bluuebunny/crossref_metadata_2025_split huggingface dataset:
Changes in Language Used for Ultrasound Reports in Early Pregnancy Loss After Initiation of Restrictive Abortion Laws [ID 2683508]
Authors: Taper Gabrielle , Gonzaga Maria , Tristan Sigrid , Alvarez Miriam J. , Thaxton Lauren D. 
Published: May 2024

INTRODUCTION:
This study compared language used to describe early pregnancy loss (EPL) in ultrasound reports at a single teaching hospital before and after the passage of Texas Senate Bill 8 (SB8) in September 2021.

METHODS:
We conducted a retrospective cohort study of pregnant patients presenting to the emergency department (ED) between January 2020 and March 2023. Charts were screened using ICD-10 codes for pregnancy and first-trimester diagnoses and included if diagnosis of EPL was present. Abstracted data from ultrasound reports included the following: diagnosis assigned by radiology and confidence of qualifying language (“diagnostic of,” “suggestive of,” or omitted diagnosis). Evidence-based diagnosis was assigned based upon ultrasound review by two independent ob-gyn providers using established ultrasound criteria for EPL. This protocol was approved for IRB exemption by the University of Texas at Austin Dell Medical School.

RESULTS:
A total of 185 charts were identified, N=103 prior to SB8 versus 82 after. After SB8, radiology-assigned diagnosis was discordant with evidence-based diagnosis more often (55% versus 45%; P=.08) and radiology impressions used less confident qualifying language (61% versus 47%; P=.03).

CONCLUSION:
Restrictive abortion laws like SB8, compounded by the Dobbs decision, may affect the diagnostic accuracy and confidence of qualifying language for diagnosis used in ultrasound reports for EPL. Language in ultrasound reports became significantly less confident after SB8 with a decrease in correct diagnosis despite clear diagnostic criteria. Failure to correctly diagnose EPL on radiology reports may delay recognition and treatment of EPL.
Treatment Goals and Symptoms of Patients Presenting to a Center for Fibroid Care [ID 2683523]
Authors: Dahiya Asha K. , Hamer Dina , Friedman Steven , Hade Erinn , Shirazian Taraneh 
Published: May 2024

INTRODUCTION:
Multidisciplinary fibroid centers represent a new model of fibroid care. We evaluated the goals and symptoms of patients presenting to our center.

METHODS:
This is a retrospective cohort study of patients presenting between June 2022 and June 2023. Patients were sent the Uterine Fibroid Symptom Quality of Life (UFS-QOL) survey and a goals questionnaire prior to first appointment. Patients who completed both were included. We obtained age, race, most recent hemoglobin level (Hgb), largest fibroid type on most recent imaging, composite symptom severity score (SS), and health-related QOL score (HRQL). This study met IRB exemption criteria.

RESULTS:
Of 581 patients, 326 (56%) completed both surveys. Mean age was 43.0 years (SD 8.0). Patients identified as Black (35.3%), White (24.8%), Asian (8.9%), and other/multiple race (7.7%). Most patients' largest fibroid was subserosal (37%), followed by intramural (28.7%), submucosal (5.9%), and combined type (28.3%). There was no difference in SS (P=.307) or HRQL (P=.504) between these groups. Most patients (60.7%) selected a top goal of symptom elimination, followed by treating anemia (21.2%) and becoming pregnant (18.1%). Almost a quarter (26.4%) reported difficulty conceiving, and they had higher SS (mean difference [MD] −6.1; 95% CI, −12.1, −0.6) and lower HRQL (MD 7.2; 95% CI, 0.4, 14.0). Patients with Hgb below 12 had higher SS (MD −8.6; 95% CI, −14.6, −2.7) and lower HRQL (MD 8.0; 95% CI, 1.1, 15.0).

CONCLUSION:
Most patients reported a primary goal of symptom elimination. Difficulty conceiving and low Hgb were associated with worse symptoms, yielding insight into treatment opportunities affecting QOL.
Is Concentrated Urine PCR Test Valuable to Detect Genital HPV Infection [ID 2683587]
Authors: Aksakal Boran , Acar Osman , Nadirova Narmin , Apa Alara , Ozturk Harika Bodur 
Published: May 2024

INTRODUCTION:
Human papillomavirus (HPV) is the leading cause of cervical cancer and early detection is crucial for effective prevention. The standard HPV detection method, cervical smear PCR, entails discomfort and deters many women. Therefore, it is challenging to screen large populations for HPV from cervical smear samples. In this study, we investigated the sensitivity of detecting HPV by PCR in concentrated urine samples.

