bluuebunny/crossref_metadata_2025_split huggingface dataset:
Perception threshold tracking: validating a novel method for assessing function of large and small sensory nerve fibers in diabetic peripheral neuropathy with and without pain
Authors: Røikjer Johan , Croosu Suganthiya Santhiapillai , Frøkjær Jens Brøndum , Hansen Tine Maria , Arendt-Nielsen Lars , Ejskjaer Niels , Mørch Carsten Dahl 
Published: September 2022

Abstract
It remains unknown why some people with diabetes develop painful neuropathies while others experience no pain. This study aimed to validate a novel method for assessing the function of small sensory nerves in diabetes to further elucidate this phenomenon. The function of large and small nerves was assessed using a novel perception threshold tracking technique in 3 well-characterized groups (n = 60) with type 1 diabetes, namely, (1) painful diabetic peripheral neuropathy (T1DM + PDPN), (2) painless diabetic peripheral neuropathy (T1DM + DPN), and (3) no neuropathy (T1DM − DPN), and healthy controls (n = 20). Electrical currents with different shapes, duration, and intensities were applied by 2 different skin electrodes activating large and small fibers, respectively. The minimal current needed to activate the fibers were analyzed as the rheobase of the stimulus–response function. Nerve fiber selectivity was measured by accommodation properties of stimulated nerves. The rheobase of both fiber types were highest for T1DM + PDPN, followed by T1DM + DPN, T1DM − DPN, and healthy controls, indicating that the nerve properties are specific in individuals with diabetes and pain. There was an overall significant difference between the groups (P < 0.01). The accommodation properties of stimulated fibers were different between the 2 electrodes (P < 0.05) apart from in the group with T1DM + PDPN, where both electrodes stimulated nerves displaying properties similar to large fibers. Perception threshold tracking reveals differences in large and small nerve fiber function between the groups with and without diabetes, DPN, and pain. This indicates that the methods have potential applications in screening DPN and explore further the features differentiating painful from nonpainful DPN.
Vestibular Migraine: Cognitive Dysfunction, Mobility, Falls
Authors: Preysner Thi A. , Gardi Adam Z. , Ahmad Sarah , Sharon Jeffrey D. 
Published: September 2022

Objective
Recent evidence has shown that vestibular migraine is strongly associated with cognitive difficulties. However, limited data exist on real-world effects of that dysfunction. The objective of this study is to understand the epidemiology of cognitive dysfunction with vestibular migraine and associated sequelae using National Health Interview Survey data.

Study Design
Randomized, population-based survey study of US adults.

Setting
We generated a case definition approximating probable vestibular migraine based on Bárány Society criteria and validated that definition in a tertiary care vestibular clinic.

Patients
Adult respondents to the 2016 NHIS, which queries a representative sample of the civilian, noninstitutionalized US population.

Intervention
Diagnostic.

Main Outcome Measures
We evaluated incidence of self-reported cognitive dysfunction with vestibular migraine and whether individuals were more likely to have impaired mobility, falls, and work absenteeism than those without either condition.

Results
Among individuals with vestibular migraine, 40% reported “some” and 12% reported “a lot” of difficulty thinking versus 13% and 2% of those without vestibular migraine, respectively. Vestibular migraine sufferers were more likely to have difficulty thinking or remembering compared with respondents without dizziness (odds ratio, 7.43; 95% confidence interval, 6.06–9.10; p < 0.001) when controlled for age, sex, education, stroke, smoking, heart disease, and diabetes. Individuals with both vestibular migraine and cognitive dysfunction had fivefold increased odds of falls and 10-fold increased odds of mobility issues compared with those without either condition. Furthermore, individuals with both vestibular migraine and cognitive dysfunction missed 12.8 more days of work compared to those without either condition.

