bluuebunny/crossref_metadata_2025_split huggingface dataset:
Barriers to HPV Vaccination in Women at a Federally Qualified Health Center [ID: 1377846]
Authors: Blakey-Cheung Sophie , Demertzis Kristen , Zeeshan Quratulain 
Published: May 2023

INTRODUCTION:
Human papillomavirus (HPV) vaccination significantly decreases the rate of HPV-related diseases; however, vaccine uptake is limited in the United States. New York State set a goal of 80% HPV vaccination by 2023. First-dose rates at our Federally Qualified Health Center (FQHC) in 2021 were 68% in girls aged 13–19 years and 31% in women aged 20–29 years. Little research surrounding barriers to HPV vaccination in adults exists.

METHODS:
An anonymized survey was distributed to providers at a network of FQHCs using REDCap. Question domains included provider demographics, provider attitudes, and practices. Questions were subdivided by patient age group. Descriptive statistics were analyzed.

RESULTS:
Our response rate was 15%. Respondent specialties included family practice (49%), women's health (27%), pediatrics (13%), and internal medicine (11%). Frequency of vaccine recommendation decreased as patient age increased. Most common barriers for vaccination included previous vaccination, parental or patient objection, and lack of time for counseling. Additional barriers in the 19–45 age group included concerns about efficacy and cost. Common reasons for patient refusal included objection to vaccination, feeling low risk for infection, lack of knowledge, and side effect concerns.

CONCLUSION:
The expansion of HPV vaccination eligibility to include women aged 27–45 in 2018 provided an opportunity to protect more patients against HPV-related diseases. Patient and provider knowledge about HPV risk and vaccine efficacy can limit the implementation. Significant barriers for vaccine administration included the lack of provider engagement, knowledge about the vaccine, and time for counseling. This study underscores the need for provider and patient education about the benefits of HPV vaccination, especially in the 19–45 age group.
What Is the Accuracy of YouTube Abortion Procedure Videos for Reliable Informational Content Based on Their Societal Bias? [ID: 1379766]
Authors: Acero Nicole , Foncham Juanita , Francis Antonia , Herrero Emma , Kayaalp Emre , Mcilvaine Jamie 
Published: May 2023

INTRODUCTION:
YouTube is commonly used as an easily accessible online resource for patients seeking to learn about medical procedures, their safety, and their risks. Abortion is a common yet polarizing medical procedure. There is no current research that evaluates the accuracy of instructional videos available to patients. Given the reliance of information gathered on the internet to inform medical decision making, this study was designed to assess whether any given video can deliver accurate information about this topic in an unbiased manner.

METHODS:
Surgical methods of abortion were used as a search query into YouTube. The videos were screened with strict exclusion criteria. The percent accuracy of each video was calculated as compared to the Surgical Curriculum in Obstetrics and Gynecology (SCOG) checklist for the corresponding procedure.

RESULTS:
Thirty-two videos were analyzed and categorized into three “video slant” groups: neutral (n=23), anti-choice (n=4), and pro-choice (n=5). Using the SCOG checklist, neutral videos had the highest average accuracy percentage of 45.9%, anti-choice videos 24.6%, and pro-choice 18.5%.

CONCLUSION:
Using the SCOG checklist, the accuracy of instructional videos were inconsistent across the three identified “video slants.” Patients should consider this when accessing YouTube videos for information regarding abortion procedures.
Presence of schistosome eggs in lymph node predict unfavorable prognosis in schistosomal colorectal cancer
Authors: Pan Weiyu , Guo Jiaojiao , Li Jiali , Su Jieakesu , Zhang Xiaolei , Liu Jia , Xu Chen , Hou Yingyong 
Published: May 2023

Objective:
The purpose of this study was to investigate the prognostic significance of schistosome eggs’ location in schistosomal colorectal cancer (SCRC).

Methods:
172 cases of SCRC were retrospectively analyzed. Patient clinicopathological parameters and survival rates were analyzed.

Results:
There were 102 males and 70 females, the median age was 71 years (range, 44-91). All patients were followed, and the median time was 50.1 months (range, 1.0-79.7). There were 87 patients with PS1 (presence site 1, eggs deposited in the mucosa) and 85 patients with PS2 (presence site 2, eggs deposited in the muscularis propria or throughout the full thickness of the intestinal wall), 159 patients presented with eggs in cutting edge and 83 patients presented with eggs in lymph node (LN). Hepatic schistosomiasis was found in 27.3% of patients by imaging modalities and correlated to patients with PS2 (P < 0.001) and LNs’ eggs (P < 0.001). Survival analyses showed that in stage III SCRC, eggs’ presence in LN associated with worse DFS (P = 0.004) or marginally worse OS (P = 0.056), patients with PS2 had shorter OS (P = 0.044). Multivariate analyses revealed hepatic schistosomiasis was an independent prognostic factor for DFS and OS in stage III SCRC (P = 0.001, 0.002, respectively). In adjusted multivariate analysis, eggs’ presence in LN was an independent prognostic factor for DFS in stage III SCRC (P = 0.006).

