bluuebunny/crossref_metadata_2025 huggingface dataset:
Residual effect of narasin on feed intake and rumen fermentation characteristics in Nellore steers fed forage-based diet
Authors: Soares Letícia Carolina Bortolanza , Marques Rodrigo S , Vaz Pires Alexandre , Alves Cruz Vinicius , Anne Ogg Makayla , Cintra Limede Arnaldo , Junior Paulo César Gonzales Dias , dos Santos Isabela Jorge , de Assis Rhaíssa Garcia , Gouvêa Vinícius N , Maia Ferreira Evandro , Polizel Daniel Montanher
Published: March 2023

This study aimed to evaluate the residual effect of narasin on intake and ruminal fermentation parameters in Nellore cattle fed a forage-based diet. Thirty rumen-cannulated Nellore steers [initial body weight (BW) = 281 ± 21 kg] were allocated to individual pens in a randomized complete block design, with 10 blocks and 3 treatments, defined according to the fasting BW at the beginning of the experiment. The animals were fed a forage-based diet containing 99% Tifton-85 haylage and 1% concentrate. Within blocks, animals were randomly assigned to one of three treatments: (1) forage-based diet without addition of narasin (CON; n = 10), (2) CON diet plus 13 mg of narasin/kg DM (N13; n = 10), or (3) CON diet plus 20 mg of narasin/kg DM (N20; n =10). The experiment lasted 156 d and was divided into two periods. The first period lasted 140 d and consisted of the daily supply of narasin. In the second period (last 16 d), the animals were not supplemented with narasin when the residual effect of the additive was evaluated. The treatments were evaluated by linear and quadratic orthogonal contrasts. The results were reported as least square means and the effect was considered significant when P ≤ 0.05. No treatment × day interaction was identified for dry matter intake (P = 0.27). There was a treatment × day (P ≤ 0.03) interaction after narasin removal for the molar proportion of acetate, propionate, ac:prop ratio, and ammonia nitrogen. The inclusion of narasin decreased linearly (P < 0.01) the molar proportion of acetate (P < 0.01), and this effect persisted until day 5 after narasin withdrawal (P < 0.01). Narasin inclusion linearly increased the molar proportion of propionate (P < 0.04), and linearly decreased (P < 0.01) ac:prop ratio up to 5 d after removing narasin from the diets. No treatment effects were observed (P > 0.45) on days 8 and 16 after the withdrawal. Narasin linearly decreased ammonia nitrogen up to 1 day after withdrawal (P < 0.01). In conclusion, the use of narasin for a prolonged period (140 d) resulted in a residual effect on rumen fermentation parameters after the removal of the additive from the diets.
Supplement feed efficiency of growing beef cattle grazing nativeCamposgrasslands during winter: a collated analysis
Authors: Cazzuli Fiorella , Sánchez Javier , Hirigoyen Andrés , Rovira Pablo , Beretta Virginia , Simeone Alvaro , Jaurena Martín , Durante Martín , Savian Jean Victor , Poppi Dennis , Montossi Fabio , Lagomarsino Ximena , Luzardo Santiago , Brito Gustavo , Velazco J Ignacio , Bremm Carolina , Lattanzi Fernando A
Published: March 2023

Supplementing growing cattle grazing native subtropical Campos grasslands during winter improves the low, even negative, average daily weight gain (ADG) typical of extensive animal production systems in Uruguay. Nonetheless, to render the practice profitable, it is crucial to control supplement feed efficiency (SFE), that is, the difference in ADG between supplemented and control animals (ADGchng) per unit of supplement dry matter (DM) intake. Little has been studied specifically on how SFE varies in these systems. The objective of this study was to quantify the magnitude and variation in SFE of growing beef cattle grazing stockpiled native Campos grasslands during winter and assess putative associations with herbage, animals, supplements, and climatic variables. We compiled data from supplementation trials carried out in Uruguay between 1993 and 2018, each evaluating between one and six supplementation treatments. The average ADG of unsupplemented and supplemented animals were 0.13 ± 0.174 and 0.49 ± 0.220 kg/animal/day, respectively. In both cases, ADG decreased linearly as the proportion of green herbage in the grazed grassland was lower, but the ADG of unsupplemented animals was further reduced when winter frosts were numerous. Estimated SFE were moderately high, with an average of 0.21 ± 0.076 ADGchng/kg DM, resulting from average ADGchng of 0.38 ± 0.180 kg/animal/day in response to an average supplementation rate of 1.84 ± 0.68 kg supplement DM intake/animal/day (0.86%  ± 0.27% body weight). No association was found between SFE and supplementation rate or type (protein vs. energy-based; P > 0.05), but forage allowance negatively affected it, and herbage mass positively affected it, yet in a smaller magnitude, suggesting that a balance is needed between the two to maximize SFE. Weather conditions during trials affected SFE (P < 0.05), with greater SFE in winters with lower temperatures and more frosts. Daytime grazing time was consistently lower in supplemented animals compared to their unsupplemented counterparts, whereas ruminating time during the day was similar, increasing as the proportion of green herbage decreased. Herbage intake estimated from energy balance suggested the existence of some substitution effect. This agrees with the moderately high SFE and with the total digestible nutrients-to-protein ratio of these subtropical humid grasslands being higher than in semi-arid rangelands and dry-season tropical pastures but lower than in sown pastures.
Effects of kangaroo mother care on feeding intolerance in preterm infants
Authors: Çaka Sinem Yalnızoğlu , Topal Sümeyra , Yurttutan Sadık , Aytemiz Selin , Çıkar Yasemin , Sarı Murat
Published: March 2023

Objective

Feeding intolerance (FI) is a common condition in preterm infants because they have an immature gastrointestinal tract. There are studies on the effects of the position on gastric residual volume (GRV) in preterm infants. Kangaroo mother care (KMC) may be an instrument for reducing FI by providing an upright position to infants. Moreover, numerous studies conducted with this therapeutic position applied by putting an infant on the mother’s chest have indicated its positive effects on the infant’s weight gain, growth and development, and vital signs. Therefore, this study aimed to reveal the impact of KMC on FI in preterm infants.

