bluuebunny/crossref_metadata_2025_split huggingface dataset:
Epidemiologic Changes of Neonatal Early-onset Sepsis After the Implementation of Universal Maternal Screening for Group B Streptococcus in Hong Kong
Authors: Wang Xuelian , Chan Peggy Hiu Ying , Lau Hoi Ying Sharon , Tsoi Kathleen , Lam Hugh Simon 
Published: July 2023

Background:
The epidemiology of neonatal early-onset sepsis (EOS) has changed with time and with changes in prevention strategy. Population-representative contemporary data provide insights on how to further improve EOS prevention and triage strategies.

Methods:
Neonates born in public hospitals in Hong Kong from January 1, 2006, to December 31, 2017 were included. The epidemiological characteristics of EOS and the use of intrapartum antibiotic prophylaxis (IAP) were compared between the 2 epochs before (January 1, 2006 to December 31, 2011) and after (January 1, 2012 to December 31, 2017) the territory-wide implementation of universal maternal group B Streptococcus (GBS) screening.

Results:
EOS developed in 1.07‰ of live births (522/490,034). After the implementation of universal GBS screening, the EOS rate decreased in neonates born ≥34 weeks (1.17‰–0.56‰, P < 0.001) and remained similar in those born <34 weeks (7.8‰–10.9‰, P = 0.15), whereas the proportions of IAP coverage increased in both groups [7.6%–23.3% (P < 0.001) and 28.5%–52.0% (P < 0.001), respectively]. The major pathogen for EOS shifted from GBS to Escherichia coli, and for early-onset meningitis from GBS to Streptococcus bovis. IAP was associated with subsequent isolation of pathogens resistant to ampicillin [adjusted odds ratio (aOR) 2.3; 95% confidence interval (CI): 1.3–4.2], and second-generation [aOR 2.0; 95% CI: 1.02–4.3] and third-generation [aOR 2.2; 95% CI: 1.1–5.0] cephalosporins.

Conclusions:
Pathogen profile of EOS changed with the implementation of universal GBS screening. S. bovis has emerged as a more common pathogen associated with the risk of meningitis. IAP may not be as effective in reducing EOS rate among infants born <34 weeks as compared with those ≥34 weeks, and newer strategies may be needed.
The Effect of Early Feeding of Full Liquids on Postoperative Infants
Authors: Kiolbasa Carolyn , Chaturvedi Apurva , Ryan Colleen , Johnsen Linda , Schmidt Barbara , Schroeder James W. , Birmingham Patrick K. , Manworren Renee C. B. 
Published: July 2023

Abstract
There is a lack of evidence-based guidance for postoperative feeding of infants after outpatient surgeries. This randomized controlled trial tested the hypothesis that infants, aged ≤12 months who are fed formula or milk at home, will have more oral intake, less pain, and less emergence delirium when fed formula/milk as compared with clear liquids in the postanesthesia care unit. Infants were randomized to receive formula/milk or clear liquids as first feeding after outpatient myringotomy and tube insertion. Pain (Faces, Legs, Activity, Cry, and Consolability) and emergence delirium (Pediatric Anesthesia Emergence Delirium) scores were recorded and compared immediately and again 15 and 30 minutes after arrival in the postanesthesia care unit. Infants randomized to the formula/milk first-feeding group had significantly more volume of oral feeding intake than infants randomized to the clear liquid first-feeding group (M = 80.5 ml, 95% CI [15, 146], p = .017). There was no significant difference in vomiting, pain scores, or emergence delirium scores between groups. These results support the practice of ad lib feeding of infants who preferred full liquids after outpatient surgical procedures.
The relationship between vitamin D and short-term blood pressure variability
Authors: Baniasad Amir , Mokhtari Ardekan Abnoos , Najafzadeh Mohammad Javad , Mousavi Mehdiabadi Fatemeh 
Published: July 2023

Objectives
This study aimed to evaluate the relationships between serum levels of 25-hydroxyvitamin D (25(OH)D) and short-term blood pressure variability (BPV) in newly diagnosed hypertensive patients.

Methods
One hundred newly diagnosed patients with stage one essential hypertension were included and divided into two groups, the deficient and non-deficient groups, according to their 25(OH)D level. The blood pressure was recorded automatically by a portable ambulatory blood pressure monitor for 24 h.

