bluuebunny/crossref_metadata_2025_split huggingface dataset:
Neurological complications of sepsis
Authors: Piva Simone , Bertoni Michele , Gitti Nicola , Rasulo Francesco A. , Latronico Nicola 
Published: February 2023

Purpose of review
Sepsis, defined as life-threatening organ dysfunction caused by a dysregulated host response to infection, is a leading cause of hospital and ICU admission. The central and peripheral nervous system may be the first organ system to show signs of dysfunction, leading to clinical manifestations such as sepsis-associated encephalopathy (SAE) with delirium or coma and ICU-acquired weakness (ICUAW). In the current review, we want to highlight developing insights into the epidemiology, diagnosis, prognosis, and treatment of patients with SAE and ICUAW.

Recent findings
The diagnosis of neurological complications of sepsis remains clinical, although the use of electroencephalography and electromyography can support the diagnosis, especially in noncollaborative patients, and can help in defining disease severity. Moreover, recent studies suggest new insights into the long-term effects associated with SAE and ICUAW, highlighting the need for effective prevention and treatment.

Summary
In this manuscript, we provide an overview of recent insights and developments in the prevention, diagnosis, and treatment of patients with SAE and ICUAW.
Approach to acute encephalitis in the intensive care unit
Authors: Venkatesan Arun , Habis Ralph , Geocadin Romergryko G. 
Published: February 2023

Purpose of review
Recent years have seen a dramatic increase in the identification of autoimmune encephalitis (AE) and the emergence of new causes of infectious encephalitis (IE). However, management of these patients remains challenging, with many requiring care in intensive care units. Here, we describe recent advances in the diagnosis and management of acute encephalitis.

Recent findings
Advances in the identification of clinical presentations, neuroimaging biomarkers, and electroencephalogram patterns have enabled more rapid diagnosis of encephalitis. Newer modalities such as meningitis/encephalitis multiplex PCR panels, metagenomic next-generation sequencing, and phage display-based assays are being evaluated in an effort to improve detection of autoantibodies and pathogens. Specific advances in the treatment of AE include establishment of a systematic approach to first-line therapies and the development of newer second-line modalities. The role of immunomodulation and its applications in IE are actively being investigated. In the ICU, particular attention to status epilepticus, cerebral edema, and dysautonomia may improve outcomes.

Summary
Substantial diagnostic delays still occur, with many cases left without an identified etiology. Antiviral therapies remain scarce, and optimal treatment regimens for AE still need to be clarified. Nevertheless, our understanding of diagnostic and therapeutic approaches to encephalitis is rapidly evolving.
Effects of ankle-foot orthoses on different gait patterns in children with spastic cerebral palsy: A statistical parametric mapping study
Authors: Dobler Florian , Cip Johannes , Lengnick Harald , Alexander Nathalie 
Published: February 2023

Background:
Ankle-foot orthoses (AFOs) are a common treatment to correct gait deviations in children with spastic cerebral palsy (SCP). Studies on the outcome of AFOs on gait often do not account for different gait patterns.

Objectives:
The aim of this study was to investigate the effects of AFOs on specific gait patterns in children with cerebral palsy.

Study Design:
Retrospective, unblinded, controlled, cross-over study.

Methods:
Twenty-seven children with SCP were assessed in the conditions walking barefoot or with shoes and AFO. AFOs were prescribed based on usual clinical practice. Gait patterns for each leg were classified as excess ankle plantarflexion in stance (equinus), excess knee extension in stance (hyperextension), or excess knee flexion in stance (crouch). Differences in spatial-temporal variables and sagittal kinematics and kinetics of the hip, knee, and ankle between the 2 conditions were determined using paired t-tests and statistical parametric mapping, respectively. The effect of AFO-footwear neutral angle on knee flexion was tested using statistical parametric mapping regression.

Results:
AFO use improved spatial-temporal variables and reduced ankle power generation in preswing. For “equinus” and “hyperextension” gait patterns, AFOs decreased ankle plantarflexion in preswing and initial swing and decreased ankle power in preswing. Ankle dorsiflexion moment increased in all gait pattern groups. Knee and hip variables did not change in any of the 3 groups. AFO-footwear neutral angle had no effect on changes in sagittal knee angle.

