bluuebunny/crossref_metadata_2025_split huggingface dataset:
Use of biologics to treat relapsing and/or refractory polyarteritis nodosa: data from a European collaborative study
Authors: Hadjadj Jérome , Canzian Alice , Karadag Omer , Contis Anne , Maurier François , Sanges Sébastien , Sartorelli Silvia , Denis Laure , de Moreuil Claire , Durel Cécile-Audrey , Durupt Stéphane , Jachiet Marie , Rouzaud Diane , Salvarani Carlo , Padoan Roberto , Dagna Lorenzo , Bonnet Fabrice , Agard Christian , Moulinet Thomas , Hermet Marion , Sterpu Raluca , Maria Alexandre Thibault Jacques , Keraen Jérémy , Guillevin Loic , Jayne David , Terrier Benjamin 
Published: June 2022

Abstract

Objectives
To describe the effectiveness and safety of biologics for the treatment of relapsing and/or refractory polyarteritis nodosa (PAN).

Methods
A retrospective European collaborative study was conducted in patients with PAN who received biologics for relapsing and/or refractory disease.

Results
Forty-two patients with PAN received a total of 53 biologic courses, including TNF-α blockers in 15 cases, rituximab (RTX) in 18 cases, tocilizumab (TCZ) in 10 cases and other biologics in 10 cases. TNF-α blockers and TCZ were mainly used for refractory diseases whereas RTX was mainly initiated for relapsing disease. After a median follow-up of 29 (8–50) months, remission, partial response, treatment failure and treatment discontinuation due to severe adverse events occurred in, respectively, 40%, 13%, 40% and 7% of patients receiving TNF-α blockers, 50%, none, 30% and 20% of TCZ recipients, and 33%, 11%, 56% and none of the RTX recipients. No remission was noted in patients treated with other biologics. Severe adverse events were observed in 14 (28%) patients without significant differences between the three biologics, leading to early biologics discontinuation in only three cases.

Conclusion
These results suggest that TCZ may be effective in relapsing and/or refractory PAN. Our data warrant further study to confirm these findings.
White-coat effect on orthostatic hypotension: a nationwide survey of Japanese general practitioners
Authors: Yuasa Shohei , Yamamoto Hareaki , Suzuki Yoshiro , Chin Keiichi , Ukai Hiroshi , Kobayashi Yusuke , Yano Yuichiro , Mori Hisao 
Published: June 2022

Objective
The relationship between the white-coat effect (WCE), defined as white-coat hypertension under treatment, and the frequency of orthostatic hypotension (OH) is not known. We conducted an orthostatic test in patients with WCE to determine the frequency of OH.

Methods
This was a cross-sectional study of 5631 patients with hypertension visiting general practitioners nationwide, in which 4305 patients with hypertension recorded their home blood pressure (BP) and consented to the orthostatic test. Patients with hypertension were divided into four groups: controlled hypertension (CHT), masked hypertension (MHT), sustained hypertension (SHT), and WCE. The orthostatic test was performed, and BP and pulse rate were measured immediately and 1 min after orthostasis.

Results
The OH frequencies immediately after standing in CHT, WCE, SHT, and MHT patients were 7, 11.7, 12.1, and 6.6%, respectively, and those at 1 min after standing were 7.1, 13.1, 11.6 and 6.9%, respectively (Chi-square test, P < 0.01, respectively). Logistic regression analysis was performed to examine the relationship between WCE and the frequency of OH. The frequency of OH immediately after standing was significantly increased [adjusted odds ratio (AOR), 1.702; 95% confidence interval (CI), 1.246–2.326; P < 0.01]. The frequency of OH at 1 min after standing was also significantly higher (AOR, 1.897; 95% CI, 1.396–2.578; P < 0.01).

Conclusion
When the standing test was performed for patients with WCE, the frequency of OH increased. Thus, it is important to recognize the possibility of OH in patients with WCE to avoid adverse events associated with excessive hypotension.
Spirituality as a Mediator Between Social Support and Benefit Finding Among Advanced Cancer Patients
Authors: Rong Huan , Yin Min , Ren Pan , Li Yanjun , Qu Haimei , Chen Xiaoju 
Published: June 2022

Background
Social support and benefit finding (BF) are important for cancer patients. The relationship between social support and BF has not been studied sufficiently in patients with advanced cancer, and the mechanism through which social support might influence BF is unclear.