Conclusion
Our findings indicate vestibular migraine is not only associated with cognitive dysfunction, but they are together associated with mobility issues, fall risk, and work absenteeism.
Safety of Thioguanine in Pediatric Inflammatory Bowel Disease: A Multi-Center Case Series
Authors: Bayoumy Ahmed B. , Jagt Jasmijn Z. , van Wering Herbert M. , de Ridder Lissy , Hummel Thalia , Wolters Victorien M. , Stapelbroek Janneke , Benninga Marc A. , Mulder Chris J.J. , de Boer Nanne K.H. , de Meij Tim G.J. ,   on behalf of the Kids with Crohn’s, Colitis (KiCC) Working Group for Collaborative Paediatric IBD Research in the Netherlands
Published: September 2022

Objectives:
Thioguanine (TG) has been shown as a safe alternative in adults with inflammatory bowel disease (IBD) who did not tolerate conventional thiopurines [azathioprine (AZA)/mercaptopurine]. However, data in pediatric IBD are scarce. Therefore, we aimed to assess the safety of TG as maintenance therapy.

Methods:
A retrospective, multicenter cohort study of children with IBD on TG was performed in the Netherlands. TG-related adverse events (AE) were assessed and listed according to the common terminology criteria for AE.

Results:
Thirty-six children with IBD (median age 14.5 years) on TG (median dose 15 mg/day) were included in 6 centers. Five AE occurred during follow-up [pancreatitis (grade 3), hepatotoxicity (grade 3) (n = 2), Clostridium difficile infection (grade 2), and abdominal pain (grade 2)]. All patients (n = 8) with a previously AZA-induced pancreatitis did not redevelop pancreatitis on TG.

Conclusions:
In pediatric IBD, TG seems a safe alternative in case of AZA-induced pancreatitis. Further research assessing long-term TG-related safety and efficacy is needed.
Nursing Students' Perceptions of Learning With NGN-Style Case Studies
Authors: Pence Patricia L. 
Published: September 2022

Background:
The National Council of State Boards of Nursing (NCSBN) developed Next Generation NCLEX (NGN) case studies and new test items, based on the NCSBN Clinical Judgment Measurement Model, to assess nurse graduates' clinical judgment and decision-making ability.

Purpose:
This study investigated nursing students' perceptions of learning with NGN-style case studies.

Methods:
A mixed-methods approach collected nursing students' perceptions in a 6-item survey.

Results:
Overall respondents agreed that the case studies were helpful in learning (n = 45; 90%), applying course concepts (n = 46; 92%), learning clinical judgment (n = 46, 92%), and promoting active learning (n = 43, 86%), and were a useful learning strategy (n = 48, 96%). Themes identified in narrative comments were critical thinking, real-life application, and a learning tool.

Conclusions:
NGN-style case studies were useful as an active learning strategy to promote clinical judgment and real-life application of course concepts.
Academic Nursing and Faculty Practice
Authors: Gonzales Kelly , Holmes LeAnn , Klein Abbey , Struwe Leeza , Hanish Alyson 
Published: September 2022

Background:
Many challenges are inherent in academic nursing, and additional unique challenges exist for faculty and nursing programs that simultaneously engage in or offer faculty practice. To date, little has been published on faculty practice and academic nursing outside of the mission of education.

Purpose:
To describe faculty practice within the context of academic nursing as it pertains to scholarship and research, annual evaluations, promotion, support of faculty practice, and additional benefits and challenges.

Methods:
A convenience sample of faculty and administrators was surveyed from 6 different universities in the United States.

Results:
A total of 25 faculty members and 11 administrators participated. Results indicate faculty practice offers both benefits and challenges to the noneducational aspects of academic nursing.

Conclusion:
The benefits and challenges should be carefully considered within the context of the future of academic nursing and faculty practice.
Reliability and validity of generalized anxiety disorder 7-item scale in early pregnant women
Authors: Gong Li-Li , Xie Xiao-Long , Liu Si-Tong , Hu Wei-Hong , Niu Yu-Jie , Sun Yi , Liu Jun-Sheng , Xia Xian 
Published: September 2022

Objective:
This study aimed to evaluate the structural reliability and validity of generalized anxiety disorder 7-item (GAD-7) scale in early pregnant women.

Methods:
In this cross-sectional study, 30,823 patients in early pregnancy registered in the Obstetrics and Gynecology Hospital of Fudan University completed the GAD-7 scale and patient health questionnaire-9 item (PHQ-9). The discriminative ability, reliability, construct validity, and criterion validity were assessed to evaluate the psychometric properties and factor structures. Items with a discrimination parameter (α) of < 0.65, factor loading of < 0.30, or cross loading of > 0.40 in two or more factors simultaneously were deleted from the scale.