Conclusion:
Although improvements in spatial-temporal variables were seen, gait deviations could only partially be corrected. Therefore, AFO prescriptions and design should individually address specific gait deviations and their effectiveness in children with SCP should be controlled.
Comparison of 18F-FDG and 68Ga-FAPI-04 Uptake in Postoperative Re-evaluation of Gastric, Duodenal, and Colorectal Cancers
Authors: Liu Huipan , Yang Xiao , Liu Lin , Qu Gengcuo , Chen Yue 
Published: February 2023

Purpose
To compare the potential efficacy of 68Ga-FAPI-04 PET/CT with that of 18F-FDG PET/CT for detecting tumor recurrence and nodal and distant metastases in gastric, duodenal, and colorectal cancers.

Methods
This single-center retrospective clinical study was performed at the Affiliated Hospital of Southwest Medical University between January 2020 and June 2022. Participants with gastric, duodenal, and colorectal cancers after curative resection underwent both 68Ga-FAPI-04 and 18F-FDG PET/CT. Histopathologic examination, morphologic imaging, and/or follow-up imaging served as the reference standards. The SUVmax of the tumor recurrence and nodal and distant metastases between 18F-FDG and 68Ga-FAPI-04 PET/CT were compared using the paired-sample t test.

Results
Forty-one participants with gastric, duodenal, and colorectal cancers were enrolled in the study (median age, 51 years; range, 19–75 years). The sensitivity of 68Ga-FAPI-04 PET/CT was higher than that of 18F-FDG PET/CT for detecting tumor recurrence (6 of 6 [100%] vs 4 of 6 [67%]), nodal metastases (92 of 92 [100%] vs 31 of 92 [34%]), and distant metastases (28 of 30 [93%] vs 20 of 30 [67%]).

Conclusion

68Ga-FAPI-04 PET/CT for tumor re-evaluation showed potential for more accurate performance of gastric, duodenal, and colorectal cancers, thereby improving treatment decision-making.
Simulation- vs. Didactic-Based Learning for Rehabilitation Nurses Caring for Patients With Autonomic Dysreflexia
Authors: Alvarado Virginia , Stutzman Sonja E. , Nairon Emerson , Olson DaiWai M. 
Published: February 2023

Abstract

Purpose
Autonomic dysreflexia (AD) is associated with spinal cord injury, manifesting in symptoms of high blood pressure, bradycardia, headache, diaphoresis, and anxiety. Nurses often manage these symptoms; thus, nursing knowledge of AD is crucial. The purpose of this study was to improve AD nursing knowledge while exploring differences between simulation and didactic learning in nurse education.

Design and Methods
This prospective pilot study used two types of learning (simulation vs. didactic) to determine if one was superior to the other regarding nursing knowledge of AD. Nurses were given a pretest, randomized to simulation or didactic learning, and then given a posttest 3 months later.

Results
Thirty nurses were enrolled in this study. Seventy-seven percent of nurses held a BSN degree with an average of 15.75 years in nursing. The mean knowledge scores for AD at baseline for the control (13.9 [2.4]) and intervention (15.5 [2.9]) groups were not statistically different (p = .1118). The mean knowledge scores for AD after either didactic- or simulation-based education for the control (15.5 [4.4]) and intervention (16.5 [3.4]) groups were not statistically different (p = .5204).

Clinical Relevance
Autonomic dysreflexia is a critical clinical diagnosis that requires prompt nursing intervention to prevent threatening consequences. This study focused on how different methods of education best benefited AD knowledge acquisition and how simulation versus didactic learning impacts overall nursing education.

Conclusions
As a whole, providing nurses with AD education was helpful in improving their understanding of the syndrome. However, our data suggest that both didactic and simulation are equally effective methods to increase AD knowledge.
Noticing Acute Changes in Health in Long-Term Care Residents
Authors: Bowen Mary Elizabeth , Rowe Meredeth , Flynn Aidan , Basehore Heather , Shin Ju Young 
Published: February 2023

Abstract

Purpose
Early signs of acute conditions and increased fall risk often go unrecognized in patients in long-term care facilities. The aim of this study was to examine how healthcare staff identify and act on changes in health status in this patient population.

