bluuebunny/crossref_metadata_2025_split huggingface dataset:
Knowledge, beliefs, and practices related to cancer screening and prevention in Lebanon: community and social media users’ perspectives
Authors: Telvizian Talar , Al Ghadban Yasmina , Alawa Jude , Mukherji Deborah , Zgheib Nathalie K. , Sawaf Bisher , Nasr Rihab , Bardus Marco 
Published: September 2020

Objective
Common to many countries in the Middle East, Lebanon has an increasing cancer burden; however, national screening programs are limited to breast cancer. The literature on cancer screening practices and beliefs is scarce. This cross-sectional study investigates the knowledge, beliefs, and practices related to the prevention and screening for breast, cervical, colon, lung, and skin cancers among Lebanese residents, recruited through social media advertisements and community outreach activities.

Methods
Participants filled an anonymous questionnaire either via a web-based interface or using tablets distributed at primary health clinics. The characteristics of the two cohorts were compared with chi-square and t-tests. We performed descriptive analysis, followed by multivariate logistic regression for predictors of cancer screening.

Results
A total of 407 participants completed the survey online, and 262 filled the study in tablets available at primary care clinics. The two samples were significantly different in terms of age, education, and perceived socioeconomic status. Online participants demonstrated higher knowledge and higher participation in screening practices than their counterparts recruited through community outreach. Mammography (44.7% online and 39.9% in-person), and cervical cancer screening (44.5% online and 36.7% community) had the highest participation rates. In both samples, participants who were older and more educated were more likely to report engagement with cancer screening practices.

Conclusions
Our study revealed significant knowledge gaps in cancer prevention and screening. Different sampling techniques accessed diverse populations, highlighting the need for educational messages and targeted screening programs to be inclusive of socio-economically disadvantaged communities with low education and health literacy.
Quantitative CT angiography predicts large artery occlusion types and successful thrombectomy in acute ischemic stroke
Authors: Chien Chun , Lin Chun-Jen , Chang Feng-Chi , Chung Chih-Ping , Lin Chung-Jung , Liu Hung-Yu , Chi Nai-Fang , Hsu Li-Chi , Tang Chih-Wei , Guo Wan-Yuo , Luo Chao-Bao , Lai Yen-Jun , Lee I-Hui 
Published: September 2020

Background:
Clinical and radiological outcomes of endovascular thrombectomy (EVT) are related to etiologies of large vessel occlusion (LVO) in acute stroke. However, preprocedural computed tomography angiography (CTA) or CT perfusion imaging can hardly distinguish embolic occlusion from atherosclerotic occlusion. We hypothesized that quantitative multiphase CTA (mCTA) of LVO may predict occlusion types and thrombectomy outcome.

Methods:
We retrospectively evaluated the consecutive stroke patients who had undergone mCTA and EVT <6 hours of onset at two independent medical centers. The intra-arterial radiodensities of Hounsfield unit (HU) were measured to examine the HUdistal/proximal ratio using receiver operating characteristic curve analysis. The derived cut-off value was re-examined in an independent cohort.

Results:
In the derivation cohort (n = 102), 81 patients (79.4%) were embolic occlusion without severe residual intracranial atherosclerotic stenosis (ICAS[−]) and 21 patients were atherosclerosis-related occlusion (ICAS[+]) based on digital subtraction angiography (DSA). The optimal cut-off to predict embolic occlusion was HU ratio <0.6 measured at 2 mm from the occlusion site (maximum area under the curve = 0.87; sensitivity 96%; specificity 81%). This cut-off also independently predicted successful recanalization using stent-retrievers and/or contact aspiration (modified Treatment in Cerebral Ischemia score ≥2b; p = 0.002) after adjusting for age, atrial fibrillation, and collateral circulation score, but not predicted favorable outcome at 3 months post stroke. Importantly, in the validation cohort (n = 95, 80% embolic occlusion), this HU ratio cut-off similarly predicted occlusion types and recanalization outcome, respectively.

