bluuebunny/crossref_metadata_2025_split huggingface dataset:
Minority Adolescent Mental Health Diagnosis Differences in a National Sample
Authors: Martin Raquel , Banaag Amanda , Riggs David S , Koehlmoos Tracey P 
Published: July 2022

ABSTRACT

Introduction
Mental health disparities and differences have been identified amongst all age groups, including adolescents. However, there is a lack of research regarding adolescents within the Military Health System (MHS). The MHS is a universal health care system for military personnel and their dependents. Research has indicated that the MHS removes many of the barriers that contribute to health disparities. Additional investigations with this population would greatly contribute to our understanding of disparities and health services delivery without the barrier of access to care.

Materials and Methods
This study analyzed the diagnostic trends of anxiety, depression, and impulse control disorders and differences within a national sample of adolescents of active-duty military parents. The study utilized 2006 to 2014 data in the MHS Data Repository for adolescents ages 13–18. The study identified 183,409 adolescents with at least one diagnosis. Multivariable logistic regressions were conducted to assess the differences and risks for anxiety, depression, and impulse control disorders in the identified sample.

Results
When compared to White Americans, minority patients had a higher likelihood of being diagnosed with an impulse control disorder (odds ratio [OR] = 1.43; confidence interval [CI] 1.39–1.48) and a decreased likelihood of being diagnosed with a depressive disorder (OR = 0.98; CI 0.95–1.00) or anxiety disorder (OR = 0.80; CI 0.78–0.83). Further analyses examining the subgroups of minorities revealed that, when compared to White Americans, African American adolescents have a much higher likelihood of receiving a diagnosis of an impulse control disorder (OR = 1.66; CI 1.61–1.72) and a lower likelihood of receiving a diagnosis of a depressive disorder (OR = 0.93; CI 0.90–0.96) and an anxiety disorder (OR = 0.75; CI 0.72–0.77).

Conclusion
This study provides strong support for the existence of race-based differences in adolescent mental health diagnoses. Adolescents of military families are a special population with unique experiences and stressors and would benefit from future research focusing on qualitative investigations into additional factors mental health clinicians consider when making diagnoses, as well as further exploration into understanding how best to address this special population’s mental health needs.
Secondary CNS myeloma with remission after systemic CNS-penetrating agents
Authors: Fernandez Luis G , Oyon Daniel Eduardo , Gondi Vinai , Grimm Sean , Khan Osaama H 
Published: July 2022

AbstractBackgroundCNS myeloma is a rare manifestation of multiple myeloma and is often associated with a dismal prognosis; however, cases are increasing in frequency as overall survival improves for MM. There is currently no standardized treatment for CNS myeloma; however, different chemotherapy and radiotherapy regimens have been described.MethodsWe had previously reported on the efficacy of proton-based craniospinal irradiation in a patient with CNS myeloma; here we present a patient with a history of extramedullary plasmacytoma, 10 years in remission status post standard systemic chemotherapy, with biopsy-proven CNS myeloma successfully treated with systemic chemotherapy as a first-line treatment.ResultsThe patient achieved clinical and radiographic remission on 2 separate occasions with systemic chemotherapy alone.ConclusionsThis case demonstrates that systemically administered agents may have activity in CNS myeloma. Further investigations are necessary to establish the optimal combination of agents and treatment schedules.
Evaluation of the association between plasma glucose-dependent insulinotropic polypeptide, respiratory quotient, and intramuscular fat deposition in feedlot cattle fed different levels of dry matter intake
Authors: Ortiz-Fraguada M Y , Relling A E 
Published: July 2022

