bluuebunny/crossref_metadata_2025_split huggingface dataset:
The impact of an oncology urgent care center on health-care utilization
Authors: D’Avella Christopher , Whooley Peter , Milano Emily , Egleston Brian , Helstrom James , Patrick Kenneth , Edelman Martin , Bauman Jessica 
Published: February 2024

Abstract

Introduction
Studies suggest that many emergency department (ED) visits and hospitalizations for patients with cancer may be preventable. The Centers for Medicare & Medicaid Services has implemented changes to the hospital outpatient reporting program that targets acute care in-treatment patients for preventable conditions. Oncology urgent care centers aim to streamline patient care. Our cancer center developed an urgent care center called the direct referral unit in 2011.

Methods
We abstracted visits to our adjacent hospital ED and direct referral unit from January 2014 to June 2018. Patient demographics, cancer and visit diagnoses, visit charges, and 30-day therapy utilization were assessed.

Results
An analysis of 13 114 visits demonstrated that increased direct referral unit utilization was associated with decreased monthly ED visits (P &lt; .001). Common direct referral unit visit diagnoses were dehydration, nausea and vomiting, abdominal pain, and fever. Patients receiving active cancer treatment more frequently presented to the direct referral unit (P &lt; .001). The average charges were $2221 for the direct referral unit and $10 261 for the ED.

Conclusion
The association of decreased ED visits with increased direct referral unit utilization demonstrates the potential for urgent care centers to reduce acute care visits. Many patients presented to our direct referral unit with preventable conditions, and these visits were associated with considerable cost savings, supporting its use as a cost-effective method to reduce acute care costs.
Severe housing cost burden and premature mortality from cancer
Authors: Lawrence Wayne R , Freedman Neal D , McGee-Avila Jennifer K , Mason Lee , Chen Yingxi , Ewing Aldenise P , Shiels Meredith S 
Published: February 2024

Abstract
Unaffordable housing has been associated with poor health. We investigated the relationship between severe housing cost burden and premature cancer mortality (death before 65 years of age) overall and by Medicaid expansion status. County-level severe housing cost burden was measured by the percentage of households that spend 50% or more of their income on housing. States were classified on the basis of Medicaid expansion status (expanded, late-expanded, nonexpanded). Mortality-adjusted rate ratios were estimated by cancer type across severe housing cost burden quintiles. Compared with the lowest quintile of severe housing cost burden, counties in the highest quintile had a 5% greater cancer mortality rate (mortality-adjusted rate ratio = 1.05, 95% confidence interval = 1.01 to 1.08). Within each severe housing cost burden quintile, cancer mortality rates were greater in states that did not expand Medicaid, though this association was significant only in the fourth quintile (mortality-adjusted rate ratio = 1.08, 95% confidence interval = 1.03 to 1.13). Our findings demonstrate that counties with greater severe housing cost burden had higher premature cancer death rates, and rates are potentially greater in non–Medicaid-expanded states than Medicaid-expanded states.
Robotic-assisted thoracoscopy in the management of mediastinal ectopic parathyroid adenoma: a case report
Authors: Steinkraus Kira C , Wittau Matthias , Kornmann Marko 
Published: February 2024

Abstract
Mediastinal ectopic parathyroid adenomas, a rare cause of primary hyperparathyroidism, has evolved significantly with the advent of robotic-assisted surgery. Traditional surgical approaches, while effective, may be associated with considerable morbidity and extended recovery periods. This study aims to evaluate the effectiveness, precision, and postoperative outcomes of robotic thoracoscopy with parathyroidectomy in the management of mediastinal ectopic parathyroid adenomas. A case of a 70-year-old man with a history of primary hyperparathyroidism underwent a successful left robotic thoracoscopy with parathyroidectomy in an ectopic mediastinal parathyroid adenoma. The robotic approach demonstrated advantages such as enhanced precision and minimal invasiveness. However, the learning curve and cost implications of this technology were identified as considerations. Robotic thoracoscopy with parathyroidectomy underscores the potential of robotic surgery in revolutionizing the management of mediastinal ectopic parathyroid adenomas, offering promising precision, emphasizing the need for ongoing research, and evaluation to optimize this innovative surgical method.
Anabolic steroids and the evaluation of patients with acute PM tendon rupture using microscopy and MRI
Authors: de Castro Pochini Alberto , Ejnisman Benno , Andreoli Carlos V , Lara Paulo H S , Godoy Ivan R B , Ribeiro Leandro M , Seixas Maria T , Belangero Paulo S , Hipolide Debora C 
Published: February 2024