Methods

The population of the study, designed as a randomized trial, consisted of 168 preterm infants [KMC: 84, Standart Care (SC): 84] hospitalized in the neonatal intensive care unit of a university hospital between June and November 2020. Infants were randomly selected and divided into two groups. After the vital signs of the infants in both groups became stable, the infants were fed in the same position. KMC was applied to the infants in the intervention group for 1 h by preparing a suitable environment after feeding. Infants in the SC group were placed in the prone position after feeding. The GRVs of the infants in both groups were recorded on the Infant Follow-up Form before the next feeding.

Results

No statistically significant difference was detected between the groups upon comparing them in terms of demographic and clinical characteristics. The body temperatures and O2 saturations of the participants in the KMC group were statistically significantly higher, and their respiratory and heart rates were lower than the SC group. The transition time to full enteral feeding was statistically significantly shorter, and FI was experienced significantly less in the KMC group infants than in the SC group (p < 0.05). There was no statistically significant difference between the groups in terms of the infants' weight gain and length of hospital stay (p > 0.05).

Conclusion

The present study demonstrated that KMC had a positive impact on FI in preterm infants. KMC is not only a safe care model providing the earliest contact between parents and infants but also a practice whose positive effect on the functioning of the digestive system in preterm infants we can use.
High Primary COVID-19 Vaccine Series Completion by People Who Inject Drugs When Colocating Services at a Syringe Services Van
Authors: Heidari Omeid , O’Conor Katie J. , Meyer Diane , Cargill Victoria , Lowensen Kelly , Farley Jason E.
Published: March 2023

Objective

The aim of the study is to describe the impact of colocating COVID-19 vaccinations with local syringe service programs on vaccine completion among people who inject drugs.

Methods

Data were derived from 6 community-based clinics. People who inject drugs who received at least one COVID-19 vaccine from a colocated clinic partnering with a local syringe service program were included in the study. Vaccine completion was abstracted from electronic medical records; additional vaccinations were abstracted using health information exchanges embedded within the electronic medical records.

Results

Overall, 142 individuals with a mean age of 51 years, predominantly male (72%) and Black, non-Hispanic (79%) received COVID-19 vaccines. More than half elected to receive a 2-dose mRNA vaccine (51.4%). Eighty-five percent completed a primary series, and 71% of those who received a mRNA vaccine completed the 2-dose series. Booster uptake was 34% in those completing a primary series.

Conclusions

Colocated clinics are an effective means of reaching vulnerable populations. As the COVID-19 pandemic continues and need for annual booster vaccines arises, it is important to bolster public support and funding to continue low-barrier preventive clinics colocated with harm reduction services for this population.
Disseminating MSSA Infection in a Preterm Infant With Rare Finding of Spinal Epidural Abscess
Authors: Huneycutt Tamatha M. , Carlson Cheryl , Newberry Desi M.
Published: March 2023

Background:

Methicillin-susceptibleStaphylococcus aureus(MSSA) occurs more frequently in the neonatal intensive care unit (NICU) than methicillin-resistantS. aureus(MRSA) and can result in comparable morbidity and mortality in the neonatal population. MSSA infection may present as pustulosis or cellulitis and evolve into bacteremia, pneumonia, endocarditis, brain abscesses, and osteomyelitis. There is a paucity of literature regarding the treatment and long-term outcomes in the premature infant.

Clinical Findings:

A 32-week twin developed MSSA sepsis with presentation of pain, decreased movement of upper extremities, and global hypotonia. Blood cultures remained positive despite antibiotic coverage.

Primary Diagnosis:

The infant was admitted to the level IV NICU with the diagnosis of MSSA bacteremia, with concern for dissemination and osteomyelitis.

Interventions:

Diagnostic studies included laboratory testing for sepsis evaluation, radiologic studies to evaluate for dissemination, immunologic testing to rule out complement deficiency, and hematology testing to rule out hypercoagulable conditions.

Outcomes:

Diagnostic testing showed extensive cellulitis, osteomyelitis, multiple liver abscesses, and epidural abscesses suggestive of spinal epidural abscess (SEA). Abscess debridement and irrigation on the left distal femur, left elbow, and right tibia were performed. The infant completed 8 weeks of IV antibiotic therapy. Immunologic and hematology testing was within normal limits.

