bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Hypothesis-Generating Prospective Longitudinal Study to Assess the Relative Contribution of Common Respiratory Viruses to Severe Lower Respiratory Infections in Young Children
Authors: Ben-Shimol Shalom , Ramilo Octavio , Leber Amy L. , van der Beek Bart Adriaan , Everhart Kathy , Mertz Sara , Mejias Asuncion , Dagan Ron 
Published: March 2023

Background:
Respiratory viruses such as respiratory syncytial virus (RSV), influenza, parainfluenza and human metapneumovirus are well-established etiologies of acute lower respiratory tract infections (ALRIs; LRI-viruses). In contrast, adenovirus (AdV), rhinovirus/enterovirus (RV/EV) and seasonal human coronaviruses (CoV), collectively termed AdV/RV/CoV, are detected both in healthy children and children with ALRI.

Methods:
The methods include a prospective longitudinal case–control study, assessing the prevalence of LRI-viruses versus AdV/RV/CoV in ALRI [community-acquired alveolar pneumonia (CAAP) and bronchiolitis] during hospitalization (visit 1), 7–14 days (visit 2) and 28–35 days (visit 3) in 2–17-month-old children. Controls were 2–27-month-old children hospitalized for elective surgery during the same respiratory seasons.

Results:
We enrolled 99 infants (37 CAAP, 38 bronchiolitis and 24 controls) and obtained 211 nasopharyngeal swabs. Overall, 163 (77%) had greater than or equal to 1 viruses detected; RV/EV (n = 94; 45%) and RSV (n = 71; 34%) were the most frequently detected viruses. In CAAP, the overall LRI-virus prevalence was 78.4%, 32.4% and 5.4% in visits 1, 2 and 3, respectively; the respective rates in bronchiolitis were 73.7%, 34.5% and 8.0%. In controls, no LRI-viruses were detected. In contrast, the overall AdV/RV/CoV prevalence was high among controls (70.8%) and similar among CAAP (48.6%, 40.5% and 40.5%) and bronchiolitis (47.4, 58.6% and 64.0%) across visits.

Conclusions:
Among ALRI cases, LRI-viruses dominated during the acute disease, with prevalence declining within 28–35 days, suggesting their causative role. In contrast, AdV/RV/CoV prevalence was similar during all 3 visits and in controls, suggesting that carriage of these viruses is common during the viral respiratory season. The current study is relatively small and of short duration; however, the findings are supported by other recent studies.
Gender-Affirming Care and Comprehensive Sexuality Education
Authors:   International Association of Forensic Nurses
Published: March 2023

ABSTRACT
Every year, an estimated 246 million children are subject to some form of gender-based violence, including mistreatment, bullying, psychological abuse, and sexual harassment. Lesbian, gay, bisexual, transgender, two-spirit, or questioning youth are at a heightened risk of experiencing violence and have unique health, educational, and social needs. Fostering an atmosphere of support and acceptance can help alleviate many of these negative outcomes.
Significance of anatomical resection and resection margin status in patients with HBV-related hepatocellular carcinoma and microvascular invasion: a multicenter propensity score-matched study
Authors: Zhang Xiu-Ping , Xu Shuai , Lin Zhao-Yi , Gao Qing-Lun , Wang Kang , Chen Zi-Li , Yan Mao-Lin , Zhang Fan , Tang Yu-Fu , Zhao Zhi-Ming , Li Cheng-Gang , Lau Wan Yee , Cheng Shu-Qun , Hu Ming-Gen , Liu Rong 
Published: March 2023

Background:
Microvascular invasion (MVI) is a risk factor for postoperative survival outcomes for patients with hepatocellular carcinoma (HCC) after hepatectomy. This study aimed to evaluate the impact of anatomical resection (AR) versus nonanatomical resection (NAR) combined with resection margin (RM) (narrow RM <1 cm vs. wide RM ≥1 cm) on long-term prognosis in hepatitis B virus-related HCC patients with MVI.

Materials and methods:
Data from multicenters on HCC patients with MVI who underwent hepatectomy was analyzed retrospectively. Propensity score matching analysis was performed in these patients.

