bluuebunny/crossref_metadata_2025_split huggingface dataset:
Examining the Factor Structure of an Adapted Posttraumatic Growth Inventory in a Sample of Childhood Cancer Survivors: A Brief Report
Authors: Stal Julia , Ramirez Cynthia N. , Huh Jimi , Tobin Jessica , Kim Yoonji , Miller Kimberly A. , Milam Joel E. 
Published: June 2022

Posttraumatic growth (PTG) represents positive changes following a trauma, crisis, and/or psychologically distressing event. Experiencing cancer can serve as a traumatic event for patients, resulting in life changes among survivors. Various PTG measures have been used to assess post-cancer change among childhood cancer survivors (CCS), but few have been evaluated for use in this population. This study examined the factor structure of an adapted, 11-item version of the Posttraumatic Growth Inventory (PTGI) among CCS. A randomly selected subgroup of participants ( N = 332) was selected from the Los Angeles Cancer Surveillance Program (mean age of 26.5 years at time of survey, mean age at diagnosis of 12 years, primarily male [53.6%], and Hispanic [51.5%]). Participants indicated the degree to which they experienced positive, negative, or no change in their life because of their cancer experience. An exploratory factor analysis (EFA) identified two factors: Appreciation of New Possibilities and Spiritual Change. The adapted, 11-item PTGI was deemed appropriate for use among CCS. Additional research is needed to confirm the use of the two-factor model with confirmatory factor analysis in an independent sample. Future research on PTG among CCS can consider spiritual change as a potential independent factor.
Postoperative Pneumolabyrinth Following the Middle Cranial Fossa Approach for Superior Semicircular Canal Dehiscence Repair, 2014‐2020
Authors: Yang Hong‐Ho , Lum Meachelle , Kaur Taranjit , Yang Isaac , Gopen Quinton S. 
Published: June 2022

AbstractObjectiveThe present study investigates risk factors and clinical outcomes of postoperative pneumolabyrinth following the middle cranial fossa approach for superior semicircular canal dehiscence repair, a complication that has not been documented previously.Study DesignRetrospective cohort study.SettingTertiary/quaternary care referral center.MethodsWe conducted a retrospective review of 332 middle cranial fossa procedures from 2014 to 2020 at a tertiary/quaternary care institution. Upon identifying pneumolabyrinth cases from postoperative computed tomography temporal bone scans, we conducted multivariable logistic regression analysis to explore demographic and clinical factors that were independently linked to this complication. We also compared the rates of postoperative symptoms among patients with different grades of pneumolabyrinth.ResultsWe identified 41 (12.3%) pneumolabyrinth cases. Patients with older age, higher preoperative pure tone average, and frank dehiscence were at higher risk for pneumolabyrinth. Furthermore, patients with pneumolabyrinth reported significantly higher rates of postoperative dizziness and exhibited significantly greater pure tone average and air‐bone gap postoperatively as compared with patients without pneumolabyrinth. Finally, higher‐grade pneumolabyrinth was associated with increased rates of postoperative hearing loss, and grade III pneumolabyrinth was associated with higher rates of postoperative tinnitus vs grade I and II cases.ConclusionPneumolabyrinth following the middle cranial fossa approach was associated with poor clinical outcomes, including dizziness and auditory impairment. Old age, high preoperative pure tone average, and frank dehiscence were risk factors for this complication. The highlighted parameters may be important to note when considering this approach as a treatment option and while monitoring postoperative recovery.
Starting a New Residency—The Early Years
Authors: Stanisce Luke 
Published: June 2022

AbstractThe social dimensions of residency are as essential as the scientific ones, particularly when starting a new program. Privileged to be the first‐ever trainee in a newly accredited residency program, this reflection details the particulars defining my experience. In an attempt to balance humility with accomplishment, the following offers unique observation and insight on the many aspects we all share in training, in the aim of contributing something meaningful to them.
Potential role of HBV DNA-induced CD8high T cell apoptosis in patients with systemic lupus erythematosus and rheumatoid arthritis
Authors: Wang Zifeng , Wang Fen , Ma Haiyang , Lv Shujuan 
Published: June 2022

