bluuebunny/crossref_metadata_2025_split huggingface dataset:
Typology of Family Relationships, Psychological Distress, and Quality of Life in Chinese Patients With Advanced Lung Cancer
Authors: Chen Jieling , Zhu Jingfen , Jian Hong , Zhao Yi , He Shanshan , He Yaping 
Published: January 2022

Background
Family relationships affect psychological adjustment and quality of life (QoL) in patients with advanced cancer. The typology of family relationships has not been examined in Chinese patients with advanced cancer.

Objective
The aims of this study were to identify profiles of family relationships and examine their relationships with psychological distress and QoL in Chinese patients with advanced lung cancer.

Methods
A total of 252 Chinese patients with advanced lung cancer at 2 hospitals in Shanghai participated in the study. They completed self-reported questionnaires. Latent profile analysis was used to identify the optimal classification of perceived family relationships based on 3 indicators (cohesiveness, expressiveness, and conflict resolution).

Results
Three profiles of family relationships were identified. The supportive profile (70.6%) showed high cohesiveness, expressiveness, and conflict resolution. The low-expressive profile (15.9%) showed low expressiveness but high cohesiveness and conflict resolution (15.9%). The conflictive profile (13.5%) showed low conflict resolution but high cohesiveness and expressiveness. Compared with supportive families, low-expressive and conflictive families were associated with worse depressive symptoms and anxiety symptoms, which could result in poorer QoL.

Conclusions
Cohesiveness, expressiveness, and conflict resolution could be used to identify family relationship typology in Chinese patients with advanced lung cancer. Family relationship typology was associated with psychological distress and QoL.

Implications for Practice
The findings indicate a need for screening families and provide culturally sensitive family interventions to effectively support families at risk of poor outcomes.
Molecular Surveillance and Prediction of Antimicrobial Resistance of Neisseria gonorrhoeae in Northern Alberta, Canada, 2015 to 2018
Authors: Pilkie Daralynn , Gratrix Jennifer , Sawatzky Pam , Martin Irene , Singh Ameeta , Prasad Errol , Naidu Prenilla , Mulvey Michael , Wong Tom , Smyczek Petra Andrea 
Published: January 2022

Background
The aims of this study was to describe molecular surveillance of Neisseria gonorrhoeae in the North Zone of Alberta (NZ) and to determine its value in predicting antimicrobial resistance.

Methods
Sequence types (STs) and single-nucleotide polymorphism (SNP) assays were performed on nucleic acid amplification testing (NAAT) samples. Sequence types of NAATs were matched to ST of cultures from across Alberta. Antimicrobial resistance prediction of NAATs for cephalosporins, azithromycin, and ciprofloxacin using SNP was compared with matching ST culture results using agar dilution and whole-genome sequencing.

Results
Of 2755 eligible specimens (2492 cases), 61.9% (1646 specimens) were sent for sequence typing, identifying 196 unique ST. Antimicrobial resistance data for 1307 additional cases were available using matching cultures. Decreased susceptibility (DS) to antimicrobials used for gonorrhea treatment was rare in the NZ; according to the SNP assay, none of the specimens had predicted DS to cephalosporins or azithromycin resistance. However, of the NZ NAAT samples tested in this study, 10.7% (131 of 1220) were predicted to have intermediate cephalosporin minimum inhibitory concentrations and 9.6% (115 of 1204) were resistant to ciprofloxacin. Based on cultures, the proportions of resistance in all of Alberta were as follows: DS to cephalosporins, 0.6% (20 of 3373); DS to intermediate cephalosporin, 16.9% (570 of 3373); azithromycin resistance, 1.2% (41 of 3373); and ciprofloxacin resistance, 32.2% (1087 of 3373).