Conclusion:
The mCTA-based quantitative radiodensities of acute LVO provides preprocedural predictive values of DSA-determined occlusion types and thrombectomy outcomes.
COVID-19 Exposure Among First Responders in Arizona
Authors: Shukla Vershalee , Lau Christine S.M. , Towns Mikayla , Mayer Jennifer , Kalkbrenner Kara , Beuerlein Steve , Prichard Pablo 
Published: September 2020

Objective:
The number of COVID-19 cases in Arizona is rapidly increasing, leading the country in the rate of new daily cases. Exposure among first responders remains unknown.

Methods:
Rates of SARS-CoV-2 IgG among first responders in Arizona were determined, and attitudes/views about the impact of COVID-19 on their work life was analyzed.

Results:
Of 3326 first responders, 50 (1.50%) tested positive for SARS-CoV-2 IgG. Most first responders thought antibody testing would help ease their anxieties (62.5%) and be beneficial to their work-life (60.6%).

Conclusion:
The rate of COVID-19 exposure among first responders in Arizona is low—1.50%. COVID-19 is a concern among many of the first responders, and antibody testing was beneficial in easing their anxieties about going to work and performing work-related duties.
Cosmetic Glove-Like Finger Prosthesis—A Novel Technique: A Case Report
Authors: Kurian Byju Paul , Mathew Cinil , Joseph Angel Mary , George Merlyn 
Published: September 2020

ABSTRACT

Introduction
Complete or partial finger loss is the most frequently encountered form of partial hand loss, which can result in physical, psychosocial, and economic damage to an individual. Thus, fabrication of a prosthesis that can offer a psychological, functional, and rehabilitative advantage can be a big morale booster to such individuals.

Materials and Methods
This clinical report presents a novel technique of prosthetic rehabilitation of a left thumb with thermoplastic resin and silicone material. Methods include making impressions of the donor and recipient finger, duplication of wax patterns of the donor finger, fabrication of a master cast for the fabrication of the finger using thermoplastic resin and silicone material, and external characterization.

Results
The thermoplastic resin silicone elastomeric prosthesis clearly fulfilled the patient's objective of restoring his defect with an aesthetically superior, lightweight prosthesis without the need to undergo any surgical procedures. The patient was comfortable using the prosthesis and was satisfied with the retention of the prosthesis. However, application of external characterization was required every 6 months.

Discussion
This article presents a new application of thermoplastic resin in maxillofacial prosthesis. This technique eliminates lengthy laboratory and clinical procedures and reduces the chair side time for practitioner and patient. It also is a cost-effective technique.

Conclusion
A convenient and affordable method of prosthetic rehabilitation of amputated fingers has been presented. The morale of the patient was also boosted to a great extent.
A Theoretical Model of Physical Function and Mobility Apprehension in Persons with Amputation of a Lower Limb
Authors: Mathis Shannon L. , Welch Maggi R. 
Published: September 2020

ABSTRACT

Introduction
An avoidance behavior is an inhibitive response to normal activities of daily life based on actions taken to escape movement in tasks that one considers challenging. In persons with lower-limb amputation, pain catastrophizing, the tendency to ruminate and magnify painful sensations, is a risk factor for mobility apprehension, an avoidance behavior. Avoidance behavior leads to physical deconditioning of the muscles. The purpose of this study was to link the psychological trait of avoidance to physiological traits of strength for the purpose of understanding balance. It was hypothesized that in persons with lower-limb amputation, poor balance will correlate directly with mobility apprehension and indirectly with muscular strength.

Materials and Methods
Adult participants who had a well-fitting prosthesis and had the ability to ambulate at least 10 ft were asked to participate in the study. Participants completed questionnaires regarding demographic information and self-report instruments measuring mobility apprehension. Mobility apprehension was measured using the Tampa Scale for Kinesiophobia (TSK). Balance was measured using the Berg Balance Scale. A handheld dynamometer was used to assess isometric strength of the left and right hip extension, trunk flexors, and trunk extensors. Hip strength was defined as the mean value of the strength of the left and right hip extensors. Core strength was defined as the mean strength value between the trunk flexors and extensor muscles.

Results
Of the participants, 80% reported comorbidities (e.g., diabetes, high blood pressure, and heart disease). The mean (SD) TSK score was 38.65 (6.68), where a score of 39 or higher indicates a high level of mobility apprehension. The mean (SD) hip and core strengths were 15.78 (9.29) lb and 5.60 (3.17) lb, respectively. The mean (SD) Berg Balance score was 46.25 (6.74). There was a moderate direct correlation between balance and hip strength (r = 0.45, p = 0.046). Core strength approached a significant direct correlation with balance (r = 0.39, p = 0.085). However, mobility apprehension was not related to balance.