Results:
The 1965 enrolled patients were divided into four groups: AR with wide RM (n=715), AR with narrow RM (n=387), NAR with wide RM (n=568), and NAR with narrow RM (n=295). Narrow RM (P<0.001) and NAR (P<0.001) were independent risk factors for both overall survival and recurrence-free survival in these patients based on multivariate analyses. For patients in both the AR and NAR groups, wide RM resulted in significantly lower operative margin recurrence rates than those patients in the narrow RM groups after propensity score matching (P=0.002 and 0.001). Patients in the AR with wide RM group had significantly the best median overall survival (78.9 vs. 51.5 vs. 48.0 vs. 36.7 months, P<0.001) and recurrence-free survival (23.6 vs. 14.8 vs. 17.8 vs. 9.0 months, P<0.001) than those in the AR with narrow RM, NAR with wide RM or with narrow RM groups, respectively.

Conclusions:
If technically feasible and safe, AR combined with wide RM should be the recommended therapeutic strategy for HCC patients who are estimated preoperatively with a high risk of MVI.
Leveraging a nationwide infection surveillance program to implement a colorectal surgical site infection reduction bundle: a pragmatic, prospective, and multicenter cohort study
Authors: Badia Josep M. , Arroyo-Garcia Nares , Vázquez Ana , Almendral Alexander , Gomila-Grange Aina , Fraccalvieri Domenico , Parés David , Abad-Torrent Ana , Pascual Marta , Solís-Peña Alejandro , Puig-Asensio Mireia , Pera Miguel , Gudiol Francesc , Limón Enric , Pujol Miquel ,   Members of the VINCat Colorectal Surveillance Team,   on behalf of VINCat Program*
Published: March 2023

Background:
Bundled interventions usually reduce surgical site infection (SSI) when implemented at single hospitals, but the feasibility of their implementation at the nationwide level and their clinical results are not well established.

Materials and Methods:
Pragmatic interventional study to analyze the implementation and outcomes of a colorectal surgery care bundle within a nationwide quality improvement program. The bundle consisted of antibiotic prophylaxis, oral antibiotic prophylaxis (OAP), mechanical bowel preparation, laparoscopy, normothermia, and a wound retractor. Control group (CG) and Intervention group (IG) were compared. Overall SSI, superficial (S-SSI), deep (D-SSI), and organ/space (O/S-SSI) rates were analyzed. Secondary endpoints included microbiology, 30-day mortality, and length of hospital stay.

Results:
A total of 37 849 procedures were included, 19 655 in the CG and 18 194 in the IG. In all, 5462 SSIs (14.43%) were detected: 1767 S-SSI (4.67%), 847 D-SSI (2.24%), and 2838 O/S-SSI (7.5%). Overall SSI fell from 18.38% (CG) to 10.17% (IG), odds ratio (OR) of 0.503 [0.473–0.524]. O/S-SSI rates were 9.15% (CG) and 5.72% (IG), OR of 0.602 [0.556–0.652]. The overall SSI rate was 16.71% when no measure was applied and 6.23% when all six were used. Bundle implementation reduced the probability of overall SSI (OR: 0.331; CI95: 0.242–0.453), and also O/S-SSI rate (OR: 0.643; CI95: 0.416–0.919). In the univariate analysis, all measures except normothermia were associated with a reduction in overall SSI, while only laparoscopy, OAP, and mechanical bowel preparation were related to a decrease in O/S-SSI. Laparoscopy, wound retractor, and OAP decreased overall SSI and O/S-SSI in the multivariate analysis.

Conclusions:
In this cohort study, the application of a specific care bundle within a nationwide nosocomial infection surveillance system proved feasible and resulted in a significant reduction in overall and O/S-SSI rates in the elective colon and rectal surgery. The OR for SSI fell between 1.5 and 3 times after the implementation of the bundle.
Intraductal papillary neoplasms of the bile duct: a European retrospective multicenter observational study (EUR-IPNB study)
Authors: Lluís Núria , Serradilla-Martín Mario , Achalandabaso Mar , Jehaes François , Dasari Bobby V.M. , Mambrilla-Herrero Sara , Sparrelid Ernesto , Balakrishnan Anita , Hoogwater Frederik J.H. , Amaral Maria J. , Andersson Bodil , Berrevoet Frederik , Doussot Alexandre , López-López Víctor , Alsammani Mohammedsuror , Detry Olivier , Domingo-del Pozo Carlos , Machairas Nikolaos , Pekli Damján , Alcázar-López Cándido F. , Asbun Horacio , Björnsson Bergthor , Christophides Thalis , Díez-Caballero Alberto , Francart David , Noel Colin B. , Sousa-Silva Donzília , Toledo-Martínez Enrique , Tzimas George N. , Yaqub Sheraz , Cauchy François , Prieto-Calvo Mikel , D’Souza Melroy A. , Spiers Harry V.M. , van den Heuvel Marius C. , Charco Ramón , Lesurtel Mickaël , Ramia José M. 
Published: March 2023

Background/Purpose:
Intraductal papillary neoplasm of the bile duct (IPNB) is a rare disease in Western countries. The main aim of this study was to characterize current surgical strategies and outcomes in the mainly European participating centers.