Conclusions
Our results highlight our ability to use culture-independent methods to predict antimicrobial resistance in N. gonorrhoeae.
Coinfection With Chlamydial and Gonorrheal Infection Among US Adults With Early Syphilis
Authors: Dionne-Odom Jodie , Workowski Kimberly , Perlowski Charlotte , Taylor Stephanie N. , Mayer Kenneth H. , McNeil Candice J. , Hamill Matthew M. , Dombrowski Julia C. , Batteiger Teresa A. , Sena Arlene C. , Wiesenfeld Harold C. , Newman Lori , Hook Edward W. 
Published: January 2022

Abstract
Among 865 adults with early syphilis considered for a multicenter treatment trial, 234 (27%) were excluded before enrollment because of bacterial sexually transmitted infection coinfection. Coinfection with Neisseria gonorrhoeae (29%), Chlamydia trachomatis (22%), or both (23%) was common. Study findings highlight the need for comprehensive bacterial sexually transmitted infection screening in patients with syphilis.
How Much Do Parents Know About Pain in Their Children?
Authors: Escobar-Castellanos María , Míguez-Navarro María Concepción , García-Mancebo Julia , Fernández-Monteagudo Belén , Pascual-García Patricia , Guerrero-Márquez Gloria , Rivas-García Arístides 
Published: January 2022

Objectives
Adequate pain control is essential to the comprehensive management of pediatric patients within the emergency department.
The aim of this study is to evaluate parents' knowledge about pain in the pediatric population patient and secondarily describe erroneous concepts that can affect a correct children's pain management.

Methods
A single-center descriptive study of cross-sectional surveys was performed between October and December 2018, with a previously validated ad hoc and anonymous questionnaire consisting of 9 items. All parents/guardians participating in the study had a child aged 0 to 18 years who had been admitted to the emergency department.

Results
Sixty-nine percent (n = 315) were women, 49.9% (n = 226) had university degrees and only 11% (n = 50) had professions related to the healthcare system. A linear association was observed between the number of correct answers and the level of education (β = 1.04; 95% confidence interval, 0.76–1.32; P < 0.001), as well as between parents with professions related to the healthcare system compared with other professions (61.4% vs 51.2% with P = 0.005). The responses of Spanish parents offered better results than answers obtained from parents from the American continent (56.4% vs 41.4% with P < 0.001). No differences were observed between parents of children with chronic diseases.

Conclusions
In our study, we observed that a considerable percentage of parents hold misconceptions about how children express pain, and therefore, it would be necessary to encourage formation programs for parents to help identify, evaluate, and correctly treat pain in their children.
Ethical Issues in Medical Rehabilitation
Authors: Friedman Alan , Friedman Basil , Lutzky Lena , Friedman Elisha , Strous Rael D. , Treger Iuly 
Published: January 2022

Abstract
Ethical allocation of scare medical resources is a ubiquitous challenge in many, if not all, medical specialties. The field of physical medicine and rehabilitation is no exception and presents its own unique dilemmas. We report on a small inpatient rehabilitation unit at a large university medical center with a large catchment area representing a vast range of socioeconomic classes. The decision of whom to admit is a constant challenge. We review the existing literature regarding ethical considerations in rehabilitation department admission criteria and attempt to analyze criteria used to admit patients to a general physical medicine and rehabilitation ward. Finally, we discuss our medical center approach to the ethical dilemma of admission priority. A systemic search was conducted in six sources (PubMed, Google Scholar, ScienceDirect, Cochrane Library, LILACS, Embase). Searches were limited to English language articles with no date restriction, reflecting all available data. A reviewer applied the inclusion criteria to identify relevant articles.
This review highlights a number of important ethical issues in evaluation and selection criteria that may assist clinicians in improving selection procedures and standardizing access to inpatient rehabilitation. Further high-quality empirical studies and reviews of ethical admission practice with regard to rehabilitation acceptance are required.
Potential Role of Insulin-Like Growth Factors in Myofascial Pain Syndrome
Authors: Grosman-Rimon Liza , Vadasz Brian , Bondi Moshe , Cohen Marc , Santos Sara , Katz Joel , Clarke Hance , Singh Simranjit , Rimon Jordan , Kumbhare Dinesh , Eilat-Adar Sigal 
Published: January 2022