Practice Recommendations:

Prompt recognition and follow-up for clinical signs of sepsis are vital when caring for premature infants. Inclusion of pediatric subspecialist recommendations to assure all diagnostic studies and treatments are completed can significantly impact the patient's outcome. Long-term follow-up is needed for premature infants with the diagnosis of SEA.
Endometrial Cancer Surgery With or Without Concomitant Stress Urinary Incontinence Surgery
Authors: Robison Katina , Wohlrab Kyle , Howe Chanelle J. , Richter Holly E. , Sung Vivian , Bevis Kerri S. , Luis Christine , McCourt Carolyn , Lowder Jerry , Occhino John , Glaser Gretchen , Lokich Elizabeth , Dunivan Gena , Brown Amy , Tunitsky-Bitton Elena , Wethington Stephanie , Chen Chi Chiung Grace , Rahn David , Carlson Matthew , Cram Robin , Raker Christina , Clark Melissa A.
Published: March 2023

OBJECTIVE:

To compare quality of life (QOL) among patients with endometrial intraepithelial neoplasia or early-stage endometrial cancer and stress urinary incontinence (SUI) who chose to have concomitant surgery with cancer surgery alone.

METHODS:

A multicenter, prospective cohort study was conducted across eight U.S. sites. Potentially eligible patients were screened for SUI symptoms. Those who screened positive were offered referral to urogynecology and incontinence treatment, including concomitant surgery. Participants were categorized into two groups: 1) concomitant cancer and SUI surgery or 2) cancer surgery alone. The primary outcome was cancer-related QOL as measured by the FACT-En (Functional Assessment of Cancer Therapy–Endometrial) (range 0–100; higher score indicates better QOL). The FACT-En and questionnaires assessing urinary symptom–specific severity and effects were assessed before surgery and 6 weeks, 6 months, and 12 months after surgery. Adjusted median regression accounting for clustering was used to examine the relationship between SUI treatment group and FACT-En scores.

RESULTS:

Of 1,322 (53.1%) patients, 702 screened positive for SUI with 532 analyzed; 110 (21%) chose concomitant cancer and SUI surgery, and 422 (79%) chose cancer surgery alone. FACT-En scores increased for both the concomitant SUI surgery and cancer surgery–only groups from the preoperative to the postoperative period. After adjustment for timepoint and preoperative covariates, the median change in FACT-En score (postoperative−preoperative) was 1.2 points higher (95% CI −1.3 to 3.6) for the concomitant SUI surgery group compared with the cancer surgery–only group across the postoperative period. Median time until surgery (22 days vs 16 days; P<.001), estimated blood loss (150 mL vs 72.5 mL; P<.001), and operative time (185.5 minutes vs 152 minutes; P<.001) were all greater for the concomitant cancer and SUI surgery group compared with the cancer-only group, respectively.

CONCLUSION:

Concomitant surgery did not result in improved QOL compared with cancer surgery alone for endometrial intraepithelial neoplasia and patients with early-stage endometrial cancer with SUI. However, FACT-En scores were improved in both groups.
Risk of Recurrence and Reintervention After Uterine-Sparing Interventions for Symptomatic Adenomyosis
Authors: Liu Lu , Tian Hongyan , Lin Dongmei , Zhao Liang , Wang Hui , Hao Yi
Published: March 2023

OBJECTIVE:

To evaluate the risk of recurrence and reintervention after uterine-sparing treatment options for symptomatic adenomyosis, including adenomyomectomy, uterine artery embolization (UAE), and image-guided thermal ablation.

DATA SOURCES:

We searched electronic databases such as Web of Science, MEDLINE, Cochrane Library, EMBASE, ClinicalTrials.gov, and Google Scholar from January 2000 to January 2022. The search was conducted using the following search terms: “adenomyosis,” “recurrence,” “reintervention,” “relapse,” and “recur.”

METHODS OF STUDY SELECTION:

All studies that described the risk of recurrence or reintervention after uterine-sparing interventions for symptomatic adenomyosis were reviewed and screened according to the eligibility criteria. Recurrence was defined as the reappearance of symptoms (painful menses or heavy menstrual bleeding) after significant or complete remission, or the reappearance of adenomyotic lesions confirmed by ultrasonography or magnetic resonance imaging.

TABULATION, INTEGRATION, AND RESULTS:

The outcome measures were presented as the frequency with percentage and pooled with 95% CI. A total of 42 studies (single-arm retrospective and prospective studies) that represented 5,877 patients were included. The recurrence rates after adenomyomectomy, UAE, and image-guided thermal ablation were 12.6% (95% CI 8.9–16.4%), 29.5% (95% CI 17.4–41.5%), and 10.0% (95% CI 5.6–14.4%), respectively. The reintervention rates were 2.6% (95% CI 0.9–4.3%), 12.8% (95% CI 7.2–18.4%), and 8.2% (95% CI 4.6–11.9%) after adenomyomectomy, UAE, and image-guided thermal ablation, respectively. Subgroup analysis and sensitivity analysis were performed, and the heterogeneity was reduced in several analyses.

CONCLUSION:

Uterine-sparing techniques were successful in treating adenomyosis with low reintervention rates. Uterine artery embolization had higher recurrence and reintervention rates than other techniques; however, patients treated with UAE had larger uteri and larger adenomyosis, indicating that selection bias may influence these results. More randomized controlled trials with a larger population are needed in the future.

SYSTEMATIC REVIEW REGISTRATION:

PROSPERO, CRD42021261289.
Risk of Stillbirth in Pregnancies Complicated by Diabetes, Stratified by Fetal Growth
Authors: McElwee Eliza R. , Oliver Emily A. , McFarling Kelli , Haney Ashley , Cuff Ryan , Head Barbara , Karanchi Harsha , Loftley Aundrea , Finneran Matthew M.
Published: March 2023

OBJECTIVE:

To compare stillbirth rates per week of expectant management stratified by birth weight in pregnancies complicated by gestational diabetes mellitus (GDM) or pregestational diabetes mellitus.

