bluuebunny/crossref_metadata_2025_split huggingface dataset:
Health Professionals can Sustain Proficiency in Motivational Interviewing With a Moderate Amount of Training: An Intervention Fidelity Study
Authors: Rimayanti Made Utari , Taylor Nicholas F. , Shields Nora , Prendergast Luke A. , O'Halloran Paul D. 
Published: June 2023

Introduction:
Motivational interviewing (MI) proficiency may erode quickly, limiting its effectiveness. We examined whether health professionals completing a 2-day workshop, with 3 to 5 hours of personalized coaching, and twice-yearly group reflections sustained proficiency for the duration of a hip fracture rehabilitation trial and whether intervention was implemented as intended.

Methods:
A fidelity study was completed as part of a process evaluation of the trial that tested whether physical activity increased among hip fracture patients randomly allocated to receive MI (experimental) compared with dietary advice (control) over ten 30-minute sessions. Twelve health professionals (none were proficient in MI before trial commencement) delivered the intervention for up to 952 days. Two hundred experimental sessions (24% of all sessions, 83 patients) were randomly selected to evaluate proficiency using the MI Treatment Integrity scale; along with 20 control sessions delivered by four dietitians. Linear mixed-effects regression analyses determined whether proficiency was sustained over time. Dose was assessed from all experimental sessions (n = 840, 98 patients).

Results:
Intervention was implemented as intended; 82% of patients received at least eight 30-minute sessions. All motivational interviewers were proficient, whereas dietitians did not inadvertently deliver MI. Time had no effect on MI proficiency (est < 0.001/d, P = .913, 95% CI, −0.001 to 0.001).

Discussion:
MI proficiency was sustained in a large trial over 2.6 years by completing a 2-day workshop, 3 to 5 hours of personalized coaching, and twice-yearly group reflections, even for those without previous experience; further research needs to establish the maximum duration of training effectiveness.
Neuropilin-1 is essential for vascular endothelial growth factor A–mediated increase of sensory neuron activity and development of pain-like behaviors
Authors: Gomez Kimberly , Duran Paz , Tonello Raquel , Allen Heather N. , Boinon Lisa , Calderon-Rivera Aida , Loya-López Santiago , Nelson Tyler S. , Ran Dongzhi , Moutal Aubin , Bunnett Nigel W. , Khanna Rajesh 
Published: June 2023

Abstract
Neuropilin-1 (NRP-1) is a transmembrane glycoprotein that binds numerous ligands including vascular endothelial growth factor A (VEGFA). Binding of this ligand to NRP-1 and the co-receptor, the tyrosine kinase receptor VEGFR2, elicits nociceptor sensitization resulting in pain through the enhancement of the activity of voltage-gated sodium and calcium channels. We previously reported that blocking the interaction between VEGFA and NRP-1 with the Spike protein of SARS-CoV-2 attenuates VEGFA-induced dorsal root ganglion (DRG) neuronal excitability and alleviates neuropathic pain, pointing to the VEGFA/NRP-1 signaling as a novel therapeutic target of pain. Here, we investigated whether peripheral sensory neurons and spinal cord hyperexcitability and pain behaviors were affected by the loss of NRP-1. Nrp-1 is expressed in both peptidergic and nonpeptidergic sensory neurons. A CRIPSR/Cas9 strategy targeting the second exon of nrp-1 gene was used to knockdown NRP-1. Neuropilin-1 editing in DRG neurons reduced VEGFA-mediated increases in CaV2.2 currents and sodium currents through NaV1.7. Neuropilin-1 editing had no impact on voltage-gated potassium channels. Following in vivo editing of NRP-1, lumbar dorsal horn slices showed a decrease in the frequency of VEGFA-mediated increases in spontaneous excitatory postsynaptic currents. Finally, intrathecal injection of a lentivirus packaged with an NRP-1 guide RNA and Cas9 enzyme prevented spinal nerve injury–induced mechanical allodynia and thermal hyperalgesia in both male and female rats. Collectively, our findings highlight a key role of NRP-1 in modulating pain pathways in the sensory nervous system.
GluCl.CreON enables selective inhibition of molecularly defined pain circuits
Authors: Middleton Steven J. , Hu Huimin , Perez-Sanchez Jimena , Zuberi Sana , McGrath Williams Joseph , Weir Greg A. , Bennett David L. 
Published: June 2023