Design
A qualitative study design was used for this study.

Methods
Six focus groups across two Department of Veterans Affairs long-term care facilities were conducted with 26 interdisciplinary healthcare staff members. Using thematic content analysis, the team preliminarily coded based on interview questions, reviewed and discussed emerging themes, and agreed on the resultant coding scheme for each category with additional independent scientist review.

Results
Themes included describing and explaining how “normal” or expected behavior is identified by staff, noticing changes in a resident, determining the significance of the change, hypothesizing reasons for an observed change, response to an observed change, and resolution of the clinical change.

Conclusions
Despite limited training in formal assessment methods, long-term care staff have developed methods to conduct ongoing assessments of the residents. This technique, individual phenotyping, often identifies acute changes; however, the lack of formal methods, language, or tools to communicate the changes means that these assessments are not often formalized in a manner that informs the residents’ changing care needs.

Clinical Relevance to the Practice of Rehabilitation Nursing
More formal objective measures of health change are needed to assist long-term care staff in expressing and interpreting the subjective phenotype changes into objective, easily communicated health status changes. This is particularly important for acute health changes and impending falls, both of which are associated with acute hospitalization.
Tsugishige Kondo, The Father of Japanese Surgery
Authors: Imai Shoichi , Narushima Mitsunaga , Banda Chihena H. , Shiraishi Makoto , Shimizu Kotaro , Okada Yoshimoto , Mitsui Kohei , Danno Kanako , Ishiura Ryohei , Yuzuriha Shunsuke , Ohmori Kitaro 
Published: February 2023

Abstract
Hideyo Noguchi is one of the most famous scientists in Japan's history, and his portrait has adorned the ¥1,000 banknotes since 2004. He had a childhood burn injury resulting in severe hand scarring and contracture that plagued his early life and education.
The resulting hand deformity required 3 separate reconstructions with the third and most complex surgery performed by Professor Tsugishige Kondo just before Noguchi's final medical doctor license examination in 1897. In this surgery, Kondo released the contractures using the first radial forearm flap performed in Japan long before the establishment of plastic surgery in the country.
Reviewing the history of Kondo, we find that he likely learned the art of reconstructive surgery along with many other surgical techniques during his stay in Europe from 1891 to 1896 where he was mentored by 4 prominent surgeons of the era: Christian Albert Theodor Billroth, Vincenz Czerny, James Israel, and Carl Nicoladoni. During this period, Czerny reported performing the world's first breast reconstruction using lipoma transfer, and Nicoladoni performed the world's first thumb reconstruction with a chest flap and with toe-to-thumb transfer. Kondo may have watched these world's first operations and may have also been taught these innovative techniques including the forearm flap directly by these pioneers. He returned to Japan and successfully applied these reconstructive surgery methods in his practice and teaching, as evidenced by the landmark surgery of Hideyo Noguchi's hand, and laid the foundations for the development of plastic surgery in Japan.
Operating in an Opioid Crisis
Authors: Hammond Jacob B. , Hung Penny , Chang Yu-Hui H. , Rebecca Alanna M. , Howard Michael A. , Teven Chad M. 
Published: February 2023

Background
In response to the opioid epidemic, the United States declared a public health emergency in 2017. We evaluated pain medication prescribing practices among plastic and reconstructive surgeons, assessing pain medication prescription rates and opioid-related mortality both nationally and regionally within the United States.

Methods
A retrospective analysis of Medicare Part D prescriber data among plastic surgeons from 2013 through 2017 was conducted. Pain medications were categorized as opioid and nonopioid medications. Trends in surgeon prescribing habits were evaluated using the Cochrane-Armitage trend test.

