bluuebunny/crossref_metadata_2025_split huggingface dataset:
Redistribution of Outpatient Oncologic Surgical Specialty Referrals During COVID-19
Authors: Sutjiadi Brian , McRae Joyce , Silva Trevor , Selleck Matthew , Reeves Mark , Garberoglio Carlos , Lum Sharon 
Published: October 2021

Background Initial reports of significantly worse outcomes for cancer patients with COVID-19 led to guidelines for triaging surgical cancer treatment. We sought to evaluate the effects of the COVID-19 pandemic on oncologic surgical specialty referrals. Methods We compared referrals to oncologic surgical specialty clinics at an academic tertiary care institution following implementation of stay-at-home orders in California (3/19/20–7/31/20, “COVID”) to the same time period the year prior (3/19/19–7/31/19, “Pre-COVID”). The number of appointments, consulted surgical services, insurance types, acuity of diagnoses, and times from referral to first appointment (TRFA) were assessed. Results The overall number of patients seen in matched time periods decreased by 21.6% from 900 (pre-COVID) to 705 (COVID). Proportions of patients with malignant and suspicious diagnoses, surgical and thoracic oncology visits, and Medicaid insurance differed from comparison groups during the COVID period ( P < .05). Overall median (interquartile range) TRFA decreased from 14 (20) to 12 (19) days ( P = .001) during COVID. Conclusion After implementation of stay-at-home orders, higher acuity and vulnerable patients were appropriately seen in oncologic surgical specialty clinics. While the long-term effects of decreased clinic visits during COVID remain uncertain, further examination of scheduling practices that led to shorter referral times may identify methods to improve timeliness of care and surgical oncologic outcomes in non-pandemic settings.
Monitoring excimer laser-guided cardiac lead extractions by uniportal video-assisted thoracoscopy: A single center experience
Authors: Wacker Max , Thewes Lena , Lux Anke , Busk Henning , Zardo Patrick , Scherner Maximilian , Awad George , Varghese Sam , Veluswamy Priya , Wippermann Jens , Slottosch Ingo 
Published: October 2021

Background Though laser guided extractions of cardiac implantable electronic devices leads have become a routine procedure, the severe complications are associated with a high mortality. Here, we report our single center experience using uniportal video-assisted thoracoscopy for laser lead extraction and compare it to stand-alone laser lead extraction. Methods The intraoperative data and postoperative clinical outcomes of patients undergoing laser lead extraction with concomitant thoracoscopy ( N = 28) or without ( N = 43) in our institution were analyzed retrospectively. Results Neither the median x-ray time (612.0 s for the thoracoscopy group vs. 495.5 s for the non-thoracoscopy group, p = 0.962), length of the operation (112.5 vs. 100.0 min, p = 0.676) or the median length of hospital stay (9.0 vs. 10.0 days, p = 0.990) differed significantly. The mean intensive care unit stay was longer for patients in the non-thoracoscopy group (0.8 vs. 2.5 days, p = 0.005). The 30-day-mortality in the thoracoscopy group was zero, whereas five patients died in the non-thoracoscopy group. Furthermore, four patients in the non-thoracoscopy group had encountered haemothorax, while none were observed in the thoracoscopy group ( p = 0.148). Conclusions The adoption of uniportal video-assisted thoracoscopy during laser-guided lead extraction of cardiac implantable electronic devices can be considered safe and does not lengthen the operating time or hospital stay. It might be useful in the detection of severe complications and, in experienced hands, possibly allow direct bleeding control.
Effect of capsular tension ring implantation during phacoemulsification on postoperative refraction
Authors: Belov Dmitrii , Nikolaenko Vadim , Potemkin Vitaly 
Published: October 2021