Abstract
Insight into nociceptive circuits will ultimately build our understanding of pain processing and aid the development of analgesic strategies. Neural circuit analysis has been advanced greatly by the development of optogenetic and chemogenetic tools, which have allowed function to be ascribed to discrete neuronal populations. Neurons of the dorsal root ganglion, which include nociceptors, have proved challenging targets for chemogenetic manipulation given specific confounds with commonly used DREADD technology. We have developed a cre/lox dependant version of the engineered glutamate-gated chloride channel (GluCl) to restrict and direct its expression to molecularly defined neuronal populations. We have generated GluCl.CreON that selectively renders neurons expressing cre-recombinase susceptible to agonist-induced silencing. We have functionally validated our tool in multiple systems in vitro, and subsequently generated viral vectors and tested its applicability in vivo. Using Nav1.8Cre mice to restrict AAV-GluCl.CreON to nociceptors, we demonstrate effective silencing of electrical activity in vivo and concomitant hyposensitivity to noxious thermal and noxious mechanical pain, whereas light touch and motor function remained intact. We also demonstrated that our strategy can effectively silence inflammatory-like pain in a chemical pain model. Collectively, we have generated a novel tool that can be used to selectively silence defined neuronal circuits in vitro and in vivo. We believe that this addition to the chemogenetic tool box will facilitate further understanding of pain circuits and guide future therapeutic development.
The Efficacy and Feasibility of a High Intensity Interval Training Program to Improve Cardiorespiratory Fitness in Truck Drivers
Authors: Gilson Nicholas D. , Mielke Gregore I. , Coombes Jeff S. , Duncan Mitch J. , Brown Wendy J. 
Published: June 2023

Objective
This cluster-controlled pilot study assessed the efficacy and feasibility of “Fit2Drive,” a depot-delivered, high-intensity interval training (HIIT) program to improve the cardiorespiratory fitness (CRF) of truck drivers.

Methods
Companies of local delivery drivers (44 men; mean [SD] age = 50.5 [9.8] years; Brisbane, Australia) were assigned to “Fit2Drive” (4 clusters; 27 drivers; 1 × 4 minutes supervised to self-managed HIIT, 3 times a week, 12 weeks) or a control (5 clusters; 17 drivers). Analyses assessed between group changes in CRF (VO2peak), HIIT session attendance, and delivery costs.

Results
Driver clusters allocated to “Fit2Drive” significantly improved CRF compared to a control (mean difference of 3.6 mL·kg-1·min-1; P < 0.019; 95% confidence interval = 0.7–6.5 mL·kg-1·min-1). Drivers who completed the program attended 70% of sessions (25/36) with delivery costs averaging $710 AUD per driver.

Conclusions
The findings support the efficacy and feasibility of Fit2Drive but also highlight challenges for in-person delivery at scale.
Tympanoplasty Healing Outcomes With Use of Postoperative Otic Quinolones
Authors: Kolb Casey L. , Dirain Carolyn O. , Antonelli Patrick J. 
Published: June 2023

Objective
Tympanoplasty usually results in tympanic membrane perforation (TMP) closure, but healing may be suboptimal (e.g., excess scarring). Factors that have been linked to impaired TM healing have become widely adopted (especially, postoperative use of quinolone ear drops). The aim of this study is to assess the frequency of suboptimal tympanoplasty healing with the use of otic quinolones postoperatively.

Study Design
Retrospective chart review.

Setting
Tertiary care facility.

Patients
One hundred patients undergoing tympanoplasty for TMP.

Intervention(s)
Tympanoplasty +/− canalplasty.

Main Outcome Measure(s)
Healing complications (e.g., granulation tissue, TMP, myringitis, bone exposure, lateralization, anterior blunting, medial canal fibrosis, and canal stenosis) and hearing loss.

Methods
Charts were reviewed for postoperative healing issues and hearing outcomes at 1 to 2 years postoperatively.

Results
TMP closure was found in 93.2%, but 34.2% had healing issues at 1 to 2 years postoperatively, with 20.6% having adverse healing outcomes (perforation (6.9%), granulation tissue (6.9%), medial fibrosis (4.1%), and myringitis, bone exposure, and webbing (all 1.4%). Another 13.7% had notable postoperative issues, such as protracted otorrhea (11.0%), otitis externa (9.6%), otitis media (1.4%), and atelectasis (2.7%). No medical, surgical, or patient factors impacted outcomes. Average air–bone gap at 1 to 2 years did not differ between patients with and without healing issues and patients with other postoperative issues (p = 0.5).

