bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of laparoscopic versus open simple nephrectomy in patients with xanthogranulomatous pyelonephritis: A singlecenter analysis of outcomes and predictors of surgical approaches and complications
Authors: Chiancone Francesco , Persico Francesco , Fabiano Marco , Meccariello Clemente , Giannella Riccardo , Fedelini Maurizio , Lughezzani Giovanni , Fedelini Paolo 
Published: November 2021

Abstract

Background
The aim of this study was to compare the outcomes of open simple nephrectomy and laparoscopic simple nephrectomy in patients with xanthogranulomatous pyelonephritis (XGP) in a single-institutional retrospective study and to identify predictive factors of surgical approaches and complications.

Materials and methods
We retrospectively analyzed the data of 67 consecutive patients with a histopathological diagnosis of XGP who underwent either open simple nephrectomy (ON) or laparoscopic simple nephrectomy (LN) from January 2014 to April 2020. The primary endpoint was the evaluation of perioperative outcomes and complications. Secondary endpoints were to define factors influencing the surgical approach and the likelihood of postoperative complications.

Results
Overall, 44 out of 67 patients (65.67%) underwent ON, while 23 (34.33%) underwent LN. Patients in the ON group experienced more postoperative pain according to the visual analogic scale (p = 0.032). Moreover, time to deambulation and time to return to full daily activities, assessed according to the 12-Item Short Form Survey physical and mental component summary scores questionnaires, were significantly shorter in the LN group (p = 0.021, p < 0.001, and p < 0.001, respectively). Of note, there were no significant differences in intraoperative and postoperative complication rates among the groups (p = 0.258 and p = 0.317, respectively). No conversion to open surgery was described. Logistic regression analysis demonstrated that urgency (p = 0.025) was the only predictor associated with a higher risk of intraoperative complications. However, no independent factors associated with postoperative complications or with the surgical approach of choice were found.

Conclusions
Based on our results, laparoscopic treatment of XGP represents a feasible alternative to ON, resulting in less postoperative pain and faster recovery. In skilled hands, LN should be considered as the treatment of choice for XGP.
Menopausal symptoms among Chinese and Japanese women: differences and similarities
Authors: Su Jing , Jogamoto Akiko , Yoshimura Hiroyuki , Yang Lu Jun 
Published: November 2021

Abstract

Objectives:
This study aimed to identify the characteristics of menopausal symptoms among Japanese and Chinese women and to determine the correlation between menopausal symptoms and self-efficacy.

Methods:
We surveyed 40- to 59-year-old women, 329 of whom were from an urban area in Northwest China (Xi’an) and 310 were from an urban area in Western Japan (Ehime), using a menopausal symptoms inventory and a self-efficacy scale. Comparison analysis was conducted among pre-, peri-, and postmenopausal status, within and between the two cultural groups. Following a two-way ANOVA, multiple comparisons were performed using the Tukey-Kramer test. The correlation between severity of menopause symptoms and self-efficacy scores was evaluated using canonical correlation analysis.

Results:
The most frequently reported symptoms were fatigue (93.6%) among Japanese women and memory loss (76.6%) among Chinese women. Japanese women showed significantly higher severity scores across all factors than Chinese, sexual function: 19.58 (SE = 0.73) versus 15.04 (SE = 0.67); mental health condition: 35.44 (SE = 1.15) versus 27.12 (SE = 0.95); interpersonal anxiety: 27.45 (SE = 0.95) versus 21.92 (SE = 0.86); autonomic balance: 42.76 (SE = 1.27) versus 35.75 (SE = 1.17); other subjective symptoms: 39.68 (SE = 1.20) versus 33.07 (SE = 1.12) in the premenopausal group (P < 0.01); and mental health conditions 35.14 (SE = 1.41) versus 29.60 (SE = 1.25), interpersonal anxiety: 27.34 (SE = 1.18) versus 20.79 (SE = 1.02), autonomic balance factors: 45.81 (SE = 1.79) versus 38.05 (SE = 1.67) in the postmenopausal group (P < 0.01). No significant differences of the factors among menopausal stages within Japanese women were found. Among Chinese women, peri- and postmenopausal women showed significantly higher severity scores on sexual function, while perimenopausal women scored higher on mental health conditions and autonomic balance factors (P < 0.01). A negative correlation was found between menopausal symptoms and self-efficacy among both Japanese and Chinese women (P < 0.01).

