disruptions that might explain the subsequent DCI found peripheral hypoxia driven mainly by higher blood lactate, arginine and proline metabolism likely associated to vascular NO, dysregulation of the citric acid cycle in the brain, defective peripheral energy metabolism and disrupted ceramide/sphingolipid metabolism. We also unexpectedly found a potential influence of gut microbiota on the onset of DCI.CONCLUSIONWe identified a high-performance predictive metabolomic/lipidomic signature of further DCI in aSAH patients at admission to a NeuroCritical Care Unit. This signature is associated with significant peripheral and cerebral biological dysregulations. We also found evidence, for the first time, pointing to a possible gut microbiota/brain DCI axis, and proposed the putative microorganisms involved.Clinical trial registrationClinicaltrials.govidentifier:NCT02397759