Results
In the present study, there was no significant relationship between vitamin D levels and short-term BPV or other parameters derived from ambulatory blood pressure monitoring (ABPM) (P > 0.05). Age (r = 0.260, P = 0.009), serum phosphorus (r = 0.271, P = 0.007), and cholesterol levels (r = 0.310, P = 0.011) were positively correlated with 25(OH)D levels, while glomerular filtration rate (r = -0.232, P = 0.021) negatively correlated with vitamin D levels. There was no crude or adjusted relationship between the levels of 25(OH)D and any parameters of ABPM in multiple linear regression analysis.

Conclusion
Although the relationship between vitamin D levels and cardiovascular diseases has been confirmed, vitamin D deficiency does not cause an increase in cardiovascular risk by influencing the short-term BPV or other parameters derived from ABPM.
Liver Cancer Vascularity Driven by Extracellular Matrix Stiffness
Authors: Taiji Ryosuke , Cortes Andrea C. , Zaske Ana Maria , Williams Malea , Dupuis Crystal , Tanaka Toshihiro , Nishiofuku Hideyuki , Chintalapani Gouthami , Peterson Christine B. , Avritscher Rony 
Published: July 2023

Background
Extracellular matrix stiffness represents a barrier to effective local and systemic drug delivery. Increasing stiffness disrupts newly formed vessel architecture and integrity, leading to tumor-like vasculature. The resulting vascular phenotypes are manifested through different cross-sectional imaging features. Contrast-enhanced studies can help elucidate the interplay between liver tumor stiffness and different vascular phenotypes.

Purpose
This study aims to correlate extracellular matrix stiffness, dynamic contrast-enhanced computed tomography, and dynamic contrast-enhancement ultrasound imaging features of 2 rat hepatocellular carcinoma tumor models.

Methods and Materials
Buffalo-McA-RH7777 and Sprague Dawley (SD)–N1S1 tumor models were used to evaluate tumor stiffness by 2-dimensional shear wave elastography, along with tumor perfusion by dynamic contrast-enhanced ultrasonography and contrast-enhanced computed tomography. Atomic force microscopy was used to calculate tumor stiffness at a submicron scale. Computer-aided image analyses were performed to evaluate tumor necrosis, as well as the percentage, distribution, and thickness of CD34+ blood vessels.

Results
Distinct tissue signatures between models were observed according to the distribution of the stiffness values by 2-dimensional shear wave elastography and atomic force microscopy (P < 0.05). Higher stiffness values were attributed to SD-N1S1 tumors, also associated with a scant microvascular network (P ≤ 0.001). Opposite results were observed in the Buffalo-McA-RH7777 model, exhibiting lower stiffness values and richer tumor vasculature with predominantly peripheral distribution (P = 0.03). Consistent with these findings, tumor enhancement was significantly greater in the Buffalo-McA-RH7777 tumor model than in the SD-N1S1 on both dynamic contrast-enhanced ultrasonography and contrast-enhanced computed tomography (P < 0.005). A statistically significant positive correlation was observed between tumor perfusion on dynamic contrast-enhanced ultrasonography and contrast-enhanced computed tomography in terms of the total area under the curve and % microvessel tumor coverage (P < 0.05).

Conclusions
The stiffness signatures translated into different tumor vascular phenotypes. Two-dimensional shear wave elastography and dynamic contrast-enhanced ultrasonography adequately depicted different stromal patterns, which resulted in unique imaging perfusion parameters with significantly greater contrast enhancement observed in softer tumors.
Construction of Sensitive Labia Minora–Clitoris–Clitoral Hood Complex in Sex Reassignment Surgery in Circumcised Populations
Authors: Balik Ozan 
Published: July 2023

Introduction
The construction of the labia minora from preputial tissues in uncircumcised patients and the preservation of the sensitivity of the labia minora are not new ideas. However, evidently, this technique is designed for uncircumcised cases.
There is no preputial tissue in the circumcised population. However, this tissue, whose inner and outer layers have different structures and appearances, is critical in the construction of the labia minora. Instead, there is an area of reepithelialization and reinnervation that heals secondarily or is closed primarily, depending on the circumcision. Also, this new skin area is devoid of the natural oily secretions of the prepuce. In addition, the removal of preputial tissue in circumcised individuals may cause uncertainty in terms of vascularity or sensitivity. In this study, we share our clinical experience regarding large labia minora creation (with preserved flap circulation without vaginal reconstruction concerns) and the use of most of the urethra as a mesh graft in the circumcised population.

