bluuebunny/crossref_metadata_2025_split huggingface dataset:
Protocol and Outcome Evaluation of Comprehensive Outpatient Treatment of Adolescent Rumination Syndrome
Authors: Lamparyk Katherine , Stephens Taylor N. 
Published: June 2022

Objectives:
Rumination syndrome (RS) is an increasingly recognized functional gastrointestinal condition with limited treatment research. Current treatment recommendations emphasize diaphragmatic breathing (DB), despite limited outcomes, and the most robust results have originated from inpatient treatment models. This paper described the protocol for Comprehensive Behavioral Treatment for Rumination Syndrome (CBT-R) utilized in an outpatient setting and evaluation of preliminary outcomes.

Methods:
The CBT-R protocol is described in detail, grounded in behavioral theory and phased treatment approach to symptom elimination. The treatment is evaluated via a retrospective case series design of pediatric patients (aged 8–18) with a primary diagnosis of RS treated in an outpatient setting by a pediatric psychologist.

Results:
Twenty-eight patients met inclusion criteria and are included in intent-to-treat analysis, with 23 patients evaluated for outcomes (47.8% female, Mage = 14.3; SD = 2.8). Sample included 17.4% with comorbid psychiatric diagnosis and 43.5% with comorbid medical diagnoses. Outcome results demonstrate improvement for a majority of patients (87.0%), with most demonstrating complete resolution of symptoms (73.9%). Treatment length varied significantly, ranging from 1 to 22 visits (M = 4.8, SD = 5.4) and was complicated by necessary admission or supplemental nutrition in 21.7% of patients. Psychological factors were related to poor treatment outcomes and longer treatment duration.

Conclusions:
CBT-R results in positive treatment outcomes for majority of patients, with most patients demonstrating complete resolution of symptoms, providing a superior outpatient treatment option for some pediatric patients. Sample characteristics challenge previous understanding of RS as female dominated and with high levels of psychiatric comorbidity.
Improved 30-Day Heart Failure Readmissions Following Implementation of an Advanced Cardiovascular Education (ACE) Academy
Authors: Oliver Beth , Travis Arlene , Hughes Ellen , Condrat Lindsay , Ullman Jennifer , Cohen Bevin , Cartwright Frances 
Published: June 2022

Background:
Heart failure readmissions are common, though some are preventable through evidence-based management.

Local Problem:
Despite outperforming national benchmarks for 30-day readmissions, compliance with an evidence-based institutional heart failure management pathway was inconsistent. The purpose of this project was to reduce 30-day heart failure readmission rates through an educational intervention and an electronic health record (EHR) redesign.

Methods:
The cardiac services nursing leadership team conducted an education and documentation needs assessment to identify knowledge gaps and practical barriers to effective utilization of evidence-based interventions for heart failure management.

Interventions:
This intervention included an Advanced Cardiovascular Education (ACE) Academy and an EHR workflow redesign for clinical and supportive nursing staff.

Results:
The 30-day heart failure readmission rates reduced immediately following the intervention, and rates continued to decrease over a 3-year follow-up.

Conclusions:
Even among hospitals outperforming national benchmarks, 30-day heart failure readmissions can be reduced and sustained with enhanced education and EHR redesign.
SARS-CoV–Related Pandemic Outbreaks and Mental Disorder Risk
Authors: Deng Xiangling , He Mengyang , Zhang Jinhe , Huang Jinchang , Luo Minjing , Zhang Zhixin , Niu Wenquan 
Published: June 2022

Abstract
This study aimed to quantify the association between exposure to pandemic outbreaks and psychological health via a comprehensive meta-analysis. Literature retrieval, study selection, and data extraction were completed independently and in duplicate. Effect-size estimates were expressed as odds ratio (OR) with 95% confidence interval (CI). Data from 22 articles, involving 40,900 persons, were meta-analyzed. Overall analyses revealed a significant association of exposing to SARS-CoV–related pandemics with human mental health (OR, 1.32; 95% CI, 1.24–1.40; p < 0.001). Subgroup analyses showed that anxiety (OR, 1.37; 95% CI, 1.19–1.58; p < 0.001), depression (OR, 1.28; 95% CI, 1.15–1.42; p < 0.001), posttraumatic stress (OR, 1.36; 95% CI, 1.17–1.58; p < 0.001), and psychological distress (OR, 1.25; 95% CI, 1.11–1.40; p < 0.001) were all obviously related to pandemic diseases. In the context of infectious disease outbreaks, the mental health of general populations is clearly vulnerable. Therefore, all of us, especially health care workers, need special attention and psychological counseling to overcome pandemic together.
Clinical Course in Patients With Melancholic and Nonmelancholic Bipolar Depression
Authors: Martino Diego J. , Valerio Marina P. , Lomastro Julieta , Igoa Ana 
Published: June 2022