Objective To investigate the potential role of hepatitis B virus (HBV) DNA-induced CD8high T cell apoptosis in patients with systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA). Methods The activity and HBV seropositivity rates of patients with SLE and RA were determined. The proportions of T cell subgroups were detected by fluorescence-activated cell sorting. The apoptosis of T cell subgroups was detected after peripheral blood mononuclear cells were stimulated with HBV DNA. Results The HBV infection rate was higher in patients with RA than in patients with SLE. Current or previous HBV infection was more common among patients with inactive SLE than among those with active SLE. Conversely, previous or current HBV infection was more common among patients with active RA than among those with inactive RA. CD4−CD8high T cell counts were higher among patients with active SLE than in those with inactive SLE. However, CD4−CD8high T cell counts were lower in patients with active RA patients than in those with inactive RA. HBV DNA increased the apoptosis of CD4−CD8high T cells. Conclusion HBV DNA-induced CD8high T cell apoptosis appears to play different roles in SLE and RA.
Construction and validation of a novel prognostic nomogram for patients with metastatic renal cell carcinoma: a SEER-based study
Authors: Lu Zhaoxiang , He Wei , Zhou Jun , Yang Cheng , Xiang Rong 
Published: June 2022

Objective We aimed to establish and validate nomograms to evaluate overall survival (OS) and cancer-specific survival (CSS) in patients with metastatic renal cell carcinoma (MRCC). Methods Between 2010 and 2015, the clinical information of patients with MRCC was selected using the Surveillance, Epidemiology, and End Results database. Two nomograms were constructed based on Cox regression analysis, and their prediction accuracy was evaluated by concordance index (C-index), receiver operating characteristic (ROC) curve, and decision curve analysis (DCA). Results After propensity score matching, there were 568 patients with MRCC in the training group and 568 in the validation group. Multivariate analyses revealed that age, residence, pathology, T stage, N stage, surgery, and metastatic sites were independent prognostic factors for the OS and CSS of MRCC. The C-index and ROC curves indicated that the two nomograms of OS and CSS showed satisfactory discriminative power. Furthermore, DCA displayed that the nomograms achieved more clinical net benefit than the American Joint Committee on Cancer staging system. Conclusion We constructed and validated two effective prognostic nomograms for patients with MRCC that accurately predicted the probabilities of 1-, 2-, and 3-year OS and CSS.
Human Milk Antibody Response After Combining Two Different COVID-19 Vaccines: Mix-and-Match
Authors: Mulleners Sien J. , Juncker Hannah G. , van Gils Marit J. , van Goudoever Johannes B. , van Keulen Britt J. 
Published: June 2022

Background SARS-CoV-2-specific antibodies are secreted into human milk after women are vaccinated against COVID-19, which might protect the breastfed infant. Due to several reports of severe side-effects of the Oxford-AstraZeneca ChAdOx1 (AZD1222) vaccine against COVID-19, some lactating women followed a heterologous vaccination schedule consisting of the first dose of AZD1222 and a second dose of an mRNA-based vaccine. However, it is unclear whether this generates a significant SARS-CoV-2-specific antibody response in human milk. Main Issue To quantify the SARS-CoV-2-specific antibody response in human milk of two lactating women receiving a heterologous vaccination schedules: AZD1222 and mRNA-based vaccine (Pfizer-BioNTech [BNT162b2] and Moderna [mRNA-1273]). Management Both participants collected 16 samples of human milk longitudinally. SARS-CoV-2-specific Immunoglobulin A was measured using an enzyme-linked immunosorbent assay. Conclusion Based on our results, it could be suggested that heterologous vaccination with AZD1222 and an mRNA-based vaccine can elicit a significant SARS-CoV-2 specific IgA response in human milk.
The Added Value of Somatosensory Potential N70 in Neurological Prognosis After Coma by Acute Brain Structural Injury: A Retrospective Study
Authors: Arciniegas-Villanueva Andrea Victoria , Fernández-Diaz Eva María , González-García Emilio , Sancho-Pelluz Javier , Mansilla-Lozano David , Diaz-Maroto María Inmaculada , Segura Tomás 
Published: June 2022