Materials and Methods
Between 2010 and 2022, 19 cases were operated on with this technique. All cases were primary interventions for male-to-female sex reassignment. Because this design of the sensitive inner surface of the labia minora, which ensured vascular safety, was not found in the literature, the design was named “butterfly flap” because of its shape.

Evaluation of Sensation
The area corresponding to both wings of the butterfly flap was evaluated with the Semmes Weinstein Monofilament test, with the patient's eyes closed, in the preoperative period. Likewise, the sensitivity of the inner surface of the labia minora in the first year of 10 patients who were able to attend follow-up clinical examination was evaluated with the same method.

Results
In our study, a clitoris and a labia minora with sensory innervation were obtained by elevating the superior 180-degree area of the neurovascular bundle surrounding the penis and using the butterfly flap we prepared in the area fed by this bundle. Fourteen cases stated that the sensation of the newly formed labia minora was erogenous and different from the tactile sensation on the body of the penis.
Reviewing the Impact of Topical and Intravenous Tranexamic Acid Use in Breast Plastic Surgery
Authors: Parmeshwar Nisha , Mehta Shayna R. , Piper Merisa 
Published: July 2023

Background
Topical and intravenous uses of tranexamic acid (TXA) have been shown to reduce bleeding and ecchymosis in various surgical fields. However, there is a lack of data evaluating the efficacy of TXA in breast surgery. This systematic review evaluates the impact of TXA on hematoma and seroma incidence in breast plastic surgery.

Methods
A systematic review of the literature was performed for all studies that evaluated the use of TXA in breast surgery including reduction mammoplasty, gynecomastia surgery, masculinizing chest surgery, or mastectomy. Outcomes of interest included rate of hematoma, seroma, and drain output.

Results
Thirteen studies met the inclusion criteria with a total of 3297 breasts, of which 1656 were treated with any TXA, 745 with topical TXA, and 1641 were controls. There was a statistically significant decrease in hematoma formation seen in patients who received any form of TXA compared with control (odds ratio [OR], 0.37; P < 0.001), and a similar tendency toward decreased hematoma with topically treated TXA (OR, 0.42; P = 0.06). There was no significant difference in seroma formation with any TXA (OR, 0.84; P = 0.33) or topical TXA (OR, 0.91; P = 0.70). When stratified by surgery, there was a 75% decrease in the odds of hematoma formation with any TXA compared with the control for oncologic mastectomy (OR, 0.25; P = 0.003) and a 56% decrease in nononcologic breast surgery (OR, 0.44; P = 0.003).

Conclusions
This review suggests that TXA may significantly reduce hematoma formation in breast surgery and may also decrease seroma and drain output. Future high-quality prospective studies are required to evaluate the utility of topical and intravenous TXA in decreasing hematoma, seroma, and drain output in breast surgery patients.
Modified Preauricular Transparotid Approach for Treating Mandibular Condylar Fractures
Authors: Arcuri Francesco , Ferri Andrea , Bianchi Bernardo , Laganà Francesco 
Published: July 2023

Aim of the Study:
We introduce a technical variant of the standard preauricular approach to treat intracapsular and condylar neck fractures: the modified preauricular transparotid approach (MPTA). The main modification, when compared with the conventional submandibular approach, is that the incision of the superficial musculoaponeurotic system is performed directly above the parotid gland, and the buccal branch of the facial nerve is dissected in a retrograde way within the parotid gland.

Case Series:
Between January 2019 and December 2020 at the Maxillofacial Departments of “Ospedale Maggiore” of Parma and “Policlinico San Martino” of Genoa 6 patients affected by intracapsular and condylar neck fractures underwent open reduction and internal with MPTA. Surgery was uneventful in all patients; no infections occurred in any of the cases; the mean procedure duration was 85 minutes, ranging from 75 to 115 minutes. At the 1-year follow-up, all patients had stable occlusion with a natural, well-balanced morphology of the face and adequate dynamic excursion of the mandible.

Conclusion:
MPTA is particularly suited for intracapsular and condylar neck fractures. Morbidity is negligible in terms of damage to the facial nerve, vascular injuries, and esthetic deformity.
Diverticulitis Familiality: A Statewide Case-Control Study
Authors: Cohan Jessica N , Horns Joshua J , Ramsay Joemy M , Huang Lyen C , Allen-Brady Kristina 
Published: July 2023

BACKGROUND:
The etiology of diverticulitis is multifactorial and poorly understood. We estimated the familiality of diverticulitis using the Utah Population Database, a statewide database linking medical records with genealogy data.