Abstract
The aim of the current study was to compare the longitudinal clinical course of patients with a history of melancholic and nonmelancholic bipolar depression. Seventy-seven euthymic outpatients with bipolar disorder were categorized as melancholic or nonmelancholic through the clinician-rated Sydney Melancholia Prototype Index. Clinical course was assessed for a period longer than 48 months by time spent ill, density of affective episodes, severity and duration of depressive episodes, and time to depressive recurrence. The mean follow-up time was 69.05 months. Patients with melancholic depressions had more severe and longer depressive episodes during follow-up, whereas patients with nonmelancholic depressions had a shorter time to depressive recurrence and more subsyndromal depressive symptoms and affective instability. These findings highlight the heterogeneity inherent to the current construct of bipolar depression and position melancholia as an interesting target for comparison with nonmelancholic depressions in other external validators in the field of bipolar disorder.
New Screening Strategy Combining Anal Papanicolaou and Human Papillomavirus Tests for Human Papillomavirus–Related Anal Cancer: A Prospective, Single-Center Study
Authors: Pisano Luigi , Grandi Vieri , Tiradritti Luana , Zuccati Giuliano , Caminati Filippo , Giani Iacopo , Bisanzi Simonetta , Matucci Marzia , Carozzi Francesca , Pimpinelli Nicola , Elbetti Claudio 
Published: June 2022

Background
The objective of this study was to evaluate the performance of a combined approach of liquid-based anal cytology and human papillomavirus (HPV) testing in predicting patients who should undergo high-resolution anoscopy for the early detection of anal cancer and anal intraepithelial neoplasia (AIN)-2+.

Methods
We conducted a prospective single-center quality improvement study. We consecutively enrolled men who had sex with men (MSM) attending our sexually transmitted disease clinic to undergo anal Papanicolaou (Pap) and HPV tests. All patients with an abnormal anal Pap test result and/or positive HPV test result underwent high-resolution anoscopy.

Results
We enrolled 217 MSM, 80 HIV-positive patients, and 137 HIV-negative patients. Cytology showed a sensitivity of 100%, a specificity of 64.1%, an accuracy of 66.7%, a positive predictive value (PPV) of 15.7%, and a negative predictive value (NPV) of 100% for the detection of AIN-2+. The high-risk (HR)-HPV test showed sensitivity, specificity, accuracy, PPV, and NPV of 100%, 36.4%, 40%, 9.4%, and 100%, respectively. The combination of abnormal cytology with identification of infection by at least 1 HR-HPV strain on the HPV test had a sensitivity of 100%, a specificity of 73%, an accuracy of 74.6%, a PPV of 19.1%, and an NPV of 100%.

Conclusion
Anal HR-HPV testing, complementary to cytology, improves the diagnostic accuracy of screening for anal cancer.
“Malignant Mesenchymoma” Revisited
Authors: Yu Sanhong , Hornick Jason L. 
Published: June 2022

Leiomyosarcoma (LMS) is the most common sarcoma in adults. Rarely, LMS dedifferentiates into an undifferentiated sarcoma. Very few cases of LMS with heterologous osteosarcomatous differentiation (OS) have been reported. The purpose of this study was to evaluate the clinicopathologic features of LMS with OS. Of 5570 LMS cases diagnosed from 2006 to 2022, 15 cases (0.2%) of LMS with OS were identified, affecting 13 females and 2 males; ages ranged from 32 to 66 years (median: 53 y). Ten tumors arose in the uterus, 2 in the retroperitoneum, and 1 each in the mesentery, mediastinum, and rectum. Primary tumors ranged from 7 to 20 cm (mean: 16 cm). The LMS components showed conventional spindle cell morphology in most cases; 3 cases showed marked pleomorphism; 3 cases contained an epithelioid component; and 1 case showed myxoid features. In 5 cases OS was identified in the primary tumor, whereas in 10 cases OS was first detected in metastases. One metastatic and 2 primary LMS showed both OS and chondrosarcomatous differentiation. Prominent osteoclastic giant cells were seen in the OS components in 11 cases. Mitotic activity ranged from 17 to 61/10 HPF with tumor necrosis in 10 cases. Twelve patients developed metastases; sites included lungs, diaphragm, kidney, adrenal glands, colon, small intestine, liver, bone, and pancreas. At last follow-up, 8 patients had died of disease, and 4 patients were alive with metastases. The interval between OS and death ranged from 3 weeks to 18 months (median: 6.5 mo). Development of OS in LMS is exceptionally rare. This form of heterologous differentiation may occur in both primary tumors and metastases. LMS with OS is highly aggressive with poor outcomes. Awareness of this phenomenon is important to avoid misdiagnosis as osteosarcoma.
Using Machine Learning to Examine Suicidal Ideation After TBI: A TBI Model Systems National Database Study
Authors: Fisher Lauren B. , Curtiss Joshua E. , Klyce Daniel W. , Perrin Paul B. , Juengst Shannon B. , Gary Kelli W. , Niemeier Janet P. , Hammond Flora McConnell , Bergquist Thomas F. , Wagner Amy K. , Rabinowitz Amanda R. , Giacino Joseph T. , Zafonte Ross D. 
Published: June 2022