Conclusions:
In stage III SCRC, eggs’ presence in LN could predict poor prognosis and hepatic schistosomiasis was an independently unfavorable prognosis factor.
In silico Evaluation of a Vancomycin Dosing Guideline Among Adults with Serious Infections
Authors: Williams Paul , Cotta Menino Osbert , Abdul-Aziz Mohd H. , Wilks Kathryn , Farkas Andras , Roberts Jason A. 
Published: May 2023

Background:
This study aimed to compare the achievement of pharmacokinetic–pharmacodynamic (PK-PD) exposure targets for vancomycin using a newly developed dosing guideline with product-information-based dosing in the treatment of adult patients with serious infections.

Methods:

In silico product-information- and guideline-based dosing simulations for vancomycin were performed across a range of doses and patient characteristics, including body weight, age, and renal function at 36–48 and 96 hours, using a pharmacokinetic model derived from a seriously ill patient population. The median simulated concentration and area under the 24-hour concentration–time curve (AUC0-24) were used to measure predefined therapeutic, subtherapeutic, and toxicity PK-PD targets.

Results:
Ninety-six dosing simulations were performed. The pooled median trough concentration target with guideline-based dosing at 36 and 96 hours was achieved in 27.1% (13/48) and 8.3% (7/48) of simulations, respectively. The pooled median AUC0-24/minimum inhibitory concentration ratio with guideline-based dosing at 48 and 96 hours was attained in 39.6% (19/48) and 27.1% (13/48) of simulations, respectively. Guideline-based dosing simulations yielded improved trough target attainment compared with product-information-based dosing at 36 hours and significantly less subtherapeutic drug exposure. The toxicity threshold was exceeded in 52.1% (25/48) and 0% (0/48) for guideline-and product-information-based dosing, respectively (P < 0.001).

Conclusions:
Critical care vancomycin dosing guidelines appeared slightly more effective than standard dosing, as per product information, in achieving PK-PD exposure associated with an increased likelihood of effectiveness. In addition, these guidelines significantly reduce the risk of subtherapeutic exposure. The risk of exceeding toxicity thresholds, however, was greater with the guidelines, and further investigation is suggested to improve dosing accuracy and sensitivity.
Solitary punctate chorioretinitis —a unique subtype of punctate inner choroidopathy
Authors: Gan Yuhong , He Guiqin , Zeng Yunkao , Zhang Xiongze , Su Yongyue , Lan Mi  , Ji Yuying , Zhuang Xuenan , Wen Feng 
Published: May 2023

Abstract

Purpose:
To describe a case series of a special subtype of punctate inner choroidopathy (PIC) with solitary lesions in the macular area— and named as solitary punctate chorioretinitis (SPC).

Methods:
This retrospective observational study clinically evaluated 12 eyes from 12 PIC patients with solitary lesions. Demographic data and multimodal imaging features were analyzed for the included patients.

Results:
All the included patients were Chinese and of Han ethnicity. The median age of the included patients was 29.5 years (range: 25-40 years). Most patients (11/12, 91.67%) were myopic, with median refraction errors of -4.4 diopters (D) (range: -8.5-0 D). Solitary chorioretinitis lesions were yellow‒white and appeared hyperfluorescent during the entire phase of fundus fluorescein angiography (FFA) without leakage (75%, 9/12) and hypofluorescent on indocyanine green angiography (ICGA) (100%, 11/11). On spectral domain optical coherence tomography (SD-OCT), active inflammatory lesions appeared as isolated, heterogeneous, moderately reflective material at the outer retina (10/12, 83.33%) in the fovea or parafoveal region with disruption of the outer retinal layers. When the inflammatory lesions regressed, the moderately reflective materials in the outer retina were absorbed or regressed with outer retinal tissue loss. Additional sequelae of lesion regression included focal choroidal excavation (FCE) and intraretinal cystoid space. Secondary choroidal neovascularization (CNV) was noticed in 2 eyes (2/12, 16.67%).