Results
A total of 708,817 pain medication claims were identified: 612,123 claims (86%) were for opioid pain medications and 96,694 claims (14%) were for nonopioid pain medications. Total pain medication claims decreased from 44% of all medications in 2013 to 37% in 2017 (P < 0.001). Opioid medications decreased from 37% of total medication claims to 32% (P < 0.001). The overall opioid prescription rate fell from 1.53 claims per beneficiary in 2013 to 1.32 in 2017 (P < 0.001). Nonopioid pain medications decreased from 7% in 2013 to 6% in 2017 (P < 0.001); nonsteroidal anti-inflammatory drug claims increased by 44%. The prescription rate of nonopioid medications decreased from 2.40 claims per beneficiary in 2013 to 2.32 in 2017 (P < 0.001). An overall increase in opioid-related mortality was observed. Trends in pain medication prescriptions varied significantly among US regions and divisions.

Conclusions
Plastic surgeons are prescribing less opioids and relying more on nonopioid pain medications. Increased adoption of multimodal pain treatment approaches among surgeons is a likely explanation for this trend in face of the current opioid crisis.
The genetic spectrum of febrile infection-related epilepsy syndrome (FIRES) and refractory status epilepticus
Authors: deCampo Danielle , Xian Julie , Karlin Alexis , Sullivan Katie R. , Ruggiero Sarah M. , Galer Peter D. , Ramos Mark , Abend Nicholas S. , Gonzalez Alex , Helbig Ingo 
Published: February 2023

AbstractFebrile infection-related epilepsy syndrome (FIRES) is a severe childhood epilepsy with refractory status epilepticus after a typically mild febrile infection. The etiology of FIRES is largely unknown, and outcomes in most individuals with FIRES are poor. Here, we reviewed the current state-of-the art genetic testing strategies in individuals with FIRES. We performed a systematic computational analysis to identify individuals with FIRES and characterize the clinical landscape using the Electronic Medical Records (EMR). Among 25 individuals with a confirmed FIRES diagnosis over the last decade, we performed a comprehensive review of genetic testing and other diagnostic testing. Management included use of steroids and intravenous immunoglobulin (IVIG) in most individuals, followed by the ketogenic diet, and, after 2014, an increasing use of immunosuppressants, IVIG, and plasma exchange (PLEX). Genetic testing was performed on a clinical basis in almost all individuals and was non-diagnostic in all patients. We compared FIRES with both status epilepticus (SE) and refractory status epilepticus (RSE) as a broader comparison cohort and identified genetic causes in 36% of patients with RSE. In summary, despite the absence of any identifiable etiologies in FIRES, we performed an unbiased analysis of the clinical landscape, identifying a heterogeneous range of treatment strategies and characterized real-world clinical practice. FIRES remains one of the most enigmatic conditions in child neurology without any known etiologies to date despite significant efforts in the field, suggesting a clear need for further studies and novel diagnostic and treatment approaches. Furthermore, the difference in genetic signatures between FIRES and RSE suggest distinct underlying etiologies.
Faster bi-stable visual switching in psychosis
Authors: Killebrew Kyle W. , Moser Hannah R. , Grant Andrea N. , Marjańska Małgorzata , Sponheim Scott R. , Schallmo Michael-Paul 
Published: February 2023

AbstractBi-stable stimuli evoke two distinct perceptual interpretations that alternate and compete for dominance. Bi-stable perception is thought to be driven at least in part by mutual suppression between distinct neural populations that represent each percept. Abnormal visual perception is observed among people with psychotic psychopathology (PwPP), and there is evidence to suggest that these visual deficits may depend on impaired neural suppression in visual cortex. However, it is not yet clear whether bi-stable visual perception is abnormal among PwPP. Here, we examined bi-stable perception in a visual structure-from-motion task using a rotating cylinder illusion in a group of 65 PwPP, 44 first-degree biological relatives, and 43 healthy controls. Data from a ‘real switch’ task, in which physical depth cues signaled real switches in rotation direction were used to exclude individuals who did not show adequate task performance. In addition, we measured concentrations of neurochemicals, including glutamate, glutamine, and γ-amino butyric acid (GABA), involved in excitatory and inhibitory neurotransmission. These neurochemicals were measured non-invasively in visual cortex using 7 tesla MR spectroscopy. We found that PwPP and their relatives showed faster bi-stable switch rates than healthy controls. Faster switch rates also correlated with significantly higher psychiatric symptom levels across all participants. However, we did not observe any significant relationships across individuals between neurochemical concentrations and SFM switch rates. Our results are consistent with a reduction in suppressive neural processes during structure-from-motion perception in PwPP, and suggest that genetic liability for psychosis is associated with disrupted bi-stable perception.
Sex differences in risk factors, burden, and outcomes of cerebrovascular disease in Alzheimer’s disease populations
Authors: Morrison Cassandra , Dadar Mahsa , Collins D. Louis ,   the Alzheimer’s Disease Neuroimaging Initiative
Published: February 2023