Abstract
This study presented a pioneering investigation of the changes in the magnetic resonance imaging images of pectoralis major muscle (PMM) tendon rupture. In all, 26 men were evaluated with acute total PMM rupture (&lt;3 months since injury) with a mean age of 37.3 years (SD = 9.7 years) and 10 control patients with a mean age of 32.6 years (SD = 4.2 years). The evaluation of the tendon PMM injuries was based on the magnetic resonance imaging exam and the histological analysis. The magnetic resonance imaging of the surgically showed two (7.1%) contralateral sides were normal, 16 (57.1%) showed superior tendinopathy, and 10 (35.7%) had total tendinopathy. Inferior tendinopathy was not observed. The tendon histology revealed degenerative changes in 16 (66.7%) fragments, with 12 (50.0%) considered as mild (&lt;25%), and four considered as (16.7%) high (&gt;50.0%) tendinopathy. Total acute rupture of the PMM tendon among weightlifters might be associated with tendinous degeneration prior to injury.
Canadian developmental pediatrics workforce survey
Authors: McLeod Scott A , Eliason Sabrina , Penner Melanie , Mickelson Elizabeth , Marello Ana , Fehlings Darcy 
Published: February 2024

Abstract

BACKGROUND
Neurodevelopmental conditions are common, and many of these conditions benefit from specialized developmental assessments or services from a developmental pediatric clinic. There is limited data about the supply of developmental pediatric subspecialists and limited knowledge about the sustainability of the current workforce providing this care in Canada.

OBJECTIVES
To understand the current Canadian developmental pediatric workforce, we conducted a survey to determine: (1) The demographic profile of developmental pediatric professionals who comprise the current workforce and their career plans; (2) The challenges and trends to inform future resource planning; and (3) Opportunities for innovative provision of developmental care in pediatrics.

DESIGN/METHODS
A 31-item questionnaire was cross-sectionally distributed to practicing developmental pediatricians in Canada. The Royal College of Physicians and Surgeons and Canadian Pediatric Society Section of Developmental Pediatrics assisted with the distribution of the survey to its membership. Results were analyzed with descriptive statistics.

RESULTS
A total of 145 participants completed the study (91% response). Forty-six percent (n = 65) of the participants had &gt;20 years of experience. Within the next 3 to 5 years, 23% (n = 32) of respondents’ plan to retire completely from practice. Trends influencing the present workload of developmental pediatricians included: (1) requirements for translation services (endorsed by 70% of respondents); (2) coordination issues with multidisciplinary assessments (endorsed by 64%); and (3) the influence of government funding resources for specific neurodevelopmental disorders (endorsed by 32%).

CONCLUSIONS
Addressing issues affecting developmental pediatrician workload and increasing the developmental pediatric workforce will be vital to address current needs. The viability of specialized developmental care in Canada will rely on recruitment and identifying barriers that inhibit trainees and physicians from choosing to practice in the field of developmental pediatrics.
Image quality in CT thorax: effect of altering reconstruction algorithm and tube load
Authors: Kataria Bharti , Woisetschläger Mischa , Nilsson Althén Jonas , Sandborg Michael , Smedby Örjan 
Published: February 2024