Conclusions:
SPC is a rare and unique subtype of PIC.SPC may also be an unrecognized etiology of some forms of FCE and idiopathic CNV.
Abnormalities in the retinal capillary plexuses in Coats' disease in adulthood on OCT angiography
Authors: Krivosic Valérie , Mecê Pedro , Dulière Cedric , Lavia Carlo , Zegrari Samira , Tadayoni Ramin , Gaudric Alain 
Published: May 2023

Abstract

Purpose:
To describe and quantify the abnormalities of the retinal capillary plexuses using OCT angiography in Coats' disease.

Methods:
Retrospective study. Eleven eyes of 11 patients with Coats’ disease (9 men and 2 women aged 32 to 80 years) compared to 9 fellow eyes and 11 healthy control eyes.
Horizontal bands of contiguous 3 x 3 mm OCT angiograms of the superficial vascular plexus (SVP) and deep capillary complex (DCC) were acquired from the optic disc to 6 mm temporal to the fovea, through areas with telangiectasia visible on fluorescein angiography in 9 cases.

Main outcome measures:
Vascular density (VD) and fractal dimension (FD).

Results:
The VD was significantly decreased in both plexuses in eyes with Coats’ disease compared to normal and fellow eyes within the 6 mm temporal to the fovea (SVP: 21.5 versus 29.4 %, p=0.00004 and versus 30.3%, p= 0.00008. DCC, 16.5 versus 23.9%, p=0.00004 and versus 24.7%, p=0.00008, respectively). The FD was also significantly decreased in eyes with Coats’ disease (SVP: 1.796 versus 1.848 p=0.001 and versus 1.833, p=0.003. DCC: 1.762 versus 1.853, p=0.003 and versus 1.838, p=0.004, respectively).

Conclusion:
Retinal plexuses’ VD was decreased in Coats' disease, including in areas with no visible telangiectasia.
Demonstrating a Statistically Significant Association Between Anal High-Grade Squamous Intraepithelial Lesion and Positive OncoE6 Anal Test in Men Who Have Sex With Men and are Living With HIV
Authors: Jordan Jeanne A. , Rivas Karina I. , Aldous Annette , Connors Kaleigh A. , Jair Kamwing , Klein David A. , Hoke Elizabeth S. , Abbott Stephen E. 
Published: May 2023

Objectives
The aim of the study is to determine whether a positive OncoE6 Anal Test result has statistically significant higher odds of being associated with high-grade squamous intraepithelial lesion (HSIL) and to calculate sensitivity and specificity of this test for predicting HSIL in adult men who have sex with men and are living with HIV (MSMLWH).

Materials and Methods
Men living with HIV 18 years or older having ≥atypical squamous cells of undetermined significance–grade anal cytology results were eligible to enroll in this cross-sectional study. Anal samples were collected just before the high-resolution anoscopy procedure. OncoE6 Anal Test results were compared with histology, the reference standard. Sensitivity, specificity, and odds ratio were calculated using HSIL as the threshold.

Results
Two hundred seventy-seven consented MSMLWH were enrolled between June 2017 and January 2022. Of these, 219 (79.1%) had biopsies obtained and histology performed; 81 of 219 participants (37%) had 1 or more biopsies with HSIL results while the remaining 138 of 219 (63%) had only low-grade squamous intraepithelial lesion or were negative for dysplasia. Anal samples from 7 participants (8.6%, 7/81) with HSIL and 3 (2.2%, 3/138) with low-grade squamous intraepithelial lesion had positive OncoE6 Anal Test results. Odds of having HSIL were 4.26 times higher among participants testing positive for HPV16/HPV18 E6 oncoprotein(s) (OR = 4.26, 95% CI = 1.07–16.95, p = .04). The OncoE6 Anal Test demonstrated excellent specificity, 97.83% (93.78–99.55), but poor sensitivity, 8.64% (3.55–17.0).

Conclusions
In this highest-risk population for anal cancer, one could combine the OncoE6 Anal Test, having excellent specificity, with the anal Pap test, having higher sensitivity. Patients found having both an abnormal anal Pap and positive OncoE6 Anal Test result could be triaged for rapid scheduling of their high-resolution anoscopy.
Two cases of spontaneous rupture of the uterine artery in the perinatal period: A case report
Authors: Hu Lingyun , Ning Jing , Li Li’an , Lu Yanping , You Yanqin 
Published: May 2023

Rationale:
Uterine artery spontaneous rupture is a rare but potentially life-threatening complication during pregnancy and puerperium. The lack of typical symptoms makes it difficult to diagnose, which can result in serious consequences for both the mother and fetus.