Background: Coma after acute brain structural injury (ABI) are associated with high mortality and disability. Somatosensory evoked potentials (SSEP) N20 and N70 are used to predict prognosis. Purpose: We assessed the utility of SSEP (N20-N70) as an early indicator of long-term functional prognosis in these patients. Methods: We conducted a retrospective cohort study of patients admitted to the intensive care unit (ICU) with a diagnosis of coma after ABI (n=60). An SSEP study including N20 and N70 was performed 24–72 hours after coma onset. Functional recovery was evaluated 6 to 12 months later using the Modified Glasgow Scale (mGS). The study was approved by our local research ethics committee. Results: The absence of N20 (41% specificity=100%) or N70 (78%) was a strong indicator of a poor outcome. In contrast, the presence of N70 was an indicator of a good outcome (specificity=64.2% sensitivity=91.3%). Conclusion: SSEP N20 and N70 are useful early prognostic markers with high specificity (N20) and sensitivity (N70). N70 has potential additional value for improving the prediction of good functional outcomes in the long term.
Long-term Follow-up of Bilateral Cleft Lip and Palate: Incidence of Speech-Correcting Surgeries and Fistula Formation
Authors: Gustafsson Charlotta , Heliövaara Arja , Rautio Jorma , Leikola Junnu 
Published: June 2022

While bilateral cleft lip and palate (BCLP) constitutes a clinical challenge for the whole cleft team, the ideal surgical protocol remains obscure. This study presents the long-term burden of care in terms of secondary surgeries, defined as fistula repair and speech-correcting surgeries (SCS), in a single center. Outcomes of two surgical protocols utilized over the years were also compared. A retrospective single-center analysis of 81 non-syndromic children with complete BCLP born between 1990 and 2010. Two surgical protocols comprising single-stage and two-stage (delayed hard palate closure) procedures were compared. Outcome was analyzed at the time of alveolar bone grafting (ABG) and post-ABG. Altogether 54 children (66.7%) had underwent secondary surgery by the time of bilateral ABG. At this point, 38.3% (n = 31) of patients had received SCS and 49.4% (n = 40) had undergone fistula repair. The corresponding incidences at the end of follow-up were 46.9% (n = 38) and 53.1% (n = 43). No significant difference emerged in SCS incidence between the 2 protocols; however, prior to ABG the single-stage protocol had a significantly lower need for fistula repair. Regarding the location of fistulas, some differences were observed, with the single-stage procedure more associated with anterior fistulas. BCLP has a high surgical burden of care in terms of secondary surgeries, defined as SCS and fistula repair. In our experience, the single-stage protocol, particularly the two-flap technique, offers better results in the management of BCLP than the two-stage approach with a short delay in hard palate closure.
Peripartum and Postpartum Analgesia and Pain in Women Prescribed Buprenorphine for Opioid Use Disorder Who Deliver by Cesarean Section
Authors: O’Connor Alane B , Smith Joel , O’Brien Liam M , Lamarche Kaitlyn , Byers Nadine , Nichols Stephanie D 
Published: June 2022

Aim: Little is known about whether pain can be effectively managed in pregnant women with opioid use disorder (OUD) during delivery hospitalization, particularly those undergoing surgery and taking buprenorphine as medication for OUD (MOUD). To address this question, we compared pain scores and opioid analgesic utilization during delivery hospitalization in women taking their pre-hospital dose of buprenorphine who delivered by cesarean section to matched controls. To inform future research efforts, we also began to explore opioid analgesic utilization and pain scores by type of anesthesia as this variable is often not included in related literature. Methods: Retrospective matched cohort study of 46 women prescribed buprenorphine during pregnancy who delivered by cesarean section during a 7-year period. Results: When compared to matched controls, women taking their pre-hospital dose of buprenorphine undergoing cesarean section utilized more opioid analgesics as measured by morphine milligram equivalents (MME) (mean MME first 48 hours 153.0 mg vs 175.1 mg, respectively, P < .01) but had similar pain scores during delivery hospitalization. There was no difference in MME utilization by maternal dose of buprenorphine though sample sizes were small. Women on buprenorphine who received spinal anesthesia with morphine had mean pain scores that were 1.4 points lower ( P = .01) during the first 48 hours than women on buprenorphine receiving other methods of anesthesia. Discussion And Conclusions: Pregnant women taking their pre-hospital dose of buprenorphine throughout their surgical delivery hospitalization were able to achieve pain relief similar to women not on MOUD but had higher MME requirements. Our results add to the emerging body of evidence suggesting that individuals on MOUD can achieve adequate post-surgical pain management without adjusting their pre-hospital dose of buprenorphine. Further research is required to fully understand the optimal buprenorphine dosing regimen during surgical hospitalizations. Our results also provide important preliminary evidence that spinal anesthesia containing opioids can be used effectively in individuals with OUD requiring surgical intervention.
Intensive Care Unit Acquired Weakness Associated With Acute Severe Asthma
Authors: Borré-Naranjo Diana , Rodríguez-Yánez Tomás , Almanza-Hurtado Amilkar , Martínez-Ávila María Cristina , Dueñas-Castell Carmelo 
Published: June 2022