Abstract

Objective
To predict suicidal ideation one year after moderate to severe traumatic brain injury (TBI).

Design
Cross-sectional design with data collected through the prospective, longitudinal TBI Model Systems (TBIMS) network at hospitalization and one year after injury. Participants who completed the Patient Health Questionnaire-9 (PHQ-9) suicide item at year one follow-up (N = 4,328) were included.

Results
A gradient boosting machine (GBM) algorithm demonstrated the best performance in predicting suicidal ideation one year after TBI. Predictors were PHQ-9 items (except suicidality), Generalized Anxiety Disorder-7 (GAD-7) items, and a measure of heavy drinking. Results of the 10-fold cross-validation GBM analysis indicated excellent classification performance with an AUC of 0.882. Sensitivity was 0.85, and specificity was 0.77. Accuracy was 0.78 (95% CI: 0.77 – 0.79). Feature importance analyses revealed that depressed mood and guilt were the most important predictors of suicidal ideation, followed by anhedonia, concentration difficulties, and psychomotor disturbance.

Conclusions
Overall, depression symptoms were most predictive of suicidal ideation. Despite the limited clinical impact of the present findings, machine learning has potential to improve prediction of suicidal behavior, leveraging electronic health record data, to identify individuals at greatest risk, thereby facilitating intervention and optimization of long-term outcomes following TBI.
How to Report Data on Bilateral Procedures and Other Issues with Clustered Data: The CLUDA Reporting Guidelines
Authors: Hemmingsen Mathilde N. , Nygaard Caroline M. T. , Kaufmann Anna , Weltz Tim K. , Larsen Andreas , Forman Julie L. , Wiberg Sebastian , Vester-Glowinski Peter , Ørholt Mathias , Herly Mikkel 
Published: June 2022

Background:
Research in plastic surgery often includes bilateral procedures. This gives rise to issues with clustered data. Clustering is when individual data points within a data set are internally related. However, many authors do not account for clustering within their data, which can lead to incorrect statistical conclusions.

Methods:
In February of 2020, the authors searched PubMed to investigate the prevalence of reporting issues with bilateral breast procedures in plastic surgery literature. The review focused on breast surgery, as it often involves bilateral procedures and, therefore, clustering. Based on the review, the authors developed guidelines for how to identify and address clustered data. The guidelines were modified by a multidisciplinary group consisting of a biostatistician with expertise in clustered data at the Section of Biostatistics, University of Copenhagen, and three doctors (M.D.s and Ph.D.s) with expertise in statistical analysis and scientific methodology from the Copenhagen University Hospital, Rigshospitalet.

Results:
A total of 113 studies were included in the review. Seventy-five studies (66 percent) contained clustered data, but only eight studies (11 percent) took clustering into account in the statistical analysis. These results were used to develop the Clustered Data, or CLUDA, reporting guidelines which consist of two sections: one to identify clustering and one for reporting and analyzing clustered data.

Conclusions:
Clustered data are abundant in plastic surgery literature. The authors propose using the Clustered Data reporting guidelines to identify and report clustered data and consulting with a biostatistician when designing a study.
Research Promotion Is Associated with Broader Influence and Higher Impact of Plastic Surgery Publications
Authors: Boyd Carter J. , Bekisz Jonathan M. , Salibian Ara A. , Karp Nolan S. , Choi Mihye 
Published: June 2022

Background:
Social media have altered the mechanisms by which published research is disseminated and accessed. The objective of this study was to measure the effect of promotion on research article dissemination, influence, and impact in Plastic and Reconstructive Surgery.