Methods:
A multi-institutional retrospective series of patients with a diagnosis of IPNB undergoing surgery between 1 January 2010 and 31 December 2020 was gathered under the auspices of the European-African Hepato-Pancreato-Biliary Association. The textbook outcome (TO) was defined as a non-prolonged length of hospital stay plus the absence of any Clavien–Dindo grade at least III complications, readmission, or mortality within 90 postoperative days.

Results:
A total of 28 centers contributed 85 patients who underwent surgery for IPNB. The median age was 66 years (55–72), 49.4% were women, and 87.1% were Caucasian. Open surgery was performed in 72 patients (84.7%) and laparoscopic in 13 (15.3%). TO was achieved in 54.1% of patients, reaching 63.8% after liver resection and 32.0% after pancreas resection. Median overall survival was 5.72 years, with 5-year overall survival of 63% (95% CI: 50–82). Overall survival was better in patients with Charlson comorbidity score 4 or less versus more than 4 (P=0.016), intrahepatic versus extrahepatic tumor (P=0.027), single versus multiple tumors (P=0.007), those who underwent hepatic versus pancreatic resection (P=0.017), or achieved versus failed TO (P=0.029). Multivariable Cox regression analysis showed that not achieving TO (HR: 4.20; 95% CI: 1.11–15.94; P=0.03) was an independent prognostic factor of poor overall survival.

Conclusions:
Patients undergoing liver resection for IPNB were more likely to achieve a TO outcome than those requiring a pancreatic resection. Comorbidity, tumor location, and tumor multiplicity influenced overall survival. TO was an independent prognostic factor of overall survival.
Comparison of the perioperative outcomes of laparoscopic and open retroperitoneal lymph node dissection for low-stage (stage I/II) testicular germ cell tumors: a systematic review and meta-analysis
Authors: Ge Si , Gan Lijian , Meng Chunyang , Li Kangsen , Wang Zuoping , Zeng Zhiqiang , Zheng Lei , Li Yunxiang 
Published: March 2023

Objective:
Comparison of the perioperative outcomes of laparoscopic retroperitoneal lymph node dissection (L-RPLND) and open retroperitoneal lymph node dissection (O-RPLND) for low-stage (stage I/II) testicular germ cell tumors.

Methods:
The authors performed a systematic review and cumulative meta-analysis of the primary outcomes of interest according to PRISMA criteria, and the quality assessment of the included studies followed the AMSTAR guidelines. Four databases were searched, including Embase, PubMed, the Cochrane Library, and Web of Science. The search period was from the creation of each database to October 2022. The statistical analysis software uses Stata17.

Results:
There were nine studies involving 579 patients. Compared with O-RPLND, L-RPLND was associated with shorter length of stay [weighted mean difference (WMD)=−3.99, 95% CI: −4.80 to −3.19, P<0.05], less estimated blood loss (WMD=−0.95, 95% CI: −1.35 to −0.54, P<0.05), shorter time to oral intake after surgery (WMD=−0.77, 95% CI: −1.50 to −0.03, P<0.05), and lower overall complications (odds ratio=0.58, 95% CI: 0.38–0.87, P<0.05). Subgroup analysis found that the complication rate of Clavien–Dindo grade II was lower in L-RPLND (odds ratio=0.24, 95% CI: 0.11–0.55, P<0.05). Interestingly, there was no statistically significant difference between the two groups in terms of operation time, lymph node yields, and recurrence rate during follow-up.

Conclusion:
L-RPLND is superior to O-RPLND and is worthy of clinical promotion.
Examining Nurses' Perception of Shift Work and Evaluating Supportive Interventions
Authors: Konkol Megan , George Elisabeth L. , Scott Paul W. , Imes Christopher C. 
Published: March 2023

Background:
Health care requires a delicate equilibrium of nurse health safety and patient safety outcomes. Shift work can disrupt this balance, resulting in poor outcomes for staff and patients.

Problem:
Limited evidence exists on nurses' perceptions of shift work, fatigue countermeasures use, and interest in risk-mitigating interventions.

Methods:
An online survey of nurses was conducted. Survey questions assessed perceptions of shift work, use of fatigue countermeasures, and potential interventions.