Purpose To assess refractive outcomes of phacoemulsification (PE) with additional capsular tension ring (CTR) implantation. Material and methods In total, 37 eyes of 37 patient who underwent PE with intraocular lens (IOL) implantation were divided into 2 groups: study group (n = 18) with CTR co-implantation (inclusion criteria was preoperative irido-phacodonesis) and control group (n = 19) without CTR. Optical biometry (IOL-Master 500) was performed for each patient before PE. Barrett Universal II Formula was used for IOL calculation. IOL power calculation error was assessed by comparing target refraction and final refraction measured by Topcon-8800 autorefractometer 1 month after surgery. Results Despite almost identical preoperative values in both groups refractive result was different. Patients with CTR co-implantation had more hyperopic IOL power calculation error of 0.41 ± 0.52 D versus 0.04 ± 0.59 D in the control group (p = 0.043). Postoperative spherical equivalent in study group was more hyperopic (−0.40 ± 1.47 D) than in control group (−0.77 ± 1.24), nevertheless, this difference was insignificant ( p = 0.166). Conclusion CTR co-implantation in patients with weak zonules and preoperative irido-phacodonesis leads to more hyperopic IOL power calculation error compared with control group.
GU-CA-COVID: a clinical audit among Italian genitourinary oncologists during the first COVID-19 outbreak
Authors: Bersanelli Melissa , Buti Sebastiano , Rizzo Mimma , Cortellini Alessio , Cattrini Carlo , Massari Francesco , Masini Cristina , Vitale Maria Giuseppa , Fornarini Giuseppe , Caffo Orazio , Atzori Francesco , Gatti Alice , Macrini Serena , Mucciarini Claudia , Galli Luca , Morelli Franco , Stellato Marco , Fanelli Martina , Corti Francesca , Zucali Paolo Andrea , Toscani Ilaria , Dalla Volta Alberto , Gernone Angela , Baldessari Cinzia , La Torre Leonardo , Zara Diego , Gennari Alessandra , Bracarda Sergio , Procopio Giuseppe , Porta Camillo 
Published: October 2021

Background: Considering the growing genitourinary (GU) cancer population undergoing systemic treatment with immune checkpoint inhibitors (ICIs) in the context of the COVID-19 pandemic, we planned a clinical audit in 24 Italian institutions treating GU malignancies. Objective: The primary objective was investigating the clinical impact of COVID-19 in GU cancer patients undergoing ICI-based therapy during the first outbreak of SARS-CoV-2 contagion in Italy. Design, setting, and participants: The included centers were 24 Oncology Departments. Two online forms were completed by the responsible Oncology Consultants, respectively, for metastatic renal cell carcinoma (mRCC) and metastatic urothelial carcinoma (mUC) patients receiving at least one administration of ICIs between 31 January 2020 and 30 June 2020. Results and limitation: In total, 287 mRCC patients and 130 mUC patients were included. The COVID-19 incidence was, respectively, 3.5%, with mortality 1%, in mRCC patients and 7.7%, with mortality 3.1%, in mUC patients. In both groups, 40% of patients developing COVID-19 permanently discontinued anticancer treatment. The pre-test SARS-CoV-2 probability in the subgroup of patients who underwent nasal/pharyngeal swab ranged from 14% in mRCC to 26% in mUC. The main limitation of the work was its nature of audit: data were not recorded at the single-patient level. Conclusion: GU cancer patients undergoing active treatment with ICIs have meaningful risk factors for developing severe events from COVID-19 and permanent discontinuation of therapy after the infection. Treatment delays due to organizational issues during the pandemic were unlikely to affect the treatment outcome in this population.
Psychometric Properties of the COVID-19 Protective Motivation Scale in Peruvians During the Health Emergency
Authors: Cornejo Bruno , Vela Brayan , Vilca Lindsey W. , Vallejos María , Huancahuire-Vega Salomón 
Published: October 2021

Objective: The COVID-19 protective motivation scale (EMP-COVID-19) has been developed for the assessment of protective motivation. This study aims to examine the psychometric properties of the EMP-COVID-19 for its application in the Peruvian community. Methods: This is an observational, cross-sectional, instrumental design study, 483 adults (≥18 years) participated in the study, in 2 samples of 81 and 402 participants from the different macro-regions of Peru through an online survey using non-probabilistic sampling. Content validation was performed through expert judgment. Exploratory factor analysis (EFA) to evaluate the factor model of the EMP-COVID-19 was performed with the first sample. The confirmatory factor analysis (CFA) to verify the goodness of fit of the analysis found in the EFA was performed with the second sample. The examination of convergent and discriminant validity included peer evaluations of each EMP-COVID-19 dimension. Finally, the reliability of the instrument was evaluated using Cronbach’s Alpha coefficient. Results: The 3-factor related model presents better fit indices (CFI = 0.99; TLI = 0.99; RMSEA = 0.077 [90% CI 0.069-0.085]) versus a unidimensional model (CFI = 0.91; TLI = 0.90; RMSEA = 0.206 [90% CI 0.199-0.213]). The scale present convergent and discriminant validity in all the dimensions Threat Appraisal (AVE = .57), Coping Appraisal (AVE = .81), and Response Costs (AVE = .67). The Coping Appraisal (α = .97; ω = .97), Threat Appraisal (α = .88; ω = .74), and Response Costs (α = .80; ω = .76) dimensions were also found to have adequate reliability indices. Conclusions: The EMP-COVID-19 scale demonstrated adequate reliability and validity based on internal structure in the study sample.
Internet survey on factors associated with care-seeking behaviours of people with chronic musculoskeletal pain in Japan
Authors: Sugai Keiko , Tsuji Osahiko , Takahashi Shoko , Matsumoto Morio , Nakamura Masaya , Fujita Nobuyuki 
Published: October 2021