Conclusions
Suboptimal healing is common after tympanoplasty. There may be significant opportunity to improve post-tympanoplasty healing beyond improving the TMP closure rate.
Over-the-Counter Pain Medication Use During Pregnancy
Authors: Vignato Julie , Mehner Brooke , Negrete Alondra , Segre Lisa S. 
Published: June 2023

Abstract

Purpose:
To examine over-the-counter pain medication use in pregnancy.

Study Design and Methods:
Secondary analysis of a weighted surveillance survey using the 2019 Iowa Pregnancy Risk Assessment Monitoring System (PRAMS) data. A sample of 759 pregnant women of childbearing age from Iowa was weighted to represent 31,728 Iowa mothers. The weighted sample represents 80% non-Hispanic White mothers, with smaller percentages of Hispanic (10%) mothers and non-Hispanic Black (7%) mothers, consistent with the population of Iowa. Approximately two-thirds of women had commercial insurance (66%), some college or greater education (62%), and were from urban areas (59%).

Analysis:
Descriptive statistics were calculated. Variables include over-the-counter pain reliever usage among all respondents and by race/ethnicity and education level.

Results:
Seventy-six percent of women reported taking over-the-counter pain relievers during pregnancy. Of these, 71% reported taking acetaminophen, 11% reported taking ibuprofen, 8% aspirin, and 3% naproxen. Nearly 80% of non-Hispanic White mothers reported taking an over-the-counter pain reliever during pregnancy compared to just 64% of mothers reported as Hispanic. Iowa mothers with a college education or greater were more likely to report over-the-counter pain reliever use during pregnancy (84%) than their counterparts with a high school education or less (64%).

Clinical Implications:
Some medications may cause harm to the fetus if taken at specific time during pregnancy. Reinforcement of current pain medication education, including risks to fetus throughout pregnancy may be needed.
The Oral Microbiome Throughout Pregnancy
Authors: Koerner Rebecca , Prescott Stephanie , Alman Amy , Duffy Allyson , Groer Maureen 
Published: June 2023

Abstract

Introduction:
Oral health is associated with systemic health, including adverse pregnancy outcomes. Understanding the oral microbiome during pregnancy may lead to targeted interventions for prevention of adverse outcomes. The purpose of this review is to examine the literature on the oral microbiome throughout pregnancy.

Methods:
We conducted a literature search with four electronic databases for original research conducted between 2012 and 2022 that examined the oral microbiome longitudinally using 16s rRNA sequencing during pregnancy.

Results:
We identified six studies that examined the oral microbiome longitudinally throughout pregnancy, though comparisons of oral niches, oral microbiome measures, and findings between studies were not consistent. Three studies identified alterations in alpha diversity throughout pregnancy and two studies identified increased pathogenic bacteria during pregnancy. Three studies reported no changes in the oral microbiome throughout pregnancy, and one study identified differences in the composition of the microbiome based on socioeconomic status and antibiotic exposure. Two studies examined adverse pregnancy outcomes in association with the oral microbiome, one reporting no associations and one reported difference in community gene composition in those diagnosed with preeclampsia.

Clinical Implications:
There is limited research on the composition of the oral microbiome throughout pregnancy. There may be alterations in the oral microbiome during pregnancy such as increased relative abundance of pathogenic bacteria. Socioeconomic status, antibiotic use, and education may contribute to differences in the microbiome composition over time. Clinicians should evaluate oral health and educate on the importance of oral health care during the prenatal and perinatal time period.
Accommodation in Children after 4.7 Years of Multifocal Contact Lens Wear in the BLINK Study Randomized Clinical Trial
Authors: Chandler Moriah A. , Robich Matthew L. , Jordan Lisa A. , Mutti Donald O. , Berntsen David A. , Fenton Rachel , Day Elizabeth , Walline Jeffrey J. ,   for the BLINK2 Study Group
Published: June 2023

ABSTRACT

Significance
When worn for myopia control in children, soft multifocal contact lenses with a + 2.50 D add reduced the accommodative response over a three-year period, but wearing them for over four years did not affect accommodative amplitudes, lag, or facility.

Purpose
To compare the accommodative response to a 3 D stimulus between single vision, +1.50 D add, and + 2.50 D add multifocal contact lens wearers during three years of contact lens wear, then to compare accommodative amplitude, lag, and facility between the three groups after an average of 4.7 years of wear.