Abstract
The objectives of this trial were to evaluate the association between different levels of dry matter intake (DMI) on gas exchange, plasma glucose-dependent insulinotropic polypeptide (GIP) concentration, and intramuscular (IM) fat deposition. We used 60 individually fed backgrounded Angus × SimAngus-crossbred steers (n = 30) in a randomized complete block design. Steers (paired by body weight [BW] and gain to feed ratio [G:F]) were randomly allocated to one of the following treatments: ad libitum intake (AI) or restricted intake (RI; the same diet fed at 85% of the AI) of a finishing diet. The diet contained 61% cracked corn, 9% corn silage, 15% distillers’ dried grains with solubles, 5% soyhulls, and 10% of a protein-mineral-vitamin premix. Measurements of CO2 emission and consumption of O2, and respiratory quotient (RQ) were taken using the GreenFeed system (n = 15/treatment). Plasma and gas samples were collected 10 d before slaughter, 1 h before and 2 h after feeding. Plasma glucose, non-esterified fatty acids, GIP, and insulin concentration and gasses (O2, CO2, and RQ) were analyzed using the MIXED procedure of SAS evaluating the fixed effect of treatment, time (repeated measurement) and their interaction, and the random effect of the block. Final BW and carcass characteristics were analyzed with a similar model, without the time statement and its interaction. Compared with RI, AI steers had greater (P &lt; 0.01) DMI and average daily gain (ADG). Steers on AI had greater final BW (P = 0.02), tended to have a greater ribeye area (P = 0.09), and had lower plasma GIP concentration (P = 0.04). There was no treatment effect (P ≥ 0.11) on G:F, subcutaneous backfat (BF), and IM fat, O2 consumption, CO2 emission, and RQ. Plasma glucose concentration of AI steers was greater before and after feeding than RI (P &lt; 0.05). In conclusion, feeding steers ad libitum increased DMI, ADG, and plasma glucose and GIP concentration but does not affect G:F, BF, IM fat, CO2 emission, and O2 consumption. Plasma GIP concentration and RQ are not associated with IM fat deposition.
Defining Objective Measures of Physician Stress in Simulated Critical Communication Encounters
Authors: Wolfe Amy H. J. , Hinds Pamela S. , du Plessis Adre J. , Gordish-Dressman Heather , Arnold Robert M. , Soghier Lamia 
Published: July 2022

OBJECTIVES:
This study had three aims: 1) quantify the difference in stress levels between low and high stress roles during simulated critical communication encounters using objective physiologic data (heart rate variability [HRV]) and subjective measures (State-Trait Anxiety Inventory [STAI]), 2) define the relationship between subjective and objective measures of stress, and 3) define the impact of trainee preparedness and reported self-efficacy on stress levels.

DESIGN:
Mixed methods simulation-based study.

SETTING:
Single center.

PATIENTS:
Pediatric critical care fellows and faculty (n = 12).

INTERVENTIONS:
Subjects participated in six simulated scenarios in both high stress “hot seat” and low stress “observer” roles.

MEASUREMENTS AND MAIN RESULTS:
Subjective stress was measured using the STAI at baseline and after each scenario. Objective stress was measured continuously using a wearable biometric device measuring HRV. Previous residency communication training and self-confidence surrounding various communication topics were collected via questionnaire. Significant changes in subjective (STAI) and objective stress (HRV) measurements in the low- versus high-stress roles were observed. STAI scores increased 8 points during low stress and 12 points during high stress role (p = 0.021) compared with baseline. Two specific HRV markers, root mean square of successive differences between normal heartbeats, a marker of parasympathetic tone, and the low frequency/high frequency (LF/HF) ratio, a marker of sympathetic activation, were significantly correlated with STAI levels (–0.032, p = 0.001; 1.030, p = 0.002, respectively). Participants who reported increased confidence in discussing code status had a significant decrease in stress response (measured via LF/HF ratio) during both the observer (p = 0.033) and hot seat roles (p = <0.001).

CONCLUSIONS:
Communicating life-altering news in a simulated environment is a stressful experience. This stress results in physiologic changes that can be measured continuously using HRV. HRV measurement may serve as a novel method in evaluating the effectiveness of communication training programs and measuring future stress-reduction interventions.
Postintensive Care Syndrome-Family Associated With COVID-19 Infection
Authors: Shirasaki Kasumi , Hifumi Toru , Isokawa Shutaro , Hashiuchi Shinsuke , Tanaka Shinobu , Yanagisawa Yaeko , Takahashi Osamu , Otani Norio 
Published: July 2022

OBJECTIVES:
To assess the prevalence of and risk factors for postintensive care syndrome in family (PICS-F) in the COVID-19 era.