STUDY DESIGN:
We identified patients with diverticulitis diagnosed between 1998 and 2018 and age- and sex-matched controls in the Utah Population Database. Risk of diverticulitis in family members of patients and controls was calculated using multivariable Poisson models. We performed exploratory analyses to determine the association of familial diverticulitis with severity of disease and age of onset.

RESULTS:
The study population included 9,563 diverticulitis patients (with 229,647 relatives) and 10,588 controls (with 265,693 relatives). Relatives of patients were more likely to develop diverticulitis (incidence rate ratio [IRR] 1.5, 95% CI 1.4 to 1.6) compared with relatives of controls. There was an elevated risk of diverticulitis among first-degree (IRR 2.6, 95% CI 2.3 to 3.0), second-degree (IRR 1.5, 95% CI 1.3 to 1.6), and third-degree relatives of patients (IRR 1.3, 95% CI 1.2 to 1.4). Complicated diverticulitis was more common among relatives of patients compared with relatives of controls (IRR 1.6, 95% CI 1.4 to 1.8). Age at diverticulitis diagnosis was similar between groups (relatives of patients 0.2 years older than relatives of controls, 95% CI –0.5 to 0.9).

CONCLUSIONS:
Our results indicate that the first-, second-, and third-degree relatives of diverticulitis patients are at elevated risk of developing diverticulitis. This information may aid surgeons in counseling patients and family members about diverticulitis risk and can inform the development of future risk-stratification tools. Further work is needed to clarify the causal role and relative contribution of various genetic, lifestyle, and environmental factors in the development of diverticulitis.
The Impact of Internet Addiction on Academic Performance among Medical Students in Bangladesh: A Cross-Sectional Study and the Potential Role of Yoga
Authors: Afrin Sumaiya , Rahman Nur-A-Safrina , Tabassum Tahsin Tasneem , Abdullah Faisal , Rahman Md. Istiakur , Simu Sumona Haque , Kumar Lakshya , Noor Khutaija , Vishal FNU , Podder Vivek 
Published: July 2023

AbstractBackgroundExcessive internet use is a growing concern globally, and internet addiction negatively impacts academic performance. Limited research has been conducted on this topic among undergraduate medical students in Bangladesh.PurposeThis study aimed to determine the prevalence of internet addiction and its impact on academic performance among medical students in Bangladesh, with a focus on the role of Yoga in reducing internet addiction.MethodsA cross-sectional study was conducted among third-year medical students in four colleges in Dhaka, Bangladesh. Simple random sampling techniques were used to select participants, and data were collected using pre-tested questionnaires and a checklist for office records through face-to-face interviews. SPSS version 25 was used for data processing and analysis.ResultsOut of 312 students, 84% were addicted to the internet, and only 16% were normal. 64.4% had good results in the first professional examination, while 35.6% had poor results. 85.9% had good attendance, while 14.1% had poor attendance. The association between internet addiction level and first professional examination results and class attendance was highly significant.ConclusionThis study highlights the high prevalence and negative impacts of internet addiction among medical students in Bangladesh. The study suggests that promoting awareness about healthy technology use, establishing a better balance between internet usage and academic study, and encouraging the practice of Yoga can help alleviate this problem. Further research and interventions are needed to tackle this emerging public health issue. Encouraging students to use the internet for academic purposes and providing education and resources can help promote healthy technology use. Healthcare professionals should also be aware of the risks and encourage seeking help if needed.
Using radio jingles to promote use of a family planning call center: A comparative interruptive time series analysis
Authors: Meekers Dominique , Olutola Olaniyi , Turk Lynn Abu 
Published: July 2023