Methods:
All articles published in Plastic and Reconstructive Surgery from January 1, 2016, to December 31, 2018, were obtained and reviewed to determine inclusion/exclusion and for the Altmetric Attention Score, citations, relative citation rate, and 16 unique promotional tags (e.g., journal club, editor’s pick, press release, patient safety, and so on) as indexed on the Plastic and Reconstructive Surgery website. The analysis included 1502 articles. Statistical analysis was completed using descriptive statistics, Pearson correlations, and t tests where appropriate with a predetermined level of significance of p ≤ 0.05.

Results:
A total of 637 articles (42.4 percent) had a promotional tag, whereas 252 (16.8 percent) had multiple tags. Articles with promotional tags had a higher Altmetric Attention Score (30.35 versus 8.22; p < 0.001), more citations (11.96 versus 8.47; p < 0.001), and a higher relative citation rate (2.97 versus 2.06; p < 0.001) compared to articles without a tag. Articles with multiple tags had a higher Altmetric Attention Score (50.17 versus 17.39; p < 0.001), more citations (15.78 versus 9.47; p < 0.001), and a higher relative citation rate (3.67 versus 2.51; p < 0.001) compared to articles with only one tag. As the number of tags increased for an article, Altmetric Attention Score (p < 0.001), citation count (p < 0.001), and relative citation rate (p < 0.001) likewise increased.

Conclusion:
This analysis strongly suggests that promotion of research articles is associated with significantly wider dissemination, broader visibility, and more subsequent citations in the literature.
Factors Related to Neuropathic Pain following Lower Extremity Amputation
Authors: Lans Jonathan , Groot Olivier Q. , Hazewinkel Merel H. J. , Kaiser Philip B. , Lozano-Calderón Santiago A. , Heng Marilyn , Valerio Ian L. , Eberlin Kyle R. 
Published: June 2022

Background:
Lower extremity amputations are common, and postoperative neuropathic pain (phantom limb pain or symptomatic neuroma) is frequently reported. The use of active treatment of the nerve end has been shown to reduce pain but requires additional resources and should therefore be performed primarily in high-risk patients. The aim of this study was to identify the factors associated with the development of neuropathic pain following above-the-knee amputation, knee disarticulation, or below-the-knee amputation.

Methods:
Retrospectively, 1565 patients with an average follow-up of 4.3 years who underwent a primary above-the-knee amputation, knee disarticulation, or below-the-knee amputation were identified. Amputation levels for above-the-knee amputations and knee disarticulations were combined as proximal amputation level, with below-the-knee amputations being performed in 61 percent of patients. The primary outcome was neuropathic pain (i.e., phantom limb pain or symptomatic neuroma) based on medical chart review. Multivariable logistic regression was performed to identify independent factors associated with neuropathic pain.

Results:
Postoperative neuropathic pain was present in 584 patients (37 percent), with phantom limb pain occurring in 34 percent of patients and symptomatic neuromas occurring in 3.8 percent of patients. Proximal amputation level, normal creatinine levels, and a history of psychiatric disease were associated with neuropathic pain. Diabetes, hypothyroidism, and older age were associated with lower odds of developing neuropathic pain.

Conclusions:
Neuropathic pain following lower extremity amputation is common. Factors influencing nerve regeneration, either increasing (proximal amputations and younger age) or decreasing (diabetes, hypothyroidism, and chronic kidney disease) it, play a role in the development of postamputation neuropathic pain.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Risk, III.
Predictive Risk Model for Serious Falls Among Older Persons Living With HIV
Authors: Womack Julie A. , Murphy Terrence E. , Leo-Summers Linda , Bates Jonathan , Jarad Samah , Smith Alexandria C. , Gill Thomas M. , Hsieh Evelyn , Rodriguez-Barradas Maria C. , Tien Phyllis C. , Yin Michael T. , Brandt Cynthia A. , Justice Amy C. 
Published: June 2022

Background:
Older (older than 50 years) persons living with HIV (PWH) are at elevated risk for falls. We explored how well our algorithm for predicting falls in a general population of middle-aged Veterans (age 45–65 years) worked among older PWH who use antiretroviral therapy (ART) and whether model fit improved with inclusion of specific ART classes.

Methods:
This analysis included 304,951 six-month person-intervals over a 15-year period (2001–2015) contributed by 26,373 older PWH from the Veterans Aging Cohort Study who were taking ART. Serious falls (those falls warranting a visit to a health care provider) were identified by external cause of injury codes and a machine-learning algorithm applied to radiology reports. Potential predictors included a fall within the past 12 months, demographics, body mass index, Veterans Aging Cohort Study Index 2.0 score, substance use, and measures of multimorbidity and polypharmacy. We assessed discrimination and calibration from application of the original coefficients (model derived from middle-aged Veterans) to older PWH and then reassessed by refitting the model using multivariable logistic regression with generalized estimating equations. We also explored whether model performance improved with indicators of ART classes.