Objective
This study aimed to investigate the relationship between social support and BF in Chinese patients with advanced cancer as mediated by their perceptions of spirituality.

Methods
This was a correlation study with a cross-sectional design. We recruited advanced-cancer patients (n = 208) from China. Patients’ sociodemographic and clinical characteristics were collected, and they were asked to complete the Benefit Finding Scale, the Multidimensional Scale of Perceived Social Support, and the Spiritual Attitude and Involvement List.

Results
Social support was associated with greater spirituality and greater BF (P < .01). Spirituality was positively correlated with BF (P < .01). Results from mediation analysis identified that both the indirect effect of social support on BF via spirituality (indirect effect, 0.268; 95% confidence interval, 0.147–0.419) and its direct effect on BF (direct effect, 0.233; 95% confidence interval, 0.031–0.429) were statistically significant, suggesting a partial mediatory effect of spirituality between social support and BF.

Conclusions
Our findings supported a positive association between social support and BF among Chinese advanced-cancer patients. The mediatory role of spirituality should provide a new perspective for augmentation of BF in these patients.

Implications for Practice
Interventions that help enhance social support and spirituality in patients with advanced cancer could facilitate their BF.
Analysis of Symptom Characteristics, Influencing Factors, and Their Predictive Value for Posttraumatic Stress Disorder in Nurses
Authors: Xue Mengxin , Yuan Yuan , Chen Hong , Dai Minghui , Sun Huiping , Qu Jiling , Zhou Ting , Zhou Jingxin , Qu Junchao , Bu Yuan , Ji Siqi , Hu Yicheng , Yao Zhenshuai , Feng Yanbing , Gu Xinyi , Liu Yongbing 
Published: June 2022

Abstract
Nurses often face a variety of nursing-related stresses, making them more prone to symptoms of posttraumatic stress disorder (PTSD). We aimed to explore symptom characteristics, influencing factors, and their predictive value for PTSD in nurses, so as to prevent the occurrence of PTSD in nurses. This was a cross-sectional study conducted in two tertiary hospitals in Yangzhou. A total of 1290 valid questionnaires were received in our study, and 190 nurses (14.7%) were positive for PTSD symptoms. The results show that individuals with higher scores on the Perceived Stress Scale-10 (PSS-10), Patient Health Questionnaire-15 (PHQ-15), Generalized Anxiety Disorder Scale-7 (GAD-7), and maladaptive cognitive emotion regulation strategies questionnaire (maladaptive CERS) were more likely to experience PTSD symptoms, whereas those with lower scores on the Perceived Social Support Scale (PSSS) were more likely to experience PTSD symptoms. Compared with the PSS-10, PHQ-15, and PSSS, GAD-7 and maladaptive CERS had higher predictive value. This study provided the optimal threshold of relevant factors that may have a positive effect on the prevention of PTSD symptoms. This has guiding implications for active prevention and intervention in some institutions.
Psychiatrists' Cognitive and Affective Biases and the Practice of Psychopharmacology: Why Do Psychiatrists Differ From One Another in How They View and Prescribe Certain Medication Classes?
Authors: Yager Joel , Ritvo Alexis D. , MacPhee Edward R. 
Published: June 2022

Abstract
Cognitive and affective biases impact clinical decision-making in general medicine. This article explores how such biases might specifically affect psychiatrists' attitudes and prescribing patterns regarding two medication classes (stimulants and benzodiazepines) and addresses related issues. To supplement personal observations, selective PubMed narrative literature searches were conducted using relevant title/abstract terms, followed by snowballing for additional pertinent titles. Acknowledging that there are many more types of biases, we describe and use clinical vignettes to illustrate 17 cognitive and affective biases that might influence clinicians' psychopharmacological practices. Factors possibly underlying these biases include temperamental differences and both preprofessional and professional socialization. Mitigating strategies can reduce the potentially detrimental impacts that biases may impose on clinical care. How extensively these biases appear, how they differ among psychiatrists and across classes of medication, and how they might be most effectively addressed to minimize harms deserve further systematic study.
Total Metacognitive Capacity Predicts Competitive Employment Acquisition Across 6 Months in Adults With Serious Mental Illness Receiving Psychiatric Rehabilitation Services
Authors: Kukla Marina , Faith Laura A. , Lysaker Paul H. , Wiesepape Courtney , Corbière Marc , Lecomte Tania 
Published: June 2022