Purpose: Many people with chronic musculoskeletal pain (CMP) seek healthcare from conventional and complementary and alternative medicine. However, treatment/therapy is not always adequate, patients often change healthcare providers, and some patients are left untreated. This study clarified care-seeking behaviours and explored factors behind the behaviours in people with CMP. Methods: Using a Japanese cross-sectional online survey, participants aged ≥ 20 years with non-cancer/fracture CMP lasting for ≥ 6 months and presenting ≤1 month, interfering with daily living activities and/or work were enrolled. We summarized and analysed the characteristics and factors associated with choice of healthcare providers; information on socio-demographics, including employment; ability to use healthcare, including income; and need for healthcare, including pain intensity, using a logistic regression model. Results: Among the 9105 respondents, 24.5% consulted physicians, 18.3% complementary and alternative medicine practitioners, and 57.2% were untreated. More respondents who had moderate–severe pain visited physician, more regularly employed and with high income visited complementary and alternative medicine, and less respondents who had moderate–severe pain were untreated. These were found to be associated with the respective healthcare use versus untreated. Conclusions: People with severe conditions, higher income and regular employment, and less severe conditions have visited physicians, complementary and alternative medicine practitioners and none, respectively. By applying this result at each type of healthcare provider, it may be possible to treat patients more appropriately.
The disconnect between visual assessment of air trapping and lung physiology for assessment of small airway disease in scleroderma-related interstitial lung disease: An observation from the Scleroderma Lung Study II Cohort
Authors: Bae Sangmee Sharon , Pourzand Lila , Hyun Kim Grace , Villegas Bianca E , Oh Andrea , Furst Daniel E , Goldin Jonathan , Tashkin Donald P 
Published: October 2021

Objective: To explore the presence of small airway disease (SAD) and emphysema in scleroderma-related interstitial lung disease (SSc-ILD) and to evaluate the physiologic and clinical correlates of SAD in SSc-ILD. Methods: Thoracic high-resolution computed tomography (HRCT) images obtained from the Scleroderma Lung Study II (SLSII) participants were reviewed by a group of thoracic radiologists. The presence of SAD was assessed by visual assessment for air trapping. HRCT scans were also evaluated for the presence of emphysema. The association of the presence of air trapping and emphysema with physiological measures of airway disease and clinical variables was evaluated. Results: A total of 155 baseline HRCT scans were reviewed. For assessment of air trapping, images needed to be adequate end-expiratory examinations, leaving 123 scans. Air trapping was seen in 13/123 (10.6%) of the SSc-ILD cohort and was independent of smoking history, asthma or the presence of gastroesophageal reflux. Air trapping on HRCT was not associated with physiologic evidence of SAD. We also identified 8/155 (5.2%) patients with emphysema on HRCT, which was independent of SAD and found mostly in prior smokers. Conclusion: We report the first study of air trapping on standardized, high-quality HRCT images as a reflection of SAD in a relatively large, well characterized SSc-ILD cohort. The presence of SAD in non-smoking SSc-ILD patients supports that SSc may cause not only restrictive lung disease (SSc-ILD), but also, to a lesser extent, obstructive disease. Physiologic measures alone may be inadequate to detect airway disease in patients with SSc-ILD.
Feasibility and acceptability of a peer youth led curriculum to improve HIV knowledge in Northern Tanzania: resilience and intervention experience from the perspective of peer leaders
Authors: Hosaka Kalei R. J. , Mmbaga Blandina T. , Gallis John A. , Dow Dorothy E. 
Published: October 2021

Abstract
Background
Youth Living with HIV (YLWH) have reduced adherence to antiretroviral therapy (ART) and worse virologic outcomes compared to children and adults. HIV peer youth led (PYL) interventions contribute to improved retention in care and psychosocial wellbeing. The study objective was to assess the feasibility and acceptability of a PYL HIV curriculum and describe change in participants’ knowledge and impact of leadership on peer leaders’ lives.