METHODS:

A national population-based retrospective cohort study of singleton, nonanomalous pregnancies complicated by pregestational diabetes or GDM was performed using national birth and death certificate data from 2014 to 2017. Stillbirth rates per 10,000 patients (stillbirth incidence at gestational age week/ongoing pregnancies−[0.5×live births at gestational age week]) were determined for each week of pregnancy from 34 to 39 completed weeks of gestation. Pregnancies were stratified by birth weight, categorized as having small-for-gestational-age (SGA), appropriate-for-gestational-age (AGA), or large-for-gestational-age (LGA) fetuses, assigned by sex-based Fenton criteria. Relative risk (RR) and 95% CI for stillbirth were calculated for each gestational age week compared with the GDM-related AGA group.

RESULTS:

We included 834,631 pregnancies complicated by either GDM (86.9%) or pregestational diabetes (13.1%) in the analysis, with a total of 3,033 stillbirths. Stillbirth rates increased with advancing gestational age for pregnancies complicated by both GDM and pregestational diabetes regardless of birth weight. Compared with pregnancies with AGA fetuses, those with both SGA and LGA fetuses were significantly associated with an increased risk of stillbirth at all gestational ages. Ongoing pregnancies at 37 weeks of gestation complicated by pregestational diabetes with LGA or SGA fetuses had respective stillbirth rates of 64.9 and 40.1 per 10,000 patients. Pregnancies complicated by pregestational diabetes had an RR of stillbirth of 21.8 (95% CI 17.4–27.2) for LGA fetuses and 13.5 (95% CI 8.5–21.2) for SGA fetuses compared with GDM-related AGA at 37 weeks of gestation. The greatest absolute risk of stillbirth was in pregnancies complicated by pregestational diabetes at 39 weeks of gestation with LGA fetuses (97/10,000).

CONCLUSION:

Pregnancies complicated by both GDM and pregestational diabetes affected by pathologic fetal growth have an increased risk of stillbirth with advancing gestational age. This risk is significantly higher with pregestational diabetes, especially pregestational diabetes with LGA fetuses.
Determinants of Cost for Outpatient Hysterectomy for Benign Indications in a Nationwide Sample
Authors: Whiteside James L. , Tumin Dmitry , Hohmann Samuel F. , Harris Alyssa
Published: March 2023

OBJECTIVE:

To identify surgeon-level variation in cost to produce an outpatient hysterectomy for benign indications in the United States.

METHODS:

A sample of patients undergoing outpatient hysterectomy in October 2015 to December 2021, excluding those with a diagnosis of gynecologic malignancy, was obtained from the Vizient Clinical Database. The primary outcome was total direct hysterectomy cost, which is a modeled cost to produce care. Patient, hospital, and surgeon covariates were analyzed with mixed-effects regression, which included surgeon-level random effects to capture unobserved differences influencing cost variation.

RESULTS:

The final sample included 264,717 cases performed by 5,153 surgeons. The median total direct cost of hysterectomy was $4,705 (interquartile range $3,522–6,234). Cost was highest for robotic hysterectomy ($5,412) and lowest for vaginal hysterectomy ($4,147). After all variables were included in the regression model, approach was the strongest of the observed predictors, but 60.5% of the variance in costs was attributable to unexplained surgeon-level differences, implying a difference in costs between the 10th and 90th percentiles of surgeons of $4,063.

CONCLUSION:

The largest observed determinant of cost to produce an outpatient hysterectomy for benign indications in the United States is approach, but differences in cost are attributable primarily to unexplained differences among surgeons. Standardization of surgical approach and technique and surgeon awareness of surgical supply costs could address these unexplained cost variations.
Postpartum Opioid-Related Mortality in Patients With Public Insurance
Authors: Suarez Elizabeth A. , Huybrechts Krista F. , Straub Loreen , Hernández-Díaz Sonia , Creanga Andreea A. , Connery Hilary S. , Gray Kathryn J. , Vine Seanna M. , Jones Hendrée E. , Bateman Brian T.
Published: March 2023

OBJECTIVE:

To assess the incidence and risk factors for postpartum opioid overdose death and describe other causes of postpartum death in individuals with opioid use disorder (OUD).

METHODS:

We conducted a cohort study that used health care utilization data from the Medicaid Analytic eXtract linked to the National Death Index in the United States from 2006 to 2013. All pregnant individuals with live births or stillbirths and continuous enrollment for 3 months before delivery were eligible, including 4,972,061 deliveries. A subcohort of individuals with a documented history of OUD in the 3 months before delivery was identified. We estimated the cumulative incidence of death as occurring between delivery and 1 year postpartum among all individuals and individuals with OUD. Risk factors for opioid overdose death were assessed using odds ratios (ORs) and descriptive statistics, including demographics, health care utilization, obstetric conditions, comorbidities, and medications.

RESULTS:

The incidence of postpartum opioid overdose death per 100,000 deliveries was 5.4 (95% CI 4.5–6.4) among all individuals and 118 (95% CI 84–163) among individuals with OUD. Individuals with OUD had a sixfold higher incidence of all-cause postpartum death than all individuals. Common causes of death in individuals with OUD were other drug- and alcohol-related deaths (47/100,000), suicide (26/100,000), and other injuries, including accidents and falls (33/100,000). Risk factors strongly associated with postpartum opioid overdose death included mental health and other substance use disorders. Among patients with OUD, postpartum use of medication to treat OUD was associated with 60% lower odds of opioid overdose death (OR 0.4, 95% CI 0.1–0.9).