Abstract
Deficits in metacognitive capacity are common among people with serious mental illness (SMI), although there is a gap in knowledge regarding how these impairments predict later functioning, especially employment. This study aimed to prospectively examine the relationship between metacognitive capacity and 6-month competitive employment attainment in adults with SMI who were participating in a study testing a cognitive behavioral therapy intervention added to supported employment services. Sixty-seven participants with complete data at baseline and the 6-month follow-up comprised the sample. Data were analyzed using stepwise logistic regression covarying for work history and study assignment. Results indicate that total metacognitive capacity at baseline significantly predicted employment acquisition at 6 months; the final model correctly classified 83.3% of participants who obtained work. In conclusion, these findings suggest that better overall metacognitive capacity may be key for future work functioning. Thus, interventions that target metacognitive capacity may lead to enhancements in community outcomes.
Epidemiological and Psychopharmacological Study About Off-Label Treatment in Child and Adolescent Psychiatric Emergencies
Authors: Minghetti Sara , Vannini Martina , Casula Laura , Asprea Martina , Gori Sara , Calvani Anna Maria , Pisano Tiziana 
Published: June 2022

Objective
The study used an epidemiological and pharmacological description of child and adolescent psychiatric emergencies (CAPEs), during which psychotropic medications are frequently administered as off-label therapies.

Methods
We retrospectively describe CAPE in 190 patients (mean age, 14.7 years) referring in the emergency department of a single tertiary center, from June 2016 to June 2018, focusing on off-label administration rate, most of all in emergency setting.

Results
An intrinsic fragility was observed in this population, where 28.4% of patients present a history of self-harm, 24.7% a concomitant neurodevelopmental disorder, and 17.3% a history of substance abuse. Psychomotor agitation was the most frequent referral reason, and it represents an unspecified clinical presentation of several conditions, while self-harm showed a stronger association with depressive disorders (55.2%).
Globally, 811 medications were administered both as baseline therapy (67.8% of off-label rate) and/or in the emergency setting, where the off-label rate raised to 78.3%. Benzodiazepines had the highest rate of off-label use (98.2% as baseline therapy, 92.9% in acute context). Nevertheless, in 83.5% cases of acute administrations, a singular oral benzodiazepine (mostly lorazepam) guaranteed psychomotor agitation resolution, with a lower rate of adverse effects in contrast with atypical antipsychotics.

Conclusions
Off-label drug use in CAPEs is a recurrent clinical practice. An international agreement about off-label drugs is crucial to obtain standard long-term pharmacoepidemiological, safety, and efficacy data. Pharmacological pediatric trials and international guidelines are also required to regulate pharmacological treatments of CAPEs, most of all in emergency settings.
Addition of Midthigh Circumference Improves Predictive Ability of Broselow Tape Weight Estimation
Authors: Saeed Wajeeha , Akbar Amber , Waseem Muhammad , Kuchinski Ann-Marie , Xu Hongyan , Gibson Robert W. 
Published: June 2022

Objectives
This study aimed to improve the accuracy of Broselow tape (BT) weight prediction by adding midthigh circumference (MTC) and to compare and standardize the methods for measuring MTC.

Methods
This prospective, observational study was conducted in a pediatric emergency department of a tertiary care children's hospital. Children up to 12 years of age presenting to emergency department were included. Children were excluded if obtaining the data would interfere with their acute management. The data collected included MTC, height, BT weight, and actual weight. Three models were built. Broselow tape–only model and MTC plus BT model used 2 methods for MTC measurements: visual approximation of thigh midpoint (visual MTC1) and Centers for Disease Control and Prevention (CDC)–defined method (CDC MTC2).