Abstract
Non-linear properties of iterative reconstruction (IR) algorithms can alter image texture. We evaluated the effect of a model-based IR algorithm (advanced modelled iterative reconstruction; ADMIRE) and dose on computed tomography thorax image quality. Dual-source scanner data were acquired at 20, 45 and 65 reference mAs in 20 patients. Images reconstructed with filtered back projection (FBP) and ADMIRE Strengths 3–5 were assessed independently by six radiologists and analysed using an ordinal logistic regression model. For all image criteria studied, the effects of tube load 20 mAs and all ADMIRE strengths were significant (p &lt; 0.001) when compared to reference categories 65 mAs and FBP. Increase in tube load from 45 to 65 mAs showed image quality improvement in three of six criteria. Replacing FBP with ADMIRE significantly improves perceived image quality for all criteria studied, potentially permitting a dose reduction of almost 70% without loss in image quality.
Guided Online Mindfulness-Based Intervention for Community Residents with Emotional Distress during the COVID-19 Pandemic
Authors: Young Daniel Kim-wan , Carlbring Per , Cheng Daphne Yi-ting , Ng Siu-man , Ng Petrus Yat-nam , Chen Joseph Qi-rong 
Published: February 2024

Abstract
This study aimed to assess the efficacy of a guided online mindfulness-based intervention (iMBI) for community residents experiencing emotional distress during the COVID-19 pandemic in Hong Kong. In a randomized controlled trial, 64 participants were recruited from collaborating community-based mental health service units in Hong Kong and assigned to either the treatment (n = 32) or control (n = 32) groups. The treatment group received a guided iMBI consisting of 16 online modules, weekly telephone counseling, and two half-day online workshops on mindfulness practice. In contrast, the waitlist control group did not receive any intervention during the initial stage. Using a 2 (two groups) × time (pre versus post) repeated measures linear mixed model and one-way analysis of variance, authors demonstrated that the treatment group experienced a significantly larger reduction in anxiety and depressive symptoms with a large effect size compared with the control group. Additionally, the treatment group showed a significantly greater improvement in mindfulness with a moderate effect size. The findings support the effectiveness of guided iMBI for community residents experiencing emotional distress during the COVID-19 pandemic in Hong Kong.
Top 50 most cited articles about female sexual dysfunction: a bibliometric analysis
Authors: Gong Susan , Yim Samuel , Kabarriti Abdo 
Published: February 2024

Abstract

Introduction
Female sexual dysfunction (FSD) consists of low libido, sexual arousal problems, anorgasmia, and dyspareunia. Sexual function is an important aspect of life for many women and is closely correlated with overall well-being. FSD is often underrepresented in the academic space when compared with male sexual disorders, such as erectile dysfunction. As FSD spans many fields (eg, urology, gynecology, psychology), bibliometric analyses are an important resource to highlight landmark articles.

Objectives
To identify key articles about FSD by citation number and bibliometric analysis to facilitate future scholarly efforts into more FSD research.

Methods
We searched for articles in the Web of Science Core Collection between 1900 and 2023 using terms specific to FSD. We identified relevant FSD articles and selected the top 50 most cited. A bibliometric analysis was performed to collect and analyze data about title, authorship, publication year, citation number, journal and impact factor, country and institution, study type, citation index, specialty, and conflict of interest.

Results
An overall 6858 results were identified. The top 50 most cited articles were published between 1997 and 2014 in 12 countries, across 32 institutions, and in 20 journals. The United States produced the most articles. The Journal of Sexual Medicine published the most articles. The mean number of citations per article was 351.64. Observational studies were most common. More than half were sponsored. Of all the specialties, most articles were categorized as urology and nephrology. Research about FSD has been much less impactful than research about male sexual dysfunction, possibly owing to stigma and decreased clinical training.

Conclusion
As FSD covers many fields, bibliometric analyses are invaluable to understand the vast body of knowledge. We hope that this research emphasizes the lack of attention that FSD has had and that it provides health care professionals with a valuable tool to understand the trajectory of FSD to guide future education efforts.
Deciphering a crucial dimeric interface governing Norrin dimerization and the pathogenesis of familial exudative vitreoretinopathy
Authors: Zhao Rulian , Liu Min , Dai Erkuan , Chen Chen , Lv Liting , Peng Li , He Yunqi , Li Shujin , Yang Mu 
Published: February 2024