Methods
An HIV curriculum was taught during monthly Saturday adolescent HIV clinics at two clinical sites in Moshi, Tanzania (2018–2019). Youth attending clinics were ages 12 to 24 years and received the HIV curriculum during routine clinical care. Peer leaders previously participated in a mental health and life skills intervention called Sauti ya Vijana (The Voice of Youth; SYV) and were recommended for leadership by SYV facilitators and clinic staff. Peer leaders were trained and supervised weekly in curriculum delivery using a “train the trainer” model. Data were collected and analyzed using mixed methods. Fidelity checklists were used to measure adherence to the curriculum. Youth participants answered written pre- and post-knowledge questions and evaluated PYL teaching. Semi-structured interviews and the Connor Davidson Resilience scale were conducted with peer leaders before and after assuming the leadership role.

Results
Peer leaders (N = 4 male; 3 female) demonstrated high fidelity (96%) to activities in each lesson and participant feedback was positive for curriculum delivery. Participants’ knowledge improved in nine of ten sessions. All but one leader—who moved away before the study ended—demonstrated stable or improved resilience with a mean difference of 3.8 (SD = 7.0) from before the intervention to after assuming the leadership role. Peer leaders reported improved leadership confidence and resilience, and their perception was that the curriculum helped normalize the HIV experience for YLWH attending clinic. Nevertheless, anticipated stigma, difficulty disclosing HIV status, and teaching ability remained barriers.

Conclusions
This study demonstrated that a PYL curriculum to improve HIV knowledge integrated into routine adolescent HIV clinic in Tanzania was feasible, acceptable, and improved knowledge while also benefiting peer leaders, thus providing evidence to continue to support efforts to scale and sustain PYL interventions for YLWH.
Psychological responses and associated factors during the initial stage of the coronavirus disease (COVID-19) epidemic among the adult population in Poland - a cross-sectional study
Authors: Sozański Bernard , Ćwirlej-Sozańska Agnieszka , Wiśniowska-Szurlej Agnieszka , Jurek Krystian , Górniak Patryk , Górski Karol , Englert-Bator Anna , Perenc Lidia 
Published: October 2021

Abstract
Introduction
The study aimed to assess the emotional state, the occurrence of symptoms of depression, anxiety, and stress, as well as the quality of life of adults living in Poland during the first weeks of the COVID-19 pandemic.

Method
The study was conducted on a group of 700 people aged 18 and over living in Poland. An anonymous online questionnaire was used in this cross-sectional study. The psychological impact of COVID-19 was measured using the Revised Event Impact Scale (IES-R) and the Depression, Anxiety, and Stress Scale (DASS - 21). The quality of life was assessed using the WHOQOL-BREF.

Results
In Poland, a high average level of post-traumatic stress was found as a result of the COVID-19 pandemic, with at least the minimum level occurring in all surveyed people. There was also a high incidence of depression (48.00%), anxiety (39.29%), and stress (54.86) in the first phase of the pandemic. The average level of quality of life in Poland was the lowest for the physical domain and amounted to 49.56 (SD = 11.71). The standard of living in the psychological domain was 60.26 (SD = 13.14).

Conclusions
The pandemic is having a significant impact on human mental health. The very high average levels of post-traumatic stress, stress, anxiety, and depression as well as low quality of life make it necessary to consider interventions that will favor the use of more adaptive defense mechanisms and build mental resilience during an infectious disease pandemic and its long-term consequences.
Understanding multidisciplinary care for people with rheumatic disease in British Columbia, Canada, through patients, nurses and physicians voices: a qualitative policy evaluation
Authors: Apantaku Glory , Aguiar Magda , Kaal K. Julia , Munro Sarah , Teo Michelle , Harrison Mark 
Published: October 2021

Abstract
Background
In 2011, the province of British Columbia (BC) moved to allow patients with complex rheumatic disease to be seen by nurses along with their rheumatologist by introducing a ‘Multidisciplinary Care Assessments’ (MCA) billing code (G31060).