Results:
The participants perceived multiple differences between day and night shifts when asked about their ability to complete both work- and life-oriented tasks. Use of fatigue countermeasures was more common while working night shift. Potential interventions included the use of blackout curtains, an on-site exercise facility, consulting a nutritionist, and block scheduling.

Conclusions:
Health care leaders should consider nurses' perceptions and interests when incorporating initiatives to mitigate the negative effects of shift work.
Beliefs in Regulating Negative Emotions and Vagally Mediated Heart Rate Variability: Does Sex Make a Difference?
Authors: Alessandri Guido , Filosa Lorenzo , Eisenberg Nancy , Ottaviani Cristina 
Published: March 2023

ABSTRACT

Objective
This ecological study explored the association between regulatory emotional self-efficacy beliefs in managing negative emotions (RESE-NE) and heart rate variability (HRV), a measure of parasympathetic modulation of the heart that has been positively associated with a better ability to flexibly adjust to a changing environment and regulate emotions.

Method
To test these associations, we used data from 161 adults working in relational professions (about 40% men; mean [standard deviation] age = 40.45 [14.17] years) whose HRV was assessed continuously for 24 hours.

Results
Individuals high in RESE-NE showed increased HRV levels (β = −0.05, p = .011). However, this effect was moderated by biological sex (β = −0.18, p = .0001) such that RESE-NE positively and significantly predicted HRV for men (β = 0.18, p < .0001) but not for women (β = −0.001, p = .989).

Conclusions
All in all, our study provides initial empirical support for the theoretical expectation derived from social cognitive theory that RESE-NE is positively correlated with a physiological indicator of adaptability to the environmental demands. This was true only for men, likely because of sex differences in physiological stress reactivity and regulation.
Opportunistic Screening for Atrial Fibrillation on Routine Chest Computed Tomography
Authors: Parker William A. , Vigneault Davis M. , Yang Issac , Bratt Alex , Marquardt Alizee C. , Sharifi Husham , Guo Haiwei Henry 
Published: March 2023

Purpose:
Quantitative biomarkers from chest computed tomography (CT) can facilitate the incidental detection of important diseases. Atrial fibrillation (AFib) substantially increases the risk for comorbid conditions including stroke. This study investigated the relationship between AFib status and left atrial enlargement (LAE) on CT.

Materials and Methods:
A total of 500 consecutive patients who had undergone nongated chest CTs were included, and left atrium maximal axial cross-sectional area (LA-MACSA), left atrium anterior-posterior dimension (LA-AP), and vertebral body cross-sectional area (VB-Area) were measured. Height, weight, age, sex, and diagnosis of AFib were obtained from the medical record. Parametric statistical analyses and receiver operating characteristic curves were performed. Machine learning classifiers were run with clinical risk factors and LA measurements to predict patients with AFib.

Results:
Eighty-five patients with a diagnosis of AFib were identified. Mean LA-MACSA and LA-AP were significantly larger in patients with AFib than in patients without AFib (28.63 vs. 20.53 cm2, P<0.000001; 4.34 vs. 3.5 cm, P<0.000001, respectively), both with area under the curves (AUCs) of 0.73. Multivariable logistic regression analysis including age, sex, and VB-Area with LA-MACSA improved the AUC for predicting AFib (AUC=0.77). An LA-MACSA threshold of 30 cm2 demonstrated high specificity for AFib diagnosis at 92% and sensitivity of 48%, and LA-AP threshold at 4.5 cm demonstrated 90% specificity and 42% sensitivity. A Bayesian machine learning model using age, sex, height, body surface area, and LA-MACSA predicted AFib with an AUC of 0.743.

Conclusions:
LA-MACSA or LA-AP can be rapidly measured from routine chest CT, and when >30 cm2 and >4.5 cm, respectively, are specific indicators to predict patients at increased risk for AFib.
Reliability and Validity Evaluation of the Chin Augmentation With Medpor Using FACE-Q Scales Effectiveness
Authors: Zang Tianying , Liu Bingyang , Tang Xiaojun , Yin Lin 
Published: March 2023

Background:
Chin augmentation (CA) is important treatment modality for microgenia. The use of implantable alloplastic biomaterials in CA grows in popularity, and there is no verifiable documentation of patients’ satisfaction about CA with Medpor (CAWM) exists in the literature, this study examined effectiveness of CAWM by analyzing patient satisfaction.