AbstractInsulin-like growth factors have diverse functions in skeletal muscles by acting through multiple signaling pathways, including growth regulation and differentiation, anti-inflammation, and antioxidation. Insulin-like growth factors have anti-inflammatory effects and also play roles in nociceptive pathways, determining pain sensitivity, in addition to their protective role against ischemic injury in both the nervous system and skeletal muscle. In skeletal muscle, insulin-like growth factors maintain homeostasis, playing key roles in maintenance, accelerating muscle regeneration, and repair processes. As part of their maintenance role, increased levels of insulin-like growth factors may be required for the repair mechanisms after exercise. Although the role of insulin-like growth factors in myofascial pain syndrome is not completely understood, there is evidence from a recent study that insulin-like growth factor 2 levels in patients with myofascial pain syndrome are lower than those of healthy individuals and are associated with increased levels of inflammatory biomarkers. Importantly, higher insulin-like growth factor 2 levels are associated with increased pain severity in myofascial pain syndrome patients. This may suggest that too low or high insulin-like growth factor levels may contribute to musculoskeletal disorder process, whereas a midrange levels may optimize healing without contributing to pain hypersensitivity. Future studies are required to address the mechanisms of insulin-like growth factor 2 in myofascial pain syndrome and the optimal level as a therapeutic agent.
What Do Rheumatology Patients Want in an After-Visit Summary? A Kano Analysis of Patient Preferences
Authors: Kumar Bharat , Zahn Carleigh , Seeman Lisa , Levins Lori , Davis Benjamin , Swee Melissa 
Published: January 2022

Background
After-visit summaries (AVS) are patient-specific documents curated by providers to summarize the content of medical encounters. Despite widespread use, little is known about rheumatology patient preferences for AVS content and style. The aims of this quality improvement project are to identify patient preferences and to design a rheumatology-specific AVS, using the Kano method.

Methods
This quality improvement project consists of 4 parts. First, investigators interviewed veterans and clinic staff to derive a list of potential features. Second, a Kano questionnaire assessing satisfaction with the presence or absence of each feature was distributed to veterans. Third, qualitative and quantitative Kano analyses were performed to categorize features as mandatory, performance, attractive, or indifferent. Fourthly, based on these findings, an AVS was drafted and distributed to Veterans with an associated survey to assess satisfaction with content, visual appeal, and readability.

Results
Nine physicians, 5 veterans, 5 schedulers, 3 nurses, and 3 medical assistants identified 15 features for inclusion in a Kano-style questionnaire. The questionnaire was distributed to 50 Veterans using consecutive sampling. Quantitative Kano analysis demonstrated 4 mandatory, 2 performance, and 3 attractive features that were ultimately included in the AVS; 6 indifferent features were excluded. A postintervention survey of 50 Veterans showed high satisfaction scores in AVS content (4.3/5), visual appeal (4.6/5), and readability (4.4/5).

Conclusions
We developed an AVS that included 9 mandatory, attractive, and performance features, as identified by the Kano method. Veterans were highly satisfied by the content, visual appeal, and readability of the AVS.
Proportionate Cardiovascular Mortality in Chronic Inflammatory Disease in Adults in the United States From 1999 to 2019
Authors: Shah Nischay N. , Wass Sojin , Hajjari Jamal , Heisler Andrew C. , Malakooti Shahdi , Janus Scott E. , Al-Kindi Sadeer G. 
Published: January 2022

Background
Despite a rising prevalence of chronic inflammatory disease (CID), the recent trends in cardiovascular disease (CVD) mortality of patients with CID is scarce. In this study, we investigated patterns of CVD mortality in systemic lupus erythematosus (SLE), inflammatory bowel disease (IBD), and rheumatoid arthritis (RA) compared with the general population.

Methods
We used the 1999 to 2019 multiple causes of death files from the national center for health statistics to analyze patterns and trends of proportionate CVD mortality in CID compared with the general population.

Results
We analyzed a total of 11,154 CVD deaths in IBD, 58,337 CVD deaths in RA, 6227 CVD deaths in SLE, and 17,826,871 CVD deaths in the general population. Between 1999 and 2019, we found that proportionate CVD mortality decreased significantly in the IBD group (25% to 16%), RA group (34% to 25%), and the general population (41% to 31%), but did not change for the SLE group (15% to 15%). Patients with SLE who died of CVD were approximately 10 years younger compared with CVD decedents with RA, IBD, or general population. The White population had higher proportionate CVD mortality than African American (IBD [19% vs 16%–18%] and SLE [14%–16% vs 12–14%], respectively).