METHODS:
Urine and cervical smear samples were collected from 126 patients (ages 20–35) at Acibadem Altunizade Hospital. Urine samples were concentrated by a tool (MyMagiCon). The presence of HPV DNA in cervical smear and urine samples was determined by PCR.

RESULTS:
Among 126 patients, HPV was detected in 57 either in at least one of the sample types (cervical smear, urine, and concentrated urine). Among all HPV-positive patients, HPV was identified in 87.7% of swab samples, 86% of concentrated urine samples, and only 73.7% of unconcentrated urine samples. The χ2 test comparing cervical smear and concentrated urine samples yielded a Kappa value of 0.78 (95% confidence), indicating strong statistical correlation within this study. Additionally, PCR from concentrated urine samples, identified six HPV-positive samples that were HPV negative in cervical smear samples of the same patients.

CONCLUSION:
It was possible to identify HPV in concentrated urine samples by PCR with a sensitivity almost equal to cervical smear sampling. Since obtaining urine is much easier than obtaining cervical smear samples, this may enable easy screening of large populations for HPV. This may have a big effect in the prevention of cervical cancer.
Do Structured Radiology Reports to Describe Uterine Fibroids Provide Adequate Information for Clinical Decision Making? [ID 2683615]
Authors: Alvarez Alexandra L. , Tordjman Laura A. , Alessandrino Francesco , Delgado Stephanie 
Published: May 2024

INTRODUCTION:
This study evaluated whether structured radiology reports for uterine fibroids can affect clinical decision-making when compared to narrative reports.

METHODS:
Three templates were developed by gynecology and radiology departments to interpret MRI reports in women with uterine fibroids. These included the following: structured report using FIGO classification (SR-FIGO), structured report without FIGO classification (SR), and narrative report (NR). Twenty reports in each group were reviewed and evaluated for presence of 19 key features deemed relevant for management of fibroids. One-way ANOVA was used to evaluate the distribution of key features. Reports were also evaluated for 1) presence of sufficient information to decide on treatment; 2) surgical approach; 3) type of surgery; 4) necessity to review the MRIs; and 5) time spent reviewing the MRIs.

RESULTS:
Eighty MRI reports for patients with uterine fibroids were reviewed. Average number of key features in each report type was significantly different (P<.001); SR-FIGO had highest number (16.95±0.19), followed by SR (16.15±0.29), and NR (9.8±0.58). A significant difference was observed between NR and SR (P=.001), NR and SR-FIGO (P=.001), whereas no significant difference was observed between SR and SR-FIGO (P=.063). No significant difference was found in answers to questions 1–5 among the three different reports (P-value range: 0.05–0.34).

CONCLUSION:
Structured MRI reports for uterine fibroids provide more information than narrative reports. Including the FIGO classification does not significantly alter clinical decision making. Further studies may help clarify whether SR-FIGO can alter treatment and surgical planning for patients with uterine fibroids.
Physician and Adolescent Hirsutism Score Ratings and Their Concordance to Androgen Levels [ID 2683618]
Authors: Reddy Sireesha Y. , Dubey Pallavi , Kim Sophie Y. , Sangha Hareena , Ramirez Paulina , Sanchez Sheralyn 
Published: May 2024

INTRODUCTION:
Hirsutism affects 5–15% of reproductive-aged women. The gold standard for quantifying hirsutism is the modified Ferriman–Gallwey (mFG) score. This study explores whether adolescent and physician ratings of hirsutism using the mFG score, correlate with androgen levels in the setting of confounders like depilation.

METHODS:
Hispanic adolescent females with irregular menstruation and suspected polycystic ovary syndrome (PCOS) were recruited from obstetrics and gynecology clinics at TTUHSC El Paso between September 2021 and May 2023. Patients completed an intake questionnaire, completed PCOS laboratory testing, and rated their hair growth using the mFG visual scoring method. Providers used same the methods for rating hirsutism during the same visit. We estimated Lin’s concordance correlation and Bland–Altman agreement between patient and provider mFG ratings. Linear regression explored factors affecting score changes. Statistical analysis was done by STATA 17.0.