Conclusions:
Japanese women reported more severe symptoms compared with their Chinese counterparts, and for Chinese women, symptoms might be specifically associated with menopausal status. Menopausal experience is associated with self-efficacy and vice versa.
Access Drives Health System Transformation and Growth
Authors: Sussman Jason H. 
Published: November 2021

SUMMARY
Healthcare is in the midst of a “great disintermediation.” New care delivery models are offering novel ways of accessing care and moving the US healthcare system from a hospital-centric to a consumer-centric focus. This transformation is opening new opportunities for technology-enabled, risk-ready innovators intent on disrupting traditional ties among health systems, primary care physicians, and consumers.
Frugal Method of Notch Modification of Scleral Contact Lenses in the Setting of Complex Ocular Surface Anatomy
Authors: Patel Raj P. , Samples Jeffrey S. , Riaz Kamran M. 
Published: November 2021

Abstract:
Scleral contact lenses (ScCLs) have gained popularity as a treatment of refractive errors in patients with complex anterior segment pathology. Patients with mechanical abnormalities of the ocular surface may be unsuccessful with traditional ScCL fitting. Scleral contact lens modifications, such as notching and microvaulting, typically incur additional financial costs and require the services of professional laboratories. We describe a frugal method of ScCL notch modification that can be performed by a practitioner using readily available tools in a single office visit. Two patients with abnormal ocular surface anatomy were fit with the practitioner-modified ScCL and achieved successful visual rehabilitation. We offer this method as a potentially economical and effective technique to achieve successful ScCL fitting in this challenging patient population with pathologies that may preclude standard ScCL usage.
Changes in Tear Meniscus Analysis of Children Who Have Type 1 Diabetes Mellitus, With and Without Vitamin D Deficiency
Authors: Aksoy Aydemir Gozde , Aydemir Emre , Asik Abdulvahit 
Published: November 2021

Purpose:
The aim of this study was to quantitatively evaluate dry eye test parameters of pediatric patients with and without vitamin D deficiency (VDD) in type 1 diabetes mellitus.

Methods:
In this prospective cross-sectional study, the Ocular Surface Disease Index, Schirmer test, tear film breakup time, corneal staining score, and anterior segment optical coherence tomography were used to determine the dry eye test parameters of pediatric patients with type 1 diabetes mellitus (T1-DMPs) (group 1) and a healthy pediatric control group (group 2). Group 1 was divided into 2 subgroups based on their vitamin D status: group 1a, who had a VDD, and group 1b, who had vitamin D levels that were within the normal range.

Results:
This study compared 90 eyes of 90 pediatric T1-DMPs with 80 eyes of 80 healthy controls. The demographic characteristics of the groups were similar (P > 0.05). The tear film breakup time, Schirmer test, corneal staining score, and values of the tear meniscus height and area were observed to have been lower in the patients in group 1a than the healthy pediatric control group, at P < 0.001. The same parameters were statistically significantly lower in the patients in group 1a when compared with group 1b (P < 0.05 for both).

Conclusions:
The tear measurements of the pediatric T1-DMPs were lower than those in the healthy pediatric control group. The accompanying VDD made this situation more pronounced.
Upper Eyelid Contour Changes After Orbital Decompression in Graves Orbitopathy
Authors: Cruz Antonio A. V. , Equitério Bruna , Diniz Stefania B. , Garcia Denny M. , Rootman Daniel B. , Goldberg Robert A. , Galindo-Ferreiro Alicia , Marqués-Fernández Victoria , Sales-Sanz Marco 
Published: November 2021

Purpose:
To evaluate the effect of orbital decompression on the upper eyelid contour.

