bluuebunny/crossref_metadata_2025_split huggingface dataset:
Relative role of community transmission and campus contagion in driving the spread of SARS-CoV-2: Lessons from Princeton University
Authors: Park Sang Woo , Daskalaki Irini , Izzo Robin M , Aranovich Irina , te Velthuis Aartjan J W , Notterman Daniel A , Metcalf C Jessica E , Grenfell Bryan T 
Published: July 2023

Abstract
Mathematical models have played a crucial role in exploring and guiding pandemic responses. University campuses present a particularly well-documented case for institutional outbreaks, thereby providing a unique opportunity to understand detailed patterns of pathogen spread. Here, we present descriptive and modeling analyses of SARS-CoV-2 transmission on the Princeton University (PU) campus—this model was used throughout the pandemic to inform policy decisions and operational guidelines for the university campus. Epidemic patterns between the university campus and surrounding communities exhibit strong spatiotemporal correlations. Mathematical modeling analysis further suggests that the amount of on-campus transmission was likely limited during much of the wider pandemic until the end of 2021. Finally, we find that a superspreading event likely played a major role in driving the Omicron variant outbreak on the PU campus during the spring semester of the 2021–2022 academic year. Despite large numbers of cases on campus in this period, case levels in surrounding communities remained low, suggesting that there was little spillover transmission from campus to the local community.
Neuro- and cognitive diversity in surgery and allied professions: celebrating difference and optimising performance
Authors: Bowman Chris R , Lewis Wyn G 
Published: July 2023

Abstract
Neurotypicality (NT) and neurodiversity (ND) are two terms used to describe separate ways of thinking and experiencing the world. The prevalence of ND within surgery and allied professions is poorly studied or understood but is likely to be significant and increasing. If our aim is to be truly inclusive, ND's effects on teams and our willingness and ability to adapt adequately must improve.
Geographic disparities of cardiovascular and cancer mortality in the USA: 1981–2019
Authors: Lebakula V , Cosby A G 
Published: July 2023

Abstract

Background
Cardiovascular and cancer mortality are the two leading causes of death in the developed world including the USA. However, mortality trends for these diseases are highly dynamic, and the geographic landscape is in transition. We analyze patterns of mortality improvement at county level during recent decades focusing on mortality decline and geographic diversity.

Methods
We grouped age-adjusted mortality rates of cardiovascular and cancer diseases from CDC WONDER for 2959 US counties into 3-year time periods to improve reliability. We calculated percent mortality decrease between 1981–83 and 2016–19 for both causes to quantify mortality improvements for counties.

Results
Using standard deviation as an index of disparities, place-based cancer mortalities were 68% larger than cardiovascular disparities. Significantly, 566 US counties had same or higher rates of cancer mortality in 2019 as in 1981. The geographic distribution of mortality improvement in either cause tends to favor largely populated areas along coasts. Less-populated, rural places in the interior and southeastern regions were experiencing less improvement.

Conclusions
At the county level, large place-based disparities exist for both causes of death with the magnitude of disparities being substantially larger for the reduction in cancer deaths. Put differently, place matters, more for cancer than cardiovascular mortality.
Lung ultrasound compared to computed tomography detection and automated quantification of systemic sclerosis-associated interstitial lung disease: preliminary study
Authors: Mohammad Reza Beigi Davide , Pellegrino Greta , Loconte Michele , Landini Nicholas , Mattone Monica , Paone Gregorino , Truglia Simona , Di Ciommo Francesca Romana , Bisconti Ilaria , Cadar Marius , Stefanantoni Katia , Panebianco Valeria , Conti Fabrizio , Riccieri Valeria 
Published: July 2023

Abstract

Background
Lung ultrasound (LUS) is a promising tool for detecting SSc-associated interstitial lung disease (SSc-ILD). Currently, consensus on the best LUS findings and execution technique is lacking.

Objectives
To compare qualitative and quantitative assessment of B-lines and pleural line (PL) alterations in SSc-ILD with chest CT analysis.

