bluuebunny/crossref_metadata_2025_split huggingface dataset:
Knowledge and perception of asymptomatic malaria in the Volta region of Ghana
Authors: Orish Verner N , Kyeremateng Caleb , Appiah Baffoe P , Addei Isaac B , Ayaba Moses A , Kwadzokpui Precious K , Marinkovic Aleksandra , Prakash Stephanie , Okorie Chuku , Izurieta Ricardo , Sanyaolu Adekunle 
Published: August 2023

ABSTRACT

Background
The control of asymptomatic malaria is considered a key aspect of malaria control. This study aimed to assess the knowledge and perception of asymptomatic malaria among people in Ho municipality of the Volta region.

Methods
A descriptive cross-sectional study involving questionnaire administration was conducted among randomly sampled residents of the Ho municipality of the Volta region of Ghana. Using SPSS version 25 statistical software, frequency distributions and proportions were computed for sociodemographic variables while knowledge and perception about asymptomatic malaria were computed into percentages and categorized into three levels based on Bloom's cut-off for further analysis. Findings with p-values &lt;0.05 were considered statistically significant.

Results
Among the 200 participants, 197 (98.5%) were aware of malaria. The majority (116 [58.0%]) of the study participants agreed to the possibility of asymptomatic infection, but most (133 [66.5%]) of the community members did not know that asymptomatic individuals can still transmit infections. The majority of the participants (184 [92.0%]) showed interest in getting further education on asymptomatic malaria and a significant majority (180 [90.0%]) expressed a willingness to take treatment after testing positive without showing any symptoms.

Conclusions
Asymptomatic malaria control can be achieved through a mass testing and treatment strategy, therefore improving the knowledge and perception about asymptomatic malaria might improve malaria control.
A comparison of changes in venous lactate and haematocrit during fluid resuscitation of dengue haemorrhagic fever
Authors: Priyankara W D Dilshan , Samarutilake D G N , Viswakula Sameera , Manoj E M , Wijewickrama Ananda , Perera Nilanka , Wanigasuriya J K P 
Published: August 2023

ABSTRACT

Background
Judicious fluid resuscitation and stringent monitoring of clinical parameters improve the outcome of dengue haemorrhagic fever (DHF). The usefulness of serum lactate to monitor adequate fluid therapy has not been adequately explored.

Methods
An observational study was conducted in Sri Lanka, recruiting 162 DHF patients within 12 h of diagnosis of the critical phase. Venous lactate level was measured at each time of performing haematocrit (HCT), using a prevalidated handheld lactate analyser.

Results
The median venous lactate level was 1.3 (range 0.3–6) mmol/L in the study population and 154 (95.2%) patients had median lactate levels of &lt;2 mmol/L. The HCT values in the study participants ranged from 28 to 62, with a median value of 43. There was no statistically significant correlation between the lactate and HCT values obtained at the same time. A significant reduction in venous lactate was not observed following the administration of fluid boluses. The expected reduction in HCT was seen following the administration of dextran and crystalloid/dextran combination. The maximum recorded lactate level positively correlated with the duration of hospital stay.

Conclusions
This study concludes that venous lactate is not an appropriate parameter with which to monitor the response to fluid therapy in uncomplicated DHF.
A Prediction Model for Severe Maternal Morbidity and Mortality After Delivery Hospitalization
Authors: Frey Heather A. , Ashmead Robert , Farmer Alyssa , Kim Yoshie H. , Shellhaas Cynthia , Oza-Frank Reena , Jackson Rebecca D. , Costantine Maged M. , Lynch Courtney D. 
Published: August 2023

OBJECTIVE:
To develop a risk stratification model for severe maternal morbidity (SMM) or mortality after the delivery hospitalization based on information available at the time of hospital discharge.