Results:
All GAD-7 scale items exhibited a high discrimination power. The reliability of the GAD-7 scale was good (Cronbach’s alpha coefficient = 0.891). Exploratory factor analysis extracted one factor with eigenvalues of greater than 1.0, which explained 61.930% of the common variance. Confirmatory factor analysis confirmed that the one-factor structure fitted the data well. The correlation coefficient with the PHQ-9 was 0.639.

Conclusion:
The Chinese version of the GAD-7 scale can be used as a screening tool for early pregnant women. It performs well in terms of discriminative ability, reliability, construct validity, and criterion validity. Pregnant women who screen positive may require more attention and investigation to confirm the presence of generalized anxiety disorder.
How Often Occult Inguinal or Spigelian Hernias Detected During Laparoscopy of Other Reasons Are Later Operated?
Authors: Paajanen Paavo , Virkkunen Antti , Paajanen Hannu , Käkelä Pirjo 
Published: September 2022

Background:
The incidence of occult inguinal or Spigelian hernias found in other laparoscopies is seldom studied and their development to symptomatic hernias is unknown.

Materials and Methods:
The orifices of all inguinal and Spigelian hernias at linea semilunaris were carefully recorded prospectively in the laparoscopic surgery during the years 2003-2004 (104 cholecystectomies, 55 fundoplications, 36 diagnostic, and 6 miscellaneous). The patients were followed up over 15 years to find out how often the detected occult hernias at index laparoscopy become later symptomatic and were repaired.

Results:
The index laparoscopic operation was performed to 201 patients with a mean age of 53±14 years. The overall frequency of unexpected hernias was 21% including 36 (18%) inguinal hernias, 5 (2.5%) Spigelian hernias, and 2 (1.0%) ventral hernias. At the index laparoscopy, only 5/201 inguinal and 2 Spigelian hernioplasties were concomitantly undertaken. After 15 years, data of 169 patients were available and new hernia repairs were performed only in 8 (4.7%) patients (2 inguinal, 4 umbilical, and 2 ventral hernias).

Conclusions:
Asymptomatic occult hernias detected during laparoscopic surgery of other reason evolve very seldom (<5%) to symptomatic and need to be repaired.
Association of Hypercholesterolemia With Gastric Intestinal Metaplasia, Findings After Sleeve Gastrectomy Pathology Review
Authors: Kermansaravi Mohammad , Rezvani Masoud , Elmi Sadr Farid , Valizadeh Rohollad , Kabir Ali , Pazouki Abdolreza 
Published: September 2022

Background:
We evaluated the relationship between comorbidities associated with obesity, body mass index (BMI), and development of intestinal metaplasia (IM) after vertical sleeve gastrectomy (VSG).

Materials and Methods:
All VSG specimens performed at an academic center between 2011 and 2018 were reviewed. All specimens underwent histopathologic assessment, while those with findings suspicious for IM underwent additional immunohistochemical work up. Baseline patient characteristics and demographic data were obtained from Iran National Obesity Surgery Database by retrospective review.

Results:
A total of 862 adult individuals underwent VSG during the study period and specimens were histopathologically examined. All patients had preoperative upper endoscopy. The most common histopathologic diagnosis was miscellaneous findings (57.8%) followed by no pathologic finding (36.7%). The minority of patients (5.5%) had IM. Although 40.5% of patients had positive Helicobacter pylori infection preoperatively, just 13.8% had still positive infection postoperatively. A significant association was found between IM and hypercholesterolemia (odds ratio: 1.95; 95% confidence interval: 1.1, 3.5).

Conclusion:
This study found a correlation between histopathologic changes in patients with IM and hypercholesterolemia. Prospective research studies are recommended to further examine this correlation.
Two Decades’ Outcomes and Trends of Adrenalectomy for Benign Pathologies in Veterans
Authors: Shahait Awni , Saleh Khaled , Weaver Donald , Mostafa Gamal 
Published: September 2022

Background:
Since the introduction of laparoscopic adrenalectomy (LA) in 1992, it has become the standard of care for most adrenal benign pathologies. This study compares the outcomes and trends of open (OA) versus LA in veterans for benign pathologies.

Methods:
Veterans Affairs Surgical Quality Improvement Program was queried for adrenalectomies performed for benign pathologies during the period 2000-2019. Data collection included demographics, comorbidities, operative details, and postoperative outcomes.