Context: Neuromuscular complications in the intensive care unit (ICU) are frequent, multifactorial, and clinically difficult to recognize during their acute phase. The physical examination is the starting point for identification. Case Report: We present a patient with a history of poorly controlled asthma who was admitted to the ICU with status asthmaticus. After 4 days of being under ventilatory support, he developed muscle weakness. The diagnostic approach made it possible to establish myopathic and neurological compromise through electrophysiology studies. Conclusions: ICU-acquired weakness (ICUAW) can bring long-term consequences, early identification, and management, as well as preventive measures, are essential to minimize chronic disability and morbidity.
Women’s experiences of navigating chronic pain within the context of living with an episodic disability
Authors: Campbell Karen A , Ford-Gilboe Marilyn , Kennedy Kelly , Jackson Kim , Mantler Tara , Oudshoorn Abram 
Published: June 2022

Objectives: Of the 6.2 million Canadians aged 15 years or older who live with disability, 61% have disabilities that are not static or continuous. These dynamic conditions are known as episodic disabilities and many disproportionately experienced by women. Chronic pain is also a common feature associated with many episodic disabilities. The purpose of this article is to explore the experience of chronic pain for women living with episodic disabilities. Methods: This qualitative study draws on the tenets of interpretive description. Thirty women, with one or more episodic disabilities and chronic pain, participated in a semi-structured interview and answered questions about their chronic pain levels, using Von Korff et al.’s graded chronic pain scale. Results: Women experienced gendered treatment within the healthcare system and reported that they were frequently dismissed by their healthcare providers, most often physicians. Healthcare professionals’ practices around pain assessment were another common challenge for women. Women who were able to access financial support from government disability programs were more likely to access allied health professionals. Many of the holistic strategies that women researched and used to treat chronic pain were self-enacted. While diet, exercise, and other self-care activities are general health promotion strategies for all, they were seen as essential aspects of living that helped women have control over chronic pain and modifying the course of their episodic disability. Conclusion: Living with chronic pain and an episodic disability is complex. The findings of this study present the impact that gendered treatment in the healthcare system has on women who live with an episodic disability and experience chronic pain. It is evident that the current system did not meet the needs of the women in our study and system changes could result in better experiences, more disclosure of alternative therapies, and increase women’s agency in their care.
Gastrointestinal manifestations of SARS-CoV-2 infection in an Italian population of hospitalized patients
Authors: Milano Angelo , Efthymakis Konstantinos , D’Ardes Damiano , Tana Marco , Mazzotta Elena , De Febis Giulia , Laterza Francesco , Tarquini Pierluigi , Marini Enrico , Porreca Ettore , Cipollone Francesco , Neri Matteo 
Published: June 2022