AbstractIntroductionThis paper measures the effect of a radio jingle campaign promoting a toll-free family planning call center (Honey&Banana) in Nigeria on the number of information requests received.MethodsCampaign effect is measured using a comparative interrupted time series design. The design assumes that without the radio campaign, the trend in the number of calls from the intervention group would have been parallel to that observed in the control group. The effect of the radio campaign is estimated as the difference between the actual and projected number of calls received.ResultsBefore the radio campaign, the trend in the monthly number of requests for family planning information was nearly flat, typically averaging below 500 calls per month. After the start of the campaign, the number of calls immediately increased substantially. The analysis predicted a gain of 360 calls per month during the campaign period. However, the results show that the campaign effect was temporary, which minimal gain after the end of the campaign.DiscussionResults from the comparative interrupted time series make a convincing case that the radio campaign substantially increased the demand for family planning information from the call center. However, there is no solid evidence that the radio jingle campaign had a longer-term effect on use of the call center after the radio broadcasts ended. Although short-term effects could be important if they benefited disadvantaged groups that cannot easily be reached through other means, we recommend that future campaigns be re-designed to facilitate permanent increases in call center use.
Early oral switch in low-riskStaphylococcus aureusbloodstream infection
Authors: Kaasch Achim J. , López-Cortés Luis Eduard , Rodríguez-Baño Jesús , Cisneros José Miguel , Navarro M. Dolores , Fätkenheuer Gerd , Jung Norma , Rieg Siegbert , Lepeule Raphaël , Coutte Laetitia , Bernard Louis , Lemaignen Adrien , Kösters Katrin , MacKenzie Colin R. , Soriano Alex , Hagel Stefan , Fantin Bruno , Lafaurie Matthieu , Talarmin Jean-Philippe , Dinh Aurélien , Guimard Thomas , Boutoille David , Welte Tobias , Reuter Stefan , Kluytmans Jan , Martin Maria Luisa , Forestier Emmanuel , Stocker Hartmut , Vitrat Virginie , Tattevin Pierre , Rommerskirchen Anna , Noret Marion , Adams Anne , Kern Winfried V. , Hellmich Martin , Seifert Harald ,   SABATO study group (members and affiliations listed in Acknowledgement record)
Published: July 2023

AbstractBackgroundStaphylococcus aureusbloodstream infection (SAB) is treated with at least 14 days of intravenously administered antimicrobials. We assessed the efficacy and safety of an early oral switch therapy in patients at low risk for SAB-related complications.MethodsIn an international non-inferiority trial, we randomized patients with SAB after 5 to 7 days of intravenous antimicrobial therapy to either switch to an oral antimicrobial or to continue with intravenous standard therapy. Main exclusion criteria were signs and symptoms of complicated SAB, non-removable foreign devices, and severe comorbidity. Composite primary endpoint was the occurrence of any SAB-related complication (relapsing SAB, deep-seated infection, and mortality attributable to SAB) within 90 days.Results213 patients were randomized into the intention-to-treat population. In the oral switch group, 14/108 (13%) participants reached the primary endpoint versus 13/105 (12%) in the standard therapy group (adjusted difference 0.7%, 95% confidence interval [CI] -7.8% to 9.1%). Participants in the oral switch group were discharged earlier (median hospital stay from SAB onset of 12 days versus 16 days; adjusted difference -3.1 days [95% CI -7.5 to 1.4]). There was no statistical difference in 30-day survival and complications of intravenous administration. More participants in the oral group experienced at least one serious adverse event (34% versus 26%, p=0.292).ConclusionOral switch was non-inferior to intravenous standard therapy in participants with low-risk SAB. However, a careful assessment of patients for signs and symptoms of complicated SAB at time of presentation and thereafter is necessary before considering early oral switch therapy.The trial was registered asNCT01792804in ClinicalTrials.gov, as DRKS00004741 in the German Clinical trials register, and as EudraCT 2013-000577-77.
The kinetic Ising model encapsulates essential dynamics of land pattern change
Authors: Stepinski Tomasz F. , Nowosad Jakub 
Published: July 2023

AbstractA land pattern change represents a globally significant trend with implications for the environment, climate, and societal well-being. While various methods have been developed to predict land change, our understanding of the underlying change processes remains inadequate. To address this issue, we investigate the suitability of the 2D kinetic Ising model (IM), an idealized model from statistical mechanics, for simulating land change dynamics. We test the IM on a variety of diverse thematic contexts. Specifically, we investigate four sites characterized by distinct patterns, presumably driven by different physical processes. Each site is observed on eight occasions between 2001 and 2019. Given the observed pattern at timesti,i= 1, …, 7, we find two parameters of the IM such that the model-evolved land pattern atti+1resembles the observed land pattern at that time. Our findings indicate that the IM produces approximate matches to the observed patterns in terms of layout, composition, texture, and patch size distributions. Notably, the IM simulations even achieve a high degree of cell-scale pattern accuracy in two of the sites. Nevertheless, the IM has certain limitations, including its inability to model linear features, account for the formation of new large patches, and handle pattern shifts.