Results:
A total of 1683 patients were included (91.4% males, mean age 59.6, mean body mass index 31.2, and 87.2% with American Society of Anesthesiologists class≥III). Overall, the mean operative time (OT) was 3.2 hours, the majority performed by general surgeons (71.4%), and the mean length of stay (LOS) was 4.1 days. There were 12 (0.7%) 30-day mortalities, and 162 patients (8.8%) developed ≥1 complication. LA was performed in 70.9% (1306), with the conversion rate of 0.85% (10). When compared with OA, patients with the laparoscopic approach were functionally independent, shorter OT, less intraoperative blood transfusion, shorter LOS, and lower mortality and morbidity. Dependent functional status, congestive heart failure, American Society of Anesthesiologists class ≥III, and smoking were independent predictors of mortality, whereas intraoperative transfusions, chronic obstructive pulmonary disease, and dependent functional status were predictors of morbidity. Trend analysis showed an 8-fold increase in the use of LA. However, trend analysis for morbidity and mortality rates showed no significant change for both approaches.

Conclusion:
LA is being well adopted in the veterans affairs system with an 8-fold increase over 20 years, with lower morbidity and mortality compared with the open approach for benign adrenal pathologies.
Long-term Outcomes of Endoscopic Thoracoscopic Sympathectomy for Primary Focal Palmar Hyperhidrosis: High Patient Satisfaction Rates Despite Significant Compensatory Hyperhidrosis
Authors: Shabat Sheer , Furman Danielle , Kupietzky Amram , Srour Botros , Mordechai-Heyn Tzlil , Grinbaum Ronit , Mazeh Haggi , Mizrahi Ido 
Published: September 2022

Background:
Endoscopic thoracoscopic sympathectomy (ETS) is the gold standard therapy for primary focal palmar hyperhidrosis (PFPH), resulting in high patient satisfaction rates. The most common side effect of ETS is compensatory hyperhidrosis (CH). Previous studies followed patients’ satisfaction degree of surgery and the incidence of CH during a limited follow-up period of 1 to 3 years. The purpose of this study was to investigate the long-term outcomes and patient satisfaction after ETS.

Materials and Methods:
After approval of our institutional review board, we conducted a retrospective review of all consecutive patients who underwent ETS for PFPH at our institution between 1998 and 2019. Electronic medical records were reviewed for short-term outcomes. Long-term outcomes were collected through telephone questionnaires. Primary outcome was the resolution of PFPH. Secondary outcomes were CH and long-term patient satisfaction.

Results:
During the study period, 256 patients underwent ETS to treat primary focal palmar hyperhidrosis at our institution between the years 1998-2019. One-hundred and fifty (58.6%) patients agreed to participate in the study and were included in the final analysis. The mean age was 23.8 (17 to 58) years, 56% were females. The mean follow-up time was 11±6.1 (1 to 22) years. Ninety-four percent reported resolution of PFPH; however, CH was reported by 90% of participants. CH decreased mean patient satisfaction score from 4.8±0.5 to 3.8±2 (P=0.009). This effect was more pronounced in patients with CH of the head and neck (P=0.009). Patients’ satisfaction decreased over time from a mean of 4.8±0.4 in the first year after surgery to a mean of 3.7±1.4 12 years or more after surgery (P <0.001). Despite this, 79% of patients reported they would recommend ETS to other patients.

Conclusions:
ETS for PFPH is highly effective and results in high patient satisfaction rates even after long-term follow-up. Despite high rates of postoperative CH, nearly 80% of patients would still recommend the procedure to fellow patients, justifying its reputation as the gold standard treatment for PFPH.
Reconstructing the SARS-CoV-2 epidemic in eastern Uganda through longitudinal serosurveillance in a malaria cohort
Authors: Briggs Jessica , Takahashi Saki , Nayebare Patience , Cuu Gloria , Rek John , Zedi Maato , Kizza Timothy , Arinaitwe Emmanuel , Nankabirwa Joaniter I. , Kamya Moses , Jagannathan Prasanna , Jacobson Karen , Rosenthal Philip J. , Dorsey Grant , Greenhouse Bryan , Ssewanyana Isaac , Rodríguez-Barraquer Isabel 
Published: September 2022