Methods
During 2021–2022, consecutive SSc patients according to 2013 ACR/EULAR classification criteria underwent pulmonary functional tests (PFTs). On the same day, if a CT was performed over a ± 6 months period, LUS was performed by two certified blinded operators using a 14-scans method. The ≥10 B-lines cut-off proposed by Tardella and the Fairchild’s PL criteria fulfilment were selected as qualitative findings. As quantitative assessment, total B-lines number and the quantitative PL score adapted from the semi-quantitative Pinal-Fernandez score were collected. CT scans were evaluated by two thoracic radiologists for ILD presence, with further processing by automated texture analysis software (QCT).

Results
Twenty-nine SSc patients were enrolled. Both qualitative LUS scores were significantly associated to ILD presence on CT, with Fairchild’s PL criteria resulting in slightly more accuracy. Results were confirmed on multivariate analysis. All qualitative and quantitative LUS findings were found to be significantly associated with QCT ILD extension and radiological abnormalities. Mid and basal PL quantitative score correlated with mid and basal QCT ILD extents. Both B-lines and PL alterations differently correlated with PFTs and clinical variables.

Conclusion
This preliminary study suggests the utility of a comprehensive LUS assessment for SSc-ILD detection compared with CT and QCT.
Diversity and Pathobiology of an Ilarvirus Unexpectedly Detected in Diverse Plants and Global Sequencing Data
Authors: Rivarez Mark Paul Selda , Faure Chantal , Svanella-Dumas Laurence , Pecman Anja , Tušek-Žnidaric Magda , Schönegger Deborah , De Jonghe Kris , Blouin Arnaud , Rasmussen David A. , Massart Sebastien , Ravnikar Maja , Kutnjak Denis , Marais Armelle , Candresse Thierry 
Published: July 2023

High-throughput sequencing (HTS) and sequence mining tools revolutionized virus detection and discovery in recent years, and implementing them with classical plant virology techniques results in a powerful approach to characterize viruses. An example of a virus discovered through HTS is Solanum nigrum ilarvirus 1 (SnIV1) ( Bromoviridae), which was recently reported in various solanaceous plants from France, Slovenia, Greece, and South Africa. It was likewise detected in grapevines ( Vitaceae) and several Fabaceae and Rosaceae plant species. Such a diverse set of source organisms is atypical for ilarviruses, thus warranting further investigation. In this study, modern and classical virological tools were combined to accelerate the characterization of SnIV1. Through HTS-based virome surveys, mining of sequence read archive datasets, and a literature search, SnIV1 was further identified from diverse plant and non-plant sources globally. SnIV1 isolates showed relatively low variability compared with other phylogenetically related ilarviruses. Phylogenetic analyses showed a distinct basal clade of isolates from Europe, whereas the rest formed clades of mixed geographic origin. Furthermore, systemic infection of SnIV1 in Solanum villosum and its mechanical and graft transmissibility to solanaceous species were demonstrated. Near-identical SnIV1 genomes from the inoculum ( S. villosum) and inoculated Nicotiana benthamiana were sequenced, thus partially fulfilling Koch's postulates. SnIV1 was shown to be seed-transmitted and potentially pollen-borne, has spherical virions, and possibly induces histopathological changes in infected N. benthamiana leaf tissues. Overall, this study provides information to better understand the diversity, global presence, and pathobiology of SnIV1; however, its possible emergence as a destructive pathogen remains uncertain. [Formula: see text] Copyright © 2023 The Author(s). This is an open access article distributed under the CC BY 4.0 International license .
Colorectal cancer screening
Authors: Mollman Burton James 
Published: July 2023

ABSTRACT
Because an estimated 10.5% of new colorectal cancer (CRC) cases occur in patients under age 50 years, the US Preventive Services Task Force in 2021 recommended CRC screening for adults ages 45 to 49 years. The prevalence of up-to-date CRC screening with any recommended test among patients age 45 years and older in the United States is only 59% in 2023, indicating that existing screening practices are ineffective. Screening options now include invasive and noninvasive measures. Multi-target stool DNA (MT-sDNA) testing is a simple, low-risk, noninvasive test that provides excellent sensitivity and specificity, is cost-effective, and may increase patient screening rates. CRC screening guideline recommendations and alternative screening methods may help improve patient outcomes and reduce morbidity and mortality. This article describes MT-sDNA testing, its effectiveness, recommended use, and potential expanding role as a screening option.
The changing employment of physicians, NPs, and PAs
Authors: Hooker Roderick S. , Christian Robert L. 
Published: July 2023