Results
A total of 430 children were enrolled during pre–coronavirus disease era. Of these, 234 were boys (54.4%) and 196 (45.6%) were girls. Data were categorized into children younger than 2 years (224 [52.1%]) and older than 2 years (206 [47.9%]). African American constituted 250 (58%); White, 136 (31%); and unspecified, 27 (6%). For the entire cohort, both models that included MTC were significantly better at weight prediction with larger adjusted R
2 (visual MTC1, 0.921; CDC MTC2, 0.928) and smaller root mean squared (RMSE) (visual MTC1, 2.70; CDC MTC2, 2.56) compared with BT-only model (adjusted R
2 = 0.843; RMSE, 3.80). Midthigh circumference plus BT models performed even better in children older than 2 years compared with BT-only model with adjusted R
2 (visual MTC1, 0.859; CDC MTC2, 0.872 vs 0.616) and RMSE (visual MTC1, 3.18; CDC MTC2, 3.03 vs 5.27).

Conclusions
The inclusion of MTC with BT resulted in a more accurate weight prediction in children especially greater than 2 years old. Midthigh circumference model using CDC-defined method was slightly better predictor of actual weight than visual approximation.
Peak age and performance trajectories in Para powerlifters
Authors: Severin Anna Cecilia , Baumgart Julia Kathrin , Haugen Thomas , Hogarth Luke 
Published: June 2022

Abstract

Objective
This study established the age-related performance trajectories in Para powerlifters, thereby presenting valuable information for athlete development.

Design
Data on athlete date-of-birth, body mass, and weight lifted in competition were analyzed for 2079 athletes between 1994 and 2019.

Results
Age-related performance trajectories showed that men and women lift their heaviest weights in competition at 36 and 41 years of age, respectively. This correspond to the mean age of competitors in the heaviest bodyweight categories at elite competitions (men 36 years, women 43 years), who were older than competitors in lighter bodyweight categories. It is possible that Para powerlifters ‘move up’ bodyweight categories as they get older and before lifting their heaviest weights in competition. High performing athletes lifted their heaviest weight in competition 2.6 years earlier than lower performing peers, and the best performances in most bodyweight categories were achieved by athletes between 31 and 35 years of age.

Conclusions
These results suggest that Para powerlifters should reach their peak performance in their early- to mid-thirties and before age-related changes to neural and hormonal processes impact muscular strength. This information can help coaches and athletes evaluate their strategies for achieving success in Para powerlifting.
The Impact of the Early COVID-19 Pandemic On Inpatient Clinical Experience for Physical Medicine and Rehabilitation Resident Physicians
Authors: Deo Prabhav , Sliwa James 
Published: June 2022

Abstract
The objective of this retrospective, observational study was to quantitatively study the impact of the early COVID-19 pandemic on the inpatient clinical experience of Physical Medicine and Rehabilitation (PM&R) resident physicians in an inpatient rehabilitation facility (IRF) setting. Inpatient clinical experience as evidenced by admissions, rehabilitation diagnosis, medical emergencies, acute care transfers, and resident work hours from January to June 2019 (pre-pandemic) were compared January to June 2020 (immediately before and during pandemic). There was a statistically significant decrease in the mean daily admissions in April 2020 and a significant increase in medically complex admissions in June 2020, reflective of medical patterns due to the pandemic. There was a decrease in mean work hours during the pandemic, but no statistically significant difference in admission rate of other rehabilitation diagnoses, medical emergencies or transfers to acute care. This study demonstrates no substantial pandemic related impact on inpatient clinical experience for PM&R residents in the studied program.
Teaching and Assessing Cognitive Competencies in Aesthetic and Plastic Surgery
Authors: Al-Halabi Becher , Vassiliou Melina , Gilardino Mirko 
Published: June 2022

Background:
Cognition, part of surgical competence, employs forward planning, error prevention, and orchestration of technical skills. Thus, an understanding of mental processes used by experts throughout patient care is essential to teaching such competencies. The authors’ study aimed to analyze and compare mental models of two distinct procedures in plastic surgery—breast augmentation and flexor tendon repair—to develop a framework to define cognitive competencies in plastic surgery aided by a review of the literature.