METHODS:
This population-based cohort study included all pregnancies among Ohio residents with Medicaid insurance from 2012 to 2017. Pregnant individuals were identified using linked live birth and fetal death records and Medicaid claims data. Inclusion was restricted to those with continuous postpartum Medicaid enrollment and delivery at 20 or more weeks of gestation. The primary outcome of the study was SMM or mortality after the delivery hospitalization and was assessed up to 42 days postpartum and up to 1 year postpartum separately. Variables considered for the model included patient-, obstetric health care professional–, and system-level data available in vital records or Medicaid claims data. Parsimonious models were created with logistic regression and were internally validated. Receiver operating characteristic curves were used to evaluate model performance, and model calibration was assessed.

RESULTS:
There were 343,842 pregnant individuals who met inclusion criteria with continuous Medicaid enrollment through 42 days postpartum and 287,513 with continuous enrollment through 1 year. After delivery hospitalization discharge, the incidence of SMM or mortality was 140.5 per 10,000 pregnancies through 42 days of delivery and 330.7 per 10,000 pregnancies through 1 year postpartum. The final model predicting SMM or mortality through 42 days postpartum included maternal prepregnancy body mass index, age, gestational age at delivery, mode of delivery, chorioamnionitis, and maternal diagnosis of cardiac disease, preeclampsia or gestational hypertension, or a mental health condition. Similar variables were included in the model predicting SMM or mortality through 365 days with chronic hypertension, pregestational diabetes, and illicit substance use added and chorioamnionitis removed. Both models demonstrated moderate prediction (area under the curve [AUC] 0.77, 95% CI 0.76–0.78 for 42-day model; AUC 0.72, 95% CI 0.71–0.73 for the 1-year model) and good calibration.

CONCLUSION:
A prediction model for SMM or mortality up to 1 year postpartum was created and internally validated with information available to health care professionals at the time of hospital discharge. The utility of this model for patient counseling and strategies to optimize postpartum care for high-risk individuals will require further evaluation.
Geographic Disparities in Potential Accessibility to Gynecologic Oncologists in the United States From 2001 to 2020
Authors: Desjardins Michael R. , Desravines Nerlyne , Fader Amanda N. , Wethington Stephanie L. , Curriero Frank C. 
Published: August 2023

OBJECTIVE:
To use a spatial modeling approach to capture potential disparities of gynecologic oncologist accessibility in the United States at the county level between 2001 and 2020.

METHODS:
Physician registries identified the 2001–2020 gynecologic oncology workforce and were aggregated to each county. The at-risk cohort (women aged 18 years or older) was stratified by race and ethnicity and rurality demographics. We computed the distance from at-risk women to physicians. Relative access scores were computed by a spatial model for each contiguous county. Access scores were compared across urban or rural status and racial and ethnic groups.

RESULTS:
Between 2001 and 2020, the gynecologic oncologist workforce increased. By 2020, there were 1,178 active physicians and 98.3% practiced in urban areas (37.3% of all counties). Geographic disparities were identified, with 1.09 physicians per 100,000 women in urban areas compared with 0.1 physicians per 100,000 women in rural areas. In total, 2,862 counties (57.4 million at-risk women) lacked an active physician. Additionally, there was no increase in rural physicians, with only 1.7% practicing in rural areas in 2016–2020 relative to 2.2% in 2001–2005 (P=.35). Women in racial and ethnic minority populations, such as American Indian or Alaska Native and Hispanic women, exhibited the lowest level of access to physicians across all time periods. For example, 23.7% of American Indian or Alaska Native women did not have access to a physician within 100 miles between 2016 and 2020, which did not improve over time. Non-Hispanic Black women experienced an increase in relative accessibility, with a 26.2% increase by 2016–2020. However, Asian or Pacific Islander women exhibited significantly better access than non-Hispanic White, non-Hispanic Black, Hispanic, and American Indian or Alaska Native women across all time periods.

CONCLUSION:
Although the U.S. gynecologic oncologist workforce increased steadily over 20 years, this has not translated into evidence of improved access for many women from rural and underrepresented areas. However, health care utilization and cancer outcomes may not be influenced only by distance and availability. Policies and pipeline programs are needed to address these inequities in gynecologic cancer care.
Assessment of Human Papillomavirus Non-16/18, Type-Specific Risk for Cervical Intraepithelial Neoplasia Grade 3 or Worse Among Women With Cervical Atypical Glandular Cells
Authors: Yilmaz Emel , Lagheden Camilla , Ghaderi Mehran , Wang Jiangrong , Dillner Joakim , Elfström K. Miriam 
Published: August 2023

OBJECTIVE:
To evaluate the risk for cervical intraepithelial neoplasia grade 3 (CIN 3) or worse (including adenocarcinoma in situ [AIS] and invasive cervical cancer) associated with non-16/18 human papillomavirus (HPV) types (other HPV) among women with atypical glandular cells (AGC) in cervical cytology.