Patient concerns:
Case 1 presented with fainting and lower abdominal discomfort, while Case 2 developed hypotension after delivery and remained in poor condition even after rehydration.

Diagnoses:
Both cases were diagnosed with uterine artery spontaneous rupture, with intraoperative findings revealing ruptures in different branches of the uterine artery.

Interventions:
Both cases underwent surgical interventions, with laparoscopic surgery performed in Case 1 and repair of the ruptured artery in Case 2.

Outcomes:
Both cases had successful outcomes, with the ruptured arteries repaired and the patients discharged from the hospital within a week after surgery.

Lessons:
Uterine artery spontaneous rupture is a rare but potentially life-threatening complication that may present with atypical symptoms. Early diagnosis and prompt surgical intervention are crucial in preventing serious complications for both the mother and fetus. Clinicians should maintain a high level of suspicion for this condition when evaluating patients presenting with unexplained symptoms or signs of peritoneal irritation during pregnancy and puerperium.
Case series: Primary aldosteronism diagnosed despite normal screening investigations: A report of three cases
Authors: Jia Minyue , Lin Liya , Yu Hanxiao , Yang Boyun , Xu Xiaohong , Song Xiaoxiao 
Published: May 2023

Rationale:Since the introduction of the aldosterone-to-renin ratio (ARR) as a screening tool for primary aldosteronism (PA), there has been a marked increase in the reported prevalence of this condition among hypertensive, even normotensive, subjects.Patient concerns:But ARR as a spot blood draw for estimating a patient’s aldosterone secretory status is influenced by many factors.Diagnoses:Here, we describe a series of patients with biochemically confirmed PA, whose diagnosis was delayed by the initial ARR assessment with non-suppressed renin.Interventions:Patient 1 had a history of resistant hypertension for many years and had a negative initial screening for secondary hypertension (including ARR). At the reevaluation, ARR was close to cutoff still with normal renin after strict and extended drug washout, and the further workup for PA demonstrated a unilateral aldosterone producing adenoma that was surgically removed, with subsequent complete biochemical remission and partial clinical success. Patient 2 was diagnosed with idiopathic hyperaldosteronism combined with obstructive sleep apnea syndrome, which could increase renin resulting in a negative ARR, and finally got a better treatment effect with PA-specific spironolactone, as well as continuous positive airway pressure. Patient 3 with hypokalemia as the main presentation was finally diagnosed with PA after excluding other diseases, and proceeded to laparoscopic adrenalectomy and histologically confirmed an aldosterone producing adenoma. Postoperatively, patient 3 achieved complete biochemical success without any medicine.Outcomes:The clinical status of all three patients was effectively managed, resulting in either complete resolution or notable improvement of their respective conditions.Lessons:After rigorous standardized diagnostic evaluation, there are still many reasons for ARR negative in PA, but they all basically occur in the background of normal or normal-high renin without suppression. A negative screening test result should be repeated and analyzed carefully if this is not consistent with the clinical picture. If, despite a repeatedly negative ARR, clinical suspicion remains high, we recommend consideration of further evaluation, including confirmatory tests and adrenal venous blood sampling (AVS) or even 68Ga-pentixafor PET/CT to better confirm the diagnosis and improve patient outcomes.
Sleep quality after stroke: A systematic review and meta-analysis
Authors: Luo Ye , Yu Guofeng , Liu Yuanfei , Zhuge Chengjun , Zhu Yinge 
Published: May 2023

Background:
Sleep-related problems are debilitating and long-lasting conditions in individuals with stroke. We aimed to estimate the prevalence of poor sleep quality after stroke by conducting a systematic review and meta-analysis.

Methods:
Five databases (PubMed, Embase, Web of Science, Scopus, and CINHAL) were searched for literature published before November 2022. Studies recruiting participants with stroke, using a validated scale to measure sleep quality and in English were included. We used the Agency for Healthcare Research and Quality Scale and Newcastle–Ottawa Scale to assess the quality of eligible studies. Pooled prevalence and subgroup analyses were performed to understand the variation in sleep quality among studies. We followed the PRISMA checklist to report the study.

Results:
Thirteen studies were included for analysis (n = 3886). The pooled prevalence of poor sleep quality was 53% (95% CI 41–65%). Studies using PSQI with a cutoff point of 7 had a prevalence of 49% (95% CI 26–71%), whereas those with a cutoff point of 5 had a higher prevalence of 66% (95% CI 63–69%) (P = .13). Geographical location could explain the prevalence variation between studies. The majority of included studies had a medium level quality of evidence (10/13).