CONCLUSION:

Postpartum individuals with OUD have a high incidence of postpartum opioid overdose death and other preventable deaths, including nonopioid substance-related injuries, accidents, and suicide. Use of medications for OUD is strongly associated with lower opioid-related mortality.
Outcomes of Menstrual Management Use in Transgender and Gender-Diverse Adolescents
Authors: Schwartz Beth I. , Bear Benjamin , Short Vanessa L. , Kazak Anne E.
Published: March 2023

OBJECTIVE:

To describe and compare the outcomes of various menstrual-management methods, including method choice, continuation, bleeding patterns, amenorrhea rates, effect on moods and dysphoria, and side effects, in transgender and gender-diverse adolescents.

METHODS:

This was a retrospective chart review of all patients seen in a multidisciplinary pediatric gender program from March 2015 to December 2020 who were assigned female at birth, had achieved menarche, and used a menstrual-management method during the study period. Data were abstracted on patient demographics and menstrual-management method continuation, bleeding patterns, side effects, and satisfaction at 3 months (T1) and 1 year (T2). Outcomes were compared between method subgroups.

RESULTS:

Among the 101 included patients, 90% chose either oral norethindrone acetate or a 52-mg levonorgestrel (LNG) intrauterine device (IUD). There were no differences in continuation rates for these methods at either follow-up time. Almost all patients had improved bleeding at T2 (96% for norethindrone acetate and 100% for IUD users), with no difference between subgroups. Amenorrhea rates were 84% for norethindrone acetate and 67% for IUD at T1 and 97% and 89%, respectively, at T2, with no differences at either point. The majority of patients had improved pain, menstrually related moods, and menstrually related dysphoria at both follow-up points. There were no differences in side effects between subgroups. There were no differences in method satisfaction between the groups at T2.

CONCLUSION:

Most patients chose norethindrone acetate or an LNG IUD for menstrual management. Continuation, amenorrhea, and improved bleeding, pain, and menstrually related moods and dysphoria were high for all patients, indicating that menstrual management is a viable intervention for gender-diverse patients who experience increased dysphoria related to menses.
Association Between Antenatal Depression Symptom Trajectories and Preterm Birth
Authors: Sakowicz Allie , Allen Emma , Alvarado-Goldberg Mayán , Grobman William A. , Miller Emily S.
Published: March 2023

OBJECTIVE:

To evaluate whether, among pregnant people referred for mental health care, improvement in antenatal depression symptoms before delivery was associated with a reduction in preterm birth.

METHODS:

This retrospective cohort study included all pregnant people referred to a perinatal collaborative care program for mental health care who delivered between March 2016 and March 2021. Those referred to the collaborative care program had access to subspecialty mental health treatment, including psychiatric consultation, psychopharmacotherapy, and psychotherapy. Depression symptoms were monitored with the self-reported PHQ-9 (Patient Health Questionnarie-9) screens in a patient registry. Antenatal depression trajectories were determined by comparing the earliest prenatal PHQ-9 score after collaborative care referral with the score closest to delivery. Trajectories were categorized as improved, stable, or worsened according to whether PHQ-9 scores changed by at least 5 points. Bivariable analyses were performed. A propensity score was generated to control for confounders that were significantly different on bivariable analyses according to trajectories. This propensity score was then included in multivariable models.

RESULTS:

Of the 732 pregnant people included, 523 (71.4%) had mild or more severe depressive symptoms (PHQ-9 score 5 or higher) on their initial screen. Antenatal depression symptoms improved in 256 (35.0%), remained stable in 437 (59.7%), and worsened in 39 (5.3%); the corresponding incidence of preterm birth was 12.5%, 14.0%, and 30.8%, respectively (P=.009). Compared with those with a worsened trajectory, pregnant people who had an improved antenatal depression symptom trajectory had a significantly decreased odds of preterm birth (adjusted odds ratio 0.37, 95% CI 0.15–0.89).

CONCLUSION:

Compared with worsened symptoms, an improved antenatal depression symptom trajectory is associated with decreased odds of preterm birth for pregnant people referred for mental health care. These data further underscore the public health importance of incorporating mental health care into routine obstetric care.
Complication Rates Following Cerebral and Coronary Angiography: Nationwide Analysis 2008–2014
Authors: Lapow Justin M. , Pammal Rajkumar S. , Brozynski Martina , Sudol Samantha , Patel Smit D. , Feldstein Eric , Nolan Bridget E. , Clare Kevin M. , Shapiro Steven , Kamal Haris , Amuluru Krishna , Frishman William , Naidu Srihari , Cooper Howard , Gandhi Chirag D. , Al-Mufti Fawaz
Published: March 2023