METHODS:
This population-based cohort study evaluates the risk of CIN 3 or worse associated with other HPV types. Human papillomavirus genotyping was performed on Pap tests collected in Sweden from 341 women with AGC that were positive for other HPV types from February 17, 2014, to December 31, 2018. The women were followed for histopathologic outcomes using comprehensive registry linkages until December 31, 2019. Cumulative incidence proportions of CIN 3 or worse by specific HPV type were calculated using 1-minus Kaplan-Meier function. Hazard ratios (HRs) for CIN 3 or worse were generated using multivariate Cox regression.

RESULTS:
Of 341 women, 134 (39.3%) had CIN 3–AIS, but there were only five (1.5%) women in the cohort with invasive cervical cancer. Human papillomavirus 45 preceded 80.0% of invasive cervical cancer cases. Among women positive for HPV33, 82.9% (95% CI 58.0–97.3%) had CIN 3 or worse during follow-up. Positivity for HPV31 conferred the highest HR for CIN 3 or worse relative to other types, both in primary cytology and primary HPV screening (HR 2.71, 95% CI 1.47–5.00 and HR 3.41, 95% CI 1.95–5.96, respectively).

CONCLUSION:
Among non-16/18 HPV types in AGC, HPV31 and 33 had the highest risk for CIN 3 or worse, whereas most of the women with invasive cancer were positive for HPV45. Extended HPV genotyping may be helpful for the management of AGC.
Abortion Bans and Resource Utilization for Congenital Heart Disease
Authors: Miller Hayley E. , Fraz Farsam , Zhang Jiaqi , Henkel Andrea , Leonard Stephanie A. , Maskatia Shiraz A. , El-Sayed Yasser Y. , Blumenfeld Yair J. 
Published: August 2023

OBJECTIVE:
To investigate the implications of potential national abortion ban scenarios on the incidence of neonatal single-ventricle cardiac defects.

METHODS:
A decision tree model was developed to predict the incidence of neonatal single-ventricle cardiac defects and related outcomes in the United States under four theoretical national abortion bans: 1) abortion restrictions in existence immediately before the June 2022 Dobbs v Jackson Women’s Health Organization Supreme Court decision, 2) 20 weeks of gestation, 3) 13 weeks of gestation, and 4) a complete abortion ban. The model included incidence of live births of neonates with single-ventricle cardiac defects, neonatal heart surgery (including heart transplant and extracorporeal membrane oxygenation [ECMO]), and neonatal death. Cohort size was based on national pregnancy incidence and different algorithm decision point probabilities were aggregated from the existing literature. Monte Carlo simulations were conducted with 10,000 iterations per model.

RESULTS:
In the scenario before the Dobbs decision, an estimated 6,369,000 annual pregnancies in the United States resulted in 1,006 annual cases of single-ventricle cardiac defects. Under a complete abortion ban, the model predicted a 53.7% increase in single-ventricle cardiac defects, or an additional 9 cases per 100,000 live births. This increase would result in an additional 531 neonatal heart surgeries, 16 heart transplants, 77 ECMO utilizations, and 102 neonatal deaths annually. More restrictive gestational age–based bans are predicted to confer increases in cases of neonatal single-ventricle cardiac defects and related adverse outcomes as well.