Methods:
Patients had undergone CAWM were followed up postoperatively. Occurrence of complications was collected, patients’ satisfactions with chin shape and surgical decision were analyzed using FACE-Q scales, the reliability of operation was studied through analyzing the statistics, and the influences of sex and follow-up time on satisfaction were compared.

Results:
One hundred ten patients who had undergone CAWM received FACE-Q scales and 64 valid questionnaires were collected. 61 (95.3%) showed high satisfaction with chin shape after CAWM (Cronbach α coefficients were all above 0.8), the median values of satisfaction of chin shape and decision making were 85 (67, 100) and 100 (75,100), respectively. The median chin satisfactions of females and males were 87 (67, 100), 79 (61,100). The median chin satisfactions of patients had surgery before 2 years ago and within 2 years were 81 (67, 100), 87 (64,100), respectively. During the follow-up, among 110, 1 (0.91%) developed graft-related infection and 1 (0.91%) developed an allergic reaction, 1 (0.91%) underwent prosthesis removal because dissatisfaction with chin shape.

Conclusions:
Chin augmentation with prothesis is a safe and efficacious way to improve microgenia. Medpor is the desired implant material with less infection, displacement and bone absorption, which is worthy of promotion and further study in CA surgery.
Comparing outcomes of ultra-low-cost hearing aids to programmable, refurbished hearing aids for adults with high frequency hearing loss in Malawi: A feasibility study
Authors: Parmar Bhavisha , Phiri Mwanaisha , Jailos Louis , Kachapila Regina , Seleb Ben , Mulwafu Wakisa , Manchaiah Vinay , Bhamla M. Saad 
Published: March 2023

AbstractIntroductionAccess to ear and hearing health services are limited or non-existent in low-income countries, with less than 10% of the global production of hearing aids is distributed to this population. The aim of this feasibility study was to compare the outcomes of an ultra-low-cost hearing aid (LoCHAid) to programmable, refurbished hearing aids for adults with high-frequency hearing loss, in Blantyre, Malawi.MethodsSixteen adults with high frequency hearing loss, and no prior experience of hearing aids, took part in this study, nine were fitted with the LoCHAid and seven were fitted with refurbished, programmable hearing aids, for a one-month trial. Five standardized hearing qualities questionnaires were used to compare outcomes pre and post device fitting and between devices. Questionnaire scales were analysed using general linear models and inductive thematic analysis was used to evaluate qualitative data.ResultsOverall, there was no significant difference found between LoCHAid and refurbished hearing aids, and the two device types each showed a similar degree of improvement after fitting. Qualitative data identified two key themes: Sound Quality and User experience.ConclusionThe results from this feasibility study are encouraging, but a comprehensive, larger clinical study is needed to draw firm conclusions about the LoCHAid’s performance. This study has identified key improvement indicators required to enhance sound quality and user experience of the LoCHAid.
An Opportunity to Standardize and Enhance Intelligent Virtual Assistant-Delivered Layperson Cardiopulmonary Resuscitation Instructions
Authors: Murk William , Goralnick Eric , Brownstein John S. , Landman Adam B. 
Published: March 2023

AbstractImportanceIntelligent virtual assistants (IVAs) are ubiquitous and hold the potential to provide bystander cardiopulmonary resuscitation (CPR) instructions during an emergency.ObjectiveTo evaluate the quality of CPR instructions provided by IVAs.DesignWe evaluated the appropriateness of responses of four IVAs (Amazon Alexa, Apple Siri, Google Assistant, and Microsoft Cortana) to eight CPR-related questions. We also evaluated text-based responses provided by OpenAI ChatGPT, a recently developed artificial intelligence large language model.ResultsOut of 32 responses provided by IVAs, only 19 (59%) were related to CPR, 9 (28%) suggested calling emergency services, and 4 (12%) provided verbal CPR instructions. All responses provided by ChatGPT were related to CPR and suggested calling emergency services. Among responses related to CPR, the answers provided varied significantly in the utility of information provided.Conclusions and RelevanceThese results highlight the need for the technology industry to partner with the medical community to improve and standardize bystander CPR instruction provided by IVAs.Key pointsQuestionWhat is the quality of cardiopulmonary resuscitation (CPR) instruction provided by intelligent virtual assistants (IVAs) including Amazon Alexa, Apple Siri, Google Assistant, and Microsoft Cortana?FindingsWhen asked questions related to CPR, IVAs frequently did not provide relevant information. Moreover, even when the information provided was relevant, actual CPR instruction was not given in most cases.MeaningThese results highlight the need to standardize bystander CPR instruction provided by IVAs.