Catheter-based angiography is an essential procedure for the diagnosis and treatment of vascular complications in patients. Since cerebral and coronary angiography are similar techniques that utilize the same access sites and general principles, the associated risks overlap and should be identified to help direct patient care. The purpose of this study was to determine complication rates in a combined cohort of cerebral and coronary angiography patients, as well as conduct a comparative analysis of coronary and cerebral angiography complications. The National Inpatient Sample was queried from 2008 to 2014 to identify patients who underwent coronary or cerebral angiography. After assessment of baseline characteristics, complication rates, and disposition in the combined cohort, propensity matching was utilized to create sub-cohorts of coronary and cerebral angiography patients based on demographics and comorbidities. Comparative analysis of procedural complications and disposition was then performed. A total of 3,763,651 hospitalizations were included in our study cohort (3,505,715 coronary angiographies and 257,936 cerebral angiographies). The median age was 62.9 years, with females being 46.42%. The most prevalent comorbidities in the overall cohort were hypertension (69.92%), coronary artery disease (69.48%), smoking (35.64%), and diabetes mellitus (35.13%). Propensity matching demonstrated that the cerebral angiography cohort had lower rates of acute and unspecified renal failure (5.4% vs 9.2%, OR 0.57, 95% CI, 0.53–0.61, P < 0.001), hemorrhage/hematoma formation (0.8% vs 1.3%, OR 0.63, 95% CI, 0.54–0.73, P < 0.001), and equivalent rates of retroperitoneum hematoma formation (0.03% vs 0.04%, OR 1.49, 95% CI, 0.76–2.90, P = 0.247) and arterial embolism/thrombus formation (0.3% vs 0.3%, OR 1.01, 95% CI, 0.81–1.27, P = 0.900). Our study showed both cerebral and coronary angiography have generally low rates of procedural complications. Matched cohort analysis demonstrated that cerebral angiography patients are at no greater risk for complications than coronary angiography patients.
Patient-Derived Tumor Organoids Can Predict the Progression-Free Survival of Patients With Stage IV Colorectal Cancer After Surgery
Authors: Wang Ting , Tang Yuting , Pan Wenjun , Yan Botao , Hao Yifan , Zeng Yunli , Chen Zexin , Lan Jianqiang , Zhao Shuhan , Deng Chuxia , Zheng Hang , Yan Jun
Published: March 2023

BACKGROUND:

Recent studies have shown patient-derived tumor organoids can predict the drug response of patients with cancer. However, the prognostic value of patient-derived tumor organoid–based drug tests in predicting the progression-free survival of patients with stage IV colorectal cancer after surgery remains unknown.

OBJECTIVE:

This study aimed to explore the prognostic value of patient-derived tumor organoid–based drug tests in patients with stage IV colorectal cancer after surgery.

DESIGN:

Retrospective cohort study.

SETTINGS:

Surgical samples were obtained from patients with stage IV colorectal cancer at the Nanfang Hospital.

PATIENTS:

A total of 108 patients who underwent surgery with successful patient-derived tumor organoid culture and drug testing were recruited between June 2018 and June 2019.

INTERVENTIONS:

Patient-derived tumor organoid culture and chemotherapeutic drug testing.

MAIN OUTCOMES MEASURES:

Progression-free survival.

RESULTS:

According to the patient-derived tumor organoid-based drug test, 38 patients were drug sensitive and 76 patients were drug resistant. The median progression-free survival was 16.0 months in the drug-sensitive group and 9.0 months in the drug resistant group (p < 0.001). Multivariate analyses showed that drug resistance (HR, 3.38; 95% CI, 1.84–6.21; p < 0.001), right-sided colon (HR, 3.50; 95% CI, 1.71–7.15; p < 0.001), mucinous adenocarcinoma (HR, 2.47; 95% CI, 1.34–4.55; p = 0.004), and non-R0 resection (HR, 2.70; 95% CI, 1.61–4.54; p < 0.001) were independent predictors of progression-free survival. The new patient-derived tumor organoid–based drug test model, which includes the patient-derived tumor organoid–based drug test, primary tumor location, histological type, and R0 resection, was more accurate than the traditional clinicopathological model in predicting progression-free survival (p = 0.001).

LIMITATIONS:

A single-center cohort study.

CONCLUSIONS:

Patient-derived tumor organoids can predict progression-free survival in patients with stage IV colorectal cancer after surgery. Patient-derived tumor organoid drug resistance is associated with shorter progression-free survival, and the addition of patient-derived tumor organoid drug tests to existing clinicopathological models improves the ability to predict progression-free survival.
Central Forehead Ischemic Skin Injury following Glabellar Botulinum: A Paradigm Microshift?
Authors: Hynes Stephanie D. , Soares Danny J.
Published: March 2023

Vascular occlusion events have surged in incidence due to the increased popularity of cosmetic injectables. Ostensibly, treatments that involve nonparticulate solutions, such as botulinum, have traditionally been thought to carry no risk of vaso-occlusive complications. In this article, we report the first published instance of a suspected ischemic skin injury after botulinum injection to the glabella and surmise on the potential etiological mechanisms that may underlie these rare occurrences.
Postabdominoplasty Scar Improvement after a Single Session with an Automated 1210-nm Laser
Authors: Palao Ricard , Gallego-Escuredo Jose Miguel , Bohbot Serge
Published: March 2023

Background:

Abdominoplasty, one of the most commonly performed aesthetic procedures, aims at correcting excess abdominal skin and fat, but generates a long abdominal scar. The efficacy of an automated portative 1210-nm laser in improving the appearance of surgical scars has been previously demonstrated in a double-blind randomized controlled trial. The purpose of this work was to document the use of this laser in real-life practice.

Methods:

Eighteen patients undergoing abdominoplasty and treated with the evaluated laser (UrgoTouch, Laboratoires Urgo; one single session immediately after the surgery) were included in this prospective, mono-center, observational study. Change in scar characteristics was assessed using the validated Observer Scar Assessment Scale, and the patients’ and surgeon’s satisfaction was rated using a four-point scale.