CONCLUSION:
Universal abortion bans are estimated to increase the incidence of neonatal single-ventricle cardiac defects, associated morbidity, and resource utilization. States considering limiting abortion should consider the implications on the resources required to care for increasing number of children that will be born with significant and complex medical needs, including those with congenital heart disease.
Safety of Vaginal Estrogen Therapy for Genitourinary Syndrome of Menopause in Women With a History of Breast Cancer
Authors: Agrawal Pranjal , Singh Sajya M. , Able Corey , Dumas Kathryn , Kohn Jaden , Kohn Taylor P. , Clifton Marisa 
Published: August 2023

OBJECTIVE:
To assess the risk of recurrence of breast cancer associated with vaginal estrogen therapy in women diagnosed with genitourinary syndrome of menopause with a history of breast cancer using a large U.S. claims database.

METHODS:
A U.S. health research network (TriNetX Diamond Network) was queried from January 2009 to June 2022. Our cohort consisted of women diagnosed with breast cancer within 5 years before the initial genitourinary syndrome of menopause diagnosis. Patients with active disease, defined as those undergoing mastectomy, radiation treatment, or chemotherapy within 3 months before diagnosis of genitourinary syndrome of menopause, were excluded. Recurrence was defined as mastectomy, radiation, chemotherapy, or secondary malignancy within 3 months to 5 years after the initiation of vaginal estrogen therapy for genitourinary syndrome of menopause. The study cohort included those with three or more vaginal estrogen prescriptions. The control cohort included women with breast cancer without any vaginal estrogen prescriptions after genitourinary syndrome of menopause diagnosis. Propensity matching was performed. A subanalysis by positive estrogen receptor status, when available, was performed.

RESULTS:
We identified 42,113 women with a diagnosis of genitourinary syndrome of menopause after breast cancer diagnosis with any estrogen receptor status, 5.0% of whom received vaginal estrogen. Of the initial cohort, 10,584 patients had a history of positive estrogen receptor breast cancer, and 3.9% of this group received vaginal estrogen. Risk of breast cancer recurrence was comparable between those who received vaginal estrogen and those who did not in both the any estrogen receptor (risk ratio 1.03, 95% CI 0.91–1.18) and positive estrogen receptor (risk ratio 0.94, 95% CI 0.77–1.15) status analyses.

CONCLUSION:
In a large, claims-based analysis, we did not find an increased risk of breast cancer recurrence within 5 years in women with a personal history of breast cancer who were using vaginal estrogen for genitourinary syndrome of menopause.
Why Are Corneal Specialists Resistant to Treating Patients Who Have Severe Ocular Surface Disease With Limbal Stem Cell Deficiency?
Authors: Holland Edward J. , Cheung Albert Y. , Djalilian Ali R. , Farid Marjan , Mannis Mark J. 
Published: August 2023

Purpose:To highlight the paucity of surgeons performing ocular surface stem cell transplantation with systemic immunosuppression (OSSTx with SI) for limbal stem cell deficiency (LSCD) patients, suboptimal treatments for LSCD, and obstacles to adoption.Methods:A review of the Eye Bank Association of America annual reports and the authors' case volume for OSSTx with SI was performed. Examination of the published literature on corneal surgeries, especially for LSCD, was completed. These findings were combined with our clinical observations to develop this editorial.Results:Despite techniques and protocols for OSSTx with SI published more than 30 years ago for the treatment of severe bilateral LSCD, only a small number of corneal specialists have adopted these techniques. There is a paucity of attention to this population of patients, with minimal publications to advance this area of our field. We are too often referred patients with LSCD and severe ocular surface disease that have had suboptimal treatments such as penetrating keratoplasties or primary keratoprostheses. Hesitancy for adopting OSSTx with SI is likely due to a lack of exposure to these procedures during training and fear of systemic immunosuppression. Corneal surgeons are likely unaware of the safety of systemic immunosuppression with appropriate monitoring especially when comanaging these patients with an organ transplant specialist.Conclusion:There is a large unmet need for the treatment of corneal blindness secondary to conjunctival and LSCD. For the vast majority of patients, OSSTx should be the first surgical choice to treat these eyes. We hope major ophthalmology centers will meet this need by building programs, and groups of corneal surgeons should collaborate to create regional centers to make this treatment more accessible to help this population.
Effect of Resistance Exercises on Function and Pain in Fibromyalgia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Authors: Wang Jyun-Jhe , Tam Ka-Wai , Hsiao Han-Yun , Liou Tsan-Hon , Rau Chi-Lun , Hsu Tzu-Herng 
Published: August 2023

Abstract

Objective
This review aimed to compare the effectiveness of resistance exercise with that of other exercises in functional improvement and pain control in patients with FM.