ABSTRACTInformation on the employment of patient-care clinicians is needed for policy planning and human resource management. The 2021 Bureau of Labor Statistics (BLS) employment data were probed for occupational settings of 698,700 physicians and surgeons, 246,690 NPs, and 139,100 physician associates/assistants (PAs). These three healthcare professionals accounted for about 1.1 million medical and surgical clinicians serving a US population of 331.5 million. Clinician demographics differ—in 2021, the median age of physicians was 45 years; NPs, 43 years; and PAs, 39 years. The largest employment location is “office of a physician” (physician, 53%; NP, 47%; PA, 51%), followed by hospitals (physician, 25%; NP, 25%; PA, 23%), and outpatient centers (physician, 4%; NP, 9%; PA, 10%). The 10-year job outlook predicts physician growth at 3%, NPs at 46%, and PAs at 28%. NP and PA employment is growing more than that of physicians because of constrained physician postgraduate education funding. Other factors influencing employment changes include medical practice mergers, the rising value of team-based care, the cost of new medical schools, and task shifting.
Reliability of Admission Procalcitonin Testing for Capturing Bacteremia Across the Sepsis Spectrum: Real-World Utilization and Performance Characteristics, 65 U.S. Hospitals, 2008–2017*
Authors: Lawandi Alexander , Oshiro Marissa , Warner Sarah , Diao Guoqing , Strich Jeffrey R. , Babiker Ahmed , Rhee Chanu , Klompas Michael , Danner Robert L. , Kadri Sameer S. 
Published: July 2023

OBJECTIVES:
Serum procalcitonin is often ordered at admission for patients with suspected sepsis and bloodstream infections (BSIs), although its performance characteristics in this setting remain contested. This study aimed to evaluate use patterns and performance characteristics of procalcitonin-on-admission in patients with suspected BSI, with or without sepsis.

DESIGN:
Retrospective cohort study.

SETTING:
Cerner HealthFacts Database (2008–2017).

PATIENTS:
Adult inpatients (≥ 18 yr) who had blood cultures and procalcitonin drawn within 24 hours of admission.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
Testing frequency of procalcitonin was determined. Sensitivity of procalcitonin-on-admission for detecting BSI due to different pathogens was calculated. Area under the receiver operating characteristic curve (AUC) was calculated to assess discrimination by procalcitonin-on-admission for BSI in patients with and without fever/hypothermia, ICU admission and sepsis defined by Centers for Disease Control and Prevention Adult Sepsis Event criteria. AUCs were compared using Wald test and p values were adjusted for multiple comparisons. At 65 procalcitonin-reporting hospitals, 74,958 of 739,130 patients (10.1%) who had admission blood cultures also had admission procalcitonin testing. Most patients (83%) who had admission day procalcitonin testing did not have a repeat procalcitonin test. Median procalcitonin varied considerably by pathogen, BSI source, and acute illness severity. At a greater than or equal to 0.5 ng/mL cutoff, sensitivity for BSI detection was 68.2% overall, ranging between 58.0% for enterococcal BSI without sepsis and 96.4% for pneumococcal sepsis. Procalcitonin-on-admission displayed moderate discrimination at best for overall BSI (AUC, 0.73; 95% CI, 0.72–0.73) and showed no additional utility in key subgroups. Empiric antibiotic use proportions were not different between blood culture sampled patients with a positive procalcitonin (39.7%) and negative procalcitonin (38.4%) at admission.