Conclusions
This study identifies current trends in CVD mortality in the CID population and elucidates current demographics in CVD mortality in CID. Although proportionate CVD mortality decreased in the general population, and in patients with RA and IBD, there was no change among patients with SLE. Further studies are needed to elucidate these differences.
Factors Associated With Participation in Clinical Trials Among Patients With Lupus
Authors: Harry Onengiya , Langefeld Carl D. , Crosby Lori E. , Modi Avani C. 
Published: January 2022

Background/Objective
Participation rates for clinical trials, including lupus trials, in the United States are low, but are even lower for underrepresented minorities. The impact of underrepresentation in trials can be far-reaching and is problematic because female subjects of color with lupus experience greater morbidity and mortality. As such, the overarching goal of this study was to characterize the factors that influence participation in lupus clinical trials.

Methods
The Lupus and Allied Diseases Association, the Lupus Foundation of America, and the Lupus Research Alliance collected data for their externally led Patient-Focused Drug Development Initiative—for the purpose of understanding and improving the rates of participation in lupus-related clinical trials. Participants completed a 46-question survey (in English or Spanish) electronically or on paper, which was distributed online or at lupus events. Logistic regression was used to test whether demographic and disease characteristics were associated with participation in past lupus trials.

Results
Data were available for 2220 respondents. Black respondents with lupus were more likely, than their White and Hispanic counterparts, to have participated in past clinical trials (p < 0.05). Although not statistically significant, Hispanic respondents were also more likely to have participated than their White counterparts (odds ratio, 1.40; 95% confidence interval, 0.96–2.11). Both demographic (ie, race/ethnicity) and medical (ie, disease severity defined as more organ involvement) factors seem to be important determinants of participation in clinical trials (p < 0.05).

Conclusions
Combining the results from this study and prior research provides insight into recruitment strategies to increase participation rates of historically underrepresented minorities.
New Biomarkers With Prognostic Impact Based on Multitracer PET/CT Imaging in Neuroendocrine Neoplasms
Authors: Delgado Bolton Roberto C. , Calapaquí Terán Adriana K. , Fanti Stefano , Giammarile Francesco 
Published: January 2022

Abstract
The search for new biomarkers in cancer is currently one of the most widely sought end points in medical imaging, with the aim of improving the management decisions based on reliable indicators of prognosis, being neuroendocrine neoplasms a challenging group of tumors under investigation. Multitracer PET/CT imaging, in which different radiotracers supply information of different metabolic aspects of the tumor, can help classify and select the most appropriate therapy, providing basic aspects that will probably allow the generation of new imaging biomarkers useful in patient management.
Hybrid PET/MRI in Staging Endometrial Cancer
Authors: Ironi Gabriele , Mapelli Paola , Bergamini Alice , Fallanca Federico , Candotti Giorgio , Gnasso Chiara , Taccagni Gian Luca , Sant'Angelo Miriam , Scifo Paola , Bezzi Carolina , Bettinardi Valentino , Rancoita Paola Maria Vittoria , Mangili Giorgia , Bocciolone Luca , Candiani Massimo , Gianolli Luigi , De Cobelli Francesco , Picchio Maria 
Published: January 2022

Aim
The assessment of deep myometrial invasion (MI) and lymph node involvement is of utmost importance in the preoperative staging of endometrial cancer (EC). Imaging parameters derived respectively from MRI and PET have shown good predictive value. The main aim of the present study is to assess the diagnostic performance of hybrid 18F-FDG PET/MRI in EC staging, with particular focus on MI and lymphnodal involvement detection.

Patients and Methods
Prospective monocentric study including 35 patients with biopsy-proven EC undergoing preoperative 18F-FDG PET/MRI (December 2018–March 2021) for staging purpose. Histological examination was the reference standard. PET (SUVmax, SUVmean with a threshold of 40% of SUVmax–SUVmean40, metabolic tumor volume, total lesion glycolysis) and MRI (volume index [VI], total tumor volume, tumor volume ratio [TVR], mean apparent diffusion coefficient, minimum apparent diffusion coefficient) parameters were calculated on the primary tumor, and their role in predicting EC risk group, the presence of lymphovascular space invasion (LVSI), and MI was assessed. Receiver operating characteristics analysis was used to assess the predictive value of PET and MRI parameters on EC characteristics.