ABSTRACTImportanceEstimating the true burden of SARS-CoV-2 infection has been difficult in sub-Saharan Africa due to asymptomatic infections and inadequate testing capacity. Antibody responses from serologic surveys can provide an estimate of SARS-CoV-2 exposure at the population level.ObjectiveTo estimate SARS-CoV-2 seroprevalence, attack rates, and re-infection in eastern Uganda using serologic surveillance from 2020 to early 2022.DesignPlasma samples from participants in the Program for Resistance, Immunology, Surveillance, and Modeling of Malaria in Uganda (PRISM) Border Cohort were obtained at four sampling intervals: October-November 2020; March-April 2021; August-September 2021; and February-March 2022. Setting: Tororo and Busia districts, Uganda.Participants1,483 samples from 441 participants living in 76 households were tested. Each participant contributed up to 4 time points for SARS-CoV-2 serology, with almost half of all participants contributing at all 4 time points, and almost 90% contributing at 3 or 4 time points. Information on SARS-CoV-2 vaccination status was collected from participants, with the earliest reported vaccinations in the cohort occurring in May 2021.Main Outcome(s) and Measure(s)The main outcomes of this study were antibody responses to the SARS-CoV-2 spike protein as measured with a bead-based serologic assay. Individual-level outcomes were aggregated to population-level SARS-CoV-2 seroprevalence, attack rates, and boosting rates. Estimates were weighted by the local age distribution based on census data.ResultsBy the end of the Delta wave and before widespread vaccination, nearly 70% of the study population had experienced SARS-CoV-2 infection. During the subsequent Omicron wave, 85% of unvaccinated, previously seronegative individuals were infected for the first time, and ∼50% or more of unvaccinated, already seropositive individuals were likely re-infected, leading to an overall 96% seropositivity in this population. Our results suggest a lower probability of re-infection in individuals with higher pre-existing antibody levels. We found evidence of household clustering of SARS-CoV-2 seroconversion. We found no significant associations between SARS-CoV-2 seroconversion and gender, household size, or recent Plasmodium falciparum malaria exposure.Conclusions and RelevanceFindings from this study are consistent with very high infection rates and re-infection rates for SARS-CoV-2 in a rural population from eastern Uganda throughout the pandemic.
Pathway analysis identifies novel non-synonymous variants contributing to extreme vascular outcomes in Williams-Beuren syndrome
Authors: Liu D. , Billington C.J. , Raja N. , Wong Z.C. , Levin M.D. , Resch W. , Alba C. , Hupalo D.N. , Biamino E. , Bedeschi M.F. , Digilio M.C. , Squeo G.M. , Villa R. , Parrish P.C.R. , Knutsen R.H. , Osgood S. , Freeman J.A. , Dalgard C.L. , Merla G. , Pober B.R. , Mervis C.B. , Roberts A.E. , Morris C.A. , Osborne L.R. , Kozel B.A. 
Published: September 2022

AbstractSupravalvar aortic stenosis (SVAS) is a characteristic feature of Williams-Beuren syndrome (WBS). SVAS is present in 67% of those with WBS, but severity varies; 21% have clinically significant SVAS requiring surgical intervention while 33% have no appreciable aortic disease. Little is known about genetic modifiers outside the 7q11.23 region that might contribute to SVAS severity. To investigate, we collaboratively phenotyped 473 individuals with WBS and performed the largest whole-genome- sequencing study to date. We developed a set of strategies for modifier discovery including extreme phenotyping (surgical SVAS vs. no SVAS) and prioritization of non-synonymous variants with increased predicted functional impact along with an allele frequency difference between the extreme phenotype groups. We identified pathways enriched in common or less frequent variants, followed by association testing of SVAS severity with the enriched pathways. The common variant analysis identified pathways including the extracellular matrix and the innate immune system, while pathways encompassing adaptive immunity, ciliary function, lipid metabolism and PI3KAKT were captured by both the common and less frequent variant analyses. Cell cycle and estrogen responsive pathways were among those identified through the less frequent variant analysis. Among the 69 genes reported in other large genome wide association studies assessing aortic traits, 11 genes, including PCSK9 and ILR6, were found in our study, suggesting overlapping disease mechanisms. In summary, this study presents novel strategies for identification of disease modifiers in rare conditions like WBS.Graphical Abstract