Methods
Seven- to 11-year-old BLINK Study participants were randomly assigned to wear single vision, +1.50 D add, or + 2.50 D add soft contact lenses (CooperVision, Pleasanton, CA). The accommodative response to a 3 D stimulus was measured at baseline and annually for three years. After 4.7 years, we measured objective accommodative amplitudes, lead/lag, and binocular facility with ±2.00 D flippers. We compared the three accommodative measures using multivariate analysis of variance, adjusting for clinic site, sex, and age group (7-9 or 10-11 years).

Results
The +2.50 D add contact lens wearers exhibited lower accommodative response than the single vision contact lens wearers for three years, but the +1.50 D add contact lens wearers only exhibited lower accommodative response than the single vision contact lens wearers for two years. After adjustment for clinic site, sex, and age group, there were no statistically significant or clinically meaningful differences between the three treatment groups for accommodative amplitude (MANOVA, P = .49), accommodative lag (MANOVA, P = .41), or accommodative facility (MANOVA, P = .87) after an average of 4.7 years of contact lens wear.

Conclusions
Almost five years of multifocal contact lens wear did not affect the accommodative amplitude, lag, or facility of children.
Trends in COVID-19 Vaccine Hesitancy and Uptake Among Persons Living With HIV in Washington, DC
Authors: Castel Amanda D. , Barth Shannon , Wilbourn Brittany C. , Horberg Michael , Monroe Anne K. , Greenberg Alan E. ,   On behalf of the DC Cohort Executive Committee
Published: June 2023

Objective:
The COVID-19 pandemic has disproportionately affected older people, people with underlying health conditions, racial and ethnic minorities, socioeconomically disadvantaged, and people living with HIV (PWH). We sought to describe vaccine hesitancy and associated factors, reasons for vaccine hesitancy, and vaccine uptake over time in PWH in Washington, DC.

Methods:
We conducted a cross-sectional survey between October 2020 and December 2021 among PWH enrolled in a prospective longitudinal cohort in DC. Survey data were linked to electronic health record data and descriptively analyzed. Multivariable logistic regression was performed to identify factors associated with vaccine hesitancy. The most common reasons for vaccine hesitancy and uptake were assessed.

Results:
Among 1029 participants (66% men, 74% Black, median age 54 years), 13% were vaccine hesitant and 9% refused. Women were 2.6–3.5 times, non-Hispanic Blacks were 2.2 times, Hispanics and those of other race/ethnicities were 3.5–8.8 times, and younger PWH were significantly more likely to express hesitancy or refusal than men, non-Hispanic Whites, and older PWH, respectively. The most reported reasons for vaccine hesitancy were side effect concerns (76%), plans to use other precautions/masks (73%), and speed of vaccine development (70%). Vaccine hesitancy and refusal declined over time (33% in October 2020 vs. 4% in December 2021, P < 0.0001).

Conclusions:
This study is one of the largest analyses of vaccine hesitancy among PWH in a US urban area highly affected by HIV and COVID-19. Multilevel culturally appropriate approaches are needed to effectively address COVID-19 vaccine concerns raised among PWH.
Defining Biliary Hyperkinesia and the Role of Cholecystectomy
Authors: Kartik Akash , Jorge Irving A , Webb Christopher , Lim Elisabeth S , Chang Yu-Hui , Madura James 
Published: June 2023

BACKGROUND:
Functional gallbladder disorder is most commonly defined by biliary colic and low ejection fraction (EF) on cholescintigraphy. Biliary hyperkinesia is a controversial type of functional gallbladder disorder, and its definition and the role of cholecystectomy in treating functional gallbladder disorder remains unclear.

STUDY DESIGN:
We conducted a retrospective review of patients who underwent cholecystokinin-stimulated cholescintigraphy and cholecystectomy at 3 Mayo Clinic sites between 2007 and 2020. Eligible patients were 18 years or older, presented with symptoms of biliary disease, had an EF greater than 50%, underwent cholecystectomy, and had no evidence of acute cholecystitis or cholelithiasis on imaging. We used receiver operating characteristics curve analysis to identify the optimal cutoff value that predicted symptom resolution within 30 days of cholecystectomy.

RESULTS:
A total of 2,929 cholecystokinin-stimulated cholescintigraphy scans were performed during the study period; the average EF was 67.5% and the median EF was 77%. Analyzing those with EFs greater than or equal to 50% yielded 1,596 patients with 141 (8.8%) going on to have cholecystectomy. No significant differences were found in age, sex, BMI, final pathology between patients with and without pain resolution. Using a cutoff EF of 81% was significantly associated with pain resolution after cholecystectomy (78.2% for EF greater than or equal to 81% vs 60.0% for EF less than 81%, p = 0.03). Chronic cholecystitis was found in 61.7% of the patients on final pathology.