Conclusion:
Poor sleep quality appears to be common in patients with stroke. Considering its negative impact on health, effective measures should be taken to improve their quality of sleep. Longitudinal studies should be conducted to examine the contributing factors and investigate the mechanisms that lead to poor sleep quality.
Asymptomatic Candida glabrata urinary tract infection in an immunocompetent young female: A case report
Authors: Deng Ruixin , Meng Xingye , Li Ruoyu , Wang Aiping , Song Yinggai 
Published: May 2023

Introduction:
Fungal urinary tract infections (UTIs) are becoming increasingly common in hospitalized patients and Candida species are the most prevalent organisms. However, recurrent candiduria in young healthy outpatients is rare thus require further examination to find the etiologic factors.

Case presentation:
We described a case of recurrent asymptomatic c caused by azole-resistant C. glabrata in a healthy young female who only had previous use of antibiotics without other risk factors. However, after removal of the predisposing factor and the use of sensitive antifungal agents, the patient’s urine cultures remained positive. This phenomenon indicated to us that the patient might have an immune-related genetic deficiency. We found a novel caspase-associated recruitment domain-containing protein 9 (CARD9) gene mutation (c.808-11G > T) which might be the cause of recurrent asymptomatic candiduria in this immune-competent young female without any underlying diseases.

Conclusions:
We report a case of recurrent asymptomatic candiduria caused by azole-resistant Candida glabrata in a young healthy female with a novel CARD9 mutation. A functional study of this mutation should be performed in the future to determine its effect on asymptomatic fungal UTIs.
Rare perivascular epithelial cell tumor of the colon 18F-FDG PET/CT imaging: A case report
Authors: Chen Qianqian , Wang Peiqi , Zhang Xiao , Zhang Jinhe 
Published: May 2023

Rationale:
Neoplasms with perivascular epithelioid cell differentiation (PEComas) are mesenchymal tumors that rarely occur in the colon. Here, we report the occurrence of a malignant PEcoma in the colon using 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT).

Patient concerns:
A 55-year-old woman was admitted to the hospital with abdominal pain for 10 days and a self-induced abdominal mass for 3 days. 18F-FDG PET/CT imaging showed a large hypermetabolic nodule and mass in the right mid-upper abdomen with heterogeneous density and a further increase in metabolism on the delayed scan.

Diagnoses:
PEComa of the colon.

Interventions:
Tumor resection was performed.

Outcomes:
The patient is well after 2 months of treatment, pending further follow-up.

Lessons:
Malignant perivascular epithelioid cell tumors originating in the colon are extremely rare, and our report suggests that PEComa should be considered as a differential diagnosis for 18F-FDG gastrointestinal malignancies. Additionally, 18F-FDG PET/CT may play a key role in the staging and extent of lesions in intestinal malignancies.
County-level Factors and Treatment Access Among Insured Women With Opioid Use Disorder
Authors: Leech Ashley A. , McNeer Elizabeth , Stein Bradley D. , Richards Michael R. , McElroy Tamarra , Dupont William D. , Patrick Stephen W. 
Published: May 2023

Background:
An over 40% increase in overdose deaths within the past 2 years and low levels of engagement in treatment call for a better understanding of factors that influence access to medication for opioid use disorder (OUD).

Objective:
To examine whether county-level characteristics influence a caller’s ability to secure an appointment with an OUD treatment practitioner, either a buprenorphine-waivered prescriber or an opioid treatment program (OTP).

Research Design and Subjects:
We leveraged data from a randomized field experiment comprised of simulated pregnant and nonpregnant women of reproductive age seeking treatment for OUD among 10 states in the US. We employed a mixed-effects logistic regression model with random intercepts for counties to examine the relationship between appointments received and salient county-level factors related to OUD.

Measures:
Our primary outcome was the caller’s ability to secure an appointment with an OUD treatment practitioner. County-level predictor variables included socioeconomic disadvantage rankings, rurality, and OUD treatment/practitioner density.

Results:
Our sample comprised 3956 reproductive-aged callers; 86% reached a buprenorphine-waivered prescriber and 14% an OTP. We found that 1 additional OTP per 100,000 population was associated with an increase (OR=1.36, 95% CI: 1.08 to 1.71) in the likelihood that a nonpregnant caller receives an OUD treatment appointment from any practitioner.

Conclusions:
When OTPs are highly concentrated within a county, women of reproductive age with OUD have an easier time securing an appointment with any practitioner. This finding may suggest greater practitioners’ comfort in prescribing when there are robust OUD specialty safety nets in the county.