CONCLUSIONS:
At 65 study hospitals, procalcitonin-on-admission demonstrated poor sensitivity in ruling out BSI, moderate-to-poor discrimination for both bacteremic sepsis and occult BSI and did not appear to meaningfully alter empiric antibiotic usage. Diagnostic stewardship of procalcitonin-on-admission and risk assessment of admission procalcitonin-guided clinical decisions is warranted.
Utilization of Transthoracic Echocardiography Is Associated with a Decreased 6-month Readmission Rate in Hospitalized Heart Failure: A Propensity Score-matched Analysis
Authors: Fu Zhiqing , Li Shan , Zhao Xiaoning , Wang Qiang 
Published: July 2023

Objective:
Repeated hospitalization due to congestion is a characteristic of the whole course of heart failure. Echocardiography can be used to assess cardiac function and volume status. However, whether echocardiography can reduce the rehospitalization rate remains unclear. This study aimed to evaluate the impact of transthoracic echocardiography (TTE) use on readmission rates in hospitalized patients with heart failure.

Methods:
The study was based on the Zigong heart failure database, which contained information on 2,008 adult patients with heart failure admitted to the Zigong Fourth People’s Hospital (Sichuan Province, China) from December 2016 to June 2019. Patients were divided into 2 groups according to the usage of TTE on the day of hospital admission (TTE group (1,371 patients) and no TTE group (637 patients), respectively). The primary outcome was the 6-month readmission rate. The statistical approaches used included multivariate Cox regression, propensity score analysis, and an inverse probability weighting model to ensure the robustness of the findings.

Results:
A significant reduction in 6-month readmission rate was observed among the TTE group compared with the no TTE group (hazard ratio = 0.60, 95% confidence interval (CI) = 0.52–0.69, P < 0.001). The frequencies of intravenous nitrates, diuretics, and inotropes during hospitalization were significantly higher in the TTE group compared with those in the no TTE group (10.9% vs. 8.3%, 88.5% vs. 86.2%, and 66.9% vs. 65.6%, respectively, all P < 0.001). The proportion of patients returning to the emergency department within 6 months was significantly lower in the TTE group compared with the no TTE group (35.6% vs. 50.3%, P < 0.001).

Conclusions:
Utilization of TEE on admission day was associated with a reduced 6-month readmission rate in hospitalized patients with heart failure.
Persistent increase and improved survival of stage I lung cancer based on a large-scale real-world sample of 26,226 cases
Authors: Wang Chengdi , Shao Jun , Song Lujia , Ren Pengwei , Liu Dan , Li Weimin 
Published: July 2023

AbstractBackground:Lung cancer prevails and induces high mortality around the world. This study provided real-world information on the evolution of clinicopathological profiles and survival outcomes of lung cancer, and provided survival information within stage I subtypes.Methods:Patients pathologically confirmed with lung cancer between January 2009 and December 2018 were identified with complete clinicopathological information, molecular testing results, and follow-up data. Shifts in clinical characteristics were evaluated usingχ2tests. Overall survival (OS) was calculated through the Kaplan–Meier method.Results:A total of 26,226 eligible lung cancer patients were included, among whom 62.55% were male and 52.89% were smokers. Non-smokers and elderly patients took increasingly larger proportions in the whole patient population. The proportion of adenocarcinoma increased from 51.63% to 71.80%, while that of squamous carcinoma decreased from 28.43% to 17.60%. Gene mutations includingEGFR(52.14%),KRAS(12.14%), andALK(8.12%) were observed. Female, younger, non-smoking, adenocarcinoma patients and those with mutatedEGFRhad better survival prognoses. Importantly, this study validated that early detection of early-stage lung cancer patients had contributed to pronounced survival benefits during the decade. Patients with stage I lung cancer, accounted for an increasingly considerable proportion, increasing from 15.28% to 40.25%, coinciding with the surgery rate increasing from 38.14% to 54.25%. Overall, period survival analyses found that 42.69% of patients survived 5 years, and stage I patients had a 5-year OS of 84.20%. Compared with that in 2009–2013, the prognosis of stage I patients in 2014–2018 was dramatically better, with 5-year OS increasing from 73.26% to 87.68%. Regarding the specific survival benefits among stage I patients, the 5-year survival rates were 95.28%, 93.25%, 82.08%, and 74.50% for stage IA1, IA2, IA3, and IB, respectively, far more promising than previous reports.Conclusions:Crucial clinical and pathological changes have been observed in the past decade. Notably, the increased incidence of stage I lung cancer coincided with an improved prognosis, indicating actual benefits of early detection and management of lung cancer.
Regional anaesthesia practices: insights from a European survey
Authors: Konijn Arjan , Aldecoa Cesar , Benhamou Dan , Frkovic Vedran , Kessler Paul , Marhofer Peter 
Published: July 2023

BACKGROUND
The use of regional anaesthesia has increased and evolved over the past two decades but to what extent is unclear. Moreover, there is no clear standardisation of best practice in the current European landscape, which could result in inconsistencies in regional anaesthesia in practice.