Methods:
A paired cross-sectional analysis of the upper eyelid contour was performed for 103 eyes of 66 patients who underwent orbital decompression. A control group of 26 normal subjects was also included. The eyelid contour of all participants were measured with Bézier lines adjusted to the eyelid contour and 9 midpupil eyelid margin (MPD) distances from a horizontal line bisecting the pupil. One central, corresponding to the margin reflex distance (MRD 1), and 8 equally distributed medially and laterally at 20% of the interval between the lines. Patients were classified as with flare if the height of the most lateral MPD relative to the MRD 1 was above the upper limit of the controls.

Results:
Preoperatively 63 of the 103 contours were classified as flare + (F+). After decompression MRD1 showed a mean decrease of 0.4 mm and the location of the contour shifted 0.8 mm medially. These changes were not correlated with proptosis reduction. Orbital decompression decreased the lateral curvature of the contours especially for the F+ lids. In 40% of the F+ eyelids the flare sign disappeared after decompression.

Conclusions:
Orbital decompression affects the lateral eyelid contour and diminishes the amount of lateral eyelid retraction surgery necessary to correct the flare sign. In 40% of the patients, the eyelid contour is normalized with proptosis reduction only.
Characteristics of Adults With Diagnosed HIV Who Experienced Housing Instability: Findings From the Centers for Disease Control and Prevention Medical Monitoring Project, United States, 2018
Authors: Marcus Ruthanne , Tie Yunfeng , Dasgupta Sharoda , Beer Linda , Padilla Mabel , Fagan Jennifer , Prejean Joseph 
Published: November 2021

Abstract
People living with HIV (PLWH) who experience homelessness have poorer clinical outcomes than people with HIV who are not homeless; however, there is limited information on PLWH who experience other forms of housing instability. We used interviews and medical record abstraction data from the Medical Monitoring Project, collected 2018–2019 (N = 4,050), to describe sociodemographic characteristics and clinical outcomes of adults with HIV by whether people experienced unstable housing in the past 12 months. Overall, 21% were unstably housed, of which 55.2% were unstably housed but not homeless. People who were unstably housed were more likely to be younger, have lower educational attainment, be previously incarcerated, live at or below the poverty level, and have poorer mental health and clinical outcomes, independent of homelessness. Interventions to address housing instability, integrated with clinical care, could benefit not just PLWH who are homeless but also those who are unstably housed.
The Utility of Pathology Reports to Identify Persons With Cancer Recurrence
Authors: Warren Joan L. , Noone Anne-Michelle , Stevens Jennifer , Wu Xiao-Cheng , Hsieh Mei-chin , Mumphrey Brent J. , Schmidt Rodney , Coyle Linda , Shields Rusty , Mariotto Angela B. 
Published: November 2021

Background:
Cancer recurrence is an important measure of the impact of cancer treatment. However, no population-based data on recurrence are available. Pathology reports could potentially identify cancer recurrences. Their utility to capture recurrences is unknown.

Objective:
This analysis assesses the sensitivity of pathology reports to identify patients with cancer recurrence and the stage at recurrence.

Subjects:
The study includes patients with recurrent breast (n=214) or colorectal (n=203) cancers.

Research Design:
This retrospective analysis included patients from a population-based cancer registry who were part of the Patient-Centered Outcomes Research (PCOR) Study, a project that followed cancer patients in-depth for 5 years after diagnosis to identify recurrences.

Measures:
Information abstracted from pathology reports for patients with recurrence was compared with their PCOR data (gold standard) to determine what percent had a pathology report at the time of recurrence, the sensitivity of text in the report to identify recurrence, and if the stage at recurrence could be determined from the pathology report.

Results:
One half of cancer patients had a pathology report near the time of recurrence. For patients with a pathology report, the report’s sensitivity to identify recurrence was 98.1% for breast cancer cases and 95.7% for colorectal cancer cases. The specific stage at recurrence from the pathology report had a moderate agreement with gold-standard data.