RESULTS:
Forty females participated in this study. The average age at enrollment was 16.19 with a mean (SD) mFG score of 10.55 (5.95) (physicians) and 18.29 (5.78) (adolescents). Adolescents reported higher mean mFG scores than physicians. There is a low level of agreement between the two groups (−7.95; 95% CI: −23.02, 7.12). Specifically, physicians underrated hirsutism scores for arm hair. Using unadjusted linear regression, DHEAS and 17-hydroxyprogesterone levels demonstrate the hormonal influence on hirsutism.

CONCLUSION:
Preliminary findings indicate discordance between physicians’ and patients’ mFG scores, possibly influenced by examination precision and patient perception. Physician-scored mFG, and evaluation of androgen levels, may serve as precise hirsutism markers for Hispanic adolescents.
Fezolinetant Compared With Placebo for Vasomotor Symptoms in Menopause: A Systematic Review and Meta-Analysis [ID 2683665]
Authors: Meirelles Dias Yasmin Jardim , Queiroz Almeida Juliana Vieira , Mora de Marco Novellino Andrea , Eskandar Karine , de Araujo Zotti Ana Isabela 
Published: May 2024

INTRODUCTION:
Although menopausal hormone therapy is the most effective choice for vasomotor symptoms (VMS), it is not appropriate for everyone. Therefore, fezolinetant, a nonhormonal, selective neurokinin 3 receptor antagonist has been proposed as an alternative therapy. We aimed to perform a meta-analysis of the clinical outcomes comparing fezolinetant and placebo for vasomotor symptoms in menopause.

METHODS:
PubMed, Embase, and Cochrane databases were searched for studies comparing 30 mg of fezolinetant with placebo in menopausal women. Outcomes assessed were frequency of moderate/severe VMS and change from baseline to week 12 in total VMS score. Our secondary outcomes were headache, bone fracture, and treatment-emergent adverse events (TEAEs) leading to discontinuation of the drug and TEAEs leading to death. We only included randomize control trials. Statistical analysis was performed using RevMan 5.4.1. Heterogeneity was assessed with I2 statistics and random-risk effect was used if 𝐼2>50%.

RESULTS:
Seven studies met inclusion criteria, with 3,678 patients included, of whom 1,067 were randomized to fenzolinetant. No statistical difference was found in frequency of moderate/severe VMS or TEAEs leading to death, TEAEs leading to drug discontinuation. However, severity of moderate and severe VMS comparing to baseline VMS (MPR) was significantly lower with fezolinetant 30 mg BID (odds ratio [OR] −0.22; 95% CI, −0.30, −0.13; P=.00001; I
2=89%). In addition, headache and bone fractures (OR −6.98; 95% CI, −6.98 to −6.73; P=.03; I
2=100%) were lower with fezolinetant compared to placebo.

CONCLUSION:
Our findings suggest that 30 mg of fezolinetant is a well-tolerated nonhormone therapy that improves vasomotor symptoms with menopause. The safety and efficacy demonstrated in our study support the potential use of fezolinetant as an effective nonhormonal treatment option and may reduce bone fractures and headaches in menopausal women.
Effect of the Affordable Care Act on Cervical Cancer Survival Rates in Californian Women [ID 2683402]
Authors: Akinyemi Oluwasegun A. , Nwokolo Vania 
Published: May 2024

INTRODUCTION:
Following the Affordable Care Act (ACA), insurance coverage among women in California surged. While ACA aimed to boost health care access and utilization, whether this has improved cancer-specific survival rates for cervical cancer patients remains questioned. In the present study, we evaluate the effect of the Affordable Care Act (ACA) on cancer-specific survival rates among women with cervical cancer by comparing pre-ACA (2000–2009) and post-ACA (2010–2020) periods.

METHODS:
This study utilized data from the Surveillance, Epidemiology, and End Results (SEER) Registry from 2000 to 2020. We bifurcated the study duration into pre-ACA (2000–2009) and post-ACA (2010–2020). The primary outcome investigated was cancer-specific survival between these periods. Our objective was to assess the effect of ACA's implementation on cancer-specific survival among women diagnosed with cervical cancer. Analytical adjustments were made for patient age, race/ethnicity, disease stage at presentation, income, marital status, and metropolitan residence status. We also considered whether cervical cancer was the primary site and incorporated treatment modalities such as curative surgery, radiotherapy, and chemotherapy into our analysis.