Conclusion
Results may assist clinicians in aiming exercise programs toward increasing hip and potentially core strength, thus improving balance to promote better mobility for individuals with a lower-limb amputation.
Canadians Reporting Sport-Related Concussions: Increasing and Now Stabilizing
Authors: Gordon Kevin E. , Kuhle Stefan 
Published: September 2020

Background:
Canada is currently engaged in a national harmonization of strategies to prevent and manage sport-related concussions.

Objective:
To examine the annual incidence rates of reported sport-related concussions or other brain injuries by participants in the Canadian Community Health Survey, a national public health survey which provides nearly 2 decades of serial data using consistent methodology.

Design:
Serial cross-sectional survey.

Setting:
Population-based Canadian survey from 2000 to 2018 that collects data on “concussions or other brain injuries.”

Participants:
Respondents 12 years and older.

Independent Variables:
Sex and age categorized 12 to 14 years, 15 to 19 years, 20 to 29 years, and 30+ years.

Outcome measures:
National incidence rates of participants reporting concussions or other brain injuries occurring within the previous year while engaged in “organized sports/leisure sports or physical exercise.”

Results:
Data were available for 2000/01, 2003, 2005/6, 2009/10, 2013/4, and 2017/8 (N = 757 383). A previously stable annual incidence of reported sport-related concussions or other brain injuries increased nearly 2 and a half-fold from 2005/06 through 2013/14 (P < 0.0001) but seems to have stabilized recently (2013/14 vs 2017/8, P = 0.35). This trend is similar for both men and women but is manifest primarily within youth (12-19 years) as opposed to adults (>19 years). Approximately 1 in 450 Canadians 12 years and older report sport-related concussions or other brain injuries as their most significant injury associated with disability in the previous year (2017-2018: 221 per 100 000 population, 95% confidence interval: 179-264).

Conclusions:
In Canada, the annual incidence rates of reported sport-related concussions or other brain injuries is changing and may reflect improved reporting and recognition.
From the Other Side of the Bed
Authors: Jones Jamie L. , Barone Claudia , Brown Lana M. , Wright Patricia , Mitchell Anita , Ray Trenda 
Published: September 2020

Background:
To provide patient- and family-centered care, health care providers must understand the caregiver experience. Evidence suggests that registered nurses functioning as family caregivers (RNFCs) may have unique experiences and challenges.

Purpose:
The purpose of this study was to explore the lived experiences of RNFCs during an adult family member's episode of care in the southern United States.

Methods:
A descriptive phenomenological approach was used to describe the essence of the RNFC experience throughout an episode of care. Twenty-five participants were recruited for semistructured, audio-recorded interviews. Data were analyzed using descriptive data analysis and constant comparison techniques.

Results:
Participants were predominantly female (88%). The essence of the phenomenon was dual roles. Five themes emerged: (1) blurring the boundaries, (2) revealing my identity, (3) having insider knowledge, (4) managing expectations, and (5) learning from my experience.

Conclusions:
While caregiver experiences may be similar, RNFCs struggle with dual roles of registered nurse and caregiver, occasionally blurring boundaries of care.
Building a Reliable Health Care System
Authors: Alexander Catherine , Rovinski-Wagner Christine , Wagner Sandra , Oliver Brant J. 
Published: September 2020

Background:
There is limited evidence available identifying best practices to promote and sustain optimal outpatient-to-inpatient handoff processes to ensure safe and reliable continuity of care.

Local Problem:
A sentinel event occurred during the transition of care from the outpatient-to-inpatient setting. A root cause analysis revealed that the facility's standard operating procedure for patient handoffs was not consistently followed.

Methods:
A Lean Six Sigma approach was used to improve patient transfer with the implementation of a Situation-Background-Assessment-Recommendation handoff policy. Inferential and statistical process control methods were used to assess performance outcomes pre- and postdissemination.