AbstractBackgroundWhite matter hyperintensity (WMH) accumulation is associated with vascular risk factors such as hypertension, diabetes, smoking, and obesity. Increased WMH burden results in increased cognitive decline and progression to mild cognitive impairment (MCI) and dementia. However, research has been inconsistent when examining whether sex differences influence the relationship between vascular risk factors, WMH accumulation, and cognition.MethodsA total of 2119 participants (987 females) with 9847 follow-ups from the Alzheimer’s Disease Neuroimaging Initiative met inclusion criteria for this study. Linear regressions were used to examine the association between vascular risk factors (individually and as a composite score) and WMH burden in males and females. When controlling for vascular risk factors, linear mixed models were also used to investigate whether the relationship between WMHs and longitudinal cognitive scores differed between males and females.ResultsMales had overall increased occipital (p<.001), but lower frontal (p<.001), total (p=.01), and deep (p<.001) WMH burden compared to females. For males, history of hypertension was the strongest contributor to WMH burden. On the other hand, the vascular composite score was the strongest factor for WMH in females. Greater increase in WMH accumulation was observed in males with a history of hypertension in the frontal region (p=.014) and males with high systolic blood pressure in the occipital region (p=.029) compared to females. With respect to cognition, WMH burden was more strongly associated with longitudinal decreases in global cognition, executive functioning, and functional activities of daily living in females compared to males.DiscussionThese findings show that controlling hypertension is important to reduce WMH burden in males. Conversely, minimizing WMH burden through vascular risk factors requires controlling many factors for females (e.g., hypertension, diabetes, smoking, alcohol abuse, etc.). The results have implications for therapies and interventions designed to target cerebrovascular pathology and the subsequent cognitive decline.
Infection prevention and control measures to reduce the transmission of mpox: a systematic review
Authors: Kuehn Rebecca , Fox Tilly , Guyatt Gordon , Lutje Vittoria , Gould Susan 
Published: February 2023

AbstractObjectivesTo make inferences regarding the effectiveness of respiratory interventions and case isolation measures in reducing or preventing the transmission of mpox on the basis of synthesis of available literature.MethodsThe WHO Clinical Management and Infection Prevention and Control guideline 2022 development group developed three structured research questions concerning respiratory and isolation infection prevention control measures for mpox. We conducted a systematic review that included a broad search of five electronic databases. In a two-stage process, we initially sought only randomized controlled trials and observational comparative studies; when the search failed to yield eligible studies, the subsequent search included all study designs including clinical and environmental sampling studies.ResultsNo studies were identified that directly addressed respiratory and isolation infection prevention control measures. To inform the review questions the review team synthesized route of transmission data in mpox. There were 2366/4309 (54.9%)cases in which investigators identified mpox infection occurring following transmission through direct physical sexual contact. There proved to be no reported mpox cases in which investigators identified inhalation as a single route of transmission. There were 2/4309 (0.0%) cases in which investigators identified fomite as a single route of transmission. Clinical and environmental sampling studies isolated mpox virus in a minority of saliva, oropharangeal swabs, mpox skin lesions, and hospital room air.ConclusionsCurrent findings provide compelling evidence that transmission of mpox occurs through direct physical contact. Because investigators have not reported any cases of transmission via inhalation alone, the impact of respiratory infection prevention control measures in reducing transmission will be minimal. Avoiding physical contact with others, covering mpox lesions and wearing a medical mask is likely to reduce onward mpox transmission; there may be minimal reduction in transmission from additionally physically isolating patients.