AbstractFamilial exudative vitreoretinopathy (FEVR) is a hereditary eye disease that could cause blindness. It has been established that Norrin forms dimers to activate β‐catenin signaling, yet the core interface for Norrin dimerization and the precise mechanism by which Norrin dimerization contributes to the pathogenesis of FEVR remain elusive. Here, we report an NDP variant, c.265T>C (p.Phe89Leu), that interrupted β‐catenin signaling by disrupting Norrin dimerization. Structural and functional analysis revealed that the Phe‐89 of one Norrin monomer interacts with Pro‐98, Ser‐101, Arg‐121, and Ile‐123 of another, forming two core symmetrical dimerization interfaces that are pivotal for the formation of a “hand‐by‐arm” dimer. Intriguingly, we proved that one of the two core symmetrical interfaces is sufficient for dimerization and activation of β‐catenin signaling, with a substantial contribution from the Phe‐89/Pro‐98 interaction. Further functional analysis revealed that the disruption of both dimeric interfaces eliminates potential binding sites for LRP5, which could be partially restored by over‐expression of TSPAN12. In conclusion, our findings unveil a core dimerization interface that regulates Norrin/LRP5 interaction, highlighting the essential role of Norrin dimerization on β‐catenin signaling and providing potential therapeutic avenues for the treatment of FEVR.
Assessment of Interaural Attenuation in Infants and Young Children Using Bone-Conducted Auditory Brainstem Response
Authors: Kariv Liron , Taitelbaum-Swead Riki , Levit Yael 
Published: February 2024

Objectives:
In hearing assessment, the term interaural attenuation (IAA) is used to quantify the reduction in test signal intensity as it crosses from the side of the test ear to the nontest ear. In the auditory brainstem response (ABR) testing of infants and young children, the size of the IAA of bone-conducted (BC) stimuli is essential for the appropriate use of masking, which is needed for the accurate measurement of BC ABR thresholds. This study aimed to assess the IAA for BC ABR testing using 0.5 to 4 kHz narrowband (NB) CE-chirp LS stimuli in infants and toddlers with normal hearing from birth to three years of age and to examine the effects of age and frequency on IAA.

Design:
A total of 55 infants and toddlers with normal hearing participated in the study. They were categorized into three age groups: the young group (n = 31, infants from birth to 3 mo), middle-aged group (n = 13, infants aged 3–12 mo), and older group (n = 11, toddlers aged 12–36 mo). The participants underwent BC ABR threshold measurements for NB CE-chirp LS stimuli at 0.5 to 4 kHz. For each participant, one ear was randomly defined as the “test ear” and the other as the “nontest ear.” BC ABR thresholds were measured under two conditions. In both conditions, traces were recorded from the channel ipsilateral to the test ear, whereas masking was delivered to the nontest ear. In condition A, the bone oscillator was placed on the mastoid of the test ear, whereas in condition B, the bone oscillator was placed on the mastoid contralateral to the test ear. The difference between the thresholds obtained under conditions A and B was calculated to assess IAA.

Results:
The means of IAA (and range) in the young age group for the frequencies 0.5, 1, 2, and 4 kHz were 5.38 (0–15) dB, 11.67 (0–30) dB, 21.15 (10–40) dB, and 23.53 (15–35) dB, respectively. Significant effects were observed for both age and frequency on BC IAA. BC IAA levels decreased with age from birth to 36 mo. In all age groups, smaller values were observed at lower frequencies and increased values were observed at higher frequencies.

Conclusions:
BC IAA levels were both age and frequency dependent. The study found that the BC IAA values for lower stimulus frequencies were smaller than previously assumed, even in infants younger than 3 mo. These results suggest that masking should be applied in BC ABR threshold assessments for NB CE-chirp LS stimuli at 0.5, 1, and 2 kHz, even in young infants. Masking may not be necessary for testing at 4 kHz if a clear response is obtained at 15 dB normal-hearing level (nHL) in infants younger than 3 mo.
Third Time’s the Charm? Indications and Outcomes for Redo-Redo Ileal Pouch-Anal Anastomosis
Authors: Maspero Marianna , Lavryk Olga , Holubar Stefan D. , Lipman Jeremy , Steele Scott R , Hull Tracy 
Published: February 2024

BACKGROUND:
Up to 20% to 40% cases of redo ileal pouch anal anastomosis will result in pouch failure. Whether to offer a second redo procedure to maintain intestinal continuity remains a controversial decision.