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus enters the cells via angiotensin-converting enzyme 2 receptor; therefore, tissues expressing this receptor are potential targets for infection. Although many studies have observed gastrointestinal (GI) symptoms in coronavirus disease 2019 (COVID-19) patients, prevalence and clinical impact are still uncertain due to the heterogeneity of reports and obstacles to generalization. Methods: In this cross-sectional study, we included symptomatic patients requiring hospital admission, with a confirmed diagnosis of COVID-19 by nasopharyngeal polymerase chain reaction test, between 18 March and 30 May 2020. Demographic data, symptoms at onset, vital signs, and laboratory tests at admission were recorded. Results: In all, 300 patients were included (57%M, 43%F). GI symptoms were mainly diarrhea (13%), anorexia (4.3%), vomiting (3%), and abdominal pain (2.3%). Overall, males were younger (68 years versus 76 years; p = 0.01); patients with GI manifestations at disease onset required significantly faster hospital admission and showed larger GI complication rates. GI symptoms were associated with abnormal high aspartate aminotransferase and alanine aminotransferase serum titers, especially in male patients. Conclusion: Our study on an Italian population during the outbreak of the COVID-19 pandemic shows that GI symptoms are part of the spectrum of the SARS-CoV-2 infection and could be the only manifestations at disease onset. Although patients with GI symptoms were associated with faster hospital admission and liver involvement, prognosis was not affected.
Prediction of the generalization of myasthenia gravis with purely ocular symptoms at onset: a multivariable model development and validation
Authors: Li Feng , Zhang Hongbin , Tao Ya , Stascheit Frauke , Han Jiaojiao , Gao Feng , Liu Hongbo , Carmona-Bayonas Alberto , Li Zhongmin , Rueckert Jens-C. , Meisel Andreas , Zhao Song 
Published: June 2022

Background: About half of myasthenia gravis (MG) patients with purely ocular symptoms at onset progress to generalized myasthenia gravis (gMG). Objectives: To develop and validate a model to predict the generalization of MG at 6 months after disease onset in patients with ocular-onset myasthenia gravis (OoMG). Methods: Data of patients with OoMG were retrospectively collected from two tertiary hospitals in Germany and China. An accelerated failure time model was developed using the backward elimination method based on the German cohort to predict the generalization of OoMG. The model was then externally validated in the Chinese cohort, and its performance was assessed using Harrell’s C-index and calibration plots. Results: Four hundred and seventy-seven patients (275 from Germany and 202 from China) were eligible for inclusion. One hundred and three (37.5%) patients in the German cohort progressed from OoMG to gMG with a median follow-up time of 69 (32–116) months. The median time to generalization was 29 (16–71) months. The estimated cumulative probability of generalization was 30.5% [95% CI (confidence interval), 24.3–36.2%) at 5 years after disease onset. The final model, which was represented as a nomogram, included five clinical variables: sex, titer of anti-AChR antibody, status of anti-MuSK antibody, age at disease onset and the presence of other autoimmune disease. External validation of the model using the bootstrap showed a C-index of 0.670 (95% CI, 0.602–0.738). Calibration curves revealed moderate agreement of predicted and observed outcomes. Conclusion: The nomogram is a good predictor for generalization in patients with OoMG that can be used to inform of the individual generalization risk, which might improve the clinical decision-making.
The First Ex-Situ Germination and Dispersal Mechanisms of the Rare, Critically Endangered Tree, Pleodendron costaricense
Authors: Pillco Huarcaya Ruthmery , López Morales Marvin , Álvarez-Alcázar Leonardo , Whitworth Andrew 
Published: June 2022

Background and Research aims The extinction of relict and rare tree species is accelerated by habitat loss and climate change. Pleodendron costaricense is a critically endangered tree, with only four mature individuals known in Southern Pacific Costa Rica. With the discovery of three additional trees, we set out to learn more about P. costaricense’s natural history and attempt the first successful germination. Methods We collected fruits from two trees and carried out preliminary germination trials in a nursery at the study site. We also used camera traps in one of the fruiting mother-trees to understand natural dispersal mechanisms of the species. Results Although plagued by excessive levels of invertebrate predation, we were able to germinate and produce 59 saplings ready for restoration planting. Five mammal species were detected on the camera traps feeding on the fruits, along with one primate potentially using the fruits as a topical medicine. Conclusion P. costaricense can be propagated ex-situ, potentially with greater success using stimulating hormones. To improve production rates, future efforts should focus on the protection of germinating seeds and saplings from seed predators. We also identified numerous potential natural mammalian seed dispersers, mostly in the family Procyonidae. Implications for Conservation Given the propagation knowledge we have developed, the active restoration efforts of the saplings by Osa Conservation to help increase population numbers, and the strict protection of the two fruiting mother trees, there is now the possibility to attain a positive conservation outcome for this critically endangered species.