OBJECTIVES
The objective of this survey was to explore regional anaesthesia practices across Europe, including the differences in procedures, use of ultrasound, reporting of complications, guidelines, training and patient safety implementation.

DESIGN
A Faculty of European regional anaesthesia experts developed a survey of 27 questions focused on respondent and institution profile, anaesthesia services, patient and safety management, training, use of guidelines, and the implementation of NRFitTM [neuraxial device connectors that meet the International Organisation for Standardisation (ISO) requirements].

SETTINGS
The survey was disseminated across several European countries via professional networks.

PARTICIPANTS
There were 794 respondents from 36 European countries.

RESULTS
The survey demonstrated that use of regional anaesthesia is growing in Europe and is supported by new technologies. Although some results are consistent with expected trends and applications (e.g. procedures predominantly performed by anaesthesiologists), there are inconsistencies in practice across European countries, especially in the specific regional anaesthesia procedures utilised for different clinical applications and the recording and reporting of regional anaesthesia complications. These inconsistencies also extended to which guidelines are primarily followed and how training is implemented. There were also variations in the general awareness and uptake of the ISO standard for NRFit.

CONCLUSION
The survey results highlight a clear need for standardisation and consistency in the use and management of regional anaesthesia across Europe. The faculty put forth several calls to action that could provide major steps in the right direction towards meeting that goal, including the establishment of European best practices, development of a complication reporting system and implementation of educational programmes to highlight the importance of NRFit.
Systemic diffuse large B-cell lymphoma manifesting initially as scalp hematoma after an acute head injury: Case report and literature review
Authors: Huang Peng-Chan , Yao Wen-Teng , Jhuang Jie-Yang , Tsai Cheng-Chia , Chen Shiu-Jau , Yang Chih-Chuan 
Published: July 2023

Abstract
Systemic diffuse large B-cell lymphoma (DLBCL) manifesting as a scalp mass is rare but serious and must be treated aggressively, with neurosurgical intervention. We report a rare case of 56-year-old woman with a 1-month history of persistent scalp hematoma over the left parietal and occipital regions of the scalp after blunt head injury which was diagnosed as DLBCL after the excision.
Trends in the incidence of adrenocortical carcinoma and pheochromocytoma/paraganglioma in Taiwan
Authors: Tsai Chung-Hsin , Huang Tun-Sung , Cheng Shih-Ping 
Published: July 2023

Abstract

Background
Adrenal malignancies are rare endocrine tumors. Recent epidemiological studies suggest that incidence rates of adrenal malignancies are increased in certain countries. In this study, we aimed to analyze temporal trends in the incidence of adrenocortical carcinoma and pheochromocytoma/paraganglioma (PPGL).

Methods
Cases of adrenal malignancies were identified from the Taiwan cancer registry, and age-standardized incidence rates (ASRs) were calculated. Annual percent change (APC) or average APC was obtained using joinpoint regression models.

Results
The ASRs of adrenocortical carcinoma ranged from 0.021 to 0.135 per 100 000 person-years. The average APC between 1995 and 2020 was 6.633% (95% confidence interval, 2.740 to 9.403). The ASRs of PPGL ranged from 0.005 to 0.056 per 100 000 person-years before 2017 and, because of changes in diagnostic criteria, the median ASR of PPGL rose to 0.314 per 100 000 person-years after 2017. The APC between 1996 and 2016 was 3.554% (95% confidence interval, -1.103 to 8.264).

Conclusions
The annual incidence of adrenocortical carcinoma has significantly increased in Taiwan over the past two decades. The incidence of malignant PPGL remained stable over this time period.