OBJECTIVE:
To report our institutional experience of second redo ileal pouch anal anastomosis procedures.

DESIGN:
This was a retrospective review. Patient-reported outcomes were compared between patients undergoing second redos with those of patients undergoing first redos using propensity score matching to balance the 2 cohorts.

SETTINGS:
Tertiary referral center.

PATIENTS:
Patients who underwent second redo ileal pouch anal anastomosis procedures between 2004 and 2021.

INTERVENTIONS:
Second redo ileal pouch anal anastomosis.

MAIN OUTCOME MEASURES:
Pouch survival, patient-reported outcomes measured using the Cleveland Global Quality of Life survey.

RESULTS:
Twenty-three patients were included (65% female), 20 (87%) with an index diagnosis of ulcerative colitis and 3 (13%) with indeterminate colitis. Final diagnosis was changed to Crohn’s disease in 8 (35%) cases. The indication for pouch salvage was the same for the first and second redo in 21 (91%) cases: 20 (87%) patients had both redo ileal pouch anal anastomoses for septic complications. After a median follow up of 39 months (interquartile range, 18.5 – 95.5), pouch failure occurred in 8 (30%) cases (7 cases due to sepsis, of which 3 never had their stoma closed, and 1 case due to poor function); all patients who experience pouch failure underwent the second redo due to septic complications. Overall pouch survival at 3 years was 76%: 62.5% in patients with final diagnosis of Crohn’s disease, versus 82.5% in ulcerative/indeterminate colitis (p = 0.09). Overall quality of life score (0 -1) was 0.6 (0.5 – 0.8). Quality of life and functional outcomes were comparable between first and second redos, except incontinence, which was higher in second redos.

LIMITATIONS:
Single center retrospective review.

CONCLUSIONS:
A second pouch salvage procedure may be offered with acceptable outcomes to selected patients with high motivation to keep intestinal continuity. See Video Abstract.
A modified Hospital Frailty Risk Score for patients with cirrhosis undergoing abdominal operations
Authors: Calthorpe Lucia , Chiou Sy Han , Rubin Jessica , Huang Chiung-Yu , Feng Sandy , Lai Jennifer 
Published: February 2024

Background and Aims:
Existing tools for perioperative risk stratification in patients with cirrhosis do not incorporate measures of comorbidity. The Hospital Frailty Risk Score (HFRS) is a widely used measure of comorbidity burden in administrative dataset analyses. However, it is not specific to patients with cirrhosis, and application of this index is limited by its complexity.

Approach and Results:
Adult patients with cirrhosis who underwent nontransplant abdominal operations were identified from the National Inpatient Sample, 2016–2018. Adjusted associations between HFRS and in-hospital mortality and length of stay were computed with logistic and Poisson regression. Lasso regularization was used to identify the components of the HFRS most predictive of mortality and develop a simplified index, the cirrhosis-HFRS. Of 10,714 patients with cirrhosis, the majority were male, the median age was 62 years, and 32% of operations were performed electively. HFRS was associated with an increased risk of both in-hospital mortality (OR=6.42; 95% CI: 4.93, 8.36) and length of stay (incidence rate ratio [IRR]=1.79; 95% CI: 1.72, 1.88), with adjustment. Using lasso, we found that a subset of 12 of the 109 ICD-10 codes within the HFRS resulted in superior prediction of mortality in this patient population (AUC = 0.89 vs. 0.79, p < 0.001).

Conclusions:
While the 109-component HFRS was associated with adverse surgical outcomes, 12 components accounted for much of the association between the HFRS and mortality. We developed the cirrhosis-HFRS, a tool that demonstrates superior predictive accuracy for in-hospital mortality and more precisely reflects the specific comorbidity pattern of hospitalized patients with cirrhosis undergoing general surgery procedures.