DESIGN:
A single-center retrospective study using questionnaires and telephone calls.

SETTING:
An ICU at St. Luke’s International Hospital.

PATIENTS:
Patients who were treated for COVID-19–related acute respiratory distress syndrome between March 23, 2020, and September 30, 2021, and their family members participated.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
PICS-F refers to the psychologic distress such as anxiety, depression, and posttraumatic stress disorder (PTSD) experienced by the patient’s family. The primary outcome was PICS-F occurrence. Furthermore, factors related to PICS-F development were identified using statistical analysis. Of 85 patients with COVID-19 who were admitted to the ICU, 57 family members consented to the study and completed the survey, and 54 family members’ data were analyzed. The median age of family members was 53.5 years, 68.5% were female, and 46.3% were spouses. The median age of patients was 55.5 years, and 83.3% were male. During their ICU stay, 68.5% received invasive mechanical ventilation, 11.1% received venovenous extracorporeal membrane oxygenation, and 11.1% underwent tracheostomy. The median ICU and hospital stays were 7 and 22 days, respectively. Overall PICS-F occurred in 33%. Anxiety, depression, and PTSD occurred in 24%, 26%, and 4% of family members, respectively. The prevalence of all three components of PICS-F was 4%. Multivariable analysis showed that Family Satisfaction with the ICU Survey (FS-ICU) scores were independently associated with PICS-F development (odds ratio, 0.941; 95% CI, 0.891–0.983; p = 0.005).

CONCLUSIONS:
One-third of family members of COVID-19 patients admitted to the ICU had symptoms of PICS-F. These results suggest that measurement of FS-ICU may be helpful as a predictor of PICS-F development. In addition, increasing the level of ICU care satisfaction of the family members may prevent PICS-F.
A Review of Pathologic Myopia
Authors: Raval Nilesh , Kang Joann J. , Kim Yu Hyon 
Published: July 2022

Abstract:
Pathologic myopia is a leading cause of vision loss worldwide and is most prevalent in developed nations in East and Southeast Asia. Although the pathophysiologic mechanisms behind pathologic myopia have yet to be elucidated, the process is thought to stem from excessive axial elongation of the globe and subsequent degeneration of vital structures within the posterior segment. The array of complications that arise from this condition can lead to significant visual impairment. The purpose of this article is to review the classification, pathophysiology, complications, and management of pathologic myopia.
Course Prerequisites: Here, There, and Everywhere. Time to Standardize?
Authors: Snyder Jennifer , Brown Darwin , Quincy Brenda 
Published: July 2022

Introduction
This study’s aim was to examine prerequisite course requirements and compare them to previous studies with a secondary aim to examine potential differences relative to program characteristics.

Methods
Data were extracted from the websites of 265 entry-level physician assistant (PA) programs from October 2020 until December 2020. Course prerequisites as well as number of courses and semester hours required were described and examined according to program location, phase, Carnegie Classification, association with a medical school, and the public/private status of the sponsoring institution.

Results
Of 264 PA programs, more than 50% of programs required 6 common prerequisites: anatomy, physiology, microbiology, statistics, general chemistry, and psychology. The total number of unique prerequisite courses was 28 for all programs with a reduction in humanities and social sciences semester hours compared to previous studies and a slight increase in credit hours required for the common 6 courses. Total prerequisite hours and courses required were higher for master’s programs; private, not-for-profit programs; newly established programs; and those not associated with a medical school. Newer programs are generally located in private, not-for-profit educational institutions that are not associated with a medical school. Programs in the Mountain Division required a lower number of prerequisites, and the South Region required the greatest number of prerequisite courses and semester hours.