Objective
To describe multidisciplinary care introduced as part of MCAs across BC and investigate the perceived impact of this intervention, the addition of nurses to the care team, on patient care from the perspective of patients, nurses, and rheumatologists.

Methods
We conducted semi-structured interviews, informed by a qualitative evaluation approach with patients, nurses, and rheumatologists from September 2019 – August 2020. Interviews investigated 1) the experiences of all stakeholders with adopting the multidisciplinary care billing code, 2) the perceived role of the nurse in the care team, and 3) the perceived impact of multidisciplinary care on patient experience and outcomes. We purposefully sampled practices for maximum variation of geographical location (rural vs. urban), size of practice (i.e., patient caseload), and number of nurses employed.

Results
We interviewed 21 patients, 13 nurses, and 12 rheumatologists from across BC. Our analysis identified variation in the way rheumatologists adopted multidisciplinary care across BC. Our analysis showed some heterogeneity in the way the MCA was delivered in rheumatology practices; however, patient education was identified as the core role of nurses across practices. We identified six core themes describing the impact of this model of care, all representing improvements in the way practices functioned, from improved efficiency to access, patient experience, time management, clinician experience, and patient health outcomes. Contextual factors that influenced the presence of these themes were related to the time the nurses spent with patients and the professional roles they performed.

Conclusion
Our results suggest nurse care can complement physician care by extending contact time for patients and promoting the efficient use of health care professionals’ skills, time, and resources. These data may encourage future uptake of the billing code to help ensure the policy delivers maximum benefits to patients given the wide range of perceived benefits described by clinicians and patients.
In-hospital COVID-19 infection echocardiographic analysis: a Brazilian, tertiary single-centre experience
Authors: Vieira Marcelo Luiz Campos , Afonso Tania Regina , Oliveira Alessandra Joslin , Stangenhaus Carolina , Dantas Juliana Cardoso Dória , de França Lucas Arraes , Daminelo Edgar , Cordovil Adriana , Martins Lara A. S. , Meirelles Rodrigo A. C. , Piveta Rafael B. , Barros-Gomes Sérgio , Aguiar Miguel O. D. , Roveri Patrícia O. , Oliveira Wércules A. , Lianza Alessandro C. , Ponchirolli Andrea P. L. , Silva Líria M. L. , Costa Rodrigo C. P. L. , Fischer Cláudio H. , Morhy Samira Saady 
Published: October 2021

Abstract
Background
Information is lacking concerning in-hospital echocardiography analysis of COVID-19 infection in Brazil. We evaluated echocardiographic parameters to predict a composite endpoint of mortality, pulmonary thromboembolism or acute renal failure.

Methods
A prospective full echocardiographic study of consecutive patients hospitalized with COVID-19, single tertiary centre in Brazil. We correlated echocardiographic findings to biomarkers, clinical information, thoracic tomography, and in-hospital composite endpoint of mortality, pulmonary thromboembolism or renal failure.

Results
One hundred eleven patients from March to October 2020, 67 ± 17 years, 65 (58.5%) men, death was observed in 21/111 (18.9%) patients, 48 (43%) required mechanical ventilation, myocardial infarction occurred in 10 (9%), pulmonary thromboembolism in 7 (6.3%) patients, haemodialysis was required for 9 (9.8%). Echocardiography was normal in 51 (46%) patients, 20 (18%) presented with decreased left ventricle ejection, 18 (16.2%) had abnormal left ventricle global longitudinal strain, 35 (31%) had diastolic dysfunction, 6 (5.4%) had an E/e’ratio > 14, 19 (17.1%) presented with right ventricle dilated/dysfunction, 31 (28%) had pericardial effusion. The echocardiographic parameters did not correlate with mortality, biomarkers, clinical events. Tricuspid velocity was related to the composite endpoint of mortality, pulmonary thromboembolism or acute renal failure (p: 00.3; value: 2.65 m/s; AUC ROC curve: 0.739; sensitivity: 73.3; specificity: 66.7; CI: 0.95, inferior: 0.613; superior: 0,866).

Conclusions
Among hospitalized patients with COVID-19, echocardiography was normal in 51(46%) patients, and 20 (18%) patients presented with a decreased left ventricle ejection fraction. Tricuspid velocity was related to the composite endpoint of mortality, pulmonary thromboembolism or acute renal failure.