Results:
Over 36 months there was a slow, steady decrease in patient transfer time including reduced variability. The most significant improvement effect occurred in the third year with a 50% reduction in transfer time.

Conclusions:
Longitudinal monitoring provides the opportunity to accurately identify beneficial outcomes, which develop downstream from initial quality improvement efforts.
Dysmenorrhea Symptom-Based Phenotypes
Authors: Chen Chen X. , Carpenter Janet S. , Ofner Susan , LaPradd Michelle , Fortenberry J. Dennis 
Published: September 2020

Background
Dysmenorrhea is a prevalent pain condition among women and a risk factor for other chronic pain conditions. Individuals vary in dysmenorrhea pain severity, the number of painful sites, and co-occurring gastrointestinal symptoms. Three dysmenorrhea symptom-based phenotypes were previously identified using latent class analysis; however, there is a need to validate these in an independent sample, so they can be used in mechanistic and interventional research. There is also a need to further characterize dysmenorrhea symptom-based phenotypes in terms of demographic, clinical, and psychobehavioral characteristics so they can be used to inform precision dysmenorrhea treatment.

Objectives
The study objectives were to (a) determine whether the same dysmenorrhea symptom-based phenotypes would be found in a new sample; (b) determine whether including demographic, clinical, and psychobehavioral covariates in latent class analyses would change individuals’ phenotype memberships; and (c) investigate relationships between dysmenorrhea symptom-based phenotypes and demographic, clinical, and psychobehavioral characteristics.

Methods
This cross-sectional survey study included 678 women (aged 14–42 years) with dysmenorrhea. Participants reported dysmenorrhea symptom severity, demographic, clinical (comorbid chronic pain and gynecological conditions), and psychobehavioral characteristics (perceived stress, anxiety, depression, sleep disturbance, and pain catastrophizing). We used latent class analysis to identify symptom-based phenotypes. We compared analyses with and without covariates (i.e., demographic, clinical, and psychobehavioral characteristics) to determine if individuals’ phenotype memberships changed. We then examined associations between phenotypes and demographic, clinical, and psychobehavioral characteristics.

Results
We reproduced three dysmenorrhea symptom-based phenotypes: the “mild localized pain” phenotype (characterized by mild abdominal cramps), the “severe localized pain” phenotype (characterized by severe abdominal cramps), and the “multiple severe symptoms” phenotype (characterized by severe pain at multiple locations and gastrointestinal symptoms). Analyses with and without covariates had little effect on individuals’ phenotype membership. Race, comorbid chronic pain condition, endometriosis, and pain catastrophizing were significantly associated with the dysmenorrhea phenotypes.

Discussion
Findings provide a foundation to further study mechanisms of dysmenorrhea symptom heterogeneity and develop dysmenorrhea precision treatments. The three dysmenorrhea symptom-based phenotypes were validated in a second sample. Demographic, clinical, and psychobehavioral factors were associated with dysmenorrhea symptom-based phenotypes.
Declining Chlamydia and Gonorrhea Diagnoses Among Pregnant Women in South Carolina, 2008 to 2018
Authors: Lazenby Gweneth B. , Savage Ashlyn H. , Horner Gwynneth , Richmond Joshua , Peterman Thomas A. 
Published: September 2020

Background
Reported US cases of chlamydia and gonorrhea have increased since 2000, whereas studies in select populations suggest that the prevalence of these diseases has decreased. We sought to determine if these diagnoses are increasing among pregnant women delivering at our center.

Methods
This is a retrospective study of women delivering at least 1 infant >18 weeks of gestation at the Medical University of South Carolina for 11 years (2008–2018). Using the perinatal information system, we collected maternal race, age, insurer, and chlamydia and gonorrhea screening results during the pregnancy of record. Cochran-Armitage trend analyses were performed to evaluate trends in these diagnoses by delivery year for all women and for age/race subgroups.

Results
During the study period, there were 24,807 deliveries. The median age of women was 28 years (interquartile range, 23–32 years). Five percent (5.0%) of women were diagnosed with chlamydia and 1.2% with gonorrhea. The percent of women diagnosed decreased for both chlamydia (9.6%–3.4%) and gonorrhea (2.5%–1.1%; P < 0.001, trend analyses for both). A higher percentage of Black women had chlamydia and gonorrhea, and both diagnoses declined over time: 17.4% to 6.9% (P < 0.0001) for chlamydia and 5.8% to 2.1% (P < 0.0001) for gonorrhea. In a subanalysis of race and age, Black women younger than 25 years experienced the most significant decline in chlamydia diagnoses (P < 0.0001).