Results:

The aesthetic outcome of the scars was very positive with a mean Observer Scar Assessment Scale score of 17.0 (SD 4.6) and 14.4 (SD 3.8) on the 6–60 point scale (60: the worst possible outcome) at 6 and 12 months, respectively. A high degree of satisfaction was also expressed by both surgeon and patients at 6 weeks, 6 months, and 12 months. No laser-related incident was reported during the study, including in patients with darker phototypes.

Conclusions:

These findings seem to be consistent with previous clinical evidence on the use of this laser on fresh incisions. The high degree of satisfaction reported by both surgeon and patients seems to comfort the benefits of this procedure at short- and long-term and support the use of this laser in daily practice of plastic surgery.
Out-of-scope Cosmetic Surgery: A Review of Malpractice Lawsuits against Nonplastic Surgeons
Authors: Moura Steven P. , Shaffrey Ellen C. , Lam Chloe S. , Wirth Peter J. , Attaluri Pradeep K. , Rao Venkat K.
Published: March 2023

Background:

The increasing patient demand for cosmetic surgeries and minimally invasive procedures has encouraged physicians without aesthetic surgery training accredited by the American Board of Medical Specialties to provide these services. This systematic review aims to determine the rate of out-of-scope practice in medical malpractice lawsuits involving cosmetic surgery or minimally invasive procedures performed by nonplastic surgeons.

Methods:

Our systematic review of the Westlaw legal database from 1979 to 2022 included 64 malpractice cases. Inclusion criteria were cosmetic surgeries or minimally invasive procedures in medical malpractice lawsuits not involving board-certified plastic surgeons. Out-of-scope was defined using the procedural competencies established by the American Council for Graduate Medical Education, the Commission on Dental Accreditation, and the Council of Podiatric Medical Education. Data on legal proceedings, provider credentials and board certification, surgical interventions, and legal outcomes were collected.

Results:

The majority of malpractice cases involving cosmetic surgeries or minimally invasive procedures occurred when providers were practicing out of scope (N = 34; 55.7%). The verdict was ruled in favor of the plaintiff (patient) in 34.4% of cases. Out-of-scope practice occurred most in family/internal medicine, no board certification, and obstetrics/gynecology (N = 4, N = 4, and N = 3, respectively). The most common allegation was permanent injury or disfigurement (N = 21; 21.4%). Plastic surgeons provided expert testimony 44.0% of the time.

Conclusion:

Our review of the Westlaw legal database suggests that the majority of nonplastic surgeon cosmetic malpractice cases may occur in the setting of out-of-scope practice.
Lamina Cribrosa Morphology in Normal Tension Glaucoma According to the Location of Visual Field Defects
Authors: Kang Yeon Soo , Haowei Zhang , Sung Mi Sun , Park Sang Woo
Published: March 2023

Précis:

The morphologic alterations in lamina cribrosa (LC) may be related to the location of visual field (VF) defects.

Purpose:

The aim of this study was to investigate morphologic differences in the LC in normal tension glaucoma (NTG) according to the location of VF defects.

Design:

This study was a retrospective, cross-sectional study.

Methods:

Ninety-six eyes of 96 patients with NTG were included in this study. The patients were divided into 2 groups according to the location of VF defects [parafoveal scotoma (PFS) and peripheral nasal step (PNS)]. All patients underwent an optical coherence tomography of the optic disc and macula using swept-source optical coherence tomography (DRI-OCT Triton; Topcon, Tokyo, Japan). The parameters of the optic disc, macula, LC, and connective tissues were compared between the groups. The relationships between the LC parameters and other structures were analyzed.

Results:

The temporal peripapillary retinal nerve fiber layer, average macular ganglion cell-inner plexiform layer, and average macular ganglion cell complex were significantly thinner in the PFS than in the PNS group (P<0.001, P<0.001, and P=0.012, respectively). The PFS group showed a more glaucomatous LC morphology with a smaller lamina cribrosa-global shape index (LC-GSI, P=0.047), more LC defects (P=0.034), and thinner LC (P=0.021) than the PNS group. LC-GSI was significantly correlated with LC thickness (P=0.011) but not with LC depth (P=0.149).

Conclusions:

In patients with NTG, those with initial PFS showed a more glaucomatous LC morphology than those with initial PNS. The morphologic differences in LC may be related to the location of the VF defects.
XEN Gel Stent Versus Nonpenetrating Deep Sclerectomy in Ocular Hypertension and Open Angle Glaucoma Patients
Authors: Almendral-Gómez Jaime , Perucho-Martínez Susana , Martín-Giral Elena , Fernández-Escámez Carlos , Buenasmañanas-Maeso Miriam , Monja-Alarcón Natalia , Toledano-Fernández Nicolás
Published: March 2023

Précis:

XEN gel stent and nonpenetrating deep sclerectomy, both either alone or in combination with cataract surgery, significantly lowered the intraocular pressure (IOP) and reduced the number of antiglaucoma medications in patients with open angle glaucoma, with no significant differences between them.