Discussion
The present study demonstrates a difference in prerequisite requirements across the country. This could translate to increased cost and a potential barrier to those considering a career as a PA.
COVID Collaborations: A Physician Assistant Program and Health Department Partnership
Authors: Jones Quinnette , Blazar Melinda , Blackley Tara , Lyn Michelle J. , Johnson Frederick S. 
Published: July 2022

Abstract
The onset of the COVID-19 pandemic resulted in the displacement of clinical-phase medical learners across the country. Physician assistant (PA) and other health professions programs were challenged to innovate and offer alternate learning experiences that would meet students’ needs as future health care professionals. At the same time, local and state health departments were faced with quickly increasing their capacity for contact tracing and case investigation in response to the growing number of COVID-19 infections. Through a collaborative partnership based on the needs of the local health department and clinical-phase PA students, the Duke PA program developed an elective in which students served as contact tracers and case investigators. PA students provided over 1500 hours of contact tracing and case investigation support to the local health department. Qualitative review showed students gained a greater appreciation of the impact of social determinants of health, saw first-hand how the pandemic disproportionately affected communities of color, and increased their knowledge about the role of public health. The partnership between the PA program and the health department was mutually beneficial and established a foundation for future collaborative experiences that support both the community and the needs of health professions’ learners.
Bone marrow adiposity in diabetes and clinical interventions
Authors: Shu Jessica B. , Kim Tiffany Y. 
Published: July 2022

Purpose of review
This study aims to review bone marrow adipose tissue (BMAT) changes in people with diabetes, contributing factors, and interventions.

Recent findings
In type 1 diabetes (T1D), BMAT levels are similar to healthy controls, although few studies have been performed. In type 2 diabetes (T2D), both BMAT content and composition appear altered, and recent bone histomorphometry data suggests increased BMAT is both through adipocyte hyperplasia and hypertrophy. Position emission tomography scanning suggests BMAT is a major source of basal glucose uptake. BMAT is responsive to metabolic interventions.

Summary
BMAT is a unique fat depot that is influenced by metabolic factors and proposed to negatively affect the skeleton. BMAT alterations are more consistently seen in T2D compared to T1D. Interventions such as thiazolidinedione treatment may increase BMAT, whereas metformin treatment, weight loss, and exercise may decrease BMAT. Further understanding of the role of BMAT will provide insight into the pathogenesis of diabetic bone disease and could lead to targeted preventive and therapeutic strategies.
Understanding and Optimizing Family Caregiver Participation in Dyadic Research
Authors: Irani Elliane , Mogle Jacqueline , Durante Ángela , Juárez-Vela Raúl , Vellone Ercole , Buck Harleah G. 
Published: July 2022

Background
Research to understand self-care behaviors increasingly engages patient–caregiver dyads. However, collecting data on dyads requires both members to complete the research protocol, potentially resulting in biased information if caregivers who do not participate differ from caregivers who do.

Objectives
The aim of the study was to examine how recruitment conditions and patients’ appraisal of dyadic engagement in heart failure management are related to caregiver participation across two research studies.

Methods
We used logistic regression to examine whether recruitment strategy and patients’ responses on the dyadic symptom management-type instrument were associated with caregivers’ participation.

Results
Caregivers not present at the initial recruitment were less likely to participate in the study. Regardless of recruitment strategy, caregivers were less likely to participate if the patient indicated primary responsibility for heart failure management. In the restricted recruitment study (recruiting both dyad members simultaneously), caregiver participation was significantly higher when patients selected a collaborative-oriented care type relative to patient- or caregiver-oriented type.

Discussion
Instruments assessing dyad-level information could aid researchers in deploying resources at recruitment, as well as in adjusting results for data that could bias results and conclusions. Our findings support the importance of considering the recruitment strategy as well as dyadic care type as part of the recruitment process.
Comparison of thicknesses of talar cartilage, tibialis anterior, and gastrocnemius muscles between high-activity patients with unilateral traumatic transtibial amputation and nonamputated individuals: A clinical and sonographic study
Authors: Örücü Atar Merve , Bilgin Esra , Demir Yasin , Korkmaz Nurdan , Gürçay Eda 
Published: July 2022

Background:
The aim of this study was to compare the thicknesses of intact talar cartilage, tibialis anterior (TA), gastrocnemius medialis (GCM), and gastrocnemius lateralis (GCL) muscles of traumatic unilateral transtibial amputees with that of nonamputated individuals by ultrasound and to investigate the relationship between cartilage and muscle thickness measurements with clinical parameters.