Conclusions:
Pathology reports alone cannot measure population-based recurrence of solid cancers but can identify specific cohorts of recurrent cancer patients. As electronic submission of pathology reports increases, these reports may identify specific recurrent patients in near real-time.
School-based health centers as a context to engage and serve communities
Authors: Cutuli J.J. 
Published: November 2021

Purpose of review
School-based health centers (SBHCs) primarily serve underserved students and families through removing barriers to care. The number of SBHCs have increased dramatically with investments from state-funding and federal-funding programs, including expanded funding from the American Rescue Plan. This article reviews findings on the perceived importance of school and community partnership. It also provides a critical review of the evidence base on impact on health, mental health, and education indicators.

Recent findings
Recent findings underscore the importance of SBHCs engaging the school and community to build trust while identifying and responding to needs. Engagement supports planning, implementing, and sustaining SBHCs. Studies of impact find that SBHCs increase participation in preventive and routine health and decrease emergency department utilization and hospitalization. However, additional research needs to rigorously test for effects of SBHCs on symptoms and indicators of wellbeing, especially with respect to mental health and education.

Summary
SBHCs increase participation of students from marginalized groups in preventive and routine care. School and community engagement are vital aspects of SBHCs, likely removing barriers related to trust. Additional rigorous evidence is needed testing efficacy of SBHCs when it comes to improving health, mental health, and education.
Features and management of men with pN1 cM0 prostate cancer after radical prostatectomy and lymphadenectomy: a systematic review of population-based evidence
Authors: Laine Charles , Gandaglia Giorgio , Valerio Massimo , Heidegger Isabel , Tsaur Igor , Olivier Jonathan , Ceci Francesco , van den Bergh Roderick C.N. , Kretschmer Alexander , Thibault Constance , Chiu Peter K. , Tilki Derya , Kasivisvanathan Veeru , Preisser Felix , Zattoni Fabio , Fankhauser Christian , Kesch Claudia , Puche-Sanz Ignacio , Moschini Marco , Pradere Benjamin , Ploussard Guillaume , Marra Giancarlo 
Published: November 2021

Purpose of review
To investigate the features and optimal management of pN+ cM0 prostate cancer (PCa) according to registry-based studies.

Recent findings
Up to 15% of PCa patients harbor lymph node invasion (pN+) at radical prostatectomy plus lymph node dissection. Nonetheless, the optimal management strategy in this setting is not well characterized.

Summary
We performed a systematic review including n = 13 studies. Management strategies comprised 13 536 men undergoing observation, 11 149 adjuvant androgen deprivation therapy (aADT), 7,075 adjuvant radiotherapy (aRT) +aADT and 705 aRT. Baseline features showed aggressive PCa in the majority of men. At a median follow-up ranging 48–134months, Cancer-related death was 5% and overall-mortality 16.6%. aADT and aRT alone had no cancer-specific survival or overall survival advantages over observation only and over not performing aRT, respectively. aADT plus aRT yielded a survival benefit compared to observation and aADT, which in one study, were limited to certain intermediate-risk categories. Age, Gleason, Charlson score, positive surgical margins, pathological stage, and positive nodes number, but not prostate specific antigen, were most relevant prognostic factors. Our work further confirmed pN+ PCa is a multifaceted disease and will help future research in defining its optimal management based on different risk categories to maximize survival and patient's quality of life.
Success with dorsal root entry zone lesioning after a failed trial of spinal cord stimulation in a patient with pain due to brachial plexus avulsion
Authors: Lopez Lucia , Sdrulla Andrei D. 
Published: November 2021

Abstract
Pain caused by brachial plexopathy (BP) represents a challenging clinical problem with few effective therapeutic options. Here, we present a patient with severe, painful BP after a high-impact motor vehicle accident who failed conservative treatments. A trial of cervical spinal cord stimulation was completed using multiple waveforms (tonic, BurstDR, and 10 kHz) over 14 days with only 30% to 40% pain reduction. Subsequently, he underwent dorsal root entry zone lesioning with a significant decrease in his pain 1 year later. Surgical exploration revealed extensive damage and avulsion of his cervical roots that was not observed on a previous brachial plexus magnetic resonance imaging. We discuss the etiology and diagnosis of traumatic BP, possible reasons for the failed spinal cord stimulation trial, and implications for management.
Machine Learning Estimation of Low-Density Lipoprotein Cholesterol in Women With and Without HIV
Authors: Dong Tony , Rana Mariam N. , Longenecker Chris T. , Rajagopalan Sanjay , Kim Chang H. , Al-Kindi Sadeer G. 
Published: November 2021