Results:
With application of the original coefficients, discrimination was good (C-statistic 0.725; 95% CI: 0.719 to 0.730) but calibration was poor. After refitting the model, both discrimination (C-statistic 0.732; 95% CI: 0.727 to 0.734) and calibration were good. Including ART classes did not improve model performance.

Conclusions:
After refitting their coefficients, the same variables predicted risk of serious falls among older PWH nearly and they had among middle-aged Veterans.
Rheinheimera maricola sp. nov., isolated from seawater of the Yellow Sea
Authors: Kim Kyung Hyun , Baek Ju Hye , Wenting Ruan , Jeon Che Ok 
Published: June 2022

A Gram-negative and facultative aerobic strain, designated as strain MA-13T, was isolated from seawater in the Yellow Sea Republic of Korea. Cells were oxidase- and catalase-positive and non-motile short rods. Growth of strain MA-13T was observed over a range of 10–37 °C (optimum, 30 °C), pH 6.0–11.0 (optimum, pH 7.0) and in the presence of 0–5.5 % (w/v) sodium chloride (optimum, 1.0–2.0 %). Strain MA-13T contained ubiquinone-8 as the respiratory quinone, phosphatidylethanolamine, an unidentified aminolipid, an unidentified phospholipid and four unidentified lipids as major polar lipids and C16 : 0, C12 : 0 3-OH and summed feature 3 (C16 : 1
ω7c and/or C16 : 1
ω6c) as major cellular fatty acids. The G+C content of the genomic DNA was 48.3 mol%. Phylogenetic analyses based on the 16S rRNA gene and whole-genome sequences revealed that strain MA-13T formed a distinct phyletic lineage in the genus

Rheinheimera

. Strain MA-13T was most closely related to

Rheinheimera lutimaris

YQF-2T,

Rheinheimera aquimaris

SW-353T,

Rheinheimera pacifica

KMM 1406T and

Rheinheimera baltica

DSM 14885T with 98.10, 98.08, 98.07 and 97.94 % 16S rRNA gene sequence similarities. Average nucleotide identity and DNA–DNA hybridization values between strain MA-13T and

R. aquimaris

KCTC 12840T,

R. pacifica

DSM 17616T and

R. baltica

DSM 14885T were 76.3, 78.6 and 76.9 % and 19.5, 21.3 and 20.5 %, respectively. Based on the phenotypic, chemotaxonomic and molecular features, strain MA-13T represents a novel species of the genus

Rheinheimera

, for which the name Rheinheimera maricola sp. nov. is proposed. The type strain is MA-13T (=KACC 22113T=JCM 34600T).
State-dependent protein-protein interactions mediating 4-1BB CAR Signaling
Authors: Ritmeester-Loy Samuel A. , Lautz Jonathan D , Zhang-Wong Yue , Gustafson Joshua , Wilson Ashley , Lin Chenwei , Gafken Philip R. , Jensen Michael C , Orentas Rimas , Smith Stephen E.P. 
Published: June 2022

AbstractCells rely on activity-dependent protein-protein interactions to convey biological signals, but the state-dependent interactome is notoriously cell-specific and undercharacterized1. In the case of chimeric antigen receptor (CAR) T cells containing a 4-1BB costimulatory domain, receptor engagement is thought to trigger the formation of protein complexes similar to those triggered by T cell receptor (TCR)-mediated signaling, but the number and type of protein-interaction-mediating binding domains differ between CARs and TCRs. Here, we performed co-immunoprecipitation mass spectrometry of a 2ndgeneration CD19-directed 4-1BB:zeta CAR (referred to as bbζCAR) and identified 67 proteins that increased their co-association after target engagement. We compared activity-induced TCR and CAR signalosomes using quantitative multiplex co-immunoprecipitation and showed that bbζCAR engagement leads to activation of two modules of protein interactions, one similar to TCR signaling that is more weakly engaged in bbζCAR vs. TCR, and one composed of TRAF signaling complexes that is not engaged by the TCR. Batch-to-batch and inter-individual variations in IL2 production correlated with differences in the magnitude of protein network activation. Future CAR T cell manufacturing protocols could measure, and eventually control, biological variation by monitoring these signalosome activation markers.One Sentence SummaryWe define a network of protein interactions engaged by chimeric antigen receptors following target binding, and show that the magnitude of network activation correlates with IL-2 secretion, a proxy measure for CAR T cell function.