Design
PubMed, Embase, Scopus, and Cochrane databases were searched for studies published from their inception until March 2023. The following medical search heading terms were used: “resistance OR strength OR strengthening” AND “fibromyalgia”. The analysis was performed using the statistical package Review Manager, version 5.4.1.

Results
This study reviewed 11 randomized controlled trials involving 530 patients. In comparison with no intervention, resistance exercise reduced the FIQ total score, pain score, tender points, and depression and improved physical function. Compared with flexibility exercise, resistance exercise reduced the FIQ total score. Compared with aerobic exercise, resistance exercise shows similar effects on pain control, reduction of tender points and improvement of physical function.

Conclusions
Compared with other exercises, resistance exercise demonstrated a more favorable effect on the FIQ total score, and the effects on pain control, tender points, physical function, and depression were comparable. Thus, resistance exercise exhibits comparable or superior effects when compared with other interventions and more precise research is needed to confirm this conclusion.
Effects of non-immersive virtual reality intervention on children with spastic cerebral palsy: a meta-analysis and systematic review
Authors: Wang Nan , Liu Naiquan , Liu Shuqi , Gao Yan 
Published: August 2023

Abstract
This review aimed to assess the effectiveness of non-immersive virtual reality intervention compared to traditional rehabilitation in improving the functions of the upper and lower extremities, balance, and social participation among children with spastic cerebral palsy. We used librarian-designed searches of 10 databases to identify research articles on randomized controlled trials that assessed the effectiveness of non-immersive virtual reality in intervening spastic cerebral palsy patients up to 4/15/2023. Independent evaluation was conducted by two trained investigators using the evaluation criteria of RCT quality indicated in the Cochrane Manual of Assessment ‘risk- of- bias tool.’ The PEDro scale was used to evaluate the method and quality of the literature. 21 research articles involving 779 patients with spastic cerebral palsy were included. Significant differences between the non-immersive virtual reality rehabilitation and traditional rehabilitation groups were observed in all indicators, except for the Jebsen-Taylor Hand Function Test. Non-immersive virtual reality intervention is effective in improving the function of the lower extremity, balance, and social participation in children with spastic cerebral palsy, but its effect on upper limb function is still controversial.
Comparative Study of Internal Device versus External Device in Le Fort III Distraction for Syndromic Craniosynostosis
Authors: Noto Mariko , Sakahara Daisuke , Kuwahara Masamitsu , Imai Keisuke 
Published: August 2023

Background:
Le Fort III distraction for syndromic craniosynostosis is performed using internal or external devices. The authors compared the results of both devices.

Methods:
The authors retrospectively evaluated 60 patients with syndromic craniosynostosis treated with Le Fort III distraction (internal or external device) between 2001 and 2021. The authors verified demographic data, surgery-related data, and complications using medical records. For each of the 2 devices, they compared the various factors associated with the device to each other.

Results:
For the external device, 32 patients with syndromic craniosynostosis were included. The mean age at surgery was 11.7 years, and the mean elongation length was 20.0 mm. Class III occlusion reoccurred in 11 patients and was significantly associated with age at surgery. Seven complications (device problems and others) were noted. Cranial pin slippage was significantly related to the elongation length. For the internal device, 28 patients with syndromic craniosynostosis were included. The mean age at surgery was 10.4 years, and the mean elongation length was 18.7 mm. There were 15 complications, including device problems, zygomaticomaxillary fractures, and infections. Elongation length was significantly related to these complications. Class III occlusion reoccurred in 9 patients and was significantly related to age at surgery.

Conclusions:
This study found that complications are significantly more likely to occur in internal devices than in external devices, especially device infection. The authors’ findings identified several factors that may assist surgeons in selecting between external and internal devices. The relationship between the amount of extension and device-related problems found in this study will be beneficial for solving these problems.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, III.