RESULTS:
Of 29,402 cervical cancer patients, 15,962 were diagnosed pre-ACA and 13,440 post-ACA. More women over 50 were diagnosed post-ACA (49.4%) than pre-ACA (44.9%). Late-stage diagnoses rose slightly post-ACA (42.7% versus 40.8%). Curative surgery decreased post-ACA (53.7% from 62.7%), but chemotherapy increased (48.6% from 39.9%). After adjusting for treatment modalities, post-ACA survival rates in California mirrored those of the pre-ACA period (hazard ratio [HR] 1.06; 95% CI, 0.98–1.15).

CONCLUSION:
The implementation of the ACA led to notable changes in treatment patterns and demographics for cervical cancer patients in California. Although health care access increased, cancer-specific survival rates were similar to the pre-ACA period when adjusting for treatment modalities.
The Role of Social Determinants of Health in Seeking Cancer-Related Information and Influencing Cancer Screening Behaviors Among U.S. Adult Women Aged 40–65 Years [ID 2683457]
Authors: Sacca Lea , Okawaraji Goodness , Marciniak Adeife , Zerrouki Yasmine 
Published: May 2024

INTRODUCTION:
Social determinants of health (SDOH) influence patients’ breast health and their decision and ability to screen for breast cancer. Our study aims to provide a general overview of SDOH acting as significant predictors of mammogram completion across different timeline categories (1–5 years ago, >5 years ago, and never had a mammogram) compared to having a mammogram a year ago or less.

METHODS:
The data were obtained from the 2020 Health Information National Trends Survey 5 (HINTS 5) Cycle 4, which was administered from February through June 2020 to a total of 2,204 females. Multinomial logistic regression was carried out to identify SDOH acting as predictors of mammogram completion for three different timeline categories (1–5 years ago, >5 years ago, and never had a mammogram) compared to having a mammogram a year ago or less.

RESULTS:
The SDOH predictor variables varied as predictors of mammogram completion across the three timeline categories. For the “mammogram 1–5 years ago” category, being Black, not having a full-time job, being single, and not having health insurance were seen as significant predictors of the screening behavior. For the “mammogram >5 years ago” category, identifying as widowed and not having health insurance showed significance as predictors of breast cancer screening. For the “never had a mammogram” category, all age categories >25 years of age, identifying as Black, being single, and not having health insurance were recorded as significant predictors of mammography. Health insurance was consistently seen as a significant predictor of mammogram completion across the different timeline categories.

CONCLUSION:
Future interventions should consider insurance status as an important factor influencing a woman’s decision to seek breast cancer screening. However, a holistic approach integrating the diverse aspects of the SDOH will be more effective in understanding the different barriers hindering at-risk women from seeking annual mammography.
Medicaid Expansion and Cervical Cancer Survival: A Comparative Analysis of Expansion Compared With Non-expansion States Using the SEER Registry [ID 2683647]
Authors: Akinyemi Oluwasegun A. , Nwokolo Vania , Weldeslase Terhas A. , Colon-Santos Lyanne , Luo Guoyang 
Published: May 2024

INTRODUCTION:
Medicaid expansion under the Affordable Care Act sought to improve access to care for millions of uninsured Americans. The implications of this policy change on patients with cervical cancer, a condition disproportionately affecting socioeconomically disadvantaged women, remains underinvestigated. This study explores the effect of Medicaid expansion on cancer-specific survival.

METHODS:
Using the SEER registry, we retrospectively analyzed cervical cancer patients from a non-expansion state (Georgia), and states that experienced Medicaid expansion (California, Connecticut, Louisiana, etc.). The study spans from 2000 to 2020. We divided the data into pre-ACA (before 2010) and post-ACA (after 2010) periods. Cancer-specific survival was our primary outcome. A difference-in-differences analysis was conducted, adjusting for age, race, income, disease stage, marital status, and regional characteristics.