Conclusions
We observed declining diagnoses of chlamydia and gonorrhea among pregnant women in our center. Although Black women delivering were more likely to have either diagnoses, they experienced a significant decline in both chlamydia and gonorrhea over time.
Syphilitic Reinfections During the Same Pregnancy—Florida, 2018
Authors: Matthias James , Sanon Ruth , Bowen Virginia B. , Spencer Emma C. , Peterman Thomas A. 
Published: September 2020

Abstract
We reviewed all cases of syphilis reported among pregnant women in Florida in 2018 for syphilitic reinfection. Nineteen (7.3%) of 261 pregnant women with syphilis were reported as reinfected during the same pregnancy. Timely rescreening and treatment prevented 6 (31.6%) of 19 reinfected women from delivering infants with congenital syphilis.
Receipt and Timeliness of Newborn Hearing Screening and Diagnostic Services Among Babies Born in 2017 in 9 States
Authors: Deng Xidong , Ema Suhana , Mason Craig , Nash Ashley , Carbone Eric , Gaffney Marcus 
Published: September 2020

Context:
By providing timely services at all steps along the continuum of the early hearing detection and intervention (EHDI) process, providers may be able to lessen potential adverse effects of late identification of hearing loss on children's language development.

Objective:
To examine the timeliness of key events in the EHDI process from birth through diagnosis of hearing loss among different populations.

Design:
Retrospective, cross-sectional.

Setting:
Data pooled from 9 states' EHDI information systems were used to determine the extent to which timely screening and diagnosis were achieved by 754 613 infants born in calendar year 2017. Enrollment into early intervention for children diagnosed is not examined here due to incomplete data.

Participants:
Nine state EHDI programs were selected to participate in this study for their successful experience in using EHDI-IS to collect detailed child-level data.

Main Outcome Measures:
Age of service, rate of service receipt.

Results:
Median age of newborn hearing screening was 1 day, and median age of hearing loss diagnosis was 68 days. Early completion of newborn hearing screening was associated with maternal education, maternal race/ethnicity, and admission into a neonatal intensive care unit (NICU). Receiving and completing follow-up diagnostic services were associated with maternal education, maternal race/ethnicity, age of screening, and enrollment into the Women, Infants, and Children program.

Conclusions:
Timely completion of the newborn hearing screening is achieved by most of the population among the participating states. Increased efforts may be considered by state EHDI programs to provide additional follow-up and education to underrepresented racial/ethnic groups, mothers with less education, and NICU infants and their families as these groups appear to be at an increased risk for delayed diagnostic testing for hearing loss.
Perceptions of Syringe Service Programs and Supervised Use Sites Among a Sample of Registered Voters in a US State
Authors: Brooks-Russell Ashley , Brandspigel Sara , Franco Carol Y. , Alishahi Musheng L. , Lee-Winn Angela E. 
Published: September 2020

Context:
The decision to initiate a syringe service program or expand to a supervised use site is often influenced by local public support or opposition.

Objective:
The purpose of this study was to better understand public attitudes to local syringe service programs to inform the possibility of expanding services.

Design, Setting, and Participants:
We surveyed a sample of registered voters (n = 690) in the 8 counties in the state of Colorado with existing syringe service programs.

Main Outcome Measures:
Respondents were asked about their awareness of and attitudes toward syringe service programs and supervised use sites.

Results:
More than three-fourths of respondents reported they were familiar with syringe service programs, but only a quarter knew they were legal, despite all survey respondents living near an operating program. Nearly one in 3 respondents thought a syringe service program or a supervised use site makes a community better, and a majority (57%) thought supervised use sites should be legal in their state. There were significant differences in attitudes toward the benefits and risks of syringe service programs by political party affiliation.

Conclusion:
Understanding the level of community knowledge and support for syringe service programs, as well as the reasons for opposition, can be helpful in addressing community concerns when seeking to initiate or expand services.