Introduction:
Low-density lipoprotein cholesterol (LDL-C) is typically estimated from total cholesterol, high-density lipoprotein cholesterol, and triglycerides. The Friedewald, Martin–Hopkins, and National Institutes of Health equations are widely used but may estimate LDL-C inaccurately in certain patient populations, such as those with HIV. We sought to investigate the utility of machine learning for LDL-C estimation in a large cohort of women with and without HIV.

Methods:
We identified 7397 direct LDL-C measurements (5219 from HIV-infected individuals, 2127 from uninfected controls, and 51 from seroconvertors) from 2414 participants (age 39.4 ± 9.3 years) in the Women's Interagency HIV Study and estimated LDL-C using the Friedewald, Martin–Hopkins, and National Institutes of Health equations. We also optimized 5 machine learning methods [linear regression, random forest, gradient boosting, support vector machine (SVM), and neural network] using 80% of the data (training set). We compared the performance of each method using root mean square error, mean absolute error, and coefficient of determination (R2) in the holdout (20%) set.

Results:
SVM outperformed all 3 existing equations and other machine learning methods, achieving the lowest root mean square error and mean absolute error, and the highest R2 (11.79 and 7.98 mg/dL, 0.87, respectively, compared with those obtained using the Friedewald equation: 12.45 and 9.14 mg/dL, 0.87). SVM performance remained superior in subgroups with and without HIV, with nonfasting measurements, in LDL <70 mg/dL and triglycerides > 400 mg/dL.

Conclusions:
In this proof-of-concept study, SVM is a robust method that predicts directly measured LDL-C more accurately than clinically used methods in women with and without HIV. Further studies should explore the utility in broader populations.
Relationships Between Age, Soluble Triggering Receptor Expressed on Myeloid Cells-1 (sTREM-1), and Mortality Among Critically Ill Adults: A Cohort Study
Authors: Sathe Neha A. , Bhatraju Pavan K. , Mikacenic Carmen , Morrell Eric D. , Mabrey F. Linzee , Liles W. Conrad , Wurfel Mark M. 
Published: November 2021

ABSTRACT

Background:
Innate immune dysregulation may contribute to age-related differences in outcomes among critically ill adults. Soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) is an important innate immune marker with prognostic value in sepsis, but age-related differences have not been studied.

Methods:
This was a prospective cohort from a large tertiary care hospital enrolling adults from both medical and trauma-surgical intensive care units (ICUs). Plasma sTREM-1 was measured in participants within 24 h of ICU admission. We analyzed associations between age (≤50 and >50 years) and sTREM-1 using linear regression. We then examined associations between sTREM-1 and both 28-day mortality and persistent organ dysfunction (defined as need for dialysis, vasopressors, or invasive mechanical ventilation) 7 days following admission using relative risk regression.

Results:
Of 231 critically ill adults, older patients (n = 122) had higher prevalence of chronic disease and sepsis on enrollment than younger patients, but acute illness severity was similar. Age over 50 was associated with 27% higher sTREM-1 concentrations (95% CI 6%–53%), adjusted for sex and Charlson comorbidity index (CCI). Two-fold higher sTREM-1 was associated with 2.42-fold higher risk for mortality (95% CI 1.57, 3.73) and 1.86-fold higher risk for persistent organ dysfunction (95% CI 1.45, 2.39), adjusted for sex, CCI, and age.

Conclusions:
sTREM-1 was elevated among critically ill older adults, and strongly associated with both death and persistent organ dysfunction. Immune responses associated with sTREM-1 may contribute to age-related differences in ICU outcomes, warranting further study as a potential therapeutic target in older adults.