CONCLUSIONS:
We determined that an EF cutoff of 81% is a reasonable upper limit of normal gallbladder EF. Patients with biliary symptoms and an EF greater than 81% but no evidence of biliary disease on ultrasound or scintigraphy can be classified as having biliary hyperkinesia. Based on our findings, we recommend cholecystectomy for this patient population.
Osteoarticular tuberculosis of the ankle, a rare localization: a case report
Authors: Malihy Zakaria , Benaissa Elmostafa , Ben Lahlou Yassine , Maleb Adil , Elouennass Mostafa 
Published: June 2023

Tuberculosis is a real scourge, posing a real public health problem in countries where the disease is endemic. Osteoarticular tuberculosis represents 2% to 5% of all tuberculosis cases and 11% to 15% of extra-pulmonary tuberculosis cases. Involvement of the foot and ankle is rarer. We report the case of osteoarticular tuberculosis of the ankle in a 71-year-old patient with type 2 diabetes and hypertension who presented to the trauma department of the Mohammed V Military Hospital with a painful swelling of the ankle. Standard X-rays and CT scan of the ankle showed inflammatory involvement of the bone and joints. Antitubercular antibiotic therapy was instituted for nine months. Given the context of endemicity, any atypical presentation of lingering bone lesions should raise the suspicion of osteoarticular tuberculosis in order to ensure early therapeutic management.
Combining a prioritization strategy and functional studies nominates 5’UTR variants underlying inherited retinal disease
Authors: Rey Alfredo Dueñas , del Pozo Valero Marta , Bouckaert Manon , Van Den Broeck Filip , Varela Malena Daich , Van Heetvelde Mattias , De Bruyne Marieke , Van de Sompele Stijn , Bauwens Miriam , Ellingford Jamie , Lenaerts Hanne , Mahieu Quinten , Josifova Dragana ,   Genomics England Research Consortium, Rivolta Carlo , Webster Andrew , Arno Gavin , Ayuso Carmen , De Zaeytijd Julie , Leroy Bart P. , De Baere Elfride , Coppieters Frauke 
Published: June 2023

AbstractBackground5’ untranslated regions (5’UTRs) are essential modulators of protein translation. Predicting the impact of 5’UTR variants is challenging and typically not performed in routine diagnostics. Here, we present a combined approach of a comprehensive prioritization strategy and subsequent functional assays to evaluate 5’UTR variation in two large cohorts of patients with inherited retinal diseases (IRDs).MethodsWe performed an isoform-level re-analysis of retinal RNA-seq data to identify the protein-coding transcripts of 378 IRD genes with highest expression in retina. We evaluated the coverage of these 5’UTRs by different whole exome sequencing (WES) capture kits. The selected 5’UTRs were analyzed in whole genome sequencing (WGS) and WES data from IRD sub-cohorts from the 100,000 Genomes Project (n = 2,417 WGS) and an in-house database (n = 1,682 WES), respectively. Identified variants were annotated for 5’UTR-relevant features and classified into 7 distinct categories based on their predicted functional consequence. We developed a variant prioritization strategy by integrating population frequency, specific criteria for each category, and family and phenotypic data. A selection of candidate variants underwent functional validation using diverse experimental approaches.ResultsIsoform-level re-quantification of retinal gene expression revealed 76 IRD genes with a non-canonical retina-enriched isoform, of which 20 display a fully distinct 5’UTR compared to that of their canonical isoform. Depending on the probe-design 3-20% of IRD genes have 5’UTRs fully captured by WES. After analyzing these regions in both IRD cohorts we prioritized 11 (likely) pathogenic variants in 10 genes (ARL3,MERTK,NDP,NMNAT1,NPHP4,PAX6,PRPF31,PRPF4,RDH12,RD3), of which 8 were novel. Functional analyses further supported the pathogenicity of 2 variants. TheMERTK:c.-125G>A variant, overlapping a transcriptional start site, was shown to significantly reduce both luciferase mRNA levels and activity. TheRDH12:c.-123C>T variant was foundin ciswith the reported hypomorphicRDH12:c.701G>A (p.Arg234His) variant in 11 patients. This 5’UTR variant, predicted to introduce an upstream open reading frame, was shown to result in reduced RDH12 protein but unaltered mRNA levels.ConclusionsThis study demonstrates the importance of 5’UTR variants implicated in IRDs and provides a systematic approach for 5’UTR annotation and validation that is applicable to other inherited diseases.