Purpose:

To compare the surgical outcomes of XEN45 implant and nonpenetrating deep sclerectomy (NPDS), either alone or in combination with cataract surgery, in patients with ocular hypertension and open angle glaucoma (OAG). A retrospective and single-center cohort study was conducted on consecutive patients who underwent a XEN45 implant or an NPDS, either alone or in combination with phacoemulsification. The primary endpoint was the mean change in IOP from the baseline to the last follow-up visit. One hundred twenty-eight eyes, 65 (50.8%) eyes in the NPDS group and 63 (49.2%) eyes in the XEN group, were included in the study. The mean preoperative IOP was significantly lowered from 17.6±5.3 mm Hg and 17.8±6.2 mm Hg to 12.6±2.6 mm Hg and 13.8±2.8 mm Hg at month 12 in the XEN and NPDS groups, respectively;P<0.0001 each. At month 12, 70 (54.7%) eyes were classified as a success, with no significant differences between XEN (57.1%; 36/63 eyes) and NPDS (52.3%; 34/65 eyes) (mean difference: 4.8%; 95% CI: −30.5% to 20.8%;P=0.7115). The number of ocular hypotensive medications was significantly reduced in the XEN (from 2.1±0.7–0.2±0.5,P<0.0001) and in the NPDS (from 2.0±0.8 to 0.3±0.6,P<0.0001) groups, with no significant differences between them (P=0.2629). The incidence of postoperative adverse events in the overall study population was 12.5%, with no significant differences between groups (P=0.1275). Seven (11.1%) eyes underwent needling (XEN group) and 10 (15.4%) goniopuncture (NPDS group);P=0.4753.

Conclusions:

XEN45 implant and the NPDS, either alone or in combination with cataract surgery, significantly lowered IOP and reduced the number of ocular hypotensive medications in ocular hypertension and patients with open angle glaucoma.
Prevalence, risk factors, and clinical correlates of anxiety, depression, and sleep disorders in chaperones for children in the emergency department in China during COVID-19
Authors: Jiang Hanlan , Zeng Jili , Wang Li , Yang Jun , Wang Pei , Wang Zaihua
Published: March 2023

The outbreak of novel coronavirus pneumonia in Wuhan, Hubei Province, in 2019 and its rapid spread across the country caused severe public panic in China. The purpose of this study was to investigate the mental health problems of children’s chaperones at the emergency clinic during the coronavirus disease 2019 (COVID-19) outbreak and to analyze the related influencing factors. A total of 260 chaperones for children in the emergency department participated in this cross-sectional study through the questionnaire constellation platform. The survey period was from February to June 2021. Information collected included demographic data and mental health scales. The Self-Assessment Scale for Anxiety, the Self-Rating Scale for Depression, and the Pittsburgh Sleep Quality Index assessed anxiety, depression, and sleep quality, respectively. Logistic regression was used to analyze influential factors associated with mental health problems. The prevalence of depression, anxiety, and sleep disorders among family members accompanying children attending the emergency room was 41.54%, 20.00%, and 93.08%, respectively, with 21.54% of family members suffering from moderate sleep disorders. Univariate analysis showed that being in Wuhan or not during the city closure (X
2 = 8.61, P < .01) was strongly associated with the occurrence of depression; female (X
2 = 4.87, P = .03), working or not (X
2 = 6.39, P = .01) and fear of going to the hospital (X
2 = 7.80, P = .01) were key factors for the occurrence of anxiety symptoms; Knowledge of transmission routes and prevention of COVID-19 (X
2 = 12.56, P = .03) was a key factor for sleep disorders; logistic stepwise regression analysis showed that fear of going to the hospital was a risk factor for anxiety symptoms (odds ratio = 2.51, P < .01, 95% confidence interval = 1.30–4.85). Our findings suggest that mental health problems were prevalent among family members accompanying children attending the emergency department during the COVID-19 outbreak, with a high prevalence of sleep disturbances in particular. Relevant factors included presence or absence in Wuhan during the outbreak closure, gender, work or absence, and fear of hospital visits. There is a need to focus on the mental health distress of the chaperones for children in the emergency department, and to provide timely intervention and diversion.
Anxiety and fear of COVID-19 in the UK general population: A cross-sectional study
Authors: Morgado-Toscano Cristina , Gómez-Salgado Juan , Fagundo-Rivera Javier , Navarro-Abal Yolanda , Rodríguez-Jiménez Lucas , Climent-Rodríguez José Antonio , Allande-Cussó Regina
Published: March 2023

There is still a generalized feeling of uncertainty in the population due to the coronavirus disease 2019 (COVID-19) pandemic, as restrictions on daily routines and social contact, accompanied by a large number of infections, negatively affect different areas of people’s lives and, therefore, their mental health. The aim of the present study was to assess the presence of anxiety and fear of COVID-19 in the general UK population, using the Anxiety and Fear to COVID-19 Assessment Scale (Ansiedad y Miedo al COVID-19) (AMICO) scale. A descriptive, cross-sectional study based on a questionnaire was conducted in a sample of the UK general population in 2021. Socio-demographic and employment variables were included. The AMICO scale was included to measure fear and anxiety about COVID-19. The relationship between variables was studied with a categorical regression analysis. In general, participants regarded themselves as well-informed about the pandemic, although 62.6% had only received 1 dose of the vaccine. Regarding the AMICO scale the total score was 4.85 (out of 10; standard deviation 2.398). Women showed higher scores for the AMICO than men. The bivariate analysis revealed statistically significant differences in relation to self-confidence, amount of information received, and vaccination variables as related to the mean AMICO scores. An average level of anxiety and fear of COVID-19 is shown in the general UK population, which is lower than most of the studies that assessed the impact of the pandemic on the general population.