Methods:
Thirty-six patients with unilateral traumatic transtibial amputation, and 36 age-matched, sex-matched, and body mass index–matched nonamputated controls were included in this cross-sectional study. Subjects’ talar cartilage, TA, GCM, and GCL muscle thickness measurements were performed using musculoskeletal ultrasound. Other outcome measures were 6-minute walking test, the Foot and Ankle Outcome Score, and Short Form-36.

Results:
TA and GCM muscles were thicker on the intact limbs of the patients than those of the controls (p = 0.015 and p = 0.014, respectively). There was no statistically significant difference in talar cartilage and GCL muscle thicknesses when patients were compared with control subjects. Talar cartilage thickness was positively correlated with body mass index, 6-minute walking test, and sport and recreation subscale score of the Foot and Ankle Outcome Score. TA and GCM muscle thicknesses were positively correlated with the duration of prosthesis use and role limitations because of the physical health subscale score of Short Form-36.

Conclusions:
TA and GCM muscles were found to be thickened on the intact sides of traumatic unilateral transtibial amputees. The correlations between lower leg muscle thicknesses and clinical parameters suggest that the observed thickness change is not necessarily pathological and has potential impact on function at least in our young cohort.
68Ga-FAPI-46 PET/CT in a Metastatic Castration-Resistant Prostate Cancer Patient With Low PSMA Expression
Authors: Aryana Kamran , Manafi-Farid Reyhaneh , Amini Hamidreza , Divband Ghasemali , Moghadam Soroush Zarehparvar 
Published: July 2022

Abstract
A 70-year-old man with mCRPC (metastatic castration-resistant prostate cancer) was referred for 68Ga-PSMA PET/CT for restaging and the possibility of targeted molecular radioligand therapy with 177Lu-PSMA. Numerous 68Ga-PSMA–avid skeletal metastases with low SUVs were noted. Because of low PSMA expression, a 68Ga-FAPI-46 PET/CT was performed to evaluate the eligibility for FAPI-based radioligand therapy. There were some discordant findings between 68Ga-PSMA and 68Ga-FAPI PET/CT scans regarding the detectability of lesions and SUVs. Our case signifies that 68Ga-FAPI theragnostic may have a potential role in the treatment of mCRPC patients with insignificant PSMA expression or in cases after the failure of 177Lu-PSMA therapy.
Diagnostic Test Accuracy of 18F-FDG PET or PET/CT in Merkel Cell Carcinoma
Authors: Shim Sung Ryul , Kim Seong-Jang 
Published: July 2022

Objective
The purpose of the current study was to evaluate the diagnostic accuracies of 18F-FDG PET or PET/CT for diagnosis of Merkel cell carcinoma (MCC) through a systematic review and meta-analysis.

Methods
The PubMed, Cochrane database, and EMBASE database, from January 1990 to January 31, 2022, were searched for studies evaluating diagnostic performance of 18F-FDG PET or PET/CT for MCC. We determined the sensitivities and specificities across studies, calculated positive and negative likelihood ratios (LR+ and LR−), and constructed summary receiver operating characteristic curves.

Results
Across 9 studies (259 patients), the pooled sensitivity of 18F-FDG PET or PET/CT was 0.91 (95% confidence interval [CI], 0.85–0.95) and a pooled specificity of 0.93 (95% CI, 0.86–0.97). Likelihood ratio syntheses gave an overall LR+ of 14.0 (95% CI, 6.6–29.6) and LR− of 0.09 (95% CI, 0.05–0.17). The pooled diagnostic odds ratio was 153 (95% CI, 57–416).

Conclusion

18F-FDG PET/CT showed an excellent performance for diagnosis of MCC. The likelihood ratio scattergram indicated that 18F-FDG PET or PET/CT is useful for exclusion and confirmation of MCC. Further large multicenter studies would be necessary to substantiate the diagnostic accuracy of 18F-FDG PET or PET/CT for MCC patients.