Results
Patients' median age was 66.57 years (SD, 10.21 years). 18F-FDG PET/MRI identified the primary tumor in all patients. Twenty-two of 35 patients had high-risk EC and 13/35 low-risk disease; 13/35 presented LVSI, 22/35 had deep MI at histological examination, and 13/35 had p53 hyperexpression.
PET/MRI was able to detect lymphnodal involvement with high accuracy and high specificity (sensitivity of 0.8571, specificity of 0.9286, accuracy of 0.9143), also showing a high negative predictive value (NPV) for lymphnodal involvement (NPV of 0.9630, positive predictive value [PPV] of 0.7500).
The assessment of deep MI using PET/MRI correctly staged 27 patients (77.1%; sensitivity of 0.7273, specificity of 0.8462, accuracy of 0.7714), with also a good PPV (PPV of 0.8889, NPV of 0.647).
MRI-derived total tumor volume, VI, and TVR were significant in predicting EC groups (high-risk vs low-risk patients) (P = 0.0059, 0.0235, 0.0181, respectively). MRI-derived volume, VI, TVR, and PET-derived metabolic tumor volume and total lesion glycolysis were able to predict LVSI (P = 0.0023, 0.0068, 0.0068, 0.0027, 0.01394, respectively). Imaging was not able to predict grading, presence of deep MI, nor hyperexpression of p53.

Conclusions

18F-FDG PET/MRI has good accuracy in preoperative staging of EC; PET and MRI parameters have synergic role in preoperatively predicting LVSI, with MRI parameters being also predictive for EC risk group.
Duodenal Ulcer-Induced Gastric Outlet Obstruction Showing Pyloric Wall Thickening and Abnormal FDG Uptake Mimicking Malignancy
Authors: Ji Xia , Dong Aisheng 
Published: January 2022

Abstract
Peptic ulcer disease is the most common benign cause of gastric outlet obstruction, in which mechanical obstruction occurs in the distal stomach, pylorus, or duodenum. We describe a case of gastric outlet obstruction induced by duodenal ulcer showing irregular pyloric wall thickening with marked enhancement on contras-enhanced CT and increased FDG uptake of the pyloric wall on FDG PET/CT mimicking malignancy.
Salvage Procedures for Facial Reanimation With Neurovascular Flaps When Previous Surgeries Failed
Authors: Ibarra Gorka , Lasso Jose M. 
Published: January 2022

Background
Facial paralysis reconstruction can be difficult in extensive defects after complex facial or cranial base tumor resection and radiotherapy or when primary smile reanimation attempt has failed. The surgical challenge is more complicated when defects are associated with recipient vessels or nerves depletion. This scenario has not been well described in the literature, and the present article will address the alternatives that plastic surgeons may use in these circumstances.

Methods
Seventy-five patients operated in the Hospital Gregorio Marañon between 2008 and 2020, for dynamic reconstruction of facial paralysis, were retrospectively evaluated, collecting data about previous facial nerve surgeries, radiotherapy, chemotherapy, recipient nerve for motor restoration and vessels used for free flaps, type of neurovascular free flap (NVFF), and functional score before and after the facial reanimation surgery. Patients presenting recipient vessel and/or nerve depletion after several facial surgeries requiring a variation from the common NVFF surgical protocol were included in this study.

Results
Six cases (8%) with facial paralysis and absent recipient homolateral vessels or nerves after severe cranial base surgery, parotid malignancies, or schwannoma surgery were included. Two patients had an immediate functional reconstruction during the oncologic resection surgery, and 4 patients had a delayed reconstruction. Three patients had previous reconstruction with free flaps, and the vascular pedicles of previous flaps were used for the new NVFF. In the other 3 cases, interposition vein grafts to the contralateral recipient vessels were required to perform NVFF. Masseteric nerve in 4 cases, hypoglossal nerve and posterior branch of the deep temporal nerve in 1 case each, were used as recipient nerves. House-Brackmann score improved in all patients after surgery.

Conclusions
Neurovascular free flap can be successfully performed to restore facial motion after depletion of homolateral recipient vessels or nerves after previous facial or cranial base surgeries. In these cases, interposition vascular grafts or the pedicle of previous flaps are essential to provide vascularization as well as an optimal orientation of flaps, to reach recipient nerves in a 1-step procedure.