RESULTS:
Among 63,796 cervical cancer patients, 55,683 (87.3%) were from Medicaid expansion states and 8,184 (12.7%) from non-expansion Georgia. The 5-year survival was 68.5% in expansion states versus 68.4% in Georgia (P>.05). Difference-in-differences analysis revealed no significant effect of policy implementation on cancer-specific survival (hazard ratio [HR] 1.01; 95% CI, 0.90–1.13). Surgical treatment significantly predicted improved survival (HR 0.46; 95% CI, 0.44–0.49). Black women had lower survival than White women (HR 1.18; 95% CI, 1.12–1.25).

CONCLUSION:
Medicaid expansion under the Affordable Care Act showed no significant effect on cervical cancer-specific survival. Surgical treatment improved survival, while Black women experienced comparatively lower survival rates.
Preoperative Counseling and Surgical Practice: Gynecologic Surgeons' Approach to Ovary-Sparing Hysterectomy [ID 2683432]
Authors: Nora Anne E. , Harris Kendra , Miller Megan , Green Isabel C. , Laughlin-Tommaso Shannon , Cohen Rassier Sarah L. 
Published: May 2024

INTRODUCTION:
Since the early 20th century, surgical practices on prophylactic oophorectomy at the time of hysterectomy have fluctuated. This study aims to assess how current gynecologic surgeons are counseling patients on ovary-sparing benign hysterectomies and assess any gaps in provider knowledge.

METHODS:
Institutional review board exception was obtained. A survey was piloted and underwent several rounds of editing before being sent to members of American Association of Gynecologic Laparoscopists (AAGL) in April 2023. The questionnaire evaluated preoperative counseling on risks and benefits of ovary-sparing hysterectomy for benign indications and surgical practices for when to perform bilateral salpingectomy and oophorectomy. Descriptive statistics and regression analyses were performed.

RESULTS:
The survey was sent out by email to 6,622 AAGL members, 3,576 opened the email, and 520 completed surveys (14% response rate). Approximately one-half (58%) completed subspeciality training. Most counsel patients on the benefits of ovarian conservation including the prevention of osteoporosis (88%), early onset menopause (87%), cardiovascular disease (84%), and dementia (52%). Fifty percent recommend routine bilateral salpingo-oophorectomy at time of hysterectomy starting at age 61, whereas 38% recommend this be performed at age 51–55 years.

CONCLUSION:
Gynecologic surgeons are counseling patients on the risks and benefits of ovarian conservation. How frequently ovary-sparing hysterectomies are offered and the age at which bilateral salpingo-oophorectomy is recommended vary by provider. Additional high-quality studies are needed to further understand the optimal timing of oophorectomy at time of benign hysterectomy, and there is also a need for provider education to minimize discrepancy in practice patterns.
Same-Day Discharge in Minimally Invasive Gynecologic Surgery: A Care Partner Perspective [ID 2683597]
Authors: Micolucci Savannah , Van Deman John , Robinson Erica F. 
Published: May 2024

INTRODUCTION:
Same-day hospital discharge after minimally invasive gynecologic surgery has gained popularity and become feasible with increased adherence to enhanced recovery after surgery protocols. Benefits include reduced hospital admissions, increased cost-effectiveness, and practicality of patient recovery at home—without any demonstrable increase in patient harm or readmissions. Although studies show patients perceive same-day discharge favorably, there are little data regarding care partner perception of this trend.

METHODS:
A REDCap survey was administered prospectively to care partners of patients undergoing minimally invasive hysterectomy (MIH) within a single tertiary-care department between November 2022 and September 2023. The 16-question survey included questions evaluating care-partner perspectives regarding same-day discharge and postoperative home care. Approximately 75 patients were targeted for recruitment. Responses were analyzed using descriptive statistics.

RESULTS:
Approximately 66.7% of care partners indicated they were “very comfortable” caring for the patient at home the night of surgery. When asked to rate the level of concern about the patient going home on the same day as surgery, 64% selected a 2 or below on a 5-point Likert scale, with 36.4% of these individuals indicating that they were “not concerned at all.” Moreover, 42.4% of the respondents reported that this was their experience with postoperative home care.

CONCLUSION:
This study demonstrates that despite having no prior experience, care partners are comfortable caring for MIH patients on postoperative day 0. This is additive to current literature on patient comfort in same-day discharge. Thus, not only is same-day discharge a reasonable option for many patients but also most care partners are comfortable supporting this plan.