Methods:
Based on data from a priori cognitive task analyses, literary sources, and field observations of breast augmentation surgery and flexor tendon repair, task lists were produced for each procedure. Two mental models were developed using fuzzy logic cognitive maps to visually illustrate and analyze cognitive processes used in either procedure. A comparison of the models aided by literature was used to define the cognitive competencies employed, identify differences in the decision-making process, and provide a guiding framework for understanding cognitive competencies.

Results:
Five distinct cognitive competency domains were identified from the literature applicable to plastic surgery: situation awareness, decision-making, task management, leadership, and communication and teamwork. Differences in processes of decision-making utilized between an elective and a trauma setting were identified. A framework to map cognitive competencies within a generic mental model in surgical care was synthesized, and methods were suggested for training on such competencies.

Conclusion:
Cognitive competencies in different settings in plastic surgery are introduced using a comparative study of two mental models of distinct procedures to guide the teaching and assessment of such competencies.
Brief Report: Quantifiable Plasma Tenofovir Among South African Women Using Daily Oral Pre-exposure Prophylaxis During the ECHO Trial
Authors: Beesham Ivana , Mansoor Leila E. , Joseph Davey Dvora L. , Palanee-Phillips Thesla , Smit Jenni , Ahmed Khatija , Selepe Pearl , Louw Cheryl , Singata-Madliki Mandisa , Kotze Philip , Heffron Renee , Parikh Urvi M. , Wiesner Lubbe , Rees Helen , Baeten Jared M. , Beksinska Mags 
Published: June 2022

Background:
HIV endpoint–driven clinical trials provide oral pre-exposure prophylaxis (PrEP) as HIV prevention standard of care. We evaluated quantifiable plasma tenofovir among South African women who used oral PrEP during the Evidence for Contraceptive Options and HIV Outcomes (ECHO) Trial.

Methods:
ECHO, a randomized trial conducted in 4 African countries between 2015 and 2018, assessed HIV incidence among HIV-uninfected women, aged 16–35 years, randomized to 1 of 3 contraceptives. Oral PrEP was offered onsite as part of the HIV prevention package at the South African trial sites. We measured tenofovir in plasma samples collected at the final trial visit among women reporting ongoing PrEP use. We used bivariate and multivariate logistical regression to assess demographic and sexual risk factors associated with plasma tenofovir quantification.

Results:
Of 260 women included, 52% were ≤24 years and 22% had Chlamydia trachomatis at enrollment. At PrEP initiation, 68% reported inconsistent/nonuse of condoms. The median duration of PrEP use was 90 days (IQR: 83–104). Tenofovir was quantified in 36% (n = 94) of samples. Women >24 years had twice the odds of having tenofovir quantified vs younger women (OR = 2.12; 95% confidence interval = 1.27 to 3.56). Women who reported inconsistent/nonuse of condoms had lower odds of tenofovir quantification (age-adjusted OR = 0.47; 95% confidence interval = 0.26 to 0.83).

Conclusions:
Over a third of women initiating PrEP and reporting ongoing use at the final trial visit had evidence of recent drug exposure. Clinical trials may serve as an entry point for PrEP initiation among women at substantial risk for HIV infection with referral to local facilities for ongoing access at trial end.

Clinical trial number:
NCT02550067.
Revealing human sensitivity to a latent temporal structure of changes
Authors: Marković Dimitrije , Reiter Andrea M.F. , Kiebel Stefan J. 
Published: June 2022

AbstractPrecisely timed behaviour and accurate time perception plays a critical role in our everyday lives, as our well-being and even survival can depend on well-timed decisions. Although the temporal structure of the world around us is essential for human decision making, we know surprisingly little about how representation of temporal structure of our everyday environment impacts decision making. How does the representation of temporal structure affect our ability to generate well-timed decisions? Here we address this question by using a well-established dynamic probabilistic learning task. Using computational modelling, we found that human subjects’ beliefs about temporal structure are reflected in their choices to either exploit their current knowledge or to explore novel options. The model-based analysis illustrates a large within-group and within-subject heterogeneity. To explain these results, we propose a normative model for how temporal structure is used in decision making, based on the semi-Markov formalism in an active inference framework. We discuss potential key applications of the presented approach to the fields